A Simple Guide to Colorectal Cancer ——————————————–What is Colorectal Cancer?——————————–
is one of the commonest cancer among males and females in the world. Colorectal cancer is cancer that starts in the large intestine (colon) or the rectum (end of the colon). Colorectal cancer can be effectively treated if detected early.
What is the cause of Colorectal Cancer?
———————————————–
Colorectal cancer occurs when cells from the intestinal wall grow and spread uncontrollably.
It may begin as polyps (growths) in the large intestine and rectum. Polyps should be monitored regularly and removed upon detection to prevent them from developing into cancer.
Who are at risk of Colorectal Cancer?
——————————————–
As with most cancers, the risk of developing colorectal cancer increases with age.
People at high risk include those with:
1. family history of personal history of endometrial, ovarian or breast cancer
3. personal history or family history of gastrointestinal polyps
4. history of inflammatory bowel disease such as chronic ulcerative colitis or Crohn’s disease.
5. Cancer elsewhere in the body
6. Certain genetic syndromes also increase the risk of developing colon cancer.
What you eat may play a role in your risk of colon cancer.
Colon cancer may be associated with a high-fat, low-fiber diet and red meat.
However, some studies found that the risk does not drop if you switch to a high-fiber diet, so the cause of the link is not yet clear.
What are the Symptoms of Colorectal Cancer?
——————————————————————
In its early stages, the cancer usually has no symptoms, which is why regular screening is important to see if it could be present.
The most common symptom of colorectal cancer, especially if it is located in the lower part of the large intestine, is changes in bowel habits. For some, it may be an increase in the number of bowel visits to the toilet, and for others, it may be constipation. Still others may complain of constipation with overflow diarrhoea, i.e., difficulty in passing motion but stools flow out without any control.
Other symptoms include
bloody or black stools from bleeding of the tumour (blood appears black on digestion in the intestines),
fatigue, appetite and weight loss of unknown cause,
Unexplained anemia
abdominal pains, cramps or bloating in the lower abdomen
Intestinal obstruction
Narrow stools
With proper screening, colon cancer can be detected BEFORE the development of symptoms, when it is most curable.
What are the signs of Colorectal Cancer?
———————————————–
The physical exam rarely shows any problems, although an abdominal mass may be felt in late cases.
A rectal exam may reveal a mass in patients with rectal cancer, but not colon cancer.
How do you Screen for Colorectal Cancer?
————————————————–
People over the age of 50 years are advised to screen for colorectal cancer, even if they have no symptoms.
A Faecal Occult Blood Test (FOBT>) is recommended once every year.
If the results are positive, other tests like a sigmoidoscopy, barium enema and colonoscopy may be required.
A complete blood count may reveal show signs of anemia with low iron levels.
What is the treatment of Colorectal Cancer?
—————————————————–
Surgery:
is the main treatment.
In surgery, the part of the large intestine containing the cancer is removed.
In some cases, the two ends of the colon can be rejoined.
Sometimes an opening called a stoma has to be left in the abdominal for the removal of waste. This opening may be temporary or permanent.
Radiation Therapy:
destroy the cancer cells with minimal damage to surrounding tissue. It is used to prevent recurrence of the cancer and for pain relief. Side effects include skin irritation,nausea,vomiting and lethargy.
Chemotherapy:
is used to kill the cancer cells in the colon and rectum as well as to prevent a recurrence.
Side effects may be quite severe with loss of hair, weight, appetite, nausea, vomiting, rashes.
Which treatment is used depends on the staging of the cancer using additional tests.
Staging of the Cancer:
—————————
Stage 0: Very early cancer on the innermost layer of the intestine
Stage I: Cancer is in the inner layers of the colon
Stage II: Cancer has spread through the muscle wall of the colon
Stage III: Cancer has spread to the lymph nodes
Stage IV: Cancer that has spread to other organs
Stage 0 colon cancer may be treated by removing the cancer cells, often during a colonoscopy.
For stages I, II, and III cancer, more extensive surgery is needed to remove the part of the colon that is cancerous.
There is some debate as to whether patients with stage II colorectal cancer should receive chemotherapy after surgery. You should discuss this with your oncologist.
Almost all patients with stage III colorectal cancer should receive chemotherapy after surgery for approximately 6 – 8 months. The chemotherapy drug 5-fluorouracil given has been shown to increase the chance of a cure in certain patients.
Chemotherapy is also used to treat patients with stage IV colon cancer.
Irinotecan, oxaliplatin, and 5-fluorouracil are commonly used drugs. You may receive just one type, or a combination of the drugs. Capecitabine is a chemotherapy drug taken by mouth, and is similar to 5-fluroruracil.
For patients with
stage IV disease that has spread to the
liver, various treatments directed specifically at the liver can be used. This may include
cutting out the cancer, burning it (ablation), or freezing it (cryotherapy). Chemotherapy or radiation can sometimes be delivered directly into the liver.
While radiation therapy is occasionally used in patients with
colon cancer, it is usually used in
combination with chemotherapy for patients with
stage III rectal cancer.
What is the Prognosis(outcome) of Colorectal Cancer?
—————————————————————-
How well a patient does depends on many things, including
the stage of the cancer.
In general, when treated at an
early stage, more than 90% of patients survive at least
5 years after their diagnosis
.
However, only about 40% of colorectal cancer is found at an
early stage.
The 5-year survival rate drops considerably once the cancer has spread
.
If the patient’s colon cancer does not come back (recur) within 5 years, it is considered as cured.
Stage I, II, and III cancers are considered
potentially curable.
Stage IV cancer is not curable in most cases.
How to prevent Colorectal Cancer?
—————————————–
Prevention of Colorectal Cancer involve:
1. early and regular screening,
2. lifestyle changes:
Maintain a balanced diet low in animal or saturated fat such as butter, coconut oil, ghee and lard.
Diets high in total fat, protein, calories and meat, and low in calcium are associated with an increased incidence of colorectal cancer.
Increase your intake to at least 2 servings of fruits and vegetables each day. Studies have shown that very low intake of fruits and vegetables is associated with an increased risk of colorectal cancer.
Quit smoking. Cigarette smoke contains many chemicals that promote the development of many types of cancers.
Increase physical activity. Physical activity promotes general health and reduces your risk of colorectal cancer.
Maintain your BMI within the healthy range of 18.5 to 22.9 (kg/m2).
The death rate for colorectal cancer has dropped in the last 15 years.
This may be due to increased awareness and screening by colonoscopy.
Colorectal cancer can almost always be caught in its earliest and most curable stages by colonoscopy.
Almost all men and women age 50 and older should have a colonoscopy.
Other types of colorectal cancer such as lymphoma, carcinoid tumors, melanoma, and sarcomas are rare. The colorectal cancer referred to in this article refers to Colorectal carcinoma.
About kenkee481
Dr Kenneth Kee is still working as a family doctor at the age of 67.
However he has reduced his consultation hours to 3 hours in the morning and 2 hours in
the afternoon.
He first started writing free blogs on medical conditions seen in the clinic in 2007 on http://kennethkee.blogspot.com.
His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com
This autobiolographical account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Conditions” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.
From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.
He apologized for typos and spelling mistakes in his earlier books.
He will endeavor to improve the writing in futures.
Some people have complained that the simple guides are too simple.
For their information they are made simple in order to educate the patients.
The later books go into more details of medical conditions.
He has published 700 kindle Books on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.
The purpose of these simple guides is to educate patient on health conditions and not meant as textbooks.
He does not do any night duty since 2000 ever since Dr Tan had his second stroke.
His clinic is now relocated to the Buona Vista Community Centre.
The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.
He is now doing some blogging and internet surfing (bulletin boards since the 1980's) starting
with the Apple computer and going to PC.
The entire PC is upgraded by himself from XT to the present Pentium duo core.
The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.
He is also into DIY changing his own toilet cistern and other electric appliance.
His hunger for knowledge has not abated and he is a lifelong learner.
The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.
This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.
Dr Kee is the author of:
"A Family Doctor's Tale"
"Life Lessons Learned From The Study And Practice Of Medicine"
"Case Notes From A Family Doctor"
“The Amazing Story of the Cold Sore Virus”
“Of Bed Bugs, Lice And Scabies! Skin Infections”
“A Simple Guide to Sexual Health”
“A Simple Guide To Cancer”
“A Simple Guide to Skin Polyp and Other Polyps”
“A Simple Guide to Sexually Transmitted Diseases”
“A Simple Guide To Stroke”
“A Simple Guide to Women's Health”
“A Simple Guide to Men's Health”
“A Simple Guide to AutoImmune Diseases”
“A Simple Guide to Alternative Therapy”
“A Simple Guide to Alzheimer's Disease and Dementia”
“A Simple Guide to Hypertension and Heart Diseases”
“A Simple Guide To Liver Diseases”
“A Simple Guide to Diabetes Mellitus and Diabetes Insipidus”
“A Simple Guide to Skin Fungal Infections”
“A Simple Guide to Hemorrhoids and Anal Diseases”
“A Simple Guide to Genetic Diseases”
“A Simple Guide to Vitamins, Minerals and Health”
“A Simple Guide to Kidney Stones and Kidney Diseases”
“A Simple Guide to Asthma and Lung Diseases”
“A Simple Guide to Allergies”
“A Simple Guide to Eating Disorders”
“A Simple Guide to Thyroid Diseases”
“A Simple Guide to Sleep Disorders”
“A Simple Guide to Bad Breath and Mouth Diseases”
“A Simple Guide to Depression and Bipolar Disorders”
“A Simple Guide to Hair Loss and Hair Diseases”
“A Simple Guide to Anger, Anxiety, Stress and Panic Attacks”
“A Simple Guide to Tenosynovitis Diseases”
“A Simple Guide to Knee Arthritis and Other Knee Diseases”
“A Simple Guide to Planter Fascilitis and Heel Diseases”
“A Simple Guide to Malaria and Mosquito Bthene Diseases”
“A Simple Guide to Blindness and Related Eye Diseases”
“A Simple Guide to Stye and Related Eyelid Diseases”
“A Simple Guide to Gastritis and Related Diseases”
“A Simple Guide to Myopia and Refractive Diseases”
“GUIDE TO BETTER SEX AND LOVE”
“A Simple Guide to Laryngitis and Vocal Cord Diseases”
“A Simple Guide to Pharyngitis and Throat Diseases”
“A Simple Guide to Back Pain and Other Spine Diseases”
“A Simple Guide to Shoulder Pain and Other Shoulder Diseases”
“A Simple Guide to Deafness and Related Ear Diseases”
“A Simple Guide to Childhood Infectious Diseases”
“A Simple Guide to Celiac Disease and Malabsorption Diseases”
“A Simple Guide to Water Borne Diseases”
“A Simple Guide to Irritable Bowel Syndrome and Colon Diseases”
“A Simple Guide to Parathyroid Disease and Calcium”
“A Simple Guide to Electrolyte Imbalance Diseases”
“A Simple Guide to Parkinson's Disease and Brain Diseases”
“A Simple Guide to Neuralgia and Related Nerve Diseases”
“A Simple Guide to Prostate Diseases”
“How To Study Wisely For Tests And Examinations”
“A Simple Guide to Chronic Fatigue Syndrome and Asthenia”
“A Simple Guide to Dizziness and Related Diseases”
“A Simple Guide to Obesity and Weight Loss”
“A Simple Guide to Headache and Related Diseases”
“A Simple Guide to Gallstones and Gallbladder Diseases”
“A Simple Guide to Hernia and Testis Diseases”
“A Simple Guide to Vasomotor Rhinitis and Nose diseases”
“A Simple Guide to Aging and Related Diseases”
“A Simple Guide to Carpal Tunnel Syndrome and Hand Diseases”
“A Simple Guide to Neck Pain and Cervical Spondylosis”
“A Simple Guide to Autism, Dyslexia and ADHD”
“A Simple Guide to Warts, Calluses and Corns”
“A Simple Guide to Schizophrenia and Other Mental Disorders”
“A Simple Guide to Acne vulgaris And Acne Rosacea”
“A Simple Guide to Skin Injuries, Cuts and Burns”
“A Simple Guide to Skin Infections, Impetigo and Other Infections”
“A Simple Guide to Skin Urticaria and Erythema diseases”
“A Simple Guide to Travel Medicine”
“A Simple Guide to Peripheral Blood Vessel Diseases”
“A Simple Guide to Skin Bleeding Diseases and Photosensitivity Diseases”
“A Simple Guide to Papulosquamous Skin Diseases”
“A Simple Guide to Multiple Sclerosis and Neuromuscular Diseases”
“A Simple Guide to Rheumatic Fever, Glomerulonephritis and Nephrotic Syndrome”
“A Simple Guide to Heat Stroke and Related Skin Diseases”
“A Simple Guide to Tuberculosis and Dangerous Diseases”
“A Simple Guide to Fibromyalgia and Other Systemic Diseases”
“A Simple Guide to Conjunctivitis and other Eye Diseases”
“A Simple Guide to Alcoholism, Pancreatitis and Liver Cirrhosis”
“A Simple Guide to Osteoporosis and Related Diseases”
“A Simple Guide to Spinal Stenosis and Pinched Nerve”
“A Simple Guide to Vitiligo and Pigmentation of the Skin”
“A Simple Guide to Osteomyelitis and Related diseases”
“A Simple Guide to Cushing's Syndrome and Related Diseases”
“A Simple Guide to Earlobe Infections and.other earlobe Diseases”
“A Simple Guide to Facial Palsy and Related Diseases”
“A Simple Guide to Colic, Breastfeeding and Infant Diseases”
“A Simple Guide to Cosmetic Surgery and Associated Procedures”
“A Simple Guide to Edema and Causative Diseases”
“A Simple Guide to Molluscum Contagiosum and Related Skin Diseases”
“A Simple Guide to Toothache and Related Diseases”
“A Simple Guide to Hallux Valgus (bunion) and forefoot Diseases”
“A Simple Guide to Uterine Fibroid and Related Uterine Diseases”
“A Simple Guide to Tinnitus and Related Diseases”
“A Simple Guide to Muscle Dystrophy Disease and Related Diseases”
“A Simple Guide to Typhoid Fever and Other Bacterial Diseases”
“A Simple Guide to Fever, Reye's Syndrome and Related Diseases”
“A Simple Guide to Sleeping Sickness and Other Parasitic Diseases”
“A Simple Guide to Physiotherapy and Related Therapies”
“A Simple Guide to Tooth Discoloration and Related Diseases”
“A Simple Guide to Appendicitis and Causative Diseases”
“A Simple Guide to Snoring and Causative Diseases”
“A Simple Guide to Mycoplasma and Lung Diseases”
“A Simple Guide to Healthy Eating and Healthy Diets”
“A Simple Guide to Green Earth and Saving the Environment”
“A Simple Guide to Pain and Its Management”
“A Simple Guide to Happiness and Contentment”
“A Simple Guide to Sarcopenia and Related Aging Diseases”
“A Pictoral Trip to Italy 2007
“The Story of the Time Travel Watch”
“Womb Gloom! The Story of A Cancer Survivor”
“A Simple Guide to Insect Bites and Their Management”
“A Simple Guide to Night Blindness and Causative Diseases”
“A Simple Guide to the Breast and its Diseases”
“A Simple Guide to Cystic Fibrosis and Lung Disorders”
“A Simple Guide to Lymphatic System and Lymphatic Diseases”
“A Simple Guide to The Tongue, Diseases and Use in Disease Diagnosis”
“A Simple Guide to The Nail, Diseases and Use in Disease Diagnosis”
“A Simple Guide to The Gait, Diseases and Use in Disease Diagnosis”
“A Simple Guide to The Posture, Spine Diseases and Use in Disease Diagnosis”
“A Simple Guide to The Face, Their Diseases and Use in Disease Diagnosis”
“A Simple Guide to Intestinal Parasitic Diseases “
“A Simple Guide to The Neck, Their Diseases and Use in Disease Diagnosis”
“A Simple Guide to The Urinary System, Their Diseases and Use in Disease Diagnosis”
“A Simple Guide to The Wounds and wound Healing”.
“A Simple Guide to Heart Beats, Their Diseases and Use in Disease Diagnosis”
“A Simple Guide to Blood Cells, Their Diseases and Use in Disease Diagnosis”
“A Simple Guide to The Eyes, Eye Diseases and Use in Disease Diagnosis”
“A Simple Guide to Speech, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Hemoptysis, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Hematuria, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Hematemesis, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Blood in Stools, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Breath Sounds, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Metabolic Diseases”
“A Simple Guide to Chest x-rays, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Chest Appearances, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Infertility and Related Diseases”
“A Simple Guide to Abdominal Signs, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Hand Tremors, Related Diseases and Use in Disease Diagnosis”
“A Simple Guide to Heart Valve Diseases”
“A Simple Guide to Congenital Heart Diseases”
“Life and Death of a Red Blood Cell (Red Bull)”
“Life and Death of a Sperm (Speedy Gonzales)”
“Life and Death of an Ovum (Lazy Lucy)”
“Life and Death of a Lymphocyte (Immune Man)”
“Life and Death of a Cancer Cell (Mutant)”
“Life and Death of a Nerve Cell (Motor Man)”
“Life and Death of a Skeletal Muscle Cell (Muscle Man)”
“Life and Death of a Heart Muscle Cell (Heart Man)”
“Life and Death of a Smooth Muscle Cell (Smooth Man)”
“Life and Death of a Hair Follicle Cell (Hairy Man)”
“Life and Death of a Liver Cell (Liver Man)”
“Life and Death of a Bone Cell (Bone Man)”
“Life and Death of a Nail (Nail Man)”
“Life and Death of a Macrophage (Macrophage)”
“Life and Death of a Skin Cell (Skin Man)”
“Life and Death of a Pancreatic Islet Cell (Insulin Man)”
“Life and Death of a Pancreatic Duct Cell (Pancreas Man)”
“Life and Death of a Pituitary Gland Cell (Pituitary Man)”
“Life and Death of a Thymus Gland Cell (Thymus Man)”
“Life and Death of an Adrenal Gland Cell (Adrenaline Man)”
“Life and Death of a Parathyroid Gland Cell (Calcium Man)”
“Life and Death of a Thyroid Gland Cell (Energy Man)”
“Life and Death of a Testis Gland Cell (Virile Man)”
“Life and Death of a Ovary Gland Cell (Fertile Female)”
“A Simple Guide to Digestion of Food in the Stomach”
“A Simple Guide to Digestion of Food in the Intestines”
“A Simple Guide to Digestion of Food in the Mouth and Gullet”
“A Simple Guide to SARS and Related Influenza Epidemics”
“A Simple Guide to Urinary Excretion and Kidney Function”
“A Simple Guide to Male Reproductive System”
“A Simple Guide to Female Reproductive System”
“A Simple Guide to Larynx and Its Function”
“A Simple Guide to The Lungs and Its Functions”
“A Simple Guide to The Ear and Its Functions”
“A Simple Guide to The Eye and Its Functions”
“A Simple Guide to The Nose and Its Functions”
“A Simple Guide to The Tongue and Its Functions”
“A Simple Guide to The Spleen and Its Functions”
“A Simple Guide to The Breast and Its Functions”
“A Simple Guide to The Platelets and Its Functions”
“A Simple Guide to The Pineal Body and Its Functions”
“A Simple Guide to The Skin and Its Functions”
“A Simple Guide to The Salivary Glands and Its Functions”
“A Simple Guide to The Lips and Its Functions”
“A Simple Guide to The Brain and Its Functions”
“A Simple Guide to The Hairs and Its Functions”
“A Simple Guide to The Gallbladder and Its Functions”
“A Simple Guide to The Heart and Its Functions”
“A Simple Guide to The Spinal Cord and Its Functions”
“A Simple Guide to The Vagina and Its Functions”
“A Simple Guide to The Penis and Its Functions”
“A Simple Guide to The Nail and Its Functions”
“A Simple Guide to The Bone and Its Functions”
“A Simple Guide to The Knee and Its Functions”
“A Simple Guide to The Shoulder and Its Functions”
“A Simple Guide to The Hip and Its Functions”
“A Simple Guide to The Ankle and Its Functions”
“A Simple Guide to The Elbow and Its Functions”
“A Simple Guide to The Wrist and Its Functions”
“A Simple Guide to The Hand and Its Functions”
“A Simple Guide to The Foot and Its Functions”
“A Simple Guide to The Thyroid and Its Functions”
“A Simple Guide to The Parathyroid and Its Functions”
“A Simple Guide to The Thymus and Its Functions”
“A Simple Guide to The Testis and Its Functions”
“A Simple Guide to The Ovary and Its Functions”
“A Simple Guide to The Nerve and Its Functions”
“A Simple Guide to The Muscle and Its Functions”
“A Simple Guide to The Heart Muscle and Its Functions”
“A Simple Guide to The Smooth Muscle and Its Functions”
“A Simple Guide to The Liver and Its Functions”
“A Simple Guide to The Pancreas and Its Functions”
“A Simple Guide to The White Blood Cell and Its Functions”
“A Simple Guide to The Jaw and Its Functions”
“A Simple Guide to The Finger and Its Functions”
“A Simple Guide to The Toe and Its Functions”
“A Simple Guide to My Poems and Stories about the Human body”
“A Simple Guide to the Healthy Lifestyle Part 1 DIET”
“A Simple Guide to the Healthy Lifestyle Part 2 EXERCISE”
“A Simple Guide to the Healthy Lifestyle Part 3 RELAXATION”
“A Simple Guide to the Healthy Lifestyle Part 4 790 Health Tips”
“A Simple Guide to the Cancer Survivor and Anti-cancer Tips”
“A Simple Guide to the Occupational Cancers and Prevention”
“A Simple Guide to the Chemical Poisoning and Prevention”
“A Simple Guide to the Work Related Skin Diseases and Prevention”
“A Simple Guide to the Work Related Eye and Prevention”
“A Simple Guide to the Work Related Ear Diseases and Prevention”
“A Simple Guide to the Work Related Anemia and Prevention”
“A Simple Guide to the Work Related Heat Diseases and Prevention”
“A Simple Guide to the Work Related PTSDs and Prevention”
“A Simple Guide to the Work Related Infections and Prevention”
“A Simple Guide to the Work Related Lung Diseases and Prevention”
“A Simple Guide to the Work Related Muscle & Skeletal Diseases and Prevention”
“A Simple Guide to the Work Related Nose Diseases and Prevention”
“A Simple Guide to the Work Related Liver Diseases and Prevention”
“A Simple Guide to the Work Related Thyroid Diseases and Prevention”
“A Simple Guide to the Work Related Bladder Diseases and Prevention”
“A Simple Guide to the Work Related Blood Diseases and Prevention”
“A Simple Guide to the Work Related Compressed Air Diseases and Prevention”
“A Simple Guide to the Restless Legs Syndrome and Related Conditions”
“A Simple Guide to Self Esteeem and Related Conditions”
“After a Head Injury and Related Conditions”
“After a Stroke, Recovery and Related Conditions”
“A Simple Guide to Sexual Abuse and Related Conditions”
“A Simple Guide to Systemic Sclerosis and Related Conditions”
“A Simple Guide to Human Growth Hormones and Related Hormones”
“A Simple Guide to Chronic Pain, Treatment and Related Conditions”
“A Simple Guide to Sprains and strains, Treatment and Related Conditions”
“A Simple Guide to Knee Injuries, Treatment and Related Conditions”
“Guide to Doctors, Medical Ethics and Medical Trivia”
“The Case of the Missing Parents”
A Family Doctor's Tale 