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Blood
Donation Camp in Dubai Snooker Club
Nutrition
- A Wellness Campaign
Bladder
Cancer: an overview
Cells
in the body normally reproduce themselves in an orderly manner. But in
cancer the cells start dividing uncontrollably, and do not die the way
normal cells do. As the cells produce more cells, a mass or tumor may
appear. The tumor can invade surrounding tissue and keep the healthy
tissue from doing its normal job. There are two kinds of tumors:
- Benign
tumors are not life threatening. They do not invade other tissues and
when they are removed they very seldom return.
- Malignant
tumors are cancerous. These tumors contain cells that divide and grow
without order. The cells will invade and take over nearby tissues and
can spread (metastasize) to other organs by traveling through the
body’s bloodstream and lymphatic system.
Survival
Bladder cancer is the sixth most common form of cancer in the United
States. The American Cancer Society predicts that in the year 2000 more
than 53,000 people will be diagnosed with bladder cancer and more than
12,000 will die from the disease. Men develop bladder cancer three times
more often than women do, and it is more common in European-Americans than
in African-Americans or Hispanics. Asians have the lowest rate of bladder
cancer. Most bladder cancers occur in industrialized countries, and the
risk of developing bladder cancer increases with age.
If
bladder cancer is found in an early stage and appropriately treated, the
survival rate is good--over 93 percent of such patients will be alive
after five years. However, if the cancer has already spread to other
organs in the pelvis when it is found, the five–year survival rate drops
to 49 percent, and if the cancer has spread to distant organs, only 6
percent will still be alive after five years. Early detection is very
important.
Types
of Bladder Cancer
Three main types of cancer can affect the bladder: transitional cell
carcinoma (TCC) , squamous cell carcinoma, and adenocarcinoma. TCC is by
far the most common type of bladder cancer, and accounts for 90 percent of
all bladder cancers. Squamous cell carcinomas account for another 8
percent, and adenocarcinomas account for only 1 percent to 2 percent of
bladder cancers.
Some
TCCs are flat and grow horizontally along the lining of the bladder, while
others are like tiny, thin-stalked mushrooms called, papillary TCCs, that
grow into the hollow center of the bladder. Both flat and papillary TCCs
can be either superficial (in situ, or limited to the transitional
epithelium layer) or invasive (where the tumor grows into the deeper
layers of the bladder).
Squamous
cell carcinoma as noted above accounts for 5 percent to 8 percent of
bladder cancers in most industrialized nations where schistosomiasis (a
parasite infection ) is not widespread and accounts for 75 percent of
bladder cancers in areas where schistosomiasis is widespread (Egypt,
Africa etc). Treatment for squamous cell carcinoma of the bladder not
associated with schistosomiasis includes chemotherapy and cystectomy
(surgical removal of the bladder). Chemotherapy regimens include 5-FU and
mitomycin C.
Adenocarcinoma
of the bladder is uncommon and accounts for 0.5 percent to 2.0 percent of
bladder cancers. It may be associated with exstrophy (turning inside out)
of the bladder or endometriosis a condition where uterine mucous membrane
is found abnormally outside the uterus.
Most
cases of adenocarcinoma , however, are not associated with either
condition. The age and sex distribution of adenocarcinoma of the bladder
is similar to TCC with most cancers in men older than age 50.
Adenocarcinomas of the bladder account for 85 percent of those associated
with exstrophy and 15 percent of those with a non functioning bladder.
Treatment options include chemotherapy and cystectomy. Chemotherapy
regimens used include 5FU, doxorubicin and mitomycin C or 5FU and
cisplatin with or without mitomycin C.
Urachal
cancer is an adenocarcinoma in more than 90 percent of the cases. The
remaining types seen are either TCC or squamous cell in origin. In the
embryo, the urachus is the continuation of the urinary bladder into the
umbilicus The urachus normally seals off before birth. Treatment options
include chemotherapy and cystectomy.
Mixed
cell bladder cancer is rare and is seen in less than one percent of all
bladder cancers. Treatment for these cancers also includes chemotherapy
and cystectomy.
Risk
Factors
A risk factor is something that increases a person’s chance of getting a
disease. For example, smoking is a risk factor for lung cancer, and
prolonged sun exposure is a risk factor for skin cancer. But it is
important to remember that even though a person has one or more risk
factors, it does not mean that the person will get the disease—it just
means that it may be more likely.
There are several known risk factors for bladder cancer:
- Smoking:
Smokers have two to five times the risk of getting bladder cancer when
compared to nonsmokers. The National Cancer Institute estimates that
smoking causes half of the bladder cancers in men and almost a third
of the cases in women. One theory holds that carcinogens
(cancer-causing chemicals) found in smoke enter the lungs and are
carried by the bloodstream to the kidneys. The kidneys filter the
carcinogens and concentrate them in the urine, and these concentrated
poisons damage the lining of the bladder while the urine is being
stored.
- Chemical
exposure: People who have had long exposure to a certain group of
chemicals (aromatic amines) are suspected to have a higher risk of
developing bladder cancer. Many of these chemicals (such as benzidine
and beta-naphthylamine which have been banned) are commonly used in
the paint, printing, dye, leather, and rubber industries. Additional
industries with a higher risk of bladder cancer are textile,
petroleum, hairdressers, aluminum workers and truck drivers.
- Race:
Whites develop bladder cancer twice as often as Blacks or Hispanics,
while Asians have the lowest risk.
- Age:
The risk of developing bladder cancer increases with age. People older
than 70 years of age have 15 to 20 times the risk of developing
bladder cancer than someone who is younger than 54 years of age.
- Chronic
bladder irritation: Patients with a long history of bladder problems
(such as frequent urinary tract infections or kidney and bladder
stones) have a higher risk of developing squamous cell bladder cancer.
These conditions do not cause the cancer, but they irritate the
bladder lining and may make it more likely that cancer will develop.
- History
of bladder cancer: Patients with a previous history of bladder cancer
have an increased risk of developing a second bladder tumor.
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Music
Therapy
Arts
Medicine

Pianists
Pain-Prevention Tips
Simple
changes in keyboard technique will prevent injury for
keyboard players. These helpful free tips are offered
from Sound Feelings. If your piano playing is not
pain-free, constant, automatic and effortless, you are
doing something wrong. This free information explains
how-to improve biomechanical efficiency, relaxation,
avoid tension by making a few small changes to your
approach to the instrument. These suggestions provide
necessary injury-retraining support to performing arts
medicine treatments to insure that the pain will not
return.
Pain-Free
Playing Should Be Effortless.
Pain-free
playing should be constant, automatic and effortless.
Unfortunately, the way piano is often taught, pain-free
playing becomes rare, deliberate and difficult. There
are many reasons why this is so.
Combining
Two Methods Offers Greatest Advantage.
I
feel grateful that my own training included top teachers
of both the “Russian School” and the “German
School” of piano technique. Generally, the Russian
School teaches how to play with gravity and relaxation.
The German School teaches how to play with hand
placement and fingering efficiency. There are other
piano “schools” but these are usually just a
combination of the two main ones described above. Each
approach has good and bad aspects. In my own playing and
teaching, I have incorporated the good aspects of each
and have discarded the bad. The result is a blueprint
for biomechanical efficiency.
Strive
for Preparation and Relaxation.
Essentially,
pain-free keyboard playing depends on two primary
elements: 1) preparation and 2) relaxation. People who
strictly follow the German approach are great at
preparation of the hand position, playing close to the
keys, but neglect to relax the hand at regular
intervals. The problem is that tension builds up and
leads to injuries. People who strictly follow the
Russian approach are initially great at relaxation, but
often make many mistakes because their hands simply are
not prepared, being further from the keys. This
indirectly leads to anxiety and tension in the long run,
which also leads to pain and injury.
Learn
the B Scale First!
From
the beginning of piano training a mistake is often made.
Most teachers teach the C major scale on the very first
lesson. It is true that this scale is the easiest on an
intellectual level because of the absence of
accidentals. However, it is actually the hardest to play
from a physical standpoint because the distance the
thumb must cross from ‘E’ to ‘F’ is much greater
than its counterpart in the B scale (which I like to
teach first.) This is setting the student up for a
lifetime of bad habits because it encourages the very
worst qualities from both schools. Right from the
beginning, the student learns how to angle the hand to
position the thumb, instead of crossing the thumb under
a non-moving hand. Also, with the obligatory “curved
fingers,” there is absolutely no room for acquiring a
natural sense of relaxation. It would be better to first
teach thumb-stretching and hand-relaxation drills.
Sit
Far Enough Away.
Distance
to the piano is crucial to pain-free playing. Most
people sit too close to the piano and wrongly establish
this as the correct distance. Notice if you keep raising
your shoulders when you play. This is usually because
you are sitting too close and your own body simply
blocks the mobility of the arms. The best guideline here
is to see if your elbows can touch one another when your
hands are placed on the white notes directly in front of
you. If not, move back.
Sit
So Your Elbows are Just Below Key Level.
Height
is also extremely important. Most people sit too high or
too low. We really have to be more respectful of our
natural body-type. Are you long-legged or long-torsoed?
Usually women have long legs and a short torso, and men
have the reverse. The problem is that standard piano
bench height is for the short-torso person. This means
that the person with a long waist will tend to tower
over the piano. Why is this bad? It means that the
elbows are positioned above the key level when they
actually should be positioned slightly below the key
level. The reason for this is that the hand, wrist and
forearm should all be in a straight line, to allow the
least friction on the tendons of the forearms which
actually control the fingers. People who sit too
high, too low, or with a “low wrist” or with a
“high wrist” usually acquire pain and ultimately
tendinitis, or carpal-tunnel syndrome. This is really so
unnecessary! The solution is to get an adjustable bench,
or sit on a chair, so that the correct height is
achieved.
Practice
Fast First!
Another
traditional myth is to practice slowly and then to
gradually speed up the passage. The problem here is that
at the slow tempo, certain bad habits go unnoticed
(extra tension, bad fingering) because they do not
interfere with the execution at this slower tempo. But
once the tempo becomes faster, all this inefficient
choreography has already been built in, and it is too
late. It would be better to practice very fast, in small
little groups, right from the beginning, to better get a
sense of what fingering and hand position will be
needed. Then go back and practice it slowly, with this
in mind.
Softer
Equals Faster.
Many
injuries lately are specific to people who play
electronic keyboards. One would think that these
lighter-action keyboards would be easier to play, but in
fact, they are harder. This is because most people have
a tendency to press harder than they would on a
naturally-weighted keyboard to overcompensate for the
lack of resistance. Also, we get fooled by the
artificial sound levels. Because of the electronic
aspect of the instrument, we become reliant on the
actual volume versus the perceived volume. If we are
recording, for example, the ultimate dynamic level may
be very loud, but to us as performers, in our monitor,
it may seem very soft. So we instinctively try to play
harder to create a louder sound, when it really
doesn’t help. Meanwhile, the louder we play, the
stiffer our fingers become. The stiffer our fingers
become, the slower we play and the more we push. The
more we push, the more pain and damage we inflict on
ourselves. The solution here is to keep mentally
reminding ourselves as we play that “softer equals
faster.” This keeps the muscle system very relaxed.
Let them set the levels in the mix.
Once you establish the correct habits, you will be able
to play for hours at a time and never get tired.
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