The famous breast cancer and coronary heart disease specialists of the United States are in Istanbul!

Medica Advanced Diagnosis Center that brings together medicine and the aesthetics of art in Nisantasi, Istanbul, in a historical place called Villa Tozan, has the world`s best equipment. For the celebration of their 10th anniversary they invited the famous American breast cancer specialist Dr. Alexander Julien Swistel and coronary heart disease specialist Dr. Varinder Singh. We asked them all we want to know about these diseases.

Dr. Swistel,  there has recently been an increase in women with breast cancer. What could be the reason and how do women react to this?
I have to say that we do not hold accurate information as to why the body produces cancerous cells. However, we think there are three reasons; genetics, diet and environmental factor. Even though stress is thought to be a factor we believe that it is not such a major one. As a matter of fact I find the reaction of women towards this issue amazing. From the very start they are more sensitive about their regular checks than men,which means doctors like us have the opportunity to give an early diagnosis, the most significant thing in cancer. And the moment the diagnosis is made there is a bond of support among women, they immediately call one another, they recommend doctors. I think they are amazing in this respect too. Men usually talk about soccer with one another; they never discuss their diseases.

Can you inform us about the latest treatment options?
At first, the same chemo and radiotherapy were used for everyone when treating cancer. But now first they get a sample of the cancerous cell, they examine it and the treatment process is initiated according to the structure. Again, before, women were absolutely against the removal of the cancerous breast no matter what. However, thanks to the common operations we conducted with aesthetic surgeons this approach changed drastically. Women prefer to renew their breasts rather than go through all that intense treatment process. In other words the breast is restructured inside with plastic surgery help, which helps them to retain their psychology for the future. If we can save the nipple the result is too good to tell from the actual one, even better than the old one. Thanks to operations with meticulous and smooth interventions by surgeons that leave no scars or marks, the patients can continue their lives as if they had not experienced such a thing.

Is it important whether the breast is small or big in terms of cancer risk? Do aesthetic operations have any risk?
We do not hold specific information about this, however, we can explain as such: as the breast tissue is larger in big breasts the risk of cancer might be higher. Aesthetic operations do not have any negative impact; we actually think it is essential for big breasts with regard to spinal and back health. Furthermore, even though breasts which have been aesthetically operated or operated for cancer renew themselves following the operation, we can carry out an operation in the same location again.

Last but not least Dr.Swistel, what do you think about girls who have their period earlier? How do you think this will affect the chance of breast cancer?
As a matter of fact this is a very frightening scene because the cancerous cell is seen in the locations where the cells change. Therefore, in the breast location that changes at every menstruation the earlier this starts, the more the danger increases. In other words between menstruation at the age of 15 or at the age of 5; 10 years difference will take the cancer risk 10 years earlier. This might be one of the reasons why the cancer incidence in younger women is higher.
During our interview with Dr. Varinder Singh from New York Presbyterian, Colombia Hospital; Singh talked about the most important aspects of coronary diseases and stated that we are actually very lucky in terms of genetics.

Dr. Singh, is this your first time in Turkey?
Yes, this is my first time here and I am very impressed. The scenery, historical monuments, the nature…This is a fascinating city… I believe from now on I will come here more often.

What shall we do to protect our heart?
As a matter of fact, looking at the values in Turkey the cholesterol level of people here is quite low.  This is a big chance, however, as the good cholesterol level is also low this increases the heart attack risk. Besides there are two major threats: The first one is smoking for men. According to official records %60 - %80 of smoke and this is the number one cause for heart attack. The other threat is the fat accumulating in belly region in women within pre and post-menopause period. In a nutshell; your women need to exercise while your men need to quit smoking.

Like in the States, there has recently been an increase in child obesity in Turkey. How should we fight against this disease which can result in coronary heart disease?
Yes, obesity has become the disease of this century. Turkey has joined this group as well because it has one of the world`s largest economies. As the income increases the eating habits change. To earn more, more work is done. Therefore, children who take their families as their examples lead similar lives without exercising, focused on eating and working. For this reason a 30-minute walk at a certain pace every day will increase the quality of your life and will make you feel good.

How do you see the progress of studies in coronary diseases treatment throughout years?
I can definitely say that they progress very fast. For example, before we had to understand the blockage level or the stiffness of the substance blocking the vein by tracking it outwards, now we insert a camera into the vein and see how blocked it is. Another example might be we could not carry out open heart surgeries in patients of an older age however, now we enter from the pelvis and without harming the sternum we can change cardiac valves. I think this is major progress.

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