Risk and Side Effects of Hormone Therapy | Oncology

What are the basic types of hormone therapy?

Hormone therapy primarily focuses on changing your body’s estrogen production after menopause. There are two main types of estrogen therapy:

  • Systemic hormonal therapy: Systemic estrogen, which comes in the form of a pill, skin patch, ring, gel, cream, or spray generally contains high doses of estrogen that are absorbed throughout the body. It can be used to treat many common symptoms of menopause.
  • Low-dose vaginal products: Low-dose vaginal estrogen preparations, which come in cream, tablet, or ring form reduce the amount of estrogen your body absorbs. For this reason, low-dose vaginal preparations are generally used only to treat vaginal and urinary symptoms of menopause.

If your uterus is not removed, your doctor will usually prescribe estrogen along with progesterone or progesterone (drugs such as progesterone). This is because estrogen alone, when not balanced by progesterone, stimulates the growth of the lining of the uterus, increasing the risk of endometrial cancer. If your uterus was removed (cervical surgery), you do not need to take progestin.

Why does the body need estrogens?

Estrogen thickens the lining of the uterus and prepares the fertilized egg for implantation. Estrogen also affects the way the body uses calcium, a mineral important in building bones. Also, estrogen helps maintain a healthy level of cholesterol in the blood. Estrogen is needed to keep the vagina healthy.

As menopause approaches, the ovaries greatly reduce the production of these hormones. Decreased or fluctuating estrogen levels can lead to medical conditions such as menopausal symptoms, such as hot flashes, and osteoporosis.

Why take progesterone?

Progesterone is used in addition to estrogen in women who have a uterus. In these women, estrogen, if taken without progesterone, increases the risk of cancer of the endometrium (the lining of the uterus). During a woman’s reproductive years, cells are removed from the endometrium at the end of menstruation. When the endometrium no longer collapses, estrogen causes the cells of the uterus to grow, a condition that can lead to cancer.

Progesterone reduces the risk of endometrial (cervical) cancer by thinning the endometrium. Women taking progesterone do not have menstruation or bleeding depending on how they are taking hormone therapy. Monthly bleeding can be reduced and, in some cases, eliminated by taking progesterone and estrogen together continuously.

Women who have had cervical surgery (surgical removal of the uterus) generally do not need to take progesterone. This is an important point because estrogen alone has fewer long-term risks than HT, which uses a combination of estrogen and progesterone.

What are the risks of hormone therapy?

In the largest clinical trial to date, hormone replacement therapy with the estrogen-progestin pill (Prima Pro) increased the risk of some serious conditions, including:

  • Heart disease
  • Race
  • Blood clots
  • Breast cancer

Later studies suggest that these risks vary:

  • Years: Women who start hormone therapy at the age of 60 years or older or 10 years from the onset of menopause are at increased risk for the above conditions. If hormone therapy is started before age 60 or within 10 years of menopause, the benefits outweigh the risks.
  • Type of hormone therapy: The risks of hormone therapy vary depending on whether estrogen is given alone or with progestin and the dose and type of estrogen.
  • Health history: Your family history and personal medical history and risk factors for cancer, heart disease, stroke, blood clots, liver disease, and osteoporosis are important factors in determining whether hormone replacement therapy is right for you.

You and your doctor should consider all of these risks when deciding whether hormone therapy is an option for you.

Who can benefit from hormone therapy?

The benefits of hormone therapy outweigh the risks if you are healthy and:

  • Keep lights from high heat in moderation. Systemic estrogen therapy remains the most effective treatment for relieving the troublesome hot flashes and night sweats of menopause.
  • You have other symptoms of menopause. Estrogen prolongs vaginal symptoms of menopause, reducing itching, burning, and discomfort during intercourse.
  • It is necessary to avoid bone loss or fractures. Systemic estrogen helps prevent osteoporosis, also known as osteoporosis. However, doctors often prescribe bisphosphonates to treat osteoporosis. Estrogen therapy can help if you are intolerant or do not benefit from other treatments.

You are experiencing early menopause or have an estrogen deficiency. If your ovaries have been surgically removed before age 45, if you stop before age 45 (premature or early menopause), or if your ovaries lose their normal function before age 40 (primary ovarian failure), your body is less susceptible to estrogen than women who normally experience menopause. Estrogen therapy can help reduce the risk of certain health conditions, such as osteoporosis, heart disease, stroke, dementia, and mood swings.

If you take hormone therapy, how can you lower your risk?

Talk to your doctor about these strategies:

  • Find the best product and delivery method for you. You can take estrogen in the form of a pill, patch, gel, vaginal cream, or a suppository or slow-release ring that is placed in the vagina. If you only experience vaginal symptoms related to menopause, a low-dose vaginal cream, tablet, or estrogen ring is often a better option than an oral pill or skin patch.
  • Reduce the amount of medicine you take. Use the least effective dose for the shortest time necessary to treat your symptoms. If you are under 45, you need enough estrogen to protect against the long-term health effects of estrogen deficiency. If you have permanent menopausal symptoms that can significantly affect your quality of life, your doctor may recommend long-term treatment.
  • Follow up regularly. See your doctor regularly to learn the benefits of hormone therapy that outweigh the risks and for screenings like mammograms and pelvic exams.
  • Choose healthy lifestyle choices. Include physical activity and exercise in your daily routine, eat a healthy diet, maintain a healthy weight, avoid smoking, limit alcohol, manage stress, and manage chronic health conditions like high cholesterol or high blood pressure.
  • If you have not had cervical surgery and are using systemic estrogen therapy, you may also need progestin. Your doctor can help you find a delivery method that offers greater benefits and convenience at lower risk and cost.

Who should not take hormone therapy (HT)?

Hormone therapy is not recommended for women in general:

  • Active or past breast cancer
  • Active or recurrent endometrial cancer
  • Abnormal vaginal bleeding that has not been evaluated
  • Active or recurring blood clots
  • History of stroke
  • Known or suspected pregnancy

Side effects of hormone therapy

As with almost all options, hormone therapy can have side effects.

The most common side effects are:

  • Monthly bleeding (if progestin is cyclical)
  • Irregular detection
  • Tender breasts

Less common side effects of hormone therapy:

  • Fluid retention
  • Headache (including migraine)
  • Skin discoloration (brown or black spots)
  • Increased breast density makes it difficult to interpret mammography
  • Irritation of the skin under the estrogen patch.

How can I reduce these side effects?

Adjusting the dose or form of medicine you are taking often reduces the side effects of hormone therapy. However, you should never make changes to your medication or stop taking it without consulting your doctor.


What is Surgical Dermatology | Dermatology

What is surgical dermatology?

Surgical dermatology focuses on diagnosing and treating skin diseases using both surgical and non-surgical procedures. If you’re dealing with precancerous moles, Mohs surgery, or earlobe repair, you’ll likely see a surgical dermatologist for treatment.

Some cosmetic cases require surgical solutions. Surgical dermatology improves the function and appearance of your skin by removing or modifying skin tissue. Most dermatological surgeries are minimally invasive procedures that are localized to the part of the skin affected by the condition or disease.

The surgical dermatology department offers a variety of surgical solutions for your skin, including the removal of cysts, sebaceous tumors, and skin cancers. In our clinic, our skin surgeons perform a precise technique of removing skin cancer known as Mohs surgery. This surgery removes cancer from one small layer at a time until healthy skin is accessed, minimizing damage to the surrounding tissue.

Procedures of a surgical dermatology

Mohs surgery

Microscopic Mohs surgery (known as MMS surgery or Mohs surgery) mainly treats the most common forms of skin cancer, basal cell carcinoma, and squamous cell carcinoma. Mohs surgery enables your surgeon to remove tissue in stages, accurately identifying and removing tumor cells while preserving healthy surrounding tissues. Cure rates for Mohs technology are close to 98 percent, the highest cure rates for skin cancer.

Fellowship-trained dermatology surgeons perform Mohs surgery on an outpatient basis. In many cases, patients only need two or three repeated operations. Some may require further treatments to completely remove the cancer cells and possibly repair the surgical wound.

As with any surgical procedure, Mohs surgery leaves a scar. After the tumor is completely removed, your doctor evaluates the wound and discusses treatment options with you, including:

  • Allow the wound to heal naturally
  • Wound repair with surgery

Photodynamic therapy

We use photodynamic therapy (PDT) to treat carcinomas and non-melanoma skin cancers. Our doctors can perform this light therapy in their office.

Our specialists apply a photosensitizing agent to the skin around and around the growth area. When the agent penetrates tissues, it is absorbed into rapidly dividing, precancerous cells. Your doctor then activates the agent by exposing it to light and stimulating the topical agent to destroy the tissues in that specific area. PDT shrinks safely and effectively or eliminates precancerous or precancerous growths.

Radiation therapy

Radiation therapy (RT) uses high-energy rays or particles to kill, shrink, or slow cancer cells. This treatment is effective for very large tumors or in locations that are difficult to treat with surgery. It is also beneficial for patients who are in poor health and who cannot tolerate surgery.

RT may be used alone or in combination with other treatments. Our Surgical dermatology surgeons work closely with the department of radiation oncology at the University of California, Los Angeles to develop individualized treatment programs for patients suitable for this treatment.

Surgical excision

Surgical excision involves removing the visible melanoma lesion as well as a small amount of surrounding tissue for examination. Surgical excision can be used for:

  • Remove the lesion completely to treat cancer with surgery
  • Taking a sample of tissue from a suspicious lesion for biopsy

Our surgical dermatology experts perform surgical excision procedures in ways that increase cosmetic results and reduce scarring and functional impairment. Surgical excision is a common removal treatment:

  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Malignant melanoma
  • Other benign or malignant skin tumors on the trunk or extremities

Our surgeons usually remove skin cancers and other tumors in the head and neck with Mohs surgery.

Topical skin cancer therapy

Precancerous skin growths can be treated with topical melanoma agents. Skin-based agents preserve the healthy tissue around the growth while treating the growth in one of two ways:

  • Direct targeting of cancer cells (chemotherapy agents)
  • Stimulating the immune system to destroy cancer cells (biological agents)

Our surgical dermatology specialists use anti-cancer agents formulated as creams, gels, or lotions that are applied directly to areas of the skin for a specific period of time. As the agents work, the affected areas of skin may become red, scaly, or crusty and may itch, sting, or burn. After treatment, normal skin cells quickly heal the affected areas.

Treatment and removal of cancerous moles

Cancerous moles are very dangerous. Cancerous moles are usually treated by a surgical dermatologist through circumcision. Cancerous moles are cut out of the skin, including a large border around the mole to ensure it is completely removed. The wound will be closed with stitches.

The removal of cancerous moles may be performed by a surgical dermatologist as an outpatient procedure.

Earlobe repair

Earrings are trendy, but they can also cause health problems! A torn earlobe is common due to large and heavy earrings, or jewellery that gets tangled in clothes or pulled by children. Whatever the cause, when it comes to a ruptured earlobe, earlobe repair is essential.

Using local anesthesia, surgical dermatologists perform earlobe repair by reattaching the split earlobes with sutures. After a period of successful earlobe repair and healing, patients who wish to have their ears pierced again may be able to do so. Consult your dermatologist about your options!


Cryosurgery involves applying a freezing agent, the most common liquid nitrogen, directly to the skin to destroy skin growth. Liquid nitrogen damages tissues through freeze-thaw cycles. Then it replaces the normal skin cells and naturally heals the area. Temporary redness and stinging may occur briefly over the treatment area as the lesion crusts and crusts over a period of one to two weeks.

Our doctors usually use cryosurgery for:

  • Benign neoplasms such as seborrheic keratosis, vulgar wart, warty keratosis, and flor
  • Possible growth of cancer such as actinic keratosis
  • Some cases of non-melanoma superficial skin cancer, basal cell carcinoma, and squamous cell carcinoma

Curettage and electrosurgery

Curettage is a surgical treatment that involves mechanical scraping of tissue with a sharp object. Electrosurgery uses heat from an electrical current to burn, cut, or coagulate tissue. Our skin surgeons use these two treatments together:

  • Non-melanoma skin cancer (basal cell carcinoma, squamous cell carcinoma)
  • Other benign lesions on the trunk or extremities

Using curettage and then electrosurgery targets the entire lesion as well as a margin of surrounding tissue to treat the affected area effectively. The resulting wound will heal naturally within a few weeks without the need for stitches.

Laser resurfacing and chemical peels

Exfoliation of the top layers of the skin can effectively treat cancerous skin growths and, in some cases, precancerous skin growths. Types of peeling:

  • Chemical peels: Alpha or beta hydroxy acids
  • Laser light resurfacing: Erbium or carbon dioxide

Treatments target the affected skin by either local dissolving (chemical peeling) or excising the treatment area (laser peeling). Treatments remove tissue deep beneath the origin of the abnormal cells. Chemical peels and laser resurfacing are commonly used to treat abnormal growths on the face, scalp, and lips.

After peeling, the underlying and adjacent skin cells help rejuvenate your skin. Some patients require a series of treatments. During the recovery phase, patients may suffer:

  • Redness
  • Mild swelling
  • Peeling

Surgical dermatology is also available for people who need help removing and healing scars, peeling skin or lesions, removing birthmarks, and countless other conditions. If you have a skin condition or problem and want to treat, cure, or eliminate it, contact a qualified and professional surgical dermatologist. Your skin needs to remember when you think about your health, so don’t delay seeking treatment if you suspect there is a problem.


Benefits and Risks of Teledermatology | Dermatology

Overview of the teledermatology

Teledermatology is a subspecialty in the medical field of dermatology and is probably one of the most common applications of telemedicine and e-health. In teledermatology, telecommunications technologies are used to exchange medical information (about skin diseases and tumors). Distance through audio, visual, and data communication. Applications include healthcare management such as diagnosis, consultation, and treatment as well as (continuing) education.

Dermatologists perennial and brown coined the term “teledermatology” in 1995. In a scientific publication, they described the value of teledermatology service in a rural area less recognized by dermatologists.

Applied teledermatology

Teledermatology is used in virtually all aspects of health care delivery except for direct patient contact. Due to the virtual nature of this clinical specialty, the role of teledermatology is very useful in the following areas, which are only in the non-clinical areas after teleradiology and telepathology.

  • Reference
  • Consultations
  • Diagnostic
  • Treatment
  • Review

Reference: The time required for paging is very short compared to traditional forwarding. Tele-referrals have the advantage of accessing a consultant/specialist regardless of the distance between the doctor/nurse and the tile consultant.

Tele-consult: Despite the relatively new terminology, teleconsultation has been around for many years. Technically, calling a doctor on the phone for advice is also in the field of teleconsultation. However, in recent years, this has been compounded by the participation of physicians in live teleconferences or as spectators at the operating table.

Under normal circumstances, the telephone network will be used for voice, fax, and data transmissions, while ethernet networks will be the general priority in more difficult situations.

Tele-diagnosis: In remote diagnosis, the doctor assesses without the physical examination he has performed, however, based on data transmitted from a remote location. It could be general photography, histopathology slides, dermoscopy, and other research results.

Tele-treatment: Teletherapy refers to the treatment that is given to the patient through telecommunications. A teledermatology specialty center specialist can consult with a consulting physician at TM Consulting, a center that maintains a patient information record (PIR) on the treatment to be taken.

PIR refers to all patient information for providing care using teledermatology, including clinical and non-clinical information. Clinical information history of illness, associated signs and symptoms, relevant history and history of treatment if applicable, clinical observations, clinical intervention, diagnosis, and treatment, etc.

Non-clinical information related to the patient, such as patient environment, demographic information, lifestyle, nature, and professional or related personal details

Review and follow up: This makes it much easier for the patient and the physician to follow up by teleconsultation after the patient has been prescribed/treated (medical or surgical) for a specific condition by face-to-face or by teleconsultation. This saves time and travel rather than ensuring the best treatment result.

All PIRs, which are periodically updated through regular examinations by the attending physician/health worker, are communicated by telecom to the consultant who follows the patient directly or through the referring health worker. The acceptance of teledermatological monitoring of leg ulcers is very high among patients, home nurses, and trauma specialists.

It seems possible to reduce health care costs and improve the standard of living of patients with leg ulcers using teledermatology by reducing the number of visits to injury centers or specialist physicians. It is highly effective in treating leg ulcers.

Mobile teledermatology

Mobile telemedicine is a system in which at least one participant (consultant or physician) uses wireless or mobile devices (i.e. mobile phones, handheld devices), as opposed to fixed telemedicine platforms traditional.

Travelers who develop skin lesions, as well as physicians traveling to hospital / non-hospital areas, can benefit from this new development in teledermatology. To facilitate access to medical advice and allow individuals to play a more active role in maintaining their own state of health, mobile teledermatology is particularly suitable for the screening or treatment of patients (i.e. the reference depending on the severity and role of their skin condition).

Another handy app for tracking people with chronic skin conditions. However, currently available studies show a high rate of missing skin cancers, including melanoma, and there is no strong enough data to recommend this diagnostic method.

A practical guide for teledermatology

The first guidelines were issued by the American Telemedicine Association in 2007 and were then updated in 2016 to reflect new knowledge and new technologies. Guidelines have been developed to standardize the practice of telemedicine, guarantee the quality of the service and the appropriate care by physicians.

Each guideline panel was supervised by experts from a specific field of study. The development process is based on professional consensus and rigorous review. Guidelines have been developed for individual providers, group and specialty practice, hospitals, and health care systems when providing services through information and communication technology.

The guidelines cover clinical practice, technical requirements, and administrative aspects of service delivery. The guidelines refer to three types of query commonly used in teledermatology: store and forward, real-time video conferencing, and the hybrid mentioned above.


Who Is A Dermatologist | Dermatologist

Who is a dermatologist?

A dermatologist is a doctor who specializes in conditions that involve the skin, hair, and nails. He can recognize and treat more than 3,000 conditions. These conditions include eczema, psoriasis, skin cancer, and many more.

The skin is an incredible organ. It’s your first line of defense against illness, and protects your other organs, warms and cools you, and sends messages about how healthy you are on the inside. Dermatology professional doctors and skin surgeons with unique skills and experience to provide the best care for the organ that cares for you.

Dermatologists have broad preparation, going to class for a long time or more to figure out how to analyze and treat more than 3,000 infections of the skin, hair, and nails just as corrective issues. Patients see the dermatology doctor for more problems than deep in the skin. Problems with their skin can harm patients’ sense of self-worth, and cause discomfort that can make daily activities difficult and, in some cases, life-threatening.

If you were to watch dermatology doctor at work any day, you might see them:

  • Treating a prominent birthmark that threatens the child’s eyesight
  • Removal of fatal maternal melanoma is in its earliest and most treatable stages
  • Provide the student with relief that makes chronic eczema nearly impossible to sleep
  • Diagnosing the life-threatening liver condition that causes unbearable itchy liver
  • Treating girl’s hair loss, helping her gain the confidence to complete her job search

Gaining the experience of providing this level of care takes many years of study. Get familiar with dermatologists and the groundbreaking consideration they give to patients.

When to see a dermatologist?

If skin, hair, or nail symptoms do not respond to home treatment, it may be time to seek professional care. If the concerns are cosmetic, then anyone can look for a specialist dermatologist.

People need to discuss any upcoming skin treatments with insurance providers, who often do not fund cosmetic procedures. Make sure to obtain copies of any medical reports, advisory notes, and diagnostic test results to confirm to the insurance company the medical need for treatment.

What do dermatologists do?

Dermatologists often perform specialized diagnostic procedures related to skin diseases. These doctors use treatments including:

  • Medications can be applied externally, injectables, and internally
  • Ultraviolet light therapy
  • A group of dermatological surgical procedures
  • Cosmetic procedures such as chemical peels, sclerotherapy (used in conditions such as varicose veins), and microdermabrasion (a skin peeling procedure)

Dermatologists may have preparation and involvement with zones, for example, electrosurgery (the careful utilization of a high-recurrence electric flow to cut or devastate tissue), cryosurgery (which includes freezing tissue), laser medical procedure, and excision surgery (which involves removal by cutting) with appropriate closure. (Including skin grafts).

Training of dermatologists

After earning a medical degree and completing an internship, a dermatologist receives another three years of specialist training and then undergoes a comprehensive examination. Many dermatologists have general practices and see patients with all kinds of skin problems.

Some dermatologists gain additional training and experience in specific areas of skin diseases, such as pediatrics, surgery, or cosmetology, and continue to practice specialized practices in these areas. With this background and knowledge, dermatologists are dedicated and qualified to diagnose and treat a wide range of diseases of the skin, hair, and nails.

What does a skin specialist treat?

The range of patients seen by dermatologists is wide, from cradle to grave. There are over 2000 described dermatoses but about 20 of them account for 90% of the workload. Inflammatory skin diseases such as eczema and psoriasis are common and without treatment lead to significant disability. Severe acne in teens is also a common reason for referral.

In the past few years, skin cancer has assumed an approximate epidemiological ratio in the population, at least in part due to the ease with which holidays abroad are available and the (false) belief that dark skin is healthy skin. Dermatologists are at the center of both skin cancer research and treatment, and this now accounts for up to 40% of the workload. Many dermatologists now spend a large portion of their time in surgery to remove tumors.

What is the workplace of a skin specialist like?

Due to the increasing rate of diseases related to the skin in recent years, dermatological treatments have revolutionized new medicines, laser therapy, phototherapy, and ultraviolet light therapy. Despite this, dermatologists are still in high demand and their work environment can be very busy. In the hospital, they provide general consultations and treating patients with various skin diseases.

Dermatologists may decide to work in a private clinic or general hospital. They may also provide training for general medical practitioners, teach at a university, or conduct clinical trials in a research laboratory. Dermatologists can decide to lead campaigns targeting the community and even offer their services to spas and other cosmetic treatment establishments.