PCOS affects a major part of a menstruating person’s life than many of them are aware of. The lack of information about the condition and the reluctance of people to talk about the matter makes it worse. As we kick off World PCOS Awareness Month, we try to understand the proper repercussions and the best ways to manage your periods. As science progresses each day, many women have taken the initiative to further the research on PCOS and the reproductive health of women. We spoke to Dr Prarthana Shah, a doctor who specialised in preventative CVD medicine and an Integrative Health Coach to get a better understanding of the vital role nutrition plays in a woman’s reproductive cycle.

Polycystic Ovary Syndrome (PCOS) is a hormonal disorder affecting millions of women worldwide. Characterized by irregular menstrual cycles, excess androgen production, and the presence of cysts on the ovaries, PCOS can lead to a range of health issues, including infertility, obesity, type 2 diabetes, cardiovascular disease, and endometrial cancer.

Role of Nutrition in PCOS Management

A balanced diet plays a crucial role in managing PCOS symptoms and reducing the risk of associated health complications. By focusing on nutrient-dense foods and avoiding certain triggers, women with PCOS can significantly improve their overall well-being.

According to Dr. Prarthana, “The first thing is B12. So, a common deficiency, even otherwise, which can affect a woman's hormonal balance, because it helps regulate your hair length, and so it's important to make sure that you're getting enough B12.” There are important nutrients that women must have for healthy menstrual cycles.

• Vitamin B12: Essential for hormonal balance, hair health, and regular menstruation.
• Vitamin D: Helps regulate hormones, supports ovarian function, and improves insulin sensitivity.
• Iron: Crucial for preventing anaemia, which is common during menstruation.
• Electrolytes: Help maintain fluid balance and prevent fatigue.
• Amino acids: Provide building blocks for proteins and support overall health.

Dietary Recommendations for PCOS

As Dr Prarthana mentioned, the key nutrients that women lack are the reason why their periods might be irregular and make it difficult for them to handle it. She suggested that it's essential to prioritize a nutrient-rich diet. Focus on consuming whole foods like fruits, vegetables, whole grains, lean proteins, and healthy fats.

Minimize your intake of processed foods, sugary drinks, processed meats, and refined carbohydrates, as these can contribute to inflammation and hormonal imbalances. Consider limiting or avoiding dairy products, as they may contain hormones that can disrupt your hormonal regulation.

She also emphasised the importance of seasonal fruits. While many people have expressed their reservations with cross-contamination and germs from fruits she says, “You have to eat seasonal fruits and vegetables. Greens and salad leaves, all of these things for vitamin B12. Now, of course, there will be some vendors that cut it up. So, don't buy it from there. one tip I personally suggest is that I use something called Veggie Wash where I wash my salad leaves in that at home. You can also wash it with salt or apple cider vinegar.”

When enjoying seasonal fruits and vegetables, be mindful of potential contamination from vendors who cut and sell them. Wash them thoroughly at home to ensure safety. Finally, stay hydrated by drinking plenty of water throughout the day to support overall health and prevent dehydration.

Lifestyle changes you should make for PCOS

According to Dr Prarthana, your lifestyle plays a really important role in PCOS, “So, I know most women, even though they regularly exercise, I mean the ones that do, also kind of skip it during the period and that is the wrong thing to do, ideally.”

She also expresses how much it actually helps with period pains and relief for women, “It's okay. You should go and do some sort of exercise. Go for a walk. It could be lighter if you're, you know, tired. But something in some form of movement, maybe yoga, stretching, whatever works for each person depending on how much pain they have. It really opens up the muscles and gives you relief.”

Other changes include,

• Manage stress: Practice stress-reduction techniques like meditation, yoga, or deep breathing.
• Prioritize sleep: Aim for 7-8 hours of quality sleep each night.
• Consider supplements: Consult with a healthcare professional about potential supplements, such as vitamin D and iron, to address specific deficiencies.

When one thinks about cancer, the first thing that comes to mind is a mass of irregular cells growing wildly. But what is a tumour? It is much more than mere cancer cells surrounded by an extensive network of blood vessels, immune cells and various supporting cells. This is the tumour microenvironment.

One of the key residents of the tumour microenvironment is the cancer-associated fibroblast (CAF), which attracts increasing interest of cancer researchers due to the fact that such cells may affect tumour growth, metastasis and therapy response.

Normal fibroblasts have a supportive function in maintaining tissue integrity through the production of collagen and other structural components. However, when cancer arises, some fibroblasts located in or near the tumour acquire an additional function and become activated. Such activated fibroblasts are called CAFs.

How CAFs May Help Cancer Grow And Spread

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CAF involvement could be likened to that of a helper to the tumour. These cells are able to modify the stroma around the cancer cells and thereby facilitate growth and invasion into adjacent tissue. CAFs are also capable of releasing factors that facilitate angiogenesis as well as the behaviour of cancer cells. Evidence exists of a correlation between CAF involvement and tumour progression and metastasis in various types of cancer.

Perhaps more significantly, CAFs can affect the immune response of the body. The immune system in humans is able to detect and target foreign bodies including cancer cells. However, some forms of CAFs play a role in ensuring an immunosuppressed environment that makes it difficult for the immune cells to interact effectively with the tumour cells. This could explain the wide variation in immunotherapy response among patients and different tumour types.

The involvement of CAFs in treatment resistance is another issue that must be considered. Cancer-associated fibroblasts are known to remodel the extracellular matrix, an environment where cells are surrounded by proteins, and generate signals that help cancer cells resist stress induced by chemo and targeted therapy. CAFs therefore make treatment difficult for certain tumours.

Could CAFs Become A New Target For Cancer Treatment?

This field of study is especially important when considering that cancer treatments are becoming increasingly personalized. Today, oncologists take into consideration such features of cancer as genetic mutation, its stage and molecular profile. Tomorrow, taking into account tumor microenvironment can give them additional knowledge on how to treat a specific type of cancer.

But there is one major issue to be taken into consideration: CAFs are not one homogenous group of cells. There can be many types of CAFs that have very different functions, sometimes even opposing. Some of them contribute to tumor growth and some may hinder it. Thus, simply killing all fibroblasts will hardly help. Instead, there are studies on how to selectively target tumor promoting CAFs and how to reprogram them. Several such methods have already been tested clinically.

There is one important point that this research gives to patients: cancer is not just a mass of aberrant cells. Cancer is an ecosystem where cancer cells constantly interact with their environment.

Understanding this ecosystem might someday help oncologists tackle the mechanisms of tumor survival and resistance to therapy- and maybe make current cancer treatments more efficient.

By Dr Pritam Kalaskar, Director, Co-founder and Medical Oncologist- M|O|C Cancer Care, India

Obesity is often associated with obstructive sleep apnea or OSA. Extra body fat is a key risk factor. Still, it is a mistake to think OSA only happens when someone is heavy. Many people who have a normal weight may not connect their symptoms to a sleep issue.

They can go for years without a proper diagnosis. Research also makes it clear that OSA can show up in people who are not obese. Risk may be more than weight-dependent and include factors such as upper airway anatomy, age, sex, family history, and others.

How Airway Anatomy Can Increase The Risk

Weight is only part of the story. The jaw, the palate, the tongue, and the passages in the upper throat can affect what happens during sleep. The airway can narrow or collapse more easily for some people. A person may not be big in body size but can have a tight or smaller upper airway.

They might have a jaw that drops back. Other facial and skull features can also increase the likelihood of OSA. Your nose problems, smoking, drinking and other unwholesome activities on Sunday could also be factors.

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Why Age And Menopause Matter

Age matters too. With time, muscle tone can change. The way the airway works can also shift. As a result, the upper airway may be more likely to collapse during sleep. For women, the risk may also shift around menopause and after it. This is why OSA should not be treated as a problem that only affects overweight men.

The symptoms should be taken seriously, not the scale. Signs such as loud snoring or snoring often, pauses seen in breathing, waking up suddenly and feeling short of breath, or choking during sleep can all call for assessment. Morning headaches can occur as well. Day-to-day problems like poor focus, irritability, and being very sleepy in the daytime are common clues. Some people do not report classic sleepiness. They may mainly notice restless sleep or ongoing tiredness during the day without a clear reason

How Doctors Assess Sleep Apnoea

A clinician should look at more than BMI. They can start with symptoms, a sleep history, neck size, what the upper airways look like, and any related health issues. If obstructive sleep apnoea is a real concern, a sleep test can show whether breathing problems happen during sleep.

The main point is this: a person can be slim and still have sleep apnoea. Deciding on testing should follow the full clinical picture, not body weight by itself. When this is remembered, some people may get help sooner, instead of having their tiredness written off as stress, bad sleep, or just normal fatigue.

A patient suffering from a rare tumour involving the sciatic nerve has made a good recovery following a successful robotic-assisted sciatic nerve schwannoma resection, marking an important milestone in advanced, minimally invasive surgical care.

Sciatic nerve schwannomas are uncommon, benign tumours that develop from the cells surrounding a nerve. Because the sciatic nerve is responsible for important motor and sensory functions of the lower limb, surgery in this region can be technically challenging. The key objective is to remove the tumour while preserving the functioning nerve fibres and minimizing the risk of neurological complications.

How Robotic Technology Can Aid Complex Surgery

The patient underwent robotic-assisted surgery under the care of a multidisciplinary surgical team. The use of robotic technology provided enhanced visualization and precise control of surgical instruments, allowing meticulous dissection around the affected nerve.

For the patient, the successful procedure meant not only removal of the tumour but also the prospect of returning to normal daily activities with preservation of neurological function.

Whenever the doctor operates on a tumour involving an important nerve, their priority is to achieve complete and safe tumour removal while protecting the nerve and its function. Robotic assistance can offer greater precision and visualization in carefully selected cases.

Following the procedure, the patient was closely monitored for neurological recovery and postoperative complications. The patient is doing well and recovering satisfactorily, providing an encouraging outcome following this complex surgical intervention.

How Minimally Invasive Techniques May Benefit Patients

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The case demonstrates how advances in surgical technology can translate into meaningful benefits for patients. Robotic-assisted surgery, when used in appropriately selected cases, can support surgeons in performing delicate procedures with enhanced precision while potentially reducing tissue trauma and facilitating recovery.

For patients diagnosed with nerve tumours, early evaluation and appropriate treatment planning are important. Symptoms can vary depending on the location and size of the tumour and may include pain, tingling, numbness, or weakness in the affected limb. Detailed imaging and neurological assessment help specialists determine the most appropriate treatment strategy.

The successful outcome reflects the importance of combining experienced surgical expertise, advanced technology, and patient-centred care. For this patient, the journey from diagnosis to successful tumour removal and recovery offers an encouraging example of what modern surgical care can achieve.

By Dr. S.K. Bala, Consultant Department of Surgical Oncology & Advanced Robotic Surgery, CMRI, CK Birla Hospitals, Kolkata