Breast cancer is ranked the number one cause of cancer amongst Indian women with an age-adjusted rate of 25.8 per 100,000 women. The number of women who succumb to this disease is almost 12.7 per 100,000 women. Radiation therapy forms an integral and important part of the armamentarium for the treatment and cure of breast cancer. The aim of radiation therapy is to kill the DNA of the cancer cells that persist and lead to relapse after surgery and chemotherapy. Radiation is delivered with megavolt X-Ray generating machines to the breast and lymph node areas after surgery to create a cancer-free zone.
Radiation is always recommended after breast-conserving surgery and over eight randomised trials since the 1980s have established the role of radiation in breast cancer. The trials done in the 1980s-1990s showed remarkable control rates of >90% for stage 1-2 breast cancer post Breast Conserving Surgery (BCS). Data has shown that radiation reduced the risk of local recurrence by 50% when given post-surgery versus the patients who did not receive radiation. The biggest benefit was seen in women less than 40 years of age where only 10% women developed recurrence as compared to 19.5% in women not receiving radiation. The study had been conducted by the European Society for Radiotherapy and Oncology enrolling 5300 women with stage 1-2 breast cancer. Women with stage 1-2 breast cancer with negative nodes in the axilla do not need radiation unless they have other aggressive features like lympho-vascular invasion, margin positive disease or triple receptor-negative breast cancer.
For stage 2-3 breast cancer with lymph node involvement in the axilla, radiation therapy is recommended as it reduces the risk of local recurrence by 67% and the risk of death by 6%. A study published in the New England Journal of Medicine reported a decrease in the risk of death from cancer by 33% and the probability of survival at 10 years with radiation treatment increased from 54% to 64%. Hence the current recommendation is to support the use of radiation therapy for women in stage 2-3 breast cancer after surgery and chemotherapy. Women at high risk of recurrence include
Cancer size >5 cms
lymph nodes involved in the armpit (axilla)
Cancer at the surgical specimen cut margin
In stage 4 breast cancer or post radical treatment with surgery and chemotherapy, the incidence of relapse is 36% in patients not treated with radiation versus 19% in patients treated with radiation. Radiation is also an effective tool for pain palliation in bone metastases and stereotactic radiosurgery (SRS) or stereotactic body radiotherapy (SBRT) is the recommended treatment for brain metastases and lung/liver metastases respectively. SRS & SBRT have been shown to aid and prolong the intracranial/intrapulmonary control of cancer in addition to chemotherapy/immunotherapy/hormone therapy.
To summarise, radiation is a key member of cancer care in breast cancer for local, loco-regional, recurrent and metastatic disease control.
The author is Chairperson Radiation Oncology, Cancer Center Medanta – The Medicity.
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Kashmiri ASHA worker serves as inspiration by donating blood 28 times
A 32-year-old woman named Bilqees Ara, an ASHA worker, has donated blood 28 times since 2012. She has served as an inspiration to others across the nation.
Bilqees, who is from the Handwara Tehsil in the Kupwara area of North Kashmir, stated that she understands the “importance of blood”.
She said that by donating a pint of blood, she not only saves a precious life but an entire family.
She began donating blood in 2012 and has since given 28 pints.
She expressed her gratitude and pride at being the saviour of so many patients in the Kashmir valley.
I’ve seen people cry helplessly as they try to get blood to save their loved ones, but I’m proud of myself because I’ve arranged blood for them as well. “I felt an inner joy after that,” she said.
In Kashmir, she is known as the “Blood Woman of Kashmir”.
She is a registered blood donor. Whenever a need arises, the officials at the Blood Bank at Handwara hospital call her and, within the shortest span of time, she makes herself available to donate blood.
Women should come forward and do this as there is nothing to be afraid of. This is to be done for society, she said. She also said that she wondered who else would do it if she refused.
If a person has blood and courage, why can’t he give it to someone else in a time of need? She asked.
Covid facilities to reduce in Delhi amid drop in cases
The Delhi government has closed 11 Covid care facilities because to a consistent reduction in cases. Two Covid Care Centers are operational at Ambedkar Nagar Hospital, which has 50 beds, and Balak Ram Hospital, which has 25 beds, according to a government report. Only five admissions were registered at Ambedkar Nagar Hospital over the past three months, while there were none at Balak Ram Hospital.
The number of patients has steadily decreased at the remaining CCCs as well, according to reports.
According to officials, the Delhi Disaster Management Authority on Thursday decided to scale back the medical staff and infrastructure that had been deployed for COVID management in a planned manner. The health department will now formulate an action plan in response to this decision.
“The deven CCCs were closed and dismantled by Delhi government and one by the Centre and three others with total 4000 bed capacity- Radha Saomi Satsang ,Chattarpur, Sawan Kirpal, Burari , and Sant Nirankari, Burari- were closed but not yet dismantled”, officials said.
India’s daily covid tally falls below 5k with 4,858 new cases
India reported 4,858 new Covid-19 cases in the last 24 hours, 806 fewer than yesterday, bringing the total to 4,45,39,046, according to data released by the Union health ministry on Monday. On the other hand, according to the health bulletin, the number of active cases rose to 48,027.
India has 0.11 percent of the infections that are still active, and the Covid recovery rate has risen to 98.71 percent. 2.76 percent was the daily positivity rate, while 1.78 percent was the weekly positivity rate.
Infections with the coronavirus are currently most common in Kerala, followed by Tamil Nadu, Maharashtra, Karnataka, Assam, and West Bengal.
The health ministry stated that as many as 18 fatalities were reported today, taking the death toll to 5,28,355. This included eight deaths reconciled by Kerala.
According to the data available, 2.16 billion doses of vaccines have been administered in the country so far under the nationwide Covid vaccination drive.
On December 19, India’s Covid-19 total had reached one billion. On May 4 and June 23, respectively, last year, it reached the depressing milestones of two and three crore. On January 25 of this year, the number of Covid cases in the nation surpassed four crore.
Over 100 people suffer food poisoning in Manipur
Since Tuesday, over 100 people, including children, have been admitted to hospitals in the Senapati district of Manipur due to a possible case of food poisoning linked to a birthday celebration in the hilly state.
According to medical officer Dr. Th Veidai Shuru of PHC Paomata on Thursday, the majority of the patients, who are from the villages of Tungjoy and Tunggam, were admitted at the Public Health Centre (PHC) Paomata while some were in the Public Health Sub-Centre (PHSC) at Tungjoy.
From Tuesday onward through Wednesday, patients with complaints of loose motion, fever, and bodily soreness were admitted to health centres.
“Now most of the patients are getting relatively better, “said Dr Veidai.
According to reports from medical facilities, about 83 people have been released, and the 31 others are anticipated to leave soon.
According to the specialists, food poisoning is a possibility. According to locals, the primary cause may be the drinking of fermented fish chutney during birthday festivities.
“However, it will take at least 7 to 14 days to get the results for the samples which we collected and sent for testing and we’ve also collected blood samples to check other diseases, Dr Veidai said.”
Meanwhile, representatives from the food safety agency visited a village in the Senapati district to determine what was causing the widespread illness.
Does Medicaid Pay for Air Purifiers?
Medicaid services, as convenient as it sounds, might not be fulfilling enough to live a comfortable life for low-income families. Air purifiers are no more a luxury and have become a requirement to stay healthy. When we come to this, the real question is: does Medicaid pay for air purifiers?
The answer to this simple question is no. Medicaid does not cover air purifiers until and unless it is prescribed by a doctor if you are medically ill. This is not just enough to know; read on to have a better idea of how medicare works and what are your other options.
Does Medicaid Pay for Air Purifiers?
Medicaid is an insuranse plan which does not cover equipment lik air purifier, room heater, humidifier, dehumidifier, and air conditioner. The plan is only entitled to cover only those devices, which are Durable Medical Equipment.
For instance, Medicare is shown to provide Positive Airway Pressure machines if you are medically proven to have obstructive sleep apnea. However, in some cases, Medicaid may reimburse you with an air purifier and humidifier if you are medically proven for its need.
To do so, you must provide a proof showing authentication of your medical need, like a prescription or a letter of medical necessity. The plan only covers medical grade air purifiers and Air Purifier Mag has shared some of the best options that may help you get your air purifier cost covered under Medicaid easily.
Why Original Medicaid does not Include Air Purifier in their Part B?
Original Medicaid part B only covers the equipments under the DME category and since the plan does not categorize air purifiers as a DME, it’s not in the list. They rather believe it to be an environmental control equipment and not primarily medical in nature.
Same is the case with the other such appliances like humidifiers and room heaters that are designed to improve or manage health conditions.
Can you Ask a Doctor to Prescribe you An Air Purifier?
You can request your doctor to prescribe you an air purifier only if you really think it could bring a difference in your health status. Medical grade air purifiers, which use HEPA filters are usually prescribed by the doctors to look after health condiitons like asthma. In some cases, doctors can refuse to sign you a prescription considering its short term benefits.
Does Medicaid Advantage Plus Pay for Air Purifiers?
Medicaid Advantage Plus is a long-term health management solution for people with chronic condition who need health devices and tools in their homes and have access to both Medicare and Medicaid plans.
The MAP plan is offered by the companies associated with Medicaid to cover all the services laid down by the original Medicaid plan.
Unlike the original plan, as allowed by the fall enrollment of 2020, the Advantage plan is more likely to be helpful in covering the cost of health equipment like air conditioners and air purifiers. Coverage plans and type of health devices covered in the Advantage plan vary from one provider to another.
Which Durable Medical Equipment does Original Medicaid Part B Cover?
Medicaid, in general, covers the major chunk i.e. 80% of the Medicaid approved health equipment also called, durable medical equipment, to be used at home. To consider it a DME, Medicaid believes the equipment should be able to be repeatedly used, must only be useful for the sick, and restricted to home usage.
The equipment the plan will cover is based on the plan you choose and your health condition. Here’s a list of equipment Medicaid plan covers:
● Hospital beds
● Seat lifts
● Pacemaker monitors
● Blood glucose monitors
● Wheelchair lifts
● Heating pads
● Oxygen regulators
● Face masks
● Alternating pressure pads, mattresses
● Motorized wheelchair
● Heat lamps
● Sitz baths
Other Ways To Get Inssurance or Pay for an Air Purifier
Either when time is running out or there is no way out to get your prescription approved by Medicaid, you can opt for other ways to cover the expenses for your DME.
Private insurance: Even though FSA or HSA debit card isn’t allowed to be used on purchase of equipments, you can reimburse the amount by FSA after buying it from your own money. Most of the insurance providers cover air purifier as long as a proof is provided in terms of prescription or letter of medical necessaity.
Second Hand: You can always pay for the the equipment from your pocket. However, one needs to understand the cost difference if one opts for an insurance plan. You can directly pay and get second hand DME at half price from Facebook Market place, eBay, or any good thrift store.
Veterans Health Care: With the help of Department of Veterans Affairs, veterans and their spouses have the benefit of getting Medicaid copayment or the complete cost of DME.
Nonprofit Assistance: There are a number of nonprofit foundations and state programs, which help elderly with DME through low or interest-free loans and different programs. Visit your state’s site to have a better idea on the available programs.
India reports 5,108 new Covid cases in 24 hours
India reported 5,108 new Covid-19 cases in the previous 24 hours on Wednesday, bringing the total number of infections to 44,510,057. According to data from the union health ministry, the country’s active caseload is 45,749, accounting for 0.1 per cent of total cases.
So far, a total of 4,39,36,092 people have been recovered, with 5,675 recovered in the last 24 hours. The recovery rate in the country stands at 98.71 per cent.
The weekly positivity rate is 1.70 per cent, while the daily positivity rate is 1.44 per cent.
According to official data, approximately 89.02 crore samples have been tested for coronavirus in the country so far, with 3,55,231 tests conducted in the last 24 hours.
Meanwhile, India’s vaccination coverage has reached 215.67 crores, with 18.70 crores being precautionary (booster) doses. The vaccine doses have been administered to 19,25,881 people in the last 24 hours.
4.06 crore people aged 12-14 received their first dose, and 3.09 crore received their second. Over 6.18 crore people aged 15 to 18 received their first doses, with over 5.27 crore receiving a second dose.
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