Chronic Lymphocytic Leukemia: Causes, Symptoms, treatments and Medications

Recent stats suggest that out of the total number of Leukemia cases, Chronic Lymphocytic Leukemia or CLL will account for a quarter of it. Most people with this condition live up to 10-20 years after getting diagnosed and getting proper treatment. However, there are some cases where disease progression is rapid, and the patients live only up to a few years. 

Causes of CLL: 

It usually starts due to a certain genetic mutation in the blood-producing cells that leads to the production of ineffective and abnormal lymphocytes. Unlike normal lymphocytes, they don’t die. Instead, they continue multiplying and starts accumulating in the blood and specific organs gradually, which causes complication. The process also interferes with the healthy cells in the bone marrow, and as a result, the production of normal blood cells gets affected. 

The risk factors may include exposure to certain chemicals like herbicides and insecticides. Having a family history of blood or bone marrow cancer may increase your chances too. 

Symptoms

• Swollen glands in the armpits, neck, and groin
• Unusual bruising and bleeding often
• Night sweats
• Shortness of breath and pale skin
• Anaemia 
• Unusual weight loss

These are some of the recognizable symptoms. If you face any of these, it is recommended to contact your healthcare professional and get a checkup done. 

Relation between Chronic Lymphocytic Leukemia and Myeloma 

Both the conditions—Multiple Myeloma and CLL consist of overlapping epidemiologic features. Even though they are seen to be originating from the mature B cells, the chances of these two cases coinciding are quite rare. In Multiple Myeloma, the plasma cells are affected, whereas, in CLL, the lymph nodes, liver and spleen are affected, which ultimately causes the bone marrow to stop functioning. 

Although both CLL and Myeloma are blood cancers, the latter is formed in the bone marrow and responsible for the subset of WBC to form a distinctive protein that causes cancer to grow and spread. They have parallel as well as divergent features. 

The common features include stage-dependent anaemia and immunodeficiency. Not only that, but both diseases respond to alkylating agents. 

Treatment of Chronic Lymphocytic Leukemia 

Although there are different options available, one must also have to keep in mind that there are side effects of each one of them. The upsides and downsides are measured with respect to various medical tests conducted, and then the doctor prescribes which way to go.

1. Radiation Therapy 

If the condition has been diagnosed in a localized stage and the only thing to deal with is an enlarged spleen or swollen lymph nodes, you can opt for low-dose radiation therapy. This treatment of Leukemia is safe and shows much lesser side effects. 

2. Surgery

Also referred to as Splenectomy, one may go with this option to remove the enlarged spleen. However, this is not advisable for an advanced stage condition. 

3. Stem Cell Transplant 

If it is a high-risk condition, stem cell transplant could be considered as an option for early treatment. 

4. Drug Therapy: Chemo and Targeted 

Chemotherapy and targeted therapy are two of the most commonly approached treatment options. The drugs can either be prescribed alone or in combination with other medications to yield the best results. Mention may be made of the following drugs in this respect:

Ibrutinib: It is classified as a Bruton’s Tyrosine Kinase that can inhibit the B-cell lymphoma 2 protein. It is prescribed alone or in combination with Rituximab. The typical dosage for this condition is 420mg per day, i.e., three Ibrutinib 140 mg tablets per day. However, it may be decreased depending upon the extent of the condition and response from the body. 

Alemtuzumab: It has been approved as both first-line and second-line treatment for Chronic Lymphocytic Leukemia. The drug is administered into the body as an injection in the vein. Doctors can prescribe it alone or with Rituximab. This targeted cancer drug can be classified as a monoclonal antibody. 

Venetoclax: It is a B-cell Lymphoma-2 oral inhibitor that is prescribed as a targeted drug alone or in combination with Obinutuzumab and Rituximab. High-risk older patients may also benefit from the combination of Venetoclax and Ibrutinib. The starting dose is 20mg daily for a week, which then ramps up to Venetoclax 100 mg to 400mg per day. The average treatment time is 24 months. 

Obinutuzumab: This is an antineoplastic cytotoxic drug that acts as an anti CD20 monoclonal antibody. It is a chemotherapy drug that is given to the patient as an intravenous infusion through a dedicated line. The B cells have CD20 proteins with which the drug binds to destroy them by engaging the adaptive immune system. 

These are some of the medications that have shown to slow down disease progression in CLL patients and helped to increase the survival rate over the years. Even though there are side effects to this, they are not consistent and easily manageable. 

Conclusion 

Typically, out of 10, 7 patients suffering from CLL have a survival rate of 5 years or more after getting diagnosed. The length of survival time also depends on your overall health condition, medical history and the extent of the disease. If the diagnosed patient has been in a healthy condition for most of their lives, the chances of survival are more for them. The treatment options do not guarantee a surefire cure; they are only for managing the condition and treating the symptoms so that they don’t get worse over time.  

Read:-  Venetoclax for Chronic Lymphocytic Leukemia

Brain Metastases- All you need to know about

What is Brain Metastases: 

As any cancerous tumor grows, cancer cells can break away and be carried to the other organs of the body by the blood or lymphatic system. This is known as metastasis, or metastases when there are so many areas of spread. The metastatic brain tumors basically are the most common brain tumors. 

Although brain metastases may begin due to any kind of cancer, the types that most commonly spread to the brain are as lung, breast and kidney cancers as well as melanoma.

When any new tumor starts spreading to the brain, it isn’t addressed as brain cancer. Rather, it’s named after the area in the body where cancer started. For instance, when lung cancer spreads to the brain is known as metastatic lung cancer.

Symptoms of brain metastases: 

If cancer spreads to the brain may compress the brain and can be responsible for causing swelling inside the skull which leads to the headaches.

Brain metastases may also interrupt the electrical activity of the brain, causing numbness, seizures, tingling or speech problems. When a tumor interrupts the signals from the brain to the muscles, it may result in coordination problems.

Some other reported symptoms areas: personality changes, vomiting, rapid emotional changes, weakness and vision changes. 

What are causes: Brain metastases basically occur when the cancerous cells travel through the bloodstream or the lymph system from the original tumor and spread to the brain. There they may start to multiply. Metastatic cancer spreads from its original location is known as primary cancer. 

There are many theories about what causes some cancers in order to spread and why a few cancers travel to the brain. Brain metastases due to the lung cancer are often detected initial period of the disease, and those due to breast cancer develop late.

What are the risk factors: Any kind of cancer may spread to the brain, but having one of the following types of cancer may put you more likely at the increased risk of brain metastases:

• Lung cancer
• Colon cancer
• Breast cancer
• Kidney cancer
• Melanoma

How are brain metastases detected?

Brain metastases can be detected when the primary cancer is diagnosed. Or, if any patient has symptoms, a healthcare provider may recommend specific tests which basically depends on the symptoms. In order to detect brain metastases, tests may include:

• Computed Tomography (CT)
• Magnetic Resonance Imaging (MRI) Scans 

Brain Metastases Treatment Options: 

Metastases breast cancer treatment options for patients with the breast cancer brain metastases as: surgical resection, whole-brain radiation therapy (WBRT), stereotactic radiosurgery (SRS), chemotherapy and targeted therapy. 

1. Surgery: Surgery can be considered as the first treatment for the metastatic brain tumors is tumor removal, or resection. A neurosurgeon: a surgeon who is specially trained in order to operate on the brain and spine will determine if the tumors can be surgically removed by observing patients health as well as status of the disease. 

Some factors which may support surgery including a single tumor larger than the 3 cm, location outside of the speech or motor surrounding areas of the brain, and limited or somewhat stable disease in other organs of the body. Symptomatic tumors can be more likely removed by the surgery. 

2. Chemotherapy: New research indicates that it may be an effective treatment modality for some patients. The use of chemotherapy basically depends on the status of the systemic disease, size of the tumor, primary site and number in the brain, existing medication, and previous history of the chemotherapy treatment, if any. 

• Recent studies demonstrate that a few tumors can be sensitive to drug therapy. SCLC, breast cancer, lymphoma and germ-cell tumors are among these tumors. Some new targeted agents for the metastatic breast cancer (lapatinib 250 mg together with the capecitabine 500 mg), non-small cell lung cancer (EGFR inhibitors, ALK inhibitors) and melanoma (Mek and BRAF inhibitors) are useful for the brain metastases from these particular cancers.
• The emerging existence evidence of the immunotherapy (ipilimumab, pembrolizumab, nivolumab) in patients with brain metastases from the NSCLC and melanoma.
• Intra-CSF chemotherapy (drugs placed within the brain or spine water compartment) may be used for leptomeningeal metastases cancerous cells that metastasize to the covering layers of the brain and spinal cord. 

Chemotherapy breast cancer medication can be combined with other therapies such as radiation. Some tumors that are sensitive to chemotherapy in other parts of the body may become resistant to the chemotherapy once in the brain.

3. Radiation Therapy: Radiation therapy can be used to treat single or multiple brain metastases. It can be used in order to treat a metastatic brain tumor, in order to help prevent the brain metastases in those people who are newly diagnosed with the small-cell lung cancer or acute lymphoblastic leukemia. 

A few types of cancer are quite responsive to the radiation than others. Small-cell lung tumor and germ-cell tumors are highly sensitive to radiation, other types of lung cancer and breast cancers are moderately sensitive, and melanoma and renal-cell carcinoma are less sensitive. 

Medication: High-dose corticosteroids can be used in order to ease the swelling around the tumors and decrease the neurological symptoms. Medications like paclitaxel 100 mg and gefitinib 250 mg also can be recommended for metastases brain tumor. 

Types of Breast Cancer

There are several types of breast cancer. All the breast cancers specifically developed in the breast, so somehow they are alike but can differ in others.

A pathologist studies the tissue removed during a biopsy to learn many things about breast cancer that affect the prognosis (chances of the survival) as well as treatment. A few of these are listed as follows.

Breast cancers mainly can be non-invasive or invasive.

NON-INVASIVE BREAST CANCER:

Non-invasive cancers mainly exist within the milk ducts or lobules in the breast. Non-invasive do not grow into or invade normal tissues within or beyond the breast. Non-invasive cancers often known as the carcinoma in situ (“in the same place”) or pre-cancers. Invasive cancers basically do grow into normal and healthy tissues. 

Ductal carcinoma in situ (DCIS): DCIS is mainly a non-invasive breast cancer (also known as stage 0). With ductal carcinoma in situ, the abnormal cells are presented in the milk ducts of the breast (the tubes that help in order to carry the breast milk to the nipple) and have not spread beyond or into the surrounding breast tissue.

INVASIVE BREAST CANCER: 

These types of breast cancers mainly spread from the original site either the milk ducts or the lobules into the surrounding breast tissue. It can spread to the lymph nodes. The several invasive breast cancer are given as:

1. Lobular carcinoma in situ (LCIS): 

It is basically an overgrowth of the cells that exist inside the lobule. Instead of a true cancer; it is a warning sign of an increased risk for developing invasive cancer in the future in either breast.

2. Invasive ductal carcinoma:

This is also called infiltrating ductal carcinoma, is the most common invasive breast cancer (approximately 50-75 % of all breast cancers). Invasive ductal carcinoma begins in the milk ducts of females breast.

3. Invasive lobular carcinoma: 

Invasive lobular carcinoma is basically the second most common breast cancer (approximately 5-15 % of all the breast cancers). It developed in the lobules of the female breast.

Tubular, colloid and papillary carcinoma and carcinomas with the medullary features are often less common invasive breast cancers.

Special Forms of Invasive Breast Cancer:

1. IBC or Inflammatory Breast Cancer: IBC is a rare as well as aggressive breast cancer. About 1-5 % of all the breast cancers are IBC. 

The main symptoms are as: redness and swelling of the breast, puckering or dimpling of the breast skin and pulling in of the nipple. These symptoms tend to occur very rapidly, over a few weeks or months. Discuss with your healthcare professional if you experience any of the following:

• Swelling of the breast
• Enlargement of the breast. 
• A lump (less common with the IBC than with other breast cancers). 
• Redness of the breast
• Dimpling/puckering of the breast skin 
• Pulling in of the nipple. 
• Breast pain. 

A few symptoms of IBC may be mistaken for a breast infection. It is basically diagnosed after the symptoms which do not improve with the help of antibiotics. If you experience these symptoms and they're longer than the week on antibiotics, tell your physician. Don’t be afraid in order to get a second opinion.

2. Paget disease of the breast: Paget disease is rare cancer in the skin of the nipple or in the skin around the nipple. 

Approximately 1-3 % of the breast cancers are Paget disease of the breast. It usually exists with DCIS or invasive breast cancer. 

Symptoms can be as follows: burning, redness or scaling of the skin on the nipple or areola; a bloody or yellowish discharge from the nipple; and, itching a flattened nipple. Talk to your healthcare professional if you experience any of these symptoms.

3. Phyllodes Tumors of the Breast: Phyllodes tumors are mainly rarest breast tumors that developed in the connective tissue of the breast (stroma) and can grow rapidly in a leaflike pattern. A few of are cancerous, but most are absolutely not.

4. Recurrent or Metastatic Breast Cancer: A returned breast cancer after previous treatment or has spread beyond the breast to other organs of the body is known as recurrent or metastatic breast cancer. 

Bevacizumab together with the paclitaxel (paclitaxel injection) or capecitabine is approved for the first-line treatment of metastatic breast cancer. 

Hormone receptor status: 

All the invasive breast cancers, as well as DCIS, are tested for the hormone (estrogen and progesterone) receptors. 

Hormone receptor-positive (estrogen and progesterone receptor-positive) tumours have many hormone receptors. The treatment of breast cancers can be possible with the help of hormone therapy such as tamoxifen and aromatase inhibitors. Most invasive breast cancers are the hormone receptor-positive.

HER2 status: 

All invasive breast cancers are basically tested for the HER2 protein. 

HER2-positive breast cancers have immense HER2 protein. These breast cancers can be treated with the help of anti-HER2 targeted therapy drugs such as trastuzumab 440mg.

Approximately 10-15 % of the newly diagnosed breast cancers are known as the HER2-positive.

As a second-line treatment, some patients may trastuzumab together with the lapatinib 250 mg. Further treatment may include the combinations of trastuzumab with the other chemotherapy drugs, or together with the lapatinib and capecitabine 500 mg.

Other targeted therapies CDK4/6 inhibitors (palbociclib 125 mg, ribociclib 200 mg and abemaciclib) are also an option for treating the ER positive advanced breast cancer together with an aromatase inhibitor or fulvestrant.

Everolimus tablets together with the exemestane, tamoxifen or fulvestrant is a treatment option for some postmenopausal patients with the ER positive advanced breast cancer which has the progressed after the treatment with a non-steroidal aromatase inhibitor.

Read:- What is Triple Negative Breast cancer

Detailed discussion on Lapatinib

Patients with HER2 positive type metastatic breast cancer and lung cancer with somatic mutations in EGFR are prescribed Lapatinib or Tykerb. It is an ERBB2 and EGFR tyrosine kinase inhibitor that can bind with the proteins to stop their actions on the cancer cells. It can be given alone or in combination with other chemotherapy drugs and hormone therapies. 

The benefits of Lapatinib

It has been classified as a signal transduction inhibitor that can target the cancer cell-stimulating proteins like HER2 and EGFR, which are found in huge numbers on them. That successfully interferes with the process of cell division and the growth of cancer cells inside the body. Lapatinib is both preferred as a first therapy and is also effective in patients who have undergone prior chemotherapy. 

Lapatinib—dosage and precautionary measures

It needs to be consumed in tablet form one hour before or after having food in the exact dose, which has been recommended by the doctor. The typical dose is Lapatinib 250 mg per day. However, your physician can modify it based on your medical history, the extent of the disease, and response from the body. It is also essential to take the Lapatinib tablet at the same time every day. Make sure to swallow the tablet whole and not divide the doses. 

Precautionary measures to take while taking Lapatinib

1. It is mandatory to inform your doctor about the medications that you’ve been taking at present, while (before) starting Lapatinib. It includes even vitamin supplements and herbal remedies. This is because the drug may interact with the constituents of the medicines, and the treatment procedure can be severely affected.
2. Make sure to consult your doctor before getting any immunization shots while the drug therapy is going on. 
3. Lapatinib may cause a potential hazard to the fetus of a pregnant woman. The ingredients of the drug can cause harm to the baby while breastfeeding as well. Therefore, it is safe to wait for a week after the treatment has been stopped before resuming breastfeeding. 
4. Use contraceptives during the course of the therapy to avoid getting pregnant. 
5. The patient must avoid grapefruit products strictly while taking Tykerb 250 mg. 
6. Keep alcoholic beverages to a minimum or try to avoid it altogether during this time. 

Lapatinib Side Effects

• Diarrhea
• A decrease in the count of red blood cells or anemia 
• Elevated liver enzymes like increase in bilirubin, AST and ALT levels
• Nausea and vomiting 
• Dizziness 
• QT prolongation (abnormal heart rhythm that causes fainting)
• Hand-foot syndrome or the Palmar-plantar erythrodysesthesia which leads to skin conditions like rash, swelling, pain, and peeling of skin on palms and soles of feet

These are the commonly occurred side effects of Lapatinib 250mg. However, the effects are tolerable as these are inconsistent side effects that don’t cause much hassle. In some cases, your doctor will prescribe medications to handle some side effects like nausea and diarrhea. Make sure to drink plenty of fluids during this time because Lapatinib has a high chance of causing dehydration. Furthermore, if you have a fever of 100.4 degrees F or higher immediately consult your doctor. 

Conclusion 

Store the medicine at a safe room temperature of 15 degrees to 30 degrees Celsius. Before prescribing, your doctor will conduct medical exams to determine whether the patient is suitable for this EGFR and HER2 inhibitor, i.e., whether the tumor has a specific genetic mutation that can be affected by this targeted drug therapy. Other than that, frequent testing will also be done to check the progression of the disease. Lapatinib price is quite high- $8730 per dosage. Therefore, it is important to have all the medical insurance papers to cover the cost. 

FAQ's

Is Lapatinib a chemotherapy medicine?

No, Lapatinib is a targeted medicine, belonging to a class of anti-cancer. This class of drugs are more specific than the chemotherapy in their mechanisms of action.

Can Lapatinib be given together with the other anti-cancer drug?

Yes, Lapatinib can be used together with other anti-cancer drugs.

• It is used together with capecitabine in order to treat advanced breast cancer in patients who've already taken treatment with chemotherapy.
• It is also used together with letrozole in order to treat breast cancer in post-menopausal women.

How Lapatinib Tablets should be taken?

Lapatinib tablets should be taken exactly as your doctor instructed. Swallow a lapatinib 250 mg tablet whole through a glass of water, at the same time each day. It is advised to take it 1-hour prior to or 1-hour following meals. 

Does Lapatinib have any effect on the liver?

Lapatinib may be responsible for causing liver damage which could be severe or life threatening. The liver damage may occur as soon as several days or as late as several months following the initiation of treatment with lapatinib. Inform your healthcare team in case you've or had liver disease. 

How long after Lapatinib treatment can I plan pregnancy?

It is recommended to use an effective method of contraception in order to avoid pregnancy while on lapatinib treatment and continue for at least 1-week following the last dose. Inform your healthcare practitioner in case you become pregnant. 

How can I manage diarrhea while on Lapatinib?

In case you suffer from diarrhoea while on Lapatinib, certain things needs to be followed:

• Drink plenty of fluids (8-10 glasses in a day) such as sports drinks, water or other clear liquids.
• Eat low-fat, high protein foods rather than fatty/spicy foods.
• Eat cooked vegetables rather than raw vegetables. 
• Remove the skin from fruits prior to eating. 
• Try to avoid milk and milk products (including ice cream) and herbal supplements (some may be responsible for causing diarrhoea).
• Inform your healthcare practitioner, in case diarrhoea is persistent.

NOTE: The piece of information mentioned about "Detailed discussion on Lapatinib" in this article is just for the informational purposes and is not served as a substitute for medical treatment, consultation, diagnosis of a qualified doctor.

Read:- Breast cancer- can it impact pregnancy journey?

About EGFR and Targeted Cancer Therapy

Well-known as HER1, EGFR, or epidermal growth factor receptor is commonly found on the surfaces of both normal and cancer cells. It has a vital role in contributing to the division and growth of cells in the body. As the molecules bind to it, chemical messages from outside of the cell are received by the EGFR. There are 7 ligands or molecules, and when any one of them activates the EGFR, a signal is sent to the protein for the process of cell division. It must be noted that cancer drugs highly target EGFR during therapy. 

EGFR has changed the entire aspect of non-small cell lung cancer treatment. How? In simple words, it can be stated that certain mutations within the EGFR has the capability of making the tumor extremely sensitive to kinase inhibitors. Research has revealed that approximately one-third of patients who have been diagnosed with NSCLC have the EGFR mutation. 

Targeted Therapy for Cancer and EGFR

It is a known fact that cancer cells divide rapidly and spreads within the body. Usually, the most prevalent forms of cancer therapies are chemotherapy and radiation that can destroy these cells. However, the only problem is that, like cancer cells, some of the normal cells also tend to divide rapidly. That is why these approaches to treatments have several side effects.

That is where the targeted drug therapies for cancer can be discussed broadly. Usually, the drugs aim to identify the cancer cells and differentiate them from the normal ones by targeting the abnormalities in the former. Although this therapy can have side effects, they are much lesser compared to that of the others. 

As mentioned previously, EGFR receptors are also present in normal cells. However, a certain mutation to the EGFR gene can result in innumerable receptors on the surface of particular cells, which leads to rapid growth, thus causing cancer. Now, targeted drugs block the EGFR receptors in places where they appear in most significant numbers or clusters. While doing this, a certain amount of normal skin cells can be affected as well because they also consist of a huge number of EGFR receptors. Therefore, skin rashes are some of the most common side effects during the course of this therapy. 

There are two ways by which targeted drug therapies work in order to block the EGFR. The ligand can be prevented from binding with the EGFR from outside the cell, while on the inside; the signal from EGFR can be prevented from reaching the proteins that cause abnormal growth. 

Important drugs that are used to conduct targeted therapy 

Cetuximab and Panitumumab are such drugs that help to block the part of EGFR outside the cell, which in turn won’t let the EGFR signal other proteins inside the cells. Similarly, targeted drugs like Erlotinib, Gefitinib, and Afatinib are given to block the EGFR inside the cell that can ultimately restrict tumor growth. 

Conclusion 

Researchers have also claimed that the next-generation EGFR targeted therapies have very few side effects. Thus, they can be tolerated easily by the patients. Apart from this, this mutation is also found in other types of cancer like breast cancer, medullary thyroid cancer, pancreatic cancer, squamous cell carcinoma, and so on. 

All about Prostatectomy

Although Prostate cancer is the second most leading cause of death due to cancer in men, the advancement of medical science has presented several types of treatments that have brought about a significant improvement in the survival rate. Surgery is the most common approach to treating this condition, where the prostate is removed entirely or partially. This process is better known as prostatectomy.

What is a prostatectomy? 

The term is used to describe the surgical procedure that removes the prostate gland, partially or completely. Typically, it involves a small surgical incision to accomplish it. There are two methods to do this: retropubic incision in the lower abdomen and a perineum incision done through the skin between the scrotum and the rectum. However, the approach will be determined depending upon your condition. 

Prostatectomy is a highly favored approach for the treatment of localized prostate cancer. Sometimes, it can also take place after radiation or hormone therapy. There are different options for this approach, such as radical prostatectomy, laparoscopic radical prostatectomy, and robot-assisted radical prostatectomy. 

Different types of radical prostatectomy 

Men who have been diagnosed with localized prostate cancer can opt for radical prostatectomy, which is used to surgically eradicate the entire gland and surrounding lymph nodes or a part of it. 

The several approaches to radical prostatectomy are-

Retropubic approach- This is the most commonly favored approach to conduct prostate cancer surgery. It is even effective if cancer has spread beyond the gland to the lymph nodes because the doctor can remove them easily by this procedure. However, if cancer has spread to other parts other than the lymph nodes, this form of surgery may not be sufficient to treat the condition. An incision is made in the abdomen to remove the prostate gland that is connected to the blood vessels. It is quite less invasive compared to the other types and ensures the recovery of the patient within a shorter time. 

Nerve Spring Prostatectomy- In highly complicated cases, cancer may get spread to the nerves that make it difficult for the surgeon to maintain the original structure or the proper functioning of the nerves. In fact, the nerves may be removed to get rid of cancer. However, if the nerve is cut from both sides, there is a high chance that the patient may face erectile dysfunction, which would not be getting better over time. Therefore, the most suitable approach is to cut and eliminate only one side of the nerve, if the situation permits that would let the patient have minor erectile functions left. In this way, the excellent network of blood vessels along the prostate gland will also be protected.  

Laparoscopic- Here, different small cuts are made, inside which thin tools are placed. A thin tube with a video camera is passed through a cut while several instruments are passed through others, which offer a clear vision to the doctor while performing the surgery. 

Robot-assisted procedure- This is nothing but laparoscopic surgery with the help of a robotic system. A robotic arm is controlled by the surgeon from a computer. Special sets of equipment are required to perform this surgery. 

Perineal approach- This procedure is favored not quite often due to the complications. However, if the nerve-sparing approach isn’t applicable in a certain condition, this can be helpful. It takes relatively less time, and the pain is also quite lesser compared to the other procedures. 

Reasons for getting a radical prostatectomy 

1. Treatment of localized prostate cancer
2. Recurring prostate bleeding 
3. Bladder stones 
4. Treating hydronephrosis 
5. Inability to empty bladder 

Risks factors

• Urinary incontinence
• Urine leakage
• Permanent erectile dysfunction 
• Sterility 
• Lymphedema

You are required to do the following before the surgery takes place-

• Fast for 8 hours
• Inform the doctor whether you are allergic to any anesthetic agents and latex, iodine, tape, etc.
• Inform the surgeon if you’re on any anti-coagulant medications
• Stop smoking 
• Remove any piece of jewellery from the body
• Empty your bladder completely 

Conclusion

Usually, regional anesthesia is preferred in this process. You are required to stay in the hospital for a couple of days after the surgery is over. Your diet will be monitored strictly, and you will gradually advance towards a solid food diet from liquid one. 

Read:- List of prostate cancer medications

List of Services offered by Ikris Pharma Network

Incepted in 2014, Ikris Pharma is an internationally acclaimed pharmaceutical wholesaler offering a gamut of services primarily in the field of medications. Envisioning the ideology to bridge international boundaries for patients, Ikris Pharma’s unswerving efforts are to provide compliant and ethical access to rare medications. Poised to achieve a customer-centric approach, the firm aids people in accessing the world’s most advanced treatments. It offers a plethora of life-saving medications from the common ones to the ones used for treating rare ailments.

Besides, the organization further supplies advanced medications to clinics, hospitals, and pharma companies. Over the past 6 years, Ikris Pharma has built an efficient network successfully and is the only company to have pan India presence. Headquartered in Noida and office set up in Belgium, Ikris Pharma has made some exclusive tie-ups with global organizations like Orphan Europe, Biomarin, and PTC therapeutic that grant them access to their medications.

The major services offered by Ikris Pharma Network

1. Name Patient Service

Utilizing their resources and infrastructural facilities, Ikris Pharma makes sure that doctors and patients can get access to drugs that have not gained approval from the health authorities of the particular country for marketing, as of yet. The sole purpose is to help the patients who have run out of all the alternative treatment options and are not even eligible for clinical trials. These drugs are specifically for dealing with uncommon diseases that do not have a steady supply in the market. 

In fact, to help the patients access the “Orphan drugs” or “Unlicensed drugs,” governments of different countries have created several provisions. Needless to say, that Ikris Pharma will approve the patient’s or doctor’s request for these drugs upon verifying the prescriptions provided. After that, they will try to identify the most appropriate source of the required medications. For the legal importation of these types of medicines, they have established reliable networks in other countries as well. So far, Ikris Pharma has managed to assist more than 2500 patients regarding the Name patient services by offering the best deals on customized cold chain products. 

2. Global Sourcing

Ikris Pharma Network has had a steady reputation in the market for the supply of safe and high-quality products. The worldwide network of reliable sources and trusted partners is mention-worthy here. They have engaged with authorized suppliers and manufacturers who not only take the good manufacturing practices seriously but also register GDP within the frame of their business management system. The validated suppliers across Europe, USA, Australia, Canada, and Japan guarantee the quality and safety of the products. 

All the drugs supplied by Ikris Pharma are steadily approved for marketing. The team members put in all the effort to source specialty medicines from across the world that meet the requirements of the consumers as well as the high standards set by the global pharmaceutical world. The high-authority and authentic sources are what Ikris Pharma is known for in the market. Together with the international and local suppliers, they strive to deliver the best for the welfare of the patients. 

 3. Access to medicines 

Be it generic medicine, branded medicines, or generic branded drugs, Ikris Pharma Network has access to all. Needless to say, that owing to the tie-ups with reputed manufacturers and suppliers; they can fill up the shortage of products at any time. Therefore, the regular demands of customers, physicians, and hospitals are met with the utmost consistency. This is what has set Ikris Pharma apart from its competitors and given them the position of a highly reliable pharmaceutical wholesaler in India. 

Their partnerships have also paved the way for Ikris Pharma to acquire a wide range of drugs for treating age-old to recently discovered diseases. The aim is to help people avail the most advanced treatment options to survive even the deadliest of conditions. For instance, certain branded and generic drugs are not yet approved in the markets of many countries but used in the USA and Europe abundantly. Through the Managed Access Program of Ikris Pharma, they can easily provide you with those medications at the most competitive market rates. 

4. International Compliance

As mentioned previously, Ikris Pharma is an internationally recognized brand. Being one of the most reputed exporters of US/EMEA and other such FDA approved generic, branded, and generic-branded drugs. Just like their global network of suppliers. It is safe to say that Ikris Pharma strives to serve as a connection between customers and their requirements of all types of medications by bridging the geographical gaps efficiently. 

Their objective lies in helping the customers get the best deals on the best quality products. The on-time delivery services at economical rates also deserve special mention in this respect that has not only helped a number of patients across the world but also ensured convenience for all. At present, Ikris Pharma Network caters to clients in all the major continents like Europe, North America, Australia, Asia, and so on. Last but not least, the workforce ensures a smooth experience for the customers and can provide proper assistance to them round the clock. 

 5. Distribution/Wholesale Supply

The procurement, storage, and distributional operations carried by Ikris Pharma are in accordance with the national guidelines. All the services provided by them are legally compliant so that a certain degree of transparency is maintained with the clients. This would certainly ensure the company to build a trustworthy relationship with them.

All the obtained medical products are stored in a safe place, which is accessed by only authorized staff members of the company. They are distributed to licensed wholesalers, pharmacies, and clinics. In case the client is an individual and not an organization, such as a patient or a physician, Ikris Pharma requires valid prescriptions to supply their products. 

Not only that, but quality-control is another significant factor that is taken quite seriously by Ikris Pharma. They also take strict measures to discard the expired products so that there is a minimal manual error. In fact, the drugs are handled with caution so that their quality is met with the high standards delivered by Ikris Pharma for years and as expected by the client.

6. RLD Supply/ Comparator Sourcing from India

Ikris Pharma is a one-stop solution for research, CRO, and licensed pharmaceutical companies that need access to medicines that have not yet been approved by the governments of their respective countries. It must be stated that the vast experience that the company has gained from the industry in all these years has been put to use. Mention may also be made of their international network of partners consisting of authorized wholesale suppliers and reliable manufacturers who have helped Ikris Pharma expand their arena of services in the current market. It is because of the authentic sources that the company is able to procure Reference listed drugs or branded innovator samples and supplies them on time. 

The prime USP that made Ikris Pharma a distinctive name in the pharmaceutical world is their specialty in obtaining RLD or Innovator Samples from different sources that are usually rare in the market and not quite easily available from most renowned names in the industry. It must also be pointed out that Ikris understands the importance of optimum temperature for the safety of drugs and takes all precautions to maintain that.

7. Contract Manufacturing/ Private Label Manufacturing

Ikris Pharma Network offers contract manufacturing services for nutraceutical and pharmaceutical products. Within a specific period of time, the company aims to manufacture and deliver the products to the clients. Taking care of the client requirements efficiently without missing the deadline and compromising quality is what lays the way for Ikris Pharma to become the best pharmaceutical wholesaler in the Indian market. 

The products that are manufactured and supplied will be under the private label of the company or the brand name. Ikris Pharma realizes the grave importance of these services and turns no stone on their approach to provide nothing but the best to the clients. They are engaged with the manufacturing and supplying of Ayurvedic and herbal products as well as generic medicines. 

What are the perks of selecting the Ikris Pharma Network?

Ikris Pharma, with its extensive global network of suppliers and manufacturers, always aims for excellence not only to maintain its streak in the market but also to guarantee only the best for the clients. They also offer round-the-clock assistance to doctors, wholesalers, and patients to enhance their experience and make sure that they get what they have been looking for. Exclusive products, FDA/EMEA, approved medications, and hard to access medications at the most economical rates—these are the reasons behind the growing success of Ikris Pharma in the market.