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Genes, environment & lifestyle fueling breast cancers even among healthy: Doctors

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New Delhi, June 28 (IANS) Genetic, environmental, and lifestyle factors are driving breast cancers even among women who seem healthy, said oncologists on Friday, even as television actress Hina Khan announced her diagnosis with stage three breast cancer.

Known to be a fitness enthusiast, the ‘Yeh Rishta Kya Kehlata Hai’ actress in an Instagram post said: “I have been diagnosed with Stage Three Breast Cancer”.

Noting that she is “doing well”, the actress stated that her “treatment has already begun, and I am ready to do everything necessary to emerge from this even stronger”.

“Stage 3 breast cancer is when the breast cancer either involves the skin or the underlying structures which we call the chest wall or the tumour are very big more than 5 cm in size or there are lymph nodes which are even seen in the neck,” Dr. Rohan Khandelwal, lead consultant and Head of the Breast Centre at CK Birla Hospital, Gurugram, told IANS.

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The doctor recommended women with Stage 3 breast cancer a whole body scan or a PET scan to see whether the disease has not spread to any other part of the body.

Breast cancer is the most common type of cancer affecting women worldwide. Data from the Indian Council of Medical Research (ICMR) showed that breast cancer is the most common cancer in India. It accounts for 28.2 per cent of all female cancers, with an estimated 216,108 cases by 2022.

Globally, there were 2.3 million women diagnosed with breast cancer and 670,000 died in 2022, as per the World Health Organization (WHO).

“Breast cancer can develop even in people who appear healthy because of the intricate interaction between hereditary and environmental variables. These variables may occasionally result in epigenetic modifications or mutations in genes that raise the risk of cancer,” Dr. Rohan said.

He explained that cells in healthy persons are equipped with internal systems that guard against abnormal growth and repair damage to DNA. These can, however, occasionally fail allowing harmed cells to multiply and perhaps develop into malignant ones.

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“In addition, healthy people can also be impacted by some risk factors, such as radiation, hormone exposure, and specific genetic abnormalities. For example, despite leading a healthy lifestyle, someone with a genetic mutation like BRCA1/2 or a family history of breast cancer may still acquire breast cancer,” the doctor said.

Dr. Pritam Kataria, Consultant, Medical Oncology, Sir HN Reliance Foundation Hospital, told IANS that as breast cancer cases are increasing, the age group is not well defined, and the risk can range from the young to middle-aged and elderly.

The doctor noted that major non-modifiable risk factors include higher age and hereditary status, which means, you are predisposed to breast cancer if there is a family history with mutations present in your DNA, like the BRCA and BRCA2 mutations. Early menage and late menopause also pose a higher risk.

On the other hand, modifiable risk factors include obesity, having no children or advanced maternity, smoking, and alcohol, he added. The doctor also pointed out the role of increasing air pollution as a risk factor.

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The experts called for early diagnosis via mammograms, which should be done every year beginning at age 40 or earlier for high-risk patients.

For those with a high risk, such as those with BRCA1 or BRCA2 gene mutations, breast MRI is recommended.

Women with thick breast tissue or abnormalities discovered on mammograms can both be investigated with ultrasound. Regular self-examinations and clinical breast exams by doctors help in the detection of unexpected changes.

A healthy lifestyle that includes eating a balanced diet, getting regular exercise, abstaining from alcohol, and quitting smoking can also help keep the risk at bay.

–IANS

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‘New Mpox Clade 1b worrying, can spread via physical contact, raise mortality rate’

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New Delhi, July 1 (IANS) The new Clade 1b strain of Mpox (previously known as Monkeypox) is worrying as it can easily spread between people with just physical contact, and result in increased mortality rate even among children, said infectious disease experts on Monday.

Currently, confined to the Democratic Republic of Congo (DRC) in Central Africa, the new strain is different from the Mpox clade 2b that caused a global outbreak in 2022, consisting of 94,707 confirmed cases in 107 countries.

“The DRC has been seeing such endemic cases for a long time. Mpox clade 1 type which is more lethal and more prominent, has been there for decades. But now it has become more transmissible because of new variations, that is clade 1b,” infectious disease expert Dr. Ishwar Gilada, told IANS.

“Unlike Clade 1, the new strain Clade 1b, estimated to have jumped to humans around September 2023, has a high mortality rate and is not limited to men who have sex with men (MSM),” added Dr Rajeev Jayadevan, co-chairman of the Indian Medical Association’s National Covid-19 Task Force.

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According to scientists from the University of Oxford in the UK, Clade 1B has a mortality rate of 5 per cent in adults and 10 per cent in children.

The new clade can affect men and women without sexual contact; and children; as well as cause miscarriages and stillbirths, they noted.

“The new strain of Mpox is worrying precisely because it may transmit more easily between people than the earlier strain,” Gautam Menon, Dean of Research and Professor of Physics and Biology, at Ashoka University told IANS.

Meanwhile, the Africa CDC reported an overall mortality rate of 6.7 per cent from 4,488 cases of suspected Mpox in 2024 in the DRC.

Seventy per cent of cases and 88 per cent of the total deaths were among children below 15. However, it is not known whether all of these cases were due to the new clade 1b strain or from the original clade 1 strain, Dr Rajeev told IANS.

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“Estimating the true mortality rate is difficult because not all cases will be reported or counted. Another problem with the clade 1 strain of Mpox is that it can be confused with chickenpox, a common infection. Recent research conducted on doctors demonstrated difficulty in differentiating the two simply by looking at the lesions. Thus, there could be inaccuracies in the number of reported cases,” Dr Rajeev explained.

There are no indications yet of the spread of this new clade 1b strain in other countries.

But “if global travel carries this new strain to other parts of the world, person-to-person transmission could occur through sexual or physical contact or both. If that happens, the pattern of spread will be different from the 2022 outbreak, where women and children were not significantly affected,” Dr. Rajeev said.

“Until such data becomes available, there is no obvious risk to India at this time,” he added.

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Yet, Dr. Ishwar, also Secretary General, People’s Health Organization-India, called for increasing vigilance with whole genome sequencing.

“There should be some kind of guidelines. We do not have any such case of Mpox currently in India, but we should be vigilant and we should keep on watching the global scenario,” he said.

Dr Gautam said that there are vaccines for Mpox and the virus fortunately “mutates more slowly than the virus causing Covid-19 and it still appears relatively hard to transmit. We should be watchful at this time but no more stringent measures are called for at this moment.”

–IANS

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Zika virus majorly asymptomatic, identical to dengue fever: Experts

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New Delhi, July 1 (IANS) Zika virus that recently infected five people in Maharashtra’s Pune is majorly asymptomatic, but can resemble dengue fever, said health experts here on Monday.

Zika virus disease (ZVD) is a mosquito-borne disease transmitted by Aedes mosquitoes, the mosquito which also transmits dengue, chikungunya, and yellow fever.

It usually bites during the daytime. It is usually a mild to moderate severity disease in adults and requires no specific treatment.

Common symptoms include mild fever, rashes, headache, muscle and joint pain, and inflammation of the underside of the eyelid, which normally lasts for 2-7 days.

“Around 80 per cent of cases are estimated to be asymptomatic, though the accuracy of this figure is hindered by the wide variance in data quality,” Dr. Suruchi Mandrekar, Consultant Internal Medicine, Manipal Hospital, Pune, told IANS.

On the other hand, “symptomatic cases are usually mild and can resemble dengue fever, and may include fever, red eyes, joint pain, headache, and a maculopapular rash,” the doctor said.

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Dr. Digvijay Adke, Consultant and In-charge, Emergency Department, DPU Super Specialty Hospital, Pune noted that “the rise in Zika virus cases, identical to dengue, is primarily owing to multiple factors including sudden weather changes, followed by clogging of drains and water accumulation in the surroundings along with poor personal hygiene practices at an individual level.”

Meanwhile, Dr. Suruchi pointed out that Zika virus infection raises concerns during pregnancy as it can cause microcephaly and other brain malformations in some babies.

In adults, it has been linked to Guillain-Barre Syndrome (GBS) and is known to affect human Schwann cells, that play an important role in supporting the development, function, and regeneration of peripheral nerves linked to movement, breathing, heartbeat, and digestion, among others.

“Prevention involves decreasing mosquito bites in areas where the disease occurs, and proper use of condoms, as it can be sexually transmitted,” Dr. Suruchi said.

Even as there is no current vaccine, the doctors called for efforts such as insect repellent, covering much of the body with clothing, and mosquito nets, and getting rid of standing water where mosquitoes reproduce.

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“It is advised to follow hygiene practices like regular washing of hands and refrain from consuming food from unhygienic spots, especially anything that is under-cooked. Including nutritionally rich elements in your daily diet like fruits and vegetables helps in building a strong immune system that helps fight against such vector-borne ailments,” Dr. Digvijay told IANS.

–IANS

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Medical professors in S. Korea to launch indefinite voluntary walkout from July 12

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Seoul, July 1 (IANS) Medical professors at three South Korea University-affiliated hospitals vowed on Monday to start an indefinite voluntary walkout later this month, amid a prolonged standoff between doctors and the government over its medical reform plan.

The emergency committee of the professors serving as senior doctors at the university announced the walkout starting July 12, excluding the operation of emergency rooms and intensive care units, calling for the government to “withdraw its pressure on medical students and trainee doctors” and engage in dialogue, Yonhap news agency reported.

“The medical community sought to launch a dialogue by offering solutions and compromises, but the government has flatly ignored all and abused its administrative orders,” the committee said in a statement.

The announcement came after professors at Severance Hospital, Gangnam Severance Hospital and Yongin Severance Hospital also began suspending the treatment of outpatients, non-emergency surgeries, and other services from Thursday last week.

Senior doctors at Asan Medical Center are also anticipated to launch a one-week walkout starting Thursday.

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Despite strong opposition from doctors, the government finalised an admissions quota hike of some 1,500 students for medical schools in May to address the shortage of doctors.

Last month, the government asked hospitals to swiftly accept the resignations of trainee doctors who have left their worksites in protest of the government’s medical reform, in an apparent move to appease the junior doctors.

About 12,000 trainee doctors have left their jobs since late February to protest against a hike in the number of medical students. In a punitive step, the government ordered hospitals not to accept the resignations of trainee doctors to prevent them from seeking jobs at other clinics.

Last week, a committee formed by the medical community to navigate joint responses to its monthslong standoff with the government over the medical reform plan, decided to convene a nationwide debate on July 26 regarding the government’s medical reform.

–IANS

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Use of AI for self-prescription poses risk to human life, warn doctors

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Hyderabad, July 1 (IANS) Use of Artificial Intelligence (IA) for self-diagnosis and prescription poses significant risk to human life, warn healthcare professionals.

On Doctors’ Day, they voiced concern over the growing trend of patients depending on Internet search results even for serious ailments.

They believe that while there are many advantages of using the Internet, there are no less problems impacting everyday lives because of it.

Ease in life and potential risks, both multiplied over the last couple of years, if not more, with the entry of AI and Machine Learning (ML), which are fast overtaking our lives, say doctors.

According to them, the Internet has emerged as a primary source of health information, fuelling a rise in unsupervised self-medication practices.

AI has introduced a new facet to this trend, which poses significant risks to human life.

Engaging in such unchecked behaviour presents grave threats and may result in fatal consequences if incorrect medications are consumed due to misjudgement.

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Potential dangers of self-medication include inaccurate self-diagnosis and the misuse of medications, leading to potentially hazardous drug interactions or incorrect dosages, they said.

AI works based on data input, and in healthcare data has to be accurate to the last decimal to ensure perfect diagnosis of the ailment to provide best medication or treatment.

Hundred per cent accuracy is certainly not possible when it comes to providing data by non-healthcare practitioners.

“The Internet, especially AI, is developed and dominated by the western world, especially the US. Basic information available on AI platforms could be those associated with the geography and demography of the West.

“Such information may or may not be suitable to people in India, because the information available will only be to the closest and not the most accurate,” Dr. Gayatri Kamineni, COO, Kamineni Hospitals told IANS.

“Dosages matter to ensure best treatment for any ailment, and if that input is wrongly provided, the result could be disastrous, even leading to fatalities in certain cases.

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“The Internet in general and AI in particular must be seen as a support function and not as a judgment to trust blindly,” she said.

Dr B Kishore Reddy, Chief Ortho Oncologist and Managing Director, Amor Hospital believes that when someone takes medication without consulting a doctor or medical professional, he might be choosing the wrong drug.

“Additionally, self-medication increases your risk of taking an incorrect dose or using drugs for longer than necessary. And if you take a substance for a prolonged period, your body may become dependent and need this substance to continue functioning correctly. “Sometimes patients may feel some short-term relief and may think taking medication to alleviate symptoms is beneficial. But there is a likely possibility that such medication could mask symptoms of an underlying medical condition, and if proper medical guidance is not sought, that underlying condition could worsen and become dangerous over time.

“Misusing or overusing medication can also increase the risk of severe medical complications, causing harmful symptoms, including nausea, convulsions and even death.”

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“Internet, especially Artificial Intelligence and Machine Learning have eased the lives of healthcare practitioners. We have access to the most advanced treatment protocols, and due to the ease in communication, the risk of making mistakes has reduced a great deal in a hospital setting.

“However, this advancement is controlled and monitored by experts who have decades of experience in providing best care. It is the combination of experience, expertise, and Internet, which delivers the best outcome for patients.

“Depending on the Internet alone, without the experience and the expertise is not advisable at all,” observed Dr. C. Mallikarjuna, Chief Urologist and Managing Director, Asian Institute of Nephrology & Urology (AINU).

–IANS

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Health insurer Niva Bupa files draft papers for Rs 3,000 crore IPO

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Mumbai, July 1 (IANS) Leading health insurer Niva Bupa on Monday filed its draft red herring prospectus (DRHP) with the markets regulator Securities Exchange Board of India (SEBI) to raise about Rs 3,000 crore ($360 million) via an initial public offering (IPO).

The draft papers filed by True North-backed Niva Bupa Health Insurance Company Ltd have a fresh issue of Rs 800 crore for the public and an offer for sale (OFS) of up to Rs 2,200 crore by existing shareholders.

The OFS comprises up to Rs 320 crore shares by Bupa Singapore Holdings Pte and Rs 1,880 crore by Fettle Tone LLP.

Bupa Singapore Holdings has a 62.27 per cent stake in the health insurer while Fettle Tone LLP has a 27.86 per cent stake in the company.

Morgan Stanley India, Kotak Investment Capital, Axis Capital, ICICI Securities and HDFC Bank have been hired for the IPO, according to reports.

Niva Bupa would be the second stand-alone health insurer, after Star Health Insurance, to list on the Indian stock exchanges.

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In September last year, leading private equity firm True North sold a 20 per cent stake in Niva Bupa Health Insurance to its partner Bupa for Rs 2,700 crore, taking the Indian firm’s valuation to Rs 13,500 crore.

–IANS

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