About Breast Cancer

This 3D medical animation outlines the progression of breast cancer and describes the stage classifications based on the extent of the disease.

Breast self-examinations help women know how their breasts normally look and feel in case of any changes. The goal, with or without breast self-exams, is to report any breast changes to a doctor or nurse right away. Fast action and proactive behavior can help save lives. You can find some suggestive ways to conduct a breast self-exam here.

Article from Gynecologic Oncology: Breast Cancer - Early Detection

Some facts contribute to higher risk of causing breast cancer e.g. marital and maternal status: More common in spinsters, or if married then have not given birth to children, or if given birth then have not breast fed their offspring and many other facts. - ABC of Breast Cancer

Simply, Breast Cancer

Male and Female Anatomy

In a quick glance, ordinary people in usual settings distinguish males and females by glancing for common facial features and anatomy. Hence, the distinguishing anatomical feature between a man and a woman is quite obvious at the upper torso. Biologically, both male and female four-week old embryos undergo a similar process of epidermal thickenings, called milk lines or mammary ridges [1]. This happens before either chromosome pairs of XX or XY interferes with determining physical traits that distinguish males from females [2]. However, during puberty, the hormone oestrogen plays a role in stimulating the development of these mammary glands in females commonly called breast. These glands consist of lobules, ducts and the fatty tissue. 

Breast Cancer Cell

Cells are naturally the main building blocks of tissues that eventually make up organs. Cancer is a dreaded word. The simplest way to explain cancer is the continuous growth of cells which at that point of time are not needed by the body forming lumps. Breast cancer is one of the most frequently diagnosed cancers in women worldwide [3]. This cancer type is however rare in males. Cancer is either caused by hereditary mistakes or by lifestyle. Hereditary is defined by the damaged DNA material passed on by either parent. A sedentary lifestyle packed with food made of white flour and diet rich in meat while lacking the greens and fruits is considered as risk to causing cancers. Obesity, early age of menarche, age of first pregnancy, nulliparity and late age of menopause are among other risk factors of breast cancers.

Breast Cancer Illustration

Breast cancer if detected at an earlier stage can save a woman’s life. Women are encouraged to carry out self breast examination each month and if at high risk due to hereditary factor are encouraged to undergo mammography. Mammography is also recommended for women above the age of 40. Please see a doctor the soonest if any of these symptoms appear: lumps or thickening of the tissue, flaking skin or discharge from the nipple, 'tethering' of the skin, as if it's being pulled from the inside, any unusual sensation or discomfort or a change in outline, shape or size of the breast [4]. Total mastectomy is the removal of the entire breast and nipple [5]. Depending on the type of breast cancer, some women will be prescribed with hormone therapy [4].

Cancer patients and cancer survivors lead a longer more fulfilling life with the support of loved ones and peers. Hence, it is important to support their decisions on the type of treatments they choose. It is not an easy decision for a woman to opt for mastectomy but it could save her life, therefore the partner’s support in this decision is very significant. The colour pink has been associated to breast cancer promotion and support towards women with breast cancer, with the pink ribbon adopted as an international symbol of breast cancer awareness since the year 1992. The colour pink and blue symbolizes support for men with breast cancer. The 10th month, October, has been officially picked as the Breast Cancer Awareness month. 

Now that you know a little about breast cancer, your support no matter how small can go a long way. 

References:

1. http://tinyurl.com/8o6dqq6

2. http://tinyurl.com/8ewjf8d

3. http://tinyurl.com/ybdo45s

4. http://tinyurl.com/9ry77z8 

5. http://tinyurl.com/3ry83f2

By Jagdish K. Chahil, Senior Scientist (R&D)

Let us Fight Together... Conquer Breast Cancer

Mumbai's Tata Memorial Hospital published its findings on cancer in India in the British medical journal, Lancet recently. It said that about 6% of all deaths in India are from cancer, and 70% of cancer deaths happen between the productive 30-69 age group. There were an estimated 5,600,000 cancer deaths in India in 2010.

I would like to share the thoughts of one of my colleague who's family friend has fought breast cancer. She is one of the many cancer survivors who is a source of inspiration to all of us, especially the women folks. She is diagnosed with Stage 3 Breast Cancer last year. The initial response was the usual shock & grief. She is a brave lady bringing up two daughters during the most challenging circumstances. She consented for all the advice by the Oncologist, underwent surgery followed by both chemo & radiotherapy. She is now cancer free and leads a joyful meaningful life without any limitations. She goes to parties, plays cards at the local club, does trekking etc. When she was told about our Molecular Screening Services (INFOHaem MSS) for early risk prediction, she remarked: “I wish everyone would undergo that kind of tests and make informed lifestyle changes to prevent the disease or be in a better position to fight it out”.

Breast cancer has overtaken cervical cancer in our state of Karnataka. According to statistics available with the Kidwai Memorial Institute of Oncology’s (KMIO) cancer registry, breast cancer accounts for 27% of all cancers suffered by women in the state, whereas cervical cancer constituting 13%. 

Dr M Vijaya Kumar, Director of KMIO claimed that the institute gets over 1,000 new cases of breast cancer every year and most of these are from urban areas like Bangalore. Although the average age of a breast cancer patient is 50, but younger women too are getting this disease fast. 

Dr Anthony Pais from Majmudar Shaw Cancer Center said that by 2020, 60% of breast cancer cases of the world will be from India. Breast cancer is increasing at a dramatic percentage of 51% globally according to the WHO. In India, one out of 26 women suffers from breast cancer, whereas in western countries, the corresponding number is one out of eight women.

According to studies conducted between 2006 and 2008, the crude incidence of breast cancer in Bangalore is 29 per 100,000 female population. This study was published by ICMR (Indian Council of Medical Research ) in 2010.  This made Bangalore at its rank of number one when it came to age adjusted rate of breast cancer in India. 

Early detection is the key to fight breast cancer and increased level of awareness can also serve the purpose, said experts during the first Breast Cancer Survivors Conference which was held recently in Pune, India. Dr. Shona Nag said, "A lot of breast cancer patients are cured now. Their survivorship is equated to life which begins for the patient after the treatment ends." Dr. Anantbhushan Ranade said more than 40% cases of breast cancer are diagnosed in the third or fourth stage. "This is a cause for concern as early diagnosis can lead to better chances of successful treatment".

We are losing millions of their most productive years to cancer. The first elaborate study to estimate the global impact of cancer on the number of healthy years of life lost by patients has found that Indians lost 18.7 million years of productive healthy life to cancer in 2008 alone. Globally, around 170 million years of healthy life were lost to cancer the same year. China accounted for 25% and India (11%) of these 170 million lost years. Both these Asian giants accounted for 67% of the burden in Asia.

Most doctors feel that early detection tests for breast cancer save thousands of lives each year, and that many more lives could be saved if even more women and their health care providers took advantage of these tests. Following the American Cancer Society's guidelines for the early detection of breast cancer improves the chances that breast cancer can be diagnosed at an early stage and treated successfully. Our MSS is in lines with the international guidelines.

We all need united effort to fight against cancer, so that we have more cancer survivors among us, or I would put it this way...Cancer Conquerors.

References:
1. http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-importance-of-finding-early
2. http://articles.timesofindia.indiatimes.com/2012-10-08/bangalore/34322345_1_breast-cancer-cervical-cancer-cancer-amounts
3. http://timesofindia.indiatimes.com/india/Millions-of-productive-years-lost-to-cancer/articleshow/16831525.cms
4. http://articles.timesofindia.indiatimes.com/2012-10-14/pune/34448222_1_fight-breast-breast-cancer-survivors-conference-shona-nag

By Sneha Gopal, Software Developer

Managing Our Own Health, Start with Cholesterol

Ian Waterston is an executive working in corporate finance; he had his first heart attack at the age of 30 when he went for hill climbing during the weekend. He learned a precious lesson from the incident, don’t be dumb. Like him, many of us think that someone as young and fit as him is impossible to have a heart attack, and according to Ian, it is dumb. We heard many stories of friends and family members suffered from heart problems, in certain cases it involves sudden heart attacks which may lead to unexpected death. It may alert us for a while, however most of time, when it comes to managing our health, we prefer to take the passive role and let the nature to take it’s course. 

Why should you manage your own health? 

Most of us leave our health to the doctors. However, we only go to see doctors when we are sick. And that comes with a hefty price tag, its either expensive medical bill, or emotional stress; sometimes it even causes loss of days of productivity. However, if we are to manage our health actively, many diseases are preventable, for example - Cardiovascular disease or in lay man term - heart disease. 

Cardiovascular (CVD) disease is the number one cause of death globally, whereby 1 in 4 deaths in government hospitals are attributed to either heart disease or strokes. To make it worse, it is a silent chronic disease which can take years to develop without any symptom at all. However, by managing the level of bad cholesterol in your body can greatly reduce the chance of getting heart disease. And you don’t even need a doctor to tell you how. 

It’s all started with Cholesterol

Heart disease occurs when a substance called plaque builds up in the arteries that supply blood to the heart. Plaque is made up of cholesterol deposits, which can accumulate in the arteries. When this happens, the arteries can narrow over time. Plaque build-up can cause chest pain/ discomfort, because the heart muscle doesn't get enough blood. A heart attack occurs when plaque totally blocks an artery carrying blood to the heart. It also can happen if a plaque deposit breaks off and clots an artery. On the other hand, a stroke happens when blood flow to a part of the brain stops. When brain cells are not getting sufficient blood and oxygen, it will be damaged and lead to loss of brain function, and even death. 

To lower bad cholesterol in your body only requires easy step such as be informed with what you eat every day. Food such as meats, poultry, shellfish, eggs, butter, cheese, and milk contain additional cholesterol, and this is on top of the cholesterol which is manufactured by our body.  Hence, have more fibrous food and complex carbohydrate such as fruit, raw vegetables, brown rice, whole grain breads in your diet. The American Heart Association recommends that you eat at least 25 grams of dietary fiber every day2.

Knowing your DNA 

However, there are also some factors which can lead to high cholesterol in your body but is not modifiable, such as hereditary. The amount of bad cholesterol in our body makes and how fast it is removed from body is determined partly by genes. If an individual inherited certain genetic mutations in those genes from his/her parents, there is a high chance that he/she is suffering from a familial disease called Hypercholesterolemia (A condition where high cholesterol is present in the blood). Today, there are many DNA test available which can ascertain whether an individual’s has inherited the genetic mutations which causes Familial Hypercholesterolemia from his/her parents. Using an advance biochip technology, Molecular Screening Services such as INFOHaem FH1536™ screens for genetic mutation from LDLR, ApoB (ApolipoproteinB) gene and PCSK9 gene. The test also involves clinical examination associates the individual’s lifestyle, family history and medical history to Familial Hypercholesterolemia. If the DNA test found to be positive, it’s important to inform your doctors immediately as you may require certain cholesterol lowering medication. 

In summary, take care of high cholesterol as soon as possible and manage your own health actively. Not doing so will put you at a higher risk of suffering from heart disease. 

1. http://collectivewizdom.com/MyHeartAttackAtAge30.html

2. http://www.americanheart.org/presenter.jhtml?identifier=514

3. http://www.infovalley.net.my/~infovall/fh1536%E2%84%A2-test-takers

________________________________________________________________________

INFOVALLEY® Molecular Screening Services is registered under Ministry of Health’s Medical Device Bureau’s MeDVER programme (Registration number: A-000531). INFOHaem™ Molecular Screening was recognized by Frost and Sullivan’s Malaysian Excellence Award 2012, as best product Innovation. For more information, kindly refer to www.infovalley.net.my. 

By Susan Ong, Product Portfolio Manager

Are You Afraid of Cholesterol?

Since we are living in a fast paced world, many of us tend to neglect the significance of taking good care of our health. As we age, our body needs the urgency for medical check up. Whenever any of us see the word “CHOLESTEROL” in the report, we are inclined to think that it is something bad to our body. To tell the truth, cholesterol is not necessarily bad for our body because there are two types of cholesterol; namely good cholesterol and bad cholesterol. Typically, cholesterol is a fat formed by the liver and is fundamental for usual body operation. It exists in the external coat of each cell in our body and has numerous functions. These functions aid the regular function of our body.

Before one starts to be afraid of cholesterol, it is better to learn the significance of good cholesterol to our body. Firstly, cholesterol builds and maintains cell membranes which are the outer layer of each cell. These cell membranes have permeability which is essential for determining which molecules can pass into the cell and which cannot. This helps to eliminate unwanted molecules from entering the cells. Moreover, cholesterol aids in the production of bile. We have read in books that sunshine provides Vitamin D to our body but has anyone wondered how is it possible for the sunshine to convert to Vitamin D? Well, with the aid of cholesterol, it is possible because it converts sunshine to vitamin D. Furthermore, it is also imperative for the body to enhance metabolism of fat soluble vitamins, including vitamins A, D, E, and K. With all these functions in hand, there isn’t any necessity to be afraid of cholesterol unless you have LDL.

Now you may ask what LDL is. LDL is the acronym for low density lipoprotein. People often refer to it as bad cholesterol. LDL carries cholesterol from the liver to cells. If too much is carried, too much for the cells to use, there can be a harmful buildup of LDL. This can increase the risk of arterial disease if levels rise too high. Most human blood contains approximately 70% LDL but this may vary, depending on the person. Too much LDL can cause the arteries to become blocked, which increases the risk of heart disease and stroke. Blocked arteries occur when excess LDL and other fatty substances attach themselves to the walls of the arteries, causing them to become narrower, meaning that blood cannot pass through as easily. Over time, partially blocked arteries also become hardened and inflamed, increasing the risk of breakage. All this increases the risk of a range of vascular diseases, such as heart disease, stroke and kidney disease. When there is bad cholesterol, the good comes along. HDL (high density lipoprotein) is often referred to as good cholesterol. Experts say HDL prevents arterial disease. Moreover, HDL does the opposite of LDL. It takes the cholesterol away from the cells and back to the liver. In the liver it is either broken down or expelled from the body as waste. 

In addition, high cholesterol itself doesn't cause any symptoms. This means that we could have high cholesterol and not know about it. The only way to know our cholesterol level is to have it tested. Once receiving the results, it is not necessarily something devastating because level of bad cholesterol in body can be reduced or controlled if we follow a balanced diet, live a healthy lifestyle and obviously by following the instructions from doctors. High cholesterol level becomes deadly only when we refuse to change our habits that contributes to the increase in cholesterol in our body.

In a nutshell, living a healthy lifestyle is everyone’s dream. Daydreaming about it but living an unhealthy lifestyle, for example, smoking, eating food which is high in cholesterol and not exercising regularly will never help in avoiding ourselves from getting high cholesterol. Cholesterol is not something to be afraid of because as stated above good cholesterol does play a vital role in our body. It is our responsibility to restrict the increase in bad cholesterol in our body. Prevention is always better than cure. Therefore, start preventing from getting high bad cholesterol since a very young age instead of trying to reduce it after getting affected. We only live once. 

Why waste it by being afraid of something that we can restrain?

References
• Grundy SM, et al. (2001). Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486-2497.
• National Heart, Lung, and Blood Institute (2005). Your Guide to Lowering Your Cholesterol With TLC (NIH Publication No. 06-5235). Available online: http://www.nhlbi.nih.gov/health/public/heart/chol/chol_tlc.pdf


By Khamsigan a/l/ Munretnam, Molecular Research Scientist

Are you Afraid of Cholesterol?

During my university years, one of my friends used to frustrate his parents by throwing away egg yolks and eating only the whites. He thought that he was reducing the risk of heart disease by avoiding cholesterol. How about you? Are you afraid of cholesterol or having high cholesterol? Are you throwing away egg yolks because you think they're bad for your health?

Let’s learn more about cholesterol. Cholesterol is a chemical compound that is naturally produced by the body and is structurally a combination of lipid (fat) and steroid. Cholesterol is a building block for cell membranes and for hormones like estrogen and testosterone. The main sources of dietary cholesterol are meat, poultry, fish, and dairy products. Organ meats, such as liver, are especially high in cholesterol content, while foods of plant origin contain no cholesterol.

Cholesterol is not a deadly poison, but a substance that you need to be healthy. High cholesterol itself does not cause heart disease. People who have low blood cholesterol have the same rates of heart disease as people who have high blood cholesterol. The cholesterol found in your blood comes from two sources: cholesterol in food that you eat and cholesterol that your liver makes from other nutrients. The amount of cholesterol that your liver produces varies according to how much cholesterol you eat. Normally, liver produces 75% of the cholesterol that circulates in our blood. The other 25% comes from food. If you eat a lot of cholesterol, your liver produces less. After a meal, dietary cholesterol is absorbed from the intestine and stored in the liver. If you don't eat much cholesterol, your liver produces more. This is why a low cholesterol diet does not typically decrease a person's blood cholesterol by more than a few percent.

Types of Cholesterol

There are two types: Bad" and "Good" Cholesterol. Particles called lipoproteins carry cholesterol in the blood. There are two kinds of lipoproteins you need to know about: LDL and HDL.

Low-density lipoproteins (LDL) cholesterol makes up the majority of the body's cholesterol. LDL is known as "bad" cholesterol because having high levels can lead to a buildup in the arteries and result in heart disease. It is very important to keep LDL levels low. LDLs are produced by the liver and carry cholesterol and other lipids (fats) from the liver to different areas of the body, like muscles, tissues, organs, and the heart. 

High-density lipoproteins (HDL) cholesterol absorbs cholesterol and carries it back to the liver, which flushes it from the body. High levels of HDL, or "good" cholesterol, reduce the risk of heart disease and stroke.

Very low density lipoproteins (VLDL) are lipoproteins that carry cholesterol from the liver to organs and tissues in the body. They are formed by a combination of cholesterol and triglycerides. VLDLs are heavier than low density lipoproteins, and are also associated with atherosclerosis and heart disease.

What Boosts Your Risk?

Several health factors, lifestyle and genetic factors can make you more likely to develop high cholesterol:

• Condition

– Age: everyone's risk for high cholesterol increases with age. Women's LDL ("bad" cholesterol) levels rise more quickly than do men's.

– Diabetes: Having diabetes can also make you more likely to develop high cholesterol. Diabetes affects the body's use of a hormone called insulin. This hormone tells the body to remove sugar from the blood. With diabetes, the body either doesn't make enough insulin, can't use its own insulin as well as it should, or both. This causes sugars to build up in the blood.

• Behavior

– Diet: Certain foods raise your cholesterol levels. These foods tend to contain saturated fats, trans fatty acids (trans fats), dietary cholesterol, or triglycerides.

– Weight: being overweight can raise LDL, lower HDL, and raise total cholesterol levels.

– Physical inactivity: Not getting enough exercise can make you gain weight, which can lead to increased cholesterol levels.

• Heredity

High cholesterol can run in families. People who have an inherited genetic condition, called familial hypercholesterolemia, have very high LDL cholesterol levels beginning at a young age.

Diseases linked to high cholesterol

Diseases linked to high cholesterol

• Coronary heart disease: If your cholesterol is too high, it builds up on the walls of your  arteries. Over time, this buildup (called plaque) causes hardening of the arteries (atherosclerosis).

• Stroke can result if the blood supply to part of the brain is reduced. 

• Peripheral vascular disease: High cholesterol also has been linked to peripheral vascular disease (PAD), which refers to diseases of blood vessels outside the heart and brain. 

• Type 2 diabetes is another disease linked to high cholesterol because diabetes can affect the different cholesterol levels. 

• High blood pressure (hypertension) and high cholesterol also are linked.

• Leriche syndrome: there is a block in the lower part of the aorta just before the starting point of the common iliac arteries leading to Claudication, Impotence and Decreased pulses

Diseases linked to low cholesterol

• American researchers found that low cholesterol predicts an increased risk of dying from diseases of the stomach, the intestines and the lungs. Most of such diseases are infectious.

• Low Cholesterol Predisposes To HIV And AIDS

• Low cholesterol levels have been shown to increase the risk for cancer.

• Low cholesterol over the long term may lead to depression, increased risk of stroke, and numerous problems related to hormonal imbalances. If you are not getting enough vitamin D from your diet, having low cholesterol may lead to vitamin D deficiency, as sunlight creates vitamin D in your body by acting on cholesterol found in your skin.

• Smith-Lemli-Opitz Syndrome: children with this syndrome are born with very low cholesterol because an enzyme that is necessary for the body’s synthesis of cholesterol does not function properly.

The Positive Roles of Cholesterol

Actually, cholesterol is essential for survival and plays many vital roles in the body.

• Cholesterol is integral part of membranes and membrane integrity depends on the obligate presence of cholesterol.

• Cholesterol is required for the synthesis of several hormones including the sex hormones.

• Vitamin D is synthesized in the body from cholesterol and it is now known that the roles of vitamin D go beyond bone formation.

• Bile salts are essential for the digestion of the fats consumed and this compound is also produced from cholesterol.

• Cholesterol is anti-inflammatory.

• Cholesterol’s presence is required for the normal functioning of the serotonin receptors. Since serotonin is a mood elevator, low cholesterol levels produce aggressive behaviour and mood swings.

Now the question is do you need Cholesterol? Definitely, you do. The cholesterol is an essential biological molecule present in our body and survival without this compound, is not possible.

The cholesterol is required to form the bile acids and salts, required to digest the fats which you consume. A wide variety of steroid hormones are produced, with the cholesterol as the precursor. It also leads to the formation of vitamin D, required for keeping your bones healthy. So, don’t be afraid of cholesterol. It is a problem only when you have more than what is needed by you.

The essential point is we need to keep ourselves healthy and not just get treated when we our cholesterol levels go badly. I am working as a Bioinformatician in INFOVALLEY since more than four years and was involved in the FH project which resulted in a high density FH1536 chip which is able to diagnose the molecular basis of Hypercholesterolemia, screening for at risk individuals, prognostic about the heart attack and stroke and also advise the doctor the most appropriate medicine. FH genotyping screening can be undergone by subjects of all ages.

Reference:

http://www.medicinenet.com/cholesterol/page2.htm#what_is_cholesterol

http://www.ravnskov.nu/the%20benefits%20of%20high%20C.htm

http://vnsatakopan.hubpages.com/hub/Does-Cholesterol-Deserve-All-the-Blame-it-Gets

http://www.ravnskov.nu/cholesterol.htm#a

http://drbenkim.com/articles-cholesterol.html

http://www.medicinenet.com/cholesterol_levels_pictures_slideshow/article.htm

By Kavitha IS, Bioinformatician