Oncology, Pulmonology & Paediatric Endocrinology

Tumour markers are substances that are produced by cancer or by other cells of the body in response to cancer or certain benign (noncancerous) conditions. Most tumour markers are made by both normal and cancer cells, but produced at much higher levels when cancer is present. Tumour markers are found in the blood, urine, stool, tumour tissue, or other tissues and bodily fluids of some patients with cancer. Tumour markers are useful in the diagnosis, detection, and management of several types of cancer, and researchers are continuously working to identify new ones with the goal of improving cancer diagnosis, management, and outcomes.

Specific inherited mutations in BRCA1 and BRCA2 increase the risk of female breast and ovarian cancers, as well as several other types of cancer. Together, BRCA1 and BRCA2 mutations account for about 20 to 25% of hereditary breast cancers, and about 5 to 10% of all breast cancers. Many experts recommend that women with a family history of breast, ovarian, fallopian tube, or peritoneal cancer be evaluated to determine if they have a genetic predisposition associated with an increased risk of developing any of these cancers.

Looking at 2012 statistics – in men, the five most common sites of cancer diagnosed were lung, prostate, colorectal, stomach, and liver cancer. In women, the five most common sites diagnosed were breast, colorectal, lung, cervical, and stomach cancer. Cancer is one of the leading causes of morbidity and mortality worldwide, with about 14 million new cases and 8.2 million cancer-related deaths in 2012. The incidence of new cases is expected to increase by approximately70% during the next 20 years.

Although genetics plays a role in certain types of cancer, there are controllable risk factors. Don't use tobacco, since it is associated with an increased risk of lung, bladder, cervical, and kidney cancers. Eat a healthy diet, limit alcohol consumption, and exercise regularly. Obesity raises the risk of certain types of cancer and heavy alcohol use can increase the risk of breast, colon, lung, kidney, and liver cancers. Protect your skin from the sun, since exposure is a direct cause of both melanoma and basal cell skin cancer. Schedule regular physical exams and follow recommendations for cancer screenings such as mammograms and colonoscopies – these are both essential, lifesaving prevention tools.

Pulmonary fibrosis, a type of interstitial lung disease, is the classification for many chronic lung disorders that cause scarring (fibrosis). The inflammation and/or scarring affects the tissue inside and between the air sacs of the lungs. When scarring occurs, the tissue becomes stiff and thicker, making it harder for oxygen to pass through the walls of the air sac into the bloodstream. Once the lung tissue becomes scarred, the damage cannot be reversed. There are many causes including autoimmune diseases, occupational exposure, environmental exposure, specific medications, and genetic/inherited diseases, but an estimated 10 to 15 % of cases are idiopathic (of unknown origin).

If you are a smoker, quitting smoking will slow COPD’s progression. Several types of medication are used; the most widely prescribed ones are short-acting and long-acting bronchodilators in the form of inhalers. Your physician may recommend a pulmonary rehabilitation program which includes exercises, disease management training, and nutritional and psychological counselling. In severe cases, oxygen therapy may be used to help alleviate shortness of breath, and very rarely, surgery may be recommended.

Cystic fibrosis (CF) is a serious lung disease that shortens the lifespan of people with the disease. An estimated 70,000 people worldwide have CF, and 75% of patients are diagnosed by age 2. An inherited disease, CF is caused by mutations in a gene that produces a protein called CFTR. The CFTR protein controls the flow of salt and water in and out of the cells of organs such as the lungs and pancreas. The disease causes the body to produce unusually thick, sticky mucus that clogs the lungs and leads to life-threatening lung infections. It also obstructs the pancreas and stops natural enzymes from helping the body break down food and absorb vital nutrients. Although there is currently no cure, specialized medical care, aggressive drug treatments/therapies, and a specialized diet, can significantly lengthen and improve the quality of life for those with the disease.

The thyroid gland manufactures and stores thyroid hormone (TH), also known as the body's metabolic hormone. When the gland releases too little TH, it results in hypothyroidism (underactive thyroid).Conversely, when it releases too much TH, it results in a condition known as hyperthyroidism (overactive thyroid). The most common cause of hyperthyroidism is the autoimmune disorder Graves’ disease. Hashimoto's thyroiditis, a form of thyroid inflammation caused by the patient's own immune system, is a common cause of hypothyroidism. An endocrinologist will determine if an underlying condition is causing the problem and recommend a course of treatment.

Endocrine diseases can cause a deficiency or excess of hormones, leading to growth failure during childhood and adolescence. Growth hormone deficiency is a disorder that involves a damaged or malfunctioning pituitary gland (the small gland at the base of the brain that secretes several hormones, including growth hormone). Turner syndrome, one of the most common genetic growth disorders in girls, is caused by a missing or abnormal X chromosome. The ovaries fail to mature and function normally, so typical sexual development associated with puberty does not occur naturally. Medications are used for disorders of the thyroid and growth hormone injections are administered in children with deficiencies caused by Turner syndrome or kidney disorders.

Premature or precocious puberty is the term given for puberty that begins before age 8 in girls or age 9 in boys. Physically, it means that signs of puberty (development of breasts, testes, pubic and underarm hair; body odour; menstrual bleeding; and increased growth rate) occur earlier than usual. Most cases of precocious puberty have no known cause. In some cases, the pituitary gland, which regulates the release of most of the body's hormones, signals the ovaries and testicles to begin hormone production prematurely. Signs of puberty may also appear early because of problems that affect the adrenal gland, ovaries, or testicles. A paediatrician will likely do some tests on your child to find out if there is an underrlying medical condition.