FAQs on Prevention of Cancer / Precautions of Cancer

Q- Can a tuberculous person ever have cancer

Ans- He can. The presence of tuberculosis or any other disease gives no assurance that cancer will not develop.

Q- Why don't the white corpuscles in the blood kill cancer

Ans- The chief function of white blood corpuscles is to protect the body against bacteria or germs. They kill germs and combat infection. Current research is being undertaken to promote such activity by certain kinds of white blood corpuscles.

Q- How can we control cancer

Ans- We can control cancer by following these conditions:

1.       By a prompt visit to a physician when suspicious signs or symptoms appear. Intelligent alertness by the individual may well save his life.

2.       By having complete, annual physical examinations, as a routine. Women over 35 should be examined once a year.

3.       By confirming diagnosis at the earliest possible moment, followed by adequate treatment.

4.       By a widespread knowledge, both layman and professional, of the character of cancer, its causes, methods of spread, and by recognising the value of early diagnosis and adequate treatment, as the means of protection.

Most important is prevention of cancer by change of lifestyles.

FAQs on Prevention of Cancer / Precautions of Cancer

Q- How can one guard against cancer

Ans- Prevention is better than cure. More than half of the cancers are preventable! Avoid smoking and tobacco chewing in any form. Alcohol should only be taken in moderation. It is better avoided. Take low fat, vegetarian diet. Avoid ill fitting dentures, Report to doctor immediately if you notice any of seven warning signals.

 Q- What is meant by a "precancerous lesion"

Ans- Any abnormal condition that if permitted to continue, may develop into cancer with passage of time. Cancer does not form in day's or week's time. It takes many years to develop. It passes through many stages normal cell __ abnormal cell __ Precancerous lesion __ Frank cancer -- Metastasic cancer.

 Q- What are some of the more important precancerous lesions

Ans- White spots on mucous (lining) membranes, especially of the mouth; non healing sores caused by jagged teeth and illfitting dental plates; dark colored moles which itch or bleed. These should all be investigated by a physician and adequately treated. Submucous fibrosis with inability to open mouth, polyps in large intestine Barret's oesophagus associated with reflux oesophagitis are some of the conditions which should alarm the patient and physician. These require careful monitoring.

 Q- What precautions should be taken to avoid cancer of the mouth

Ans- Cancer of mouth is a largely preventable disease. Avoid use of tobacco in any form (pan masala, gutkha etc.) Any sore in mouth which does not heal in three weeks time should be examined by doctor and if required biopsied. : Keep the mouth clean. Have jagged teeth filed or removed. Do not use an ill-fitting dental plate, which causes a sore on the gums or cheek. If white spots appear in the mouth or on the tongue, stop the use of tobacco and see a doctor.

 Q- What precautions should be taken to avoid cancer of the skin

Ans- Dark colored moles and warts, which become itchy or bleed or ulcerate should be removed. Fair-skinned people should avoid overexposure to direct sun rays. Recurrent blisters. on the lip should be carefully examined. Skin should always be kept clean.

 Q- Should all moles be removed

Ans- No. A flat colorless mole is probably as harmless as a freckle. Bluish-black hairless moles, especially when subjected to irritation, should be removed. Any mole or wart showing changes in size or color or bleeding should be promptly and completely removed and the tissue examined by a pathologist to determine if cancer is present.

 Q- Can immunity to cancer be acquired as with diptheria or typhoid fever

Ans- Production of immunity is possible only in diseases caused by germs. As cancer is not caused by germs, immunity cannot be developed against it. But scientists are exploring possibilities of vaccines for cancer.

 Q- Why do many people wait before consulting a physician when cancer may be present or suspected

Ans- Primarily because of fear. Ignorance of the signs of cancer and the vital importance of early treatment also play a role. Some people also think there is a social disgrace in having cancer and so hide the fact from their physicians and often from friends and relatives. This is not a justifiable attitude.

FAQs on Causes of Cancer / Cancer Causes

Q- Can one's mental condition influence the course of cancer?

Ans- Cancer is a disease of body cells. One's mental condition has no direct effect on the course of the disease since this malignant change is apparently due to physical process. But positive attitudes, fighting spirits and healthy thinking helps you to cope with cancer better. SO,it has an indirect bearing on response to cancer treatment.

Q- Does radiation cause cancer? Do Cell phones cause Cancer?

Ans- Indiscriminate use of X-rays frequently may increase your chances of getting cancer. Lately, there are certain reports quoting higher incidence of Leukaemia and Brain Tumours in persons using Cellphone. But this needs further research.

FAQs on Causes of Cancer

Q- Does the use of alcohol bear any relation to cancer?

Ans- Alcohol is a predisposing factor for the development of cancer of oesophagus, laryngopharynx and liver.

 Q- Is cancer hereditary?

Ans- There are probably inherited tendencies that may lead to cancers of different types. The presence of cancer in one or both parents should be a cause for greater alertness in looking for and recognizing suspicious symptoms in the individual. Cancer however is not inherited except for one type of eye cancer known as Retinoblastoma. Only 5% of breast cancers are considered hereditary.

 Q- Can cancer be transmitted by kissing or casual contact between person or between persons and animals?

Ans- No. There is no record of cancer having been transmitted by kissing or by any contact, accidental or otherwise, between individuals or between person and animals.

 Q- Do corns become cancerous?

Ans- Cancer may occur in any tissue to the body, but a corn does not as a rule develop into cancer.

 Q- Do freckles turn into cancer?

Ans- Simple freckles do not. However, flat moles containing pigment of a bluish-black colour and looking like dark freckles, may become cancerous and should be checked periodically.

 Q- Do piles turn into cancer?

Ans- No. Piles or hemorrhoids are merely enlarged veins in the rectal wall. Cancer is occasionally found in the tissue above the hemorrhoids. So "bleeding piles" should be examined carefully to determine whether cancer is also present. Rectal bleeding can occur due to cancer.

FAQs on Cause of Cancer

Q- What causes cancer?

Ans- Though it is very difficult to pinpoint the definite cause. Certain substances, known as carcinogens, can definitely increase your chances of getting cancer. For instance, people who smoke or chew tobacco are more prone to mouth, throat and lung cancer, Contrary to popular opinion, beedi smoking is twice as dangerous as cigarettes. Continued irritation of tissues can lead to cancer. Pollution, preserved food, smoked and junk food are also contributory. Even certain viruses can cause cancer (EBV, Hepatitis B, HPV). Among-st other known causes are asbestos, arsenic, pitch, tar, ultraviolet rays.

 Q- Is cancer caused by a germ?

Ans- There is no scientific evidence that cancer is directly caused by a germ. Although certain viruses are known to cause cancer but they form < 2% of the cancer burden.

 Q- Does cancer come form a single bruise?

Ans- No. A single injury to soft tissue or bone does not give rise to cancer.

 Q- What is the relation of food to cancer?

Ans- High fat, low roughage western diet predisposes to colon cancer. Diet rich in animal fats also contributes to breast cancer. Green leafy vegetables and fresh fruits contain certain antioxidants which prevent cancer. Recently tomato, ginger and cabbage etc. have been found to have medicinal antioxidant property. Avoid junk food, smoked food and preserved food. Be vegetarian and prevent cancer!

 Q- Will irregularity in eating cause cancer of the stomach?

Ans- There is no scientific evidence that it will, since cancer of stomach may occur in people who eat most regularly.

 Q- Does eating hot food cause cancer?

Ans- There is little evidence that the temperature of food is an important factor in development of cancer. But recently too hot food has been correlated with food pipe cancer. Too spicy food may be related to stomach cancer as is evident from its high incidence in Southern parts of India.

FAQs on Oncology / Cancer Treatment

Q- How can you tell if you have cancer?

Ans- There are 7 early warning signals. But the real tragedy about cancer is that it produces very minor symptoms at first. So you could have cancer and not know it. The best way to detect cancer is to have a regular yearly check-up.

 Q- How does a doctor tell if growth is cancerous?

Ans- By performing a biopsy or FNAC i.e. examining a small portion of the tissue under a microscope. In advanced cases, physical examination alone may reveal the diagnosis. But the chances of cure at late stage are very poor.

 Q- Are cancer and leprosy related?

Ans- No. Leprosy is caused by a germ. Both the symptoms and the treatment for the two diseases are entirely different.

 Q- Is cancer a modern disease?

Ans- As long ago as 3,000 BC., Egyptian historians made references to " tumours and ulcers". Mummies from the Gizeb Pyramids were found to have cancer involving the bones. But the incidence of cancer is increasing. It is related to 'our life styles and urbanisation i.e, tobacco, alcohol use, pollution, preserved and junk food etc. "It is becoming a disease of modernization.

 Q- Are some people more prone to certain types of cancer?

Ans- Yes. Your life-style may make you more prone to some cancers. e.g. cancers of the colon, lung and skin are common in Britain and U.S.A. Cancers involving the oral cavity are more common in India. In women, cancer of the breast, uterus and gall bladder are common.

 Q- What are your chances of getting cancer?

Ans- One out of every 8 Indians develop cancer in their lifetime. There are about 8.5 lakh cancer patients in India alone (Year, 2000). Though cancer can occur at any age, the incidence is high after the age of 40 to 45.

FAQs on Cancer / Oncology Treatment

Q-What is cancer?

Ans- Cancer is an abnormal growth of a body cell or group of cells. If it is not destroyed or removed, cancer can spread very rapidly, and eventually lead to death.

 Q-What is the difference between normal and cancerous growth?

Ans- There are billions of cells in the human body. Normally, they grow in a well-regulated pattern. When cancer sets in, a group of cells suddenly start multiplying haphazardly and form a lump or "tumour".

 Q- How many kinds of tumours are there?

Ans- There are two kinds of tumour - Malignant & Benign. A benign tumour is more common, and is generally harmless. It doesn't spread to other parts of body. A malignant tumour on the other hand, never stops growing unless until treated and can spread to other parts of the body. cancer is the name given to a malignant growth.

 Q- Is cancer contagious or infectious?

Ans- No. Since cancer is not caused by a germ, it is not "catching", and cannot be transmitted from one person to another.

 Q- Is cancer a blood disease?

Ans- No. cancer cells may move through the blood stream to another part of the body indicating spread of disease. Cancer can however develop in certain tissues, which form the blood cells.

 Q- How does cancer spread

Ans- In 3 ways.

1.       Cancer cells grow through the walls of blood vessels and are carried by the blood stream to other parts of the body.

2.       They enter the lymphatic stream and are carried to the lymph glands.

3.       They grow directly in contiguity from one tissue to another.

Q- How fast does cancer grow?

Ans- There is no definite rate of growth of cancer tissue. Some cancers grow fast and some are slow growing. For example it takes 2 to 5 years for breast cancer to develop to 1cm.

 Q- Is cancer a single disease?

Ans- No. The term "cancer" includes all forms of malignant growth. Very many varieties are known. These have certain characteristics in common, such as uncontrolled growth, a tendency to spread widely in the body and fatal termination if not treated early and adequately. They differ in certain characteristics, such as location in the body, microscopic appearance, and response to treatment.

FAQs on Obesity And Metabolic Surgery

Q- Is it suitable for patients of all ages?

Ans- Patients between 18 and 65 are considered most suitable for this type of surgery but this surgery may also be considered for younger or older patients depending on individual factors. Your surgeon will advise you appropriately.

Q- How long will I stay in Hospital?

Ans- Patients are admitted to hospital on the day of surgery or day prior to it and are usually discharged 48-72 hours later.

Q- Will I have lot of pain or nausea/vomiting after surgery?

Ans- Since this surgery is carried out laparoscopically/robotically in more than 99% of patients, it does not result in too much pain. You will be given appropriate pain-killers as needed. In the early period, patients experience some nausea/vomiting but that is easily controlled with medications.

Q- Can I eat normally after surgery?

Ans- Patients are allowed to drink water on the first day after surgery and liquid diet is started on the second day. For good healing, it is essential that patients stay on liquid/pureed diet for 4 weeks. After 4 weeks, consistency and texture of food is gradually increased and by 3 months, most patients are able to eat normal, healthy diet off a small plate.

Q- When can I resume normal activities after surgery?

Ans- Surgeons will ask you to be up and about as early as 4 hours after surgery. This reduces your risk of chest infection and clots in the legs. After that, patients gradually resume all normal activities within the limits of comfort. After a week, patients are able to manage most activities of daily living completely independently. Gentle exercises like walking, swimming, jogging etc. can be started after 2 weeks but strenuous exercises are best delayed for 3 months.

Q- Will I need to take vitamin/mineral supplements after surgery?

Ans- We screen patients pre-operatively and postoperatively for any deficiencies and supplement vitamins and minerals as and when necessary. Gastric bypass patients are typically recommended routine iron, calcium/vitamin D, and vitamin B12 supplements.

Q- Will I develop loose skin?

Ans- Significant weight loss will inevitably result in some loose skin. Extent of loose skin depends on the amount and distribution of fat in patient’s body and patient’s ability to exercise and tone up. Some patients will need further surgical procedure(s) to remove loose skin.

Q- How to get appointments?

Ans- You can get appointment through following methods:

1.       Phone:

·         During Office Hours:0091- 11- 29871280, 29871281

·         Outside Office Hours:011-26925801, 011-26925858

Email: assistance@apollohospitalsdelhi.com

FAQs on Obesity And Metabolic Surgery

Q- Is this surgery safe?

Ans- This type of surgery is being performed in western countries for more than five decades with exceptional safety. Your surgeon will also inform you about complications/side effects of your chosen surgical procedure. Risk of this surgery is similar to gall bladder surgery.

Q- Which operation is best for me?

Ans- There are a number of bariatric / metabolic procedures to choose from and no one procedure fits all patients. Our surgeons will recommend the most appropriate procedure for you. If you have a strong opinion regarding the best procedure for yourself, please discuss it with your surgeon. We also offer robotic surgery at our center.

Q- Do I need to lose some weight prior to surgery?

Ans- Weight loss immediately prior to surgery is known to improve surgical safety in some patients. Our surgeons will advise you appropriately. We also recommend a liver reducing diet for 10-14 days prior to surgery to improve safety of this surgery.

Q- I suffer with diabetes. Do I need this surgery?

Ans- Please refer to question no. 2. If your BMI is more than 35, you are a suitable candidate for this surgery. If your BMI is between 27.5 and 35, you will only be considered suitable for this surgery if you suffer with inadequately controlled diabetes (type 2 diabetes mellitus). Your physician or endocrinologist will be able to give you appropriate advice.

Q- How much weight will I lose?

Ans- Typically, patients lose approximately 75-85% of their excess weight within the first 12-18 months after surgery (with sleeve gastrectomy and gastric bypass) and maintain most of that in the long term. However, as can be expected, weight loss also depends on individuals’ ability to reform their eating behavior and lifestyle. It is extremely uncommon with current surgical procedures to lose “too much” weight.

Q- Is this surgery cost effective?

Ans- This surgery should be considered as an investment in your health and personality with manifold returns in future. It is widely recognized that this surgery pays back for itself in approximately 2 year time through reduced healthcare costs and gain in individual’s economic productivity. It is commonly described as something that adds “years to your life” and “life to your years”.

FAQs on Obesity And Metabolic Surgery

Q- Common Health Consequences of Obesity.

Ans- Obesity is the mother of all diseases and accumulation of fat impairs functioning of almost every single organ system in human body. It is a significant risk factor in the development of high blood pressure, diabetes, coronary heart disease, stroke, kidney failure, asthma, chronic obstructive lung disease (COLD), and even certain types of cancers. Obesity also causes osteoarthritis of the hips, knees & lumbar spine, infertility, sleep apnea, gall bladder stones, urinary incontinence, impotency, loss of libido, varicose veins and acid reflux. Depending on the severity of obesity, a person’s lifespan may be reduced by a period ranging from a few years to many decades.

Psychological and Social Consequence of Obesity

Not only does Obesity have an adverse effect on a person’s appearance, it also reduces their self-confidence and leads to social stigma and isolation. In addition, Obesity decreases a person’s employability and his ability to work hard. Obese people have higher rates of absenteeism from work and that means decreased productivity and increased costs for employers.

Q- How to prevent or treat obesity?

Ans- Since weight can gradually creep up on us, it is important to keep a close eye on weight and B.M.I. Medical practitioners must use every healthcare contact with people to identify overweight or obese people. A late diagnosis will usually mean that patients will inevitably develop obesity related diseases with serious implications. In early stages, people can often remedy the situation by reducing their calorie intake and spending more calories. In late stages and for those with uncontrolled diabetes, bariatric and metabolic surgery may be the only option.

Q- Who is suitable for this surgery?

Ans- Suitability for this surgery is determined by a number of factors, which mainly include patient’s BMI and other health conditions like diabetes. Patients must have tried other methods of weight loss and failed to maintain weight loss with them. They must also commit to lifelong dietary and lifestyle changes and regular follow up is required after surgery. Local guidelines state that bariatric / metabolic surgery should be considered for following patient groups.

1.       BMI = 35

2.       BMI = 30 with inadequately controlled diabetes or metabolic syndrome

It may also be considered for selected patients with BMI = 27.5 with inadequately controlled diabetes or metabolic syndrome.

FAQs on Obesity And Metabolic Surgery

Q- What is Obesity?

Ans- Obesity is a medical condition in which there is an abnormal growth of fatty tissue due to enlargement in the size of fat cells or an increase in the number of fat cells or both. It is the fifth leading cause of death in the world. About 2.8 million adults die each year because of being overweight or obese. Moreover, 44% cases of diabetes, 23% cases of Ischemic Heart Disease and 7% to 41% of some cancers can be attributed to over-weight and obesity.

Q- How do I find out if I am obese?

Ans- Body Mass Index (BMI) is the most reliable indicator for determining if an individual is obese or not. Other commonly used indicators are Waist Circumference, and Waist to Hip Ratio (WHR). Every individual should attempt to know these parameters for themselves and aim to keep them in the healthy range.

The easiest way to find out if your weight is within normal range or not is to calculate your Body Mass Index (BMI). BMI is expressed as an individual’s weight in kilograms divided by the square of height in meters (Kg/m2).

BMI = Weight in Kg/ Height in meters2 (Wt. in Kg divided by square of height in meters)

According to WHO, a Body Mass Index of 18.5-24.99 is normal and a BMI more than or equal to 25 (23.0 for Indians) means a person is overweight.

·         BMI: 25.0-29.9 (Pre-Obese or Overweight)

·         BMI: 30.0-34.9 (Obese Class I)

·         BMI: 35.0-39.9 (Obese Class II)

·         BMI: =40.0 (Obese Class III)

Since Indians have a higher percentage of body fat and a higher tendency to have the “riskier” abdominal fat (fat around the waist), obesity starts at a lower BMI in Indians.

·         BMI: 23.0 – 27.5 (Pre-Obese or Overweight)

·         BMI: 27.5-32.5 (Obese Class 1)

·         BMI: 32.5 – 37.5 (Obese Class II)

·         BMI: =37.5 (Obese Class III)

People with distribution of fat predominantly in the abdomen (belly fat) are at higher risk of health hazards than people in whom fat is evenly distributed around the body’s periphery. Sufficient evidence suggests that abdominal obesity plays a big role in the development of diabetes and heart disease.

Waist Circumference and Waist Hip Ratio (WHR):

Men, whose waist circumference is greater than or equal to 94 cm (90 cm for Indians) and women with a waist circumference of greater than or equal to 80 cm, have a higher risk of metabolic complications. Risk is substantially increased for men with a waist circumference of more than 102 cm and women with a waist circumference of more than 88 cm. Your waistline is truly linked to your lifeline!

A Waist Hip Ratio (WHR) of > 0.9 in men and > 0.85 in women is indicative of significant abdominal fat accumulation and substantially increases the risk of metabolic complications.

Q- What Causes Obesity?

Ans- Obesity is caused by an imbalance between the calories consumed and calories spent. We consume calories in the form of food and drinks and then spend these calories on our day-to-day activities. All over the world, there has been an increase in the intake of calorie-dense food over the past few decades. At the same time, physical activity of people has decreased dramatically because of a sedentary life style, use of domestic appliances and domestic aids, and drastic change in modes of transportation leading to less expenditure of calories. Central heating and air-conditioning have also played a role.Surplus calories (intake minus expenditure) are stored in body as fat. Over a period of time, this leads to an increase in weight and we become overweight (pre-obese) and then obese.

FAQs on IVF / Infertility

Q- When should I seek medical help for fertility?

Ans- A couple is considered to be infertile if they have not conceived after a year of unprotected intercourse a woman over 35, or a woman who is known to suffer from endometriosis, PCOS etc should seek medical help only after 6 months of unprotected intercourse.

Q- When is IVF needed?

Ans- Please refer to detailed IVF page under treatments offered section.

Q- How painful is the procedure?

Ans- We retrieve eggs under short general anaesthesia hence, you don't feel any pain. Embryo transfer is not a painful procedure and is just like IUI procedure.

Q- How much hospital stay is required after laparoscopic and robotic surgery?

Ans- One to two days approximately.

Q- Is there any cost difference between open/ laparoscopic/ robotic surgeries?

Ans- Open and laparoscopic surgeries have almost same cost. Robotic surgery is a little more expensive in view of the cost of the equipment's.

Q- Does IVF cause increase in birth defect?

Ans- The rate of birth defect in natural conception is approximately 4%. IVF may have risk slightly more than that but ICSI has approximately 6% (not a significant difference from the natural conception)

Q- Upto how many embryos can be transferred?

Ans- Depending upon the age of the patient up to 3 embryos can be transferred.

Q- Do I need to be admitted during the IVF cycle?

Ans- Yes, but only for few hours on the day of egg retrieval as it is done under general anesthesia.

Q- Do I need to have bed rest after the embryo till the pregnancy is confirmed or throughout the 9 months?

Ans- No, we don't advise any rest after the embryo transfer except for half an hour as studies do not show any positive effect of rest on conception rate or pregnancy.

FAQs on Atherosclerosis and Angina Pectoris

Q- What is atherosclerosis and angina pectoris?

Ans- Angina pectoris (also referred to angina) is chest pain / pressure that occur when the blood and oxygen supply to the heart muscles cannot keep up with the needs of the muscle. When coronary arteries are narrowed by more than 50% to 70%, the arteries may not be able to increase the supply of blood to heart muscles during exercise / other period of high demand for oxygen.

·         An insufficient supply of oxygen to the heart muscle cause angina

·         Angina that occurs with exercise or exertion is called exertional angina.

Diabetic patients, progressive decrease in blood flow to the heart may occur without any pain or with just shortness of breath or unusually early fatigue.

Q- What is unstable angina?

Ans- Exertional angina usually feels like a pressure, heaviness, squeezing or aching across the chest. This pain may travel to the neck, jaw arms back or even the teeth and may be accompanied by shortness of breath, nausea or a cold sweat. Exertional angina typically lasts from one to 15 min and relieved by rest or by placing a tablet of NTG under tongue. Both resting and NTG decreases the heart muscle’s demand for oxygen, this relieving angina. Angina also can occur at rest. Angina at rest more commonly indicates that a coronary artery has narrowed to such a critical degree that the heart is not receiving enough oxygen even at rest. Angina at rest infrequently may be sued to spasm of a coronary artery (a condition called Prinzmetal’s or variant angina.

Causes:- Classified as one of the following two types-

·  Stable Angina

·  Unstable Angina

·  Coronary artery spasm Other Causes:-

·         Blockage of a coronary artery by blood clot or by compression from something outside the artery

·         Inflammation or infection of coronary arteries

Injury to one / more coronary arteries.

Q- What are the risk factors?

·        Ans-  Hypertension

·         Hyperlepidemia

·         Diabetes

·         Smoking

·         Male genders

·         Inactive ( sedentary life style)

·         Family H/O of Coronary artery diseases

·         Aging

Regular use of stimulants especially nicotine, cocaine or amphetamines

Q- What are the Symptoms?

Ans-Angina itself is a symptom (or set of symptoms) not a diseases. Any of following may signal angina

Any uncomfortable pressure, fullness, squeezing or pain in the centre of the chest

·         It may also feel like tightness, burning or a heavy weight

·         Pain may spread to the shoulder, neck or arms

It may be located in upper abdomen, back or jaw.

Q- What are the examination and Test?

·         Ans- ECG

·         Chest x-ray

·         Blood test - cardiac enzymes(CPKMB, TROP I)

·         Exercise stress test

·         Thallium stress test

·         Dobutamine echo cardiogram stress test

Coronary angiogram

Q- What are the treatments?

Ans- Treatment of angina depend on the serenity of symptoms and result of test that are done to find the underlying cause

Self care at home:-

·         Call immediate help and intervention is the best chance for survival if someone is having heart attack

·         Lie down in a comfortable position with the head up

·         Chew a regular adult aspirin or its equivalent or use of tablet NTG

·         Medical treatment – Aspirin, clopidogrel, atorvastatin, beta blocker

·         Surgical Treatment

Regular follow up.

Q- What is the prevention?

Ans- Best action is to reduce risk factor early in life Although no one can escape aging, inherited risk or gender, certain risk factors are in your control

·         Stop smoking and using nicotine in any form

·         Control high blood pressure

·         Lower blood fat (through diet, exercise and medication)

·         Maintain a healthy weight

·         Control diabetic and blood sugar

Do not use stimulants such as cocaine and amphetamines.