Doctor’s blog

Here again I am writing the bad news. And the bad news is that the institute I work has not been permitted for admitting students for the academic year 2008-09 and it is final from the highest court of the nation. So no one can do anything right now. We can only hope for the best in the coming year. And hope is something that keeps people going and going strongly.

We are in a situation where we have no control of it. The people who have control seem to be least bothered. We are in a catch 22 situation. We are in a position what have been called Sterling’s law which says “bad things happen in the worst possible time”. And we are in that situation now.

As I have mentioned in my earlier writings that for a business or any thing to succeed the mission of the thing or business has to be clear and specified. Due to absence of mission we are in the present situation. It is apparent that the mission is not clear, from the result we are getting.

Every body is worried about the future of the students who are already pursuing their studies at the institute. Students are the worst sufferers. They have no where to go to seek help as the authorities are not helping.

I have said many things but you may not understand what I said. Let me explain. The college (medical college) authorities have tried to get permission for the admission of this year (2008-09) batch, but failed to get permission due to lack of infrastructure and faculty. They tried repeatedly to get the permission with out any success. Instead of trying to improve the deficiencies they were trying to get by somehow convincing the inspecting authority. But all efforts to convince the authority failed and we are now in this situation.

But the bad news is that nobody knows how the institute will run and what will happen to the students if the institute does not get permission in the next year also. This is the million dollar question.   

Breast cancer in males is uncommon. Breast cancer incidence in males is 150 times less common in males than females. Like, in USA in the year 2006, only 1720 men developed breast cancer compare to about 170,000 cases of breast cancer in females in the same year. Male breast cancer is usually not diagnosed promptly like female breast cancer due to unexpected nature and small size of soft breast tissue in men.

Male breast cancer generally presents as a unilateral lump (mass) in the breast and locally advanced presentations are quite common. Any mass (gynaecomastia or male breast) in the male breast especially if it is one sided and above 40 years of age should be evaluated carefully. Biopsy should be performed from the mass. Gynaecomastia usually starts as unilateral or asymmetric mass in males. If gynaecomastia is bilaterally symmetric it is almost invariably due to endocrine disease or a drug effect and very rarely a breast cancer.

It should be kept in mind, that the risk of cancer is much greater in men with gynecomastia, compare to normal men and in such men, gross asymmetry of the breasts should arouse suspicion of cancer and evaluated properly.

Treatment: Male breast cancer is best managed by mastectomy and axillary lymph node dissection (modified radical mastectomy). When male breast cancer is matched to female breast cancer by age and stage, its overall results are identical. As approximately 90% of male breast cancers contain estrogen receptors, they respond well to endocrine (hormone) therapy. Even metastatic breast cancers (60%) also respond to hormone therapy.

Male breast cancer responds well to adjuvant systemic therapy, and, if not medically contraindicated, the same criteria for the use of adjuvant therapy that is used in women should be applied to men. The sites of relapse and response to chemotherapeutic agents are virtually identical for breast cancers in both sexes.