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बुधवार, 16 मार्च 2016

Neoplasm of the Lung

Neoplasm of the Lung ;
The incidence of lung cancer peaks between ages 55 and 65 years. Lung cancer accounts for 29% of all cancer deaths (31% in men, 26% in women). Lung cancer is responsible for more deaths in the United States each year than breast cancer, colon cancer, and prostate cancer combined; more women die each year of lung cancer than of breast cancer.
Most lung cancers are caused by carcinogens and tumor promoters inhaled via cigarette smoking etc.
Clinical Features
Although 5–15% of patients with lung cancer are identified while they are asymptomatic, usually as a result of a routine chest radiograph or through the use of screening CT scans.
Most patients present Central or endobronchial growth of the primary tumor which may cause cough, hemoptysis, wheeze and stridor, dyspnea, and postobstructive pneumonitis (fever and productive cough).
Peripheral growth of the primary tumor may cause pain from pleural or chest wall involvement, dyspnea on a restrictive basis, and symptoms of lung abscess resulting from tumor cavitation.
Regional spread of tumor in the thorax (by contiguous growth or by metastasis to regional lymph nodes) may cause tracheal obstruction, esophageal compression with dysphagia, recurrent laryngeal nerve paralysis with hoarseness, phrenic nerve paralysis with elevation of the hemidiaphragm and dyspnea, and sympathetic nerve paralysis with Horner’s syndrome (enophthalmos, ptosis, miosis, and ipsilateral loss of sweating).
Malignant pleural effusion often leads to dyspnea.
Pancoast’s (or superior sulcus tumor) syndrome results from local extension of a tumor growing in the apex of the lung with involvement of the eighth cervical and first and second thoracic nerves, with shoulder pain that characteristically radiates in the ulnar distribution of the arm, often with radiologic destruction of the first and second ribs. Often Horner’syndrome and Pancoast’s syndrome coexist.
Other problems of regional spread include superior vena cava syndrome from vascular obstruction; pericardial and cardiac extension with resultant tamponade, arrhythmia, or cardiac failure; lymphatic obstruction with resultant pleural effusion; and lymphangitic spread through the lungs with hypoxemia and dyspnea.
Common clinical problems related to metastatic lung cancer include:-
Brain metastases with headache, nausea, and neurologic deficits;
Bone metastases with pain and pathologic fractures;
Bone marrow invasion with cytopenias or leukoerythroblastosis;
Liver metastases causing liver dysfunction, biliary obstruction, anorexia, and pain;
Lymph node metastases in the supraclavicular region and occasionally in the axilla and groin;
Spinal cord compression syndromes from epidural or bone metastases.
Adrenal metastases are common but rarely cause adrenal insufficiency
Chest x-ray
CT scan of chest and abdomen
CT or MRI scan of brain and radionuclide scan of bone if any finding suggests the presence of tumor metastasis in these organs
Tumor tissue can be obtained by a bronchial or transbronchial biopsy during fiberoptic bronchoscopy; by node biopsy during mediastinoscopy; from the operative specimen at the time of definitive surgical resection; by percutaneous biopsy of an enlarged lymph node, soft tissue mass, lytic bone lesion, bone marrow, or pleural lesion; by fine-needle aspiration of thoracic or extrathoracic tumor masses using CT guidance; or from an adequate cell block obtained from a malignant pleural effusion.
Ayurved treatment by Panchkarma: (Purificative Procedure) especially Vaman is very useful. Associated therapy with following procedures may also be helpful.
Ura- basti
Internal Medicine may be used:
Pushkarmula, (Inula racemosa), janjabilsami
Bharangi, (Clerodendron serratum)
Ashwagandha kshar (Withania somnifera), Winter cherry
Haridra, (Curcuma longa), Turmeric
Daruharidra, (Berberis species), Indian berberry
Bhallataka, (Semecarpus anacardium) Marking nut
Vansha, (Bambusa arundinacia), Bamboo manna
Shirish, (Albizzia lebbeck)
Pippali, (Piper longum), long pepper
Tulasi, (Ocimun sanctum), Holy basil
Brihat panchmula: It is group of 5 herbal drugs viz; Bilwa,{(Aegle marmelos), Bengal Quince}, Gambhari, {(Gmelina arborea)}, Patala, (Stereospermum suaveolans), Agnimantha, (Premna integrifolia), Syonaka, (Oroxylum indicum).
Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur.. 
drsnojha@rediffmail. com   

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