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accurate evaluation of the presence of tumors and the extent of the

spread of disease.

Stool DNA testing: Pre-malignant adenomas and cancers do not

degrade during the digestion process and remain stable even in the

stool. Such testing, in combination with Polymerase Chain

Reaction, can help to detect the presence of colon cancer with a

high rate of accuracy.

Treatment of Colorectal Cancer in Men

Colorectal cancer is sometimes curable in the early stages. Chances

of a successful cure diminish in the more advanced stages of colon


Common treatment options include surgery, chemotherapy, and

radiotherapy. Doctors advise these treatments individually or as a

combination according to the degree and the progress of the cancer.

Surgery: Colorectal cancer could require palliative, curative,

bypass, fecal diversion or ‘open and close’ surgery according to

location of tumor.

In very early stages, polyps may be removes through surgical

techniques. In advanced cases, it is necessary to remove a section

of the colon that contains the tumor to reduce the possibility and

extent of recurrence.

Curative surgery involves total mesorectal excision.

Palliative surgery can prevent further morbidity due to bleeding of

tumor and its effects. Doctors prefer a proximal fecal diversion

through bypass surgery if the tumor affects other adjacent organs in

the vicinity.

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If it is a serious and very advanced stage of colorectal cancer,

doctors remove the colon through open and close surgery.

Laparoscopic-assisted surgery can reduce size of incision and

thereby minimize risks of infection.

Chemotherapy: This can shrink the tumor or slow its growth. This

is the primary form of therapy if colon cancer is in the initial stages.

Doctors may also advise this form of treatment after surgery.

Radiation therapy: This is not commonly used with colon cancer.

It might cause radiation enteritis. It is sometimes used to reduce

pain and if the tumor perforates the colon.

There are various support therapies to aid treatment of colorectal

cancer. These include counseling through cancer support groups,

social support groups etc.

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Part-IV: The Top Three Cancer Killers in Women

12. Lung Cancer in Women

Lung cancer is a major cause of death in women. Although it is the

second most common cancer after breast cancer, it causes more

deaths in women than the other cancers, like ovarian cancer and

breast cancer, put together.

Lung cancer has been steadily increasing in women while lung

cancer in men has registered a decline over the years.

Causes for Lung Cancer in Women

Lung cancer in women is believed to mostly be due to smoking

which is showing an alarmingly increasing trend among females.

Women start smoking in their teens. There are around more than

500,000 teenage girls in the USA using tobacco products.

A major attraction towards smoking is the belief that smoking can

control weight. There are many advertisements that cater to this

belief too.

These advertisements use the approach that smoking can boost

your confidence, show you as more independent and boost your

circle of friends.

Smoking advertisements featuring women also exudes an exclusive

sense of relaxation, pleasure, and higher social acceptability.

When you start smoking, you develop an addiction. It becomes

difficult to quit smoking, although it is possible to do so. Women

often find it more difficult to quit smoking than men do.

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Nonsmokers and Lung Cancer in Women

Although smoking is a dominant cause for lung cancer in women,

non-smoking women also fall prey to lung cancer. This is primarily

due to passive smoking, radon gas, hormonal levels of estrogen and

certain genetic factors that cause different responses to

carcinogenic substances.

Lung cancer is reaching alarming levels in women and is sometimes

more severe than in men.

Detection of Lung Cancer in Women

Although women normally undergo chest x-rays annually to detect

the presence of lung cancer, these tests do not always deliver

effective results.

X-rays cannot detect small tumors and there are sometimes some

mis-interpretation of x-ray findings.

A lung-cancer screening technique using a CT scanner delivers

better results in detecting cancer. Such scans present a three-

dimensional picture of your lungs and indicate the exact location

and presence of all internal organs.

This scan can detect very minute tumors and, therefore, detect

malignancy in its early stages.

Effect of Lung Cancer in Women

Although lung cancer is a common disease in men and women, it

may assume greater significance in women, due to biological and

genetic differences between males and females.

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These differences include:

Women have high levels of estrogen. Smoking causes serious

changes in these levels. This affects the growth of cancer cells in a


The genetic make-up of a woman is more susceptible to harmful

effects of tobacco smoke. Changes in their genetic build-up may

mean that their body is unable to control unwanted cell growth. This

might lead to uninhibited growth of cancerous cells.

The metabolism of tobacco products and chemicals present in them

are different in men and women. A woman’s body is less able to

repair damaged DNA, which is a major cause for lung cancer in


But, women seem to show a higher rate of survival with lung cancer

than men do.

Effects of Quitting Smoking and Lung Cancer in Women

The best way to escape from lung cancer is to quit smoking. This act

can sometimes produce goods results including:

Pulse rate and blood pressure register high levels during smoking.

When women quit, these may register a sharp fall and start

dropping, even returning to normal levels with some people.

Carbon monoxide levels in the blood remain very high in women

smokers. These carcinogen levels often drop after they quit


You become more energetic within few weeks of quitting smoking.

Nerve endings start growing and therefore, your sense of taste and

smell improves.

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Within a year of quitting smoking, you may feel a marked change in

any breathlessness, cough or tiredness that you were having, as

you are able to breathe in and better process more oxygen.

If you stay smoke-free for five years, your risks of developing

mouth, esophageal or bladder cancer and lung infections like

pneumonia and bronchitis could fall by more than fifty percent.

The levels could be similar to those of a nonsmoker after ten to

fifteen years of nonsmoking. You reduce changes of strokes, heart

ailments, and premature death by around fifty to seventy percent.

Survival Rates of Lung Cancer in Women

As in any disease, early detection of symptoms of lung cancer can

yield positive results of a longer and more comfortable future.

Patients survive up to about five years at the time of writing though

there are promising signs of improved treatments in current


The main cause for this is the low rate of early detection. Lung

cancer does not show any early warning signs. Often, incessant

cough, chest pain, or wheezing come to the fore after the disease

spreads extensively.

The best way is to not smoke. If you already have developed an

addiction to smoking, it is best to quit immediately.

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Breast Cancer in Women

Breast cancer is the most common form of cancer among women

and the second most common cause for death in women in the

United States.

Many men also suffer this disease.

This starts as a lump in your breast or there could be changes in the

structure of your breast. This type of cancer is more prevalent in

white women with a lesser incidence in Asian and African women.

Anatomy of the Breast

Each breast is on chest muscles covering your ribs. There are

around fifteen to twenty lobes in each breast. These contain smaller

lobules, which contain many small milk-producing glands. Milk flows

through lobules and ducts to nipples.

The dark area around the nipple is the areola. Breasts

have many lymph vessels with small round shaped

organs called lymph nodes. There are groups of such

lymph nodes in the underarm, chest, collarbone and

other body parts. These lymph nodes arrest bacteria,

some cancer cells and other harmful substances.

Start of Breast Cancer

The breast and every body part consist of tiny cells. These cells,

grow, divide and die on their own. New cells form when your body

needs them.

Cells follow specific patterns. However, sometimes this orderly

arrangement changes. New cells form when there is no need and

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old cells do not die. The process of growth continues more rapidly

than there is a need. Extra cells clump together to form a tumor.

Tumors can be benign or malignant. Benign tumors are harmless

and it is possible to remove them. They do not usually grow again.

Malignant tumors cause a lot of harm. The cells of these tumors

damage nearby organs and tissues. These cells continue to grow.

Although it is possible to remove these tumors, they often grow

again soon.

Sometimes, cancerous cells break away from their original lump and

start forming lumps in other body parts. Breast cancer cells can

spread to any part of the body.

Symptoms of Breast Cancer in Women

Common symptoms of breast cancer include:

• Change in size or shape of breast like nipple turning inward

• Swelling of breast or breast skin turning reddish

• Scaly and swollen nipples or development of tenderness in


• Formation of lump in breast or near the underarm

• Pain in the breasts

Risk Factors for Breast Cancer in Women

There is no specific, known cause of breast cancer. However, there

are certain risk factors that could possibly encourage the start of

breast cancer.

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These include:

Family History: If any of your family members or paternal or

maternal relations have breast cancer, there is a possibility of you

having it too. If a family member develops breast cancer before the

age of forty, your risk may be higher.

Age: The risk for breast cancer may increase with age. Women over

the age of sixty face a higher risk of developing breast cancer. If

you develop cancer in one breast, there is a stronger possibility of

developing it in the other too.

Genetic Causes: Changes in specific genes like BRCA2, BRCA1 and

others could increase breast cancer risks.

Menstrual History: Women having their first menstrual period

before the age of twelve may have a higher than average risk of

breast cancer.

Women entering menopause after fifty-five also develop a higher

risk for breast cancer.

Conceiving the first child after the age of thirty can prove risky.

Women without any children show a higher rate of breast cancer.

Women on estrogen and progestin therapy after menopause may

have a higher risk of developing breast cancer.

Other Factors: If you undergo radiation therapy for any reason,

you may face a higher risk of breast cancer in later life.

Excessive weight gain after menopause could increase chances of

breast cancer.

Women with dense breast tissues may be more likely to develop

breast cancer.

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Lack of physical activity could increase the chance of breast cancer


Some researchers believe that excessive intake of alcohol may be a

factor in some cases of breast cancer.

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Screening to Detect Breast Cancer

Early detection of breast cancer can help you secure remedial

measures in the early stages.

Breast cancer screening can be through regular screening

mammogram (an x-ray picture of your breasts), clinical breast

examination and self-examination of breasts.

You should have mammograms every one or two

years if you are in your forties. This may show a breast

lump even before you can feel it. Such lumps may or

may not be cancerous, but further detailed tests like

biopsy can determine abnormalities.

Clinical breast examination takes around ten

minutes and a professional health care provider can check your

breasts for any abnormalities. Such checking involves looking for

dimpling, rashes or any abnormalities in your breasts.

Additionally, health care providers also check under your arms for

enlargement of any lymph nodes.

Self-examination of breasts is a good way to check for breast

cancer. However, there can be small changes in your breasts due to

aging, before and during menstrual periods, menopause, birth

control treatments and others natural reasons.

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Diagnosis of Breast Cancer

Doctors prescribe detailed screening, mammograms and other

imaging procedures to detect the presence of breast cancer.

If there were lumps in your breasts, doctors would try to feel its size

and texture. Benign lumps move easily while cancerous lumps are

usually hard and may have odd shapes.

Ultrasound imaging is another technique of diagnosing breast

cancer. Waves from ultrasound devices bounce off tissues. The

computer uses echoes to create a picture. This shows if lumps are

solid or filled with fluid. Solid masses of lumps may be cancerous.

Magnetic resonance imaging (MRI) makes detailed pictures of breast

tissue using magnets. These produce more detailed results and help

diagnosis too.

A biopsy involves removing small pieces of suspected tissue from

your breasts to conduct detailed microscopic examination. Doctors

prescribe additional tests if your biopsy tests are positive. These

tests can help doctors determine the stage of your breast cancer.

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Treatment Options for Breast Cancer in Women

Before starting treatments for your breast cancer, you can get a

second opinion and then decide on the most suitable treatment


Common treatment options include chemotherapy, surgery,

radiation therapy, biological therapy and hormone therapy.

Often, it is necessary to have a combination of treatments rather

than a single type of treatment.


Surgery is among the most common forms of treatment for breast


Breast sparing surgery is where doctors remove cancerous cells

through surgical methods without removing the breast. They make

incisions to remove the whole lump or make a separate incision at

the lymph nodes to remove cancerous cells from the lymphatic


Radiation therapy is often used as a follow-up treatment.

Mastectomy surgery involves removal of the infected breast.

Doctors also remove lymph nodes from underneath the arm.

Radiation therapy is a follow-up treatment.

You may choose to have breast reconstruction, a plastic surgery to

rebuild and reshape your breast.

Breast removal surgery may cause some imbalance and discomfort

in your neck and back. Surgery often causes tenderness and pain.

You can take pain relievers to control your pain. Other side effects

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of surgery include tingling and numbness in underarm, chest, upper

arm and shoulder.

Although most such effects go away after few months, numbness

does not go away in some cases.

Radiation therapy: This treatment option uses high-energy rays to

kill cancerous cells. Doctors normally prescribe this treatment after

performing surgery for breast cancer. The amount of radiation

therapy depends on the spread of cancer within your body. This

therapy can destroy any remaining cancerous cells in your breast.

Radiation therapy can be external radiation or internal radiation.

External radiation is through outside machines. You need to go to

hospital for a specific number of days to receive treatment.

Internal radiation is through implanting of plastic tubes with

radioactive substance in your breast. You need hospitalization while

you have these implants within your body.

Normally, such therapy extends for many days. Then, the doctors

remove the implants and allow you to go home.

Common side effects of radiation therapy are heavy breasts,

tenderness, itchiness in the area and redness and dryness.

Wear loose clothing initially to help your wounds heal well. Although

it is necessary to remain active during radiation therapy, you will

feel very tired and exhausted.

Chemotherapy: This treatment option uses a combination of drugs

to kill cancerous cells. Doctors either inject these drugs

intravenously or prescribe pills. According to the severity of breast

cancer, you can have chemotherapy treatment at home, as an

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outpatient or under hospitalization. Drugs travel throughout your

body in your blood. Therefore, you feel exhausted, bleed or bruise

easily and may develop infections.

Common side-effects of chemotherapy include hair loss, nausea,

vomiting, lack of appetite, diarrhea and mouth and lip sores.

Some cancer drugs could initiate menopause, causing vaginal

dryness, hot flashes and permanent infertility too.

In some cases, you could become fertile during chemotherapy


Hormone therapy: This curative therapy prevents cancerous cells

from gaining access to certain natural hormones like progesterone

and estrogen they require for growing and developing within your


Doctors use drugs like estradiol, tamoxifen and others to prevent

your ovaries from making estrogen. Doctors could also remove your

ovaries surgically to prevent supply of such hormones to cancerous

cells within your breast.

Common side effects of hormone therapy include hot flashes,

vaginal discharge, headaches, nausea, fatigue, vomiting, irritation of

skin around vagina, irregular menstrual periods and skin rash.

Biological therapy: This therapy involves strengthening the

immune system to fight cancer. Doctors use Herceptin through the

patient’s veins. Common side effects include pain, vomiting,

weakness, diarrhea, nausea, rashes, breathing problems.

In some cases, there may be some damage to the heart.

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Colorectal Cancer in Women

Many women may believe colorectal cancer to be a man’s disease

and do not pay attention to any possible symptoms.

The truth is that colorectal cancer can affect women too. One in

every seventeen women in the United States could develop

colorectal cancer.

The risk increases with age. Women over sixty-five are equally

susceptible to breast cancer and colorectal cancer.

Women often express greater concern for breast cancer and are

ready to undergo screening tests for it. It is equally important to

understand that colorectal cancer can also prove to be a major

health concern for women and not only men.

Colorectal Cancer

This is cancer of the colon. Certain body cells in the colon do not

function normally. They divide very fast and produce excessive

tissue which accumulates as a tumor.

The colon and rectum together complete the process of digestion.

Cancerous growth in the colon is colon cancer and cancerous growth

in the rectum is rectal cancer. Together, they are termed colorectal


Symptoms of Colorectal Cancer

In the early stages of colorectal cancer, there are hardly any

symptoms. They develop much later.

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Common symptoms include:

• Abdominal pain

• Blood in the stool

• Unexplained weight loss

• Changes in bowel habits

• Iron deficiency anemia

• Excessive tiredness

Common Factors that may Encourage Colorectal Cancer

Factors that could incite colorectal cancer in women include:

a high or low fiber diet. If you eat a diet rich in refined

products and many sugary products, you have a higher risk

of contracting colorectal cancer.

Menopause. Menopause could bring in marked changes in

your body constitution and could cause cancer too.

family history of colon cancer. If there is a family history

of colorectal cancer, there is a stronger possibility that you

could develop it too.

lack of physical activity. If you do not follow any regular

exercising pattern and lead a sedentary life, risk of such

cancer is high.

Age. Women over fifty have a higher risk of contracting

colorectal cancer. Risk doubles with every additional five


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presence of other cancers. If you already suffer from any

other type of cancer like breast cancer or lung cancer, it is

possible to develop colorectal cancer faster.


Obese women have a higher chance of developing colorectal cancer.

Regular exercises can help reduce weight and thereby reduce risks

of developing this type of cancer.

If you have hormonal replacement therapy for your post menopause

problems, you can reduce risks of colorectal cancer.

Intake of regular calcium supplements, lots of fresh fruits and

vegetables and a diet rich in fiber can reduce colorectal cancer risks.

Diagnosing Colorectal Cancer in Women

Common methods for diagnosing colorectal cancer include:

Colonoscopy (every ten years). Colonoscopy delivers

accurate results for detecting colorectal cancer. Women over

the age of fifty should undergo this screening test. If you

have a family history of colon cancer, it is best to go for a

colonoscopy after the age of forty.


Fecal occult blood test (yearly)

Barium enema (every five to ten years). A barium enema

test requires injection or ingestion of barium, which then

settles as a lining in the colon wall. This helps in getting a

clear picture of infections, tumors, and other abnormal

growth in the colon. Doctors check for hidden blood in stools

through fecal occult blood tests.

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The major hindrance in screening methods is that women are often

reluctant to go in for screening of colon cancer. Plus, there is a wide

presumption that colorectal cancer affects men only.

This delay often allows cancer to grow. Colorectal cancer in the

early stages is often curable but it presents a different picture in the

later stages.

Very few women realize the high-risk factor of colon cancer and go

in for regular screening.

Treatment Avenues for Colorectal Cancer

It is possible to treat colorectal cancer. There are numerous

remedial therapies and medications for this cancer.

Estrogen replacement therapy, common among menopausal

women, is one such therapy.

Many recommend drinking lots of water to help reduce the incidence

of colorectal cancer.

Extensive diet restriction can bring in lot of relief for those suffering

from colorectal cancer. Staying away from red meat and other

animal fats is advised by some people. We should all include more

legumes, fish, poultry, and whole grains in our diet unless advised

otherwise by our doctor.

Chemo-preventive agents like nonsteroidal anti-inflammatory drugs

may bring in marked relief from colorectal cancer symptoms and,

some believe, may help with the disease itself.

Colorectal cancer develops in stages and early treatment produces

best results. Treatment in stage I projects a 95% chance of five-

year survival which goes down to three percent if the cancer

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advances to stage IV. So, it is best to look for early treatment for

colorectal cancer in women just as it is with all forms of cancer.

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Part-V: Diagnosis and Treatment

Detection and Diagnosis of Cancer

Detection and diagnosis of the cancer is done through the following


Imaging Techniques

Through imaging techniques, doctors can get a detail picture of

what is going on without making any incisions. The various imaging

techniques include:

1. X-rays:

X-rays are a type of electromagnetic radiation that helps us get a

clear picture of the inside of our body. The dense structures of our

body, such as cartilage and bones easily absorb, these

electromagnetic rays but lighter substances (for example, blood) do

not absorb them. So, any form of abnormal growth or cancer should

appear as a shadow on the photograph.

A mammogram is a form of an X-ray and is the basis of screening

for breast cancer.

2. CT scans:

A CT scan or CAT scan takes various X-ray photos from various

angles of the body and then compiles them together, through a

powerful computer and 3D imaging programs. The slices, showing

cross sections of the patient’s body help the doctor to locate exactly

where any tumor is.

A CT scan can be a great help in planning radiotherapy or surgery.

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3. MRI scans:

MRI or Magnetic Resonance Imaging uses magnetism to form a

picture of the inside of your body. The body is exposed to a

magnetic force that is 20,000 plus times stronger than the earth’s

magnetic field.

The body responds by vibrating slightly to release radio waves,

which the scanner captures.

The waves are analyzes to form a picture of the inside of your body.

It gives doctors a more detailed view than an X-ray. Therefore,

doctors use them for head and brain examination and for measuring

blood flow.

4. PET scans:

PET or Positron Emission Tomography is a recently developed

technology, in which tiny ‘tracers’ are injected in the patient. These

tracers release positrons, a subatomic particle, which collides with

the atoms in your body to release energy in tiny bursts. The scanner

picks up these energy bursts and forms a picture of the areas where

the tracer has traveled.

A PET scan can help medical specialists to find out whether the

tissue remaining after treatment of cancer is living or dead tissue.

5. Ultrasound:

This scan produces pictures of the inside your body through sound

waves. This process involves sending sounds waves through small

speakers, which rebound off the internal organs. There are

microphones that pick up these reflected sound waves and transmit

to the computer program which helps to give an informative image.

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Endoscopy is a process in which an instrument is used to look into

the internal parts of your body to check if there is any problem. This

instrument is an endoscope; a thin, long, flexible tube which has a

camera and a light on the end. The endoscope is most often

inserted in the body through the gullet or anus. Sometimes, the

surgeon makes a small incision to insert it.

The surgeon can also take samples of any abnormal tissue inside

the patient’s body.

Tissue samples through biopsy:

A microscopic examination of the tissue or, at times, blood (such as

when testing for leukemia) of the suspected area may help to

confirm whether it is cancerous.

Biopsy is the process of obtaining the tissue from the suspected

cancerous area. A small piece of tissue is cut with a scalpel or a

hollow needle can be used to obtain the sample. The needle finds its

way to the suspected area with the help of an ultrasonography or CT


Though the process does not require much time, most biopsies are

painful, which is why the doctors numb the area by using local


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Different types of Biopsies

1. Fine Needle Aspiration: This technique is quite popular in

Sweden but it is now spreading to other countries also. This process

involves an injection to draw the cells from the tumor or lump in the


2. Excisional Biopsy: This is the process of removing the entire

organ or the lump in the body for testing. This technique is not

widely used today, but may be used for breast lumps, spleen and

lymphoma tests.

3. Incisional Biopsy:

This biopsy process is used for soft tissue tumors (for example fat,

connective tissues, and muscles). A portion of the tumor is removed

for study to determine whether it is malignant (sarcomas) or


4. Endoscopic Biopsy:

This the most common form of biopsy. The endoscope is inserted

through the hole in the body or surgical incision. The endoscope is a

fiberoptic instrument that is flexible and offers visual monitoring of

the abnormal area. Forceps are attached to this instrument, which

helps in extracting tissue samples.

5. Colposcopic Biopsy:

Your gynecologist will perform this test for you; it is a further

assessment of the Pap smear result. A colposcope provides visual

examination of the cervix and helps in removing cells for biopsy.

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6. Punch Biopsy:

In this process, a small cutter is used to remove a circular tissue

sample. Dermatologists use this process to evaluate the suspect

area and skin rashes.

7. Bone Marrow Biopsy:

This process is similar to fine needle aspiration, but this needle is

large and strong because the needle has to pass through bone.

Anesthesia is used for this biopsy but there are chances of you

feeling uncomfortable throughout.

Molecular diagnostics:

Molecular diagnosis help the specialists determine the presence of