
Dr. Shamit Chopra, MS, MD (US), FAHNS (Fellow, American Head and Neck Society)
HoD & Division Head, Head & Neck Oncology, Microvascular & Robotic Surgery
WHAT ARE HEAD & NECK CANCERS?
Head and neck cancer generally refers to cancers of the inner lining (mucosa) of the nose, mouth, throat, voice box, and the lymph nodes of the neck in around 90% of cases. Cancers of the thyroid and salivary glands, skin cancers and tumors arising from non-mucosal structures within the head and neck comprise the remainder.
Head and neck cancers are the commonest cancers in India and constitute about 30% of the total cancer case load in the country. In contrast, they are the sixth commonest cancers worldwide.
WHAT CAUSES HEAD AND NECK CANCERS?
– Cigarette/bidi smoking or chewing tobacco over a prolonged time period is the predominant risk factor
– Prolonged & excessive intake of alcohol.
– Betel nut chewing and oral submucous fibrosis (unique to the Indian population)
– HPV (Human Papilloma Virus) infection
– Exposure to certain chemicals- nickel, arsenic, chromates and wood dust.
– Long-term (chronic) irritation from dentures, sharp teeth or hot spicy foods.
– Prior exposure to radiation (for thyroid cancers)
– Contrary to a popular myth, head and neck cancer (with the exception of medullary thyroid carcinoma) does not run in families.
WHAT ARE THE COMMON SYMPTOMS OF HEAD AND NECK CANCERS?
- A lump in the nose, neck or throat, with or without pain
- A persistent sore throat
- Trouble swallowing (dysphagia)
- Unexplained weight loss
- Frequent coughing
- Change in voice or hoarseness
- Ear pain or trouble hearing
- Headaches
- A red or white patch in the mouth
- Bad breath that’s unexplained by hygiene
- Nasal obstruction or persistent congestion
- Frequent nose bleeds or unusual discharge
- Trouble breathing
WHAT HELPS US MAKE THE DIAGNOSIS OF HEAD AND NECK CANCER?
– Thorough history
– Detailed physical examination, with emphasis on the head and neck
– Fine-needle aspiration biopsy (sampling cells by using a needle) of an enlarged lump in the neck, thyroid or salivary glands
– Biopsy (taking a small piece of tissue) of an ulcer or growth in the mouth, throat, nasal cavity, or a skin lesion
– Radiology, including ultrasound of the neck, CT and MRI scanning of the head and neck
– Nuclear medicine scanning, including various isotope scans and PET scan
– At present, there are no reliable blood tests or markers, unlike other cancers, that help us diagnose head and neck squamous cell carcinomas. Thyroglobulin and calcitonin are markers for different variants of thyroid cancers.
HOW IS HEAD AND NECK CANCER TREATED?
After obtaining a diagnosis and assigning a disease stage (cancers are staged I to IV), treatment options are discussed among the surgical, radiation and medical oncologists, pathologists and radiologists in the multidisciplinary tumor board conference.
Broadly speaking, early-stage disease (I and II) is treated with single modality treatment (surgery or radiation therapy- the choice is dictated by the site and type of cancer, and by patient factors). Advanced disease (III and IV) is treated with multimodality treatment (two or sometimes all three modalities of surgery, radiation therapy and chemotherapy). A multidisciplinary approach to treatment should be followed, and speech and swallowing therapists, psychological counselors and social and rehabilitation workers should be involved in patient care.
ARE HEAD AND NECK CANCERS CURABLE?
The curability of head and neck cancer, like all other cancers, depends on the stage of the disease. Cure rates of head and neck cancer are higher than of most other body sites if the appropriate treatment can be given. In a developing country like ours, patients may ignore the abovementioned symptoms or seek alternative treatments. By the time they present to a cancer specialist, they may have advanced disease. Spread to the lymph nodes of the neck decreases the cure rate by about 50%; and spread to the chest indicates a dismal prognosis, with the only remaining option being chemotherapy. The vast majority of thyroid cancers have a 90-95% cure rate with surgery with or without radioactive iodine.
Hey There. I discovered your weblog the use of msn. That is an extremely neatly written article. I will make sure to bookmark it and return to learn more of your useful info. Thanks for the post. I will certainly return.
It is my belief that mesothelioma is actually the most deadly cancer. It has unusual qualities. The more I look at it the more I am persuaded it does not behave like a true solid flesh cancer. In the event that mesothelioma can be a rogue viral infection, so there is the probability of developing a vaccine plus offering vaccination for asbestos open people who are open to high risk regarding developing upcoming asbestos associated malignancies. Thanks for discussing your ideas about this important ailment.
I’d like to find out more? I’d like to find out more details.
Hello just wanted to give you a quick heads up. The words in your post seem to be running off the screen in Chrome. I’m not sure if this is a format issue or something to do with internet browser compatibility but I figured I’d post to let you know. The style and design look great though! Hope you get the issue resolved soon. Cheers
Incredible points. Solid arguments. Keep up to date the great spirit.
Also visit my page – MelXArvelo
I simply want to say I am very new to blogs and seriously loved this web site. Almost certainly I’m want to bookmark your blog post . You absolutely come with beneficial articles. Thanks for sharing your blog site.
Pretty! This was a really wonderful post. Many thanks for supplying this information.
Here is my web site :: vegan travelers notebook
Nice blog here! Also your site loads up fast! What hosting company have you been using?
Can I get your affiliate hyperlink to your host? If only my site loaded as quickly as yours lol
Here is my web-site – LoydOMeehl
I simply want to tell you that I’m beginner to blogs and really savored your web-site. Almost certainly I’m going to bookmark your website . You definitely have really good well written articles. Thank you for revealing your website page.
Thanks for the auspicious writeup. It if truth be told was once a leisure account it. Look advanced to more added agreeable from you! However, how can we communicate?
I simply want to say I am just very new to weblog and definitely savored this web blog. Very likely I’m planning to bookmark your site . You absolutely have tremendous well written articles. Thank you for sharing with us your blog.
whoah this blog is magnificent i love reading your articles. Keep up the good work! You know, lots of people are hunting around for this information, you could aid them greatly.
What i do not realize is if truth be told how you’re no longer actually a lot more well-liked than you might be now. You’re so intelligent. You recognize therefore considerably in relation to this subject, made me for my part consider it from so many numerous angles. Its like men and women are not interested until it¡¦s something to accomplish with Girl gaga! Your individual stuffs excellent. All the time handle it up!
I’ve been exploring for a bit for any high quality articles or blog posts on this sort of space . Exploring in Yahoo I eventually stumbled upon this site. Reading this info So i’m glad to exhibit that I have a very good uncanny feeling I discovered just what I needed. I most unquestionably will make certain to do not omit this web site and provides it a look regularly.
I carry on listening to the news broadcast speak about receiving boundless online grant applications so I have been looking around for the top site to get one. Could you advise me please, where could i get some?
Superb post however I was wanting to know if you could write a litte more on this topic? I’d be very grateful if you could elaborate a little bit further. Bless you!
Great post but I was wondering if you could write a litte more on this topic? I’d be very grateful if you could elaborate a little bit more. Many thanks!
I just want to mention I’m beginner to blogs and truly liked you’re blog site. Probably I’m going to bookmark your blog post . You definitely have wonderful well written articles. Thanks for sharing your web site.
You’re consequently amazing. Oh my Lord. Lord bless you.
I’m amazed, I must say. Seldom do I come across a blog that’s equally educative and entertaining, and without a doubt, you’ve hit the nail on the head. The issue is something too few folks are speaking intelligently about. I’m very happy that I stumbled across this during my search for something relating to this.
You really make it seem so easy with your presentation but I find this matter to be really something which I think I would never understand. It seems too complicated and extremely broad for me. I am looking forward for your next post, I’ll try to get the hang of it!
Best view i have ever seen !
I blog frequently and I really thank you for your information. This great article has really peaked my interest. I’m going to bookmark your blog and keep checking for new details about once per week. I opted in for your Feed as well.
Best view i have ever seen !
One important thing is that while you are searching for a student loan you may find that you will want a co-signer. There are many circumstances where this is true because you will find that you do not employ a past credit standing so the financial institution will require that you’ve got someone cosign the borrowed funds for you. Great post.
It’s really a nice and useful piece of information. I’m happy that you shared this useful information with us. Please keep us up to date like this. Thank you for sharing.
Would you be focused on exchanging hyperlinks?
Best view i have ever seen !
Best view i have ever seen !
Excellent web site you have got here.. It’s hard to find high-quality writing like yours these days. I really appreciate individuals like you! Take care!!
Very good info. Lucky me I found your website by chance (stumbleupon). I’ve book-marked it for later.
Best view i have ever seen !
If you are looking for the ultimate extreminator company, look no more. These guys dominate!
Thank you for another informative website. Where else could I am getting that type of info written in such a perfect means? I’ve a undertaking that I am just now working on, and I have been on the glance out for such info.
bookmarked!!, I love your web site.
Great information. Lucky me I found your site by chance (stumbleupon). I’ve book-marked it for later!
Someone essentially assist to make severely posts I might state. That is the very first time I frequented your website page and so far? I surprised with the analysis you made to create this particular submit incredible. Magnificent task!
Having read this I believed it was rather informative. I appreciate you spending some time and energy to put Judi Bola Online this article together. I once again find myself spending way too much time both reading and commenting
Great blog post! I’ll be back to view your next piece! Thank you!
That is a good tip particularly to those fresh to the blogosphere. Simple but very accurate info… Thank you for sharing this one. A must read article.
This is the perfect site for everyone who wants to understand this topic. You realize a whole lot its almost tough to argue with you (not that I personally will need to…HaHa). You definitely put a fresh spin on a topic that’s been discussed for a long time. Wonderful stuff, just wonderful.
Informative Site… Hello guys here are some links that contains information that you may find useful yourselves. It’s Worth Checking out….Chrissy Bowlby
Hi, I do believe this is an excellent web site. I stumbledupon it 😉 I am going to return yet again since i have book-marked it. Money and freedom is the best way to change, may you be rich and continue to help other people.
Greetings! Very helpful advice in this particular article! It’s the little changes that will make the greatest changes. Thanks for sharing!
I wanted to thank you for this wonderful read!! I certainly enjoyed every bit of it. I have you book-marked to look at new things you post…
I really loved this blog post. You are an excellent writer. I’ll be back to see more! Thank you
Good day! I just would like to offer you a big thumbs up for the great info you have here on this post. I will be coming back to your website for more soon.
Generally I don’t read article on blogs, but I wish to say that this write-up very forced me to try and do it! Your writing style has been amazed me. Thanks, very nice article.
Having read this I thought it was extremely enlightening. I appreciate you taking the time and effort to put Judi Bola Online this article together. I once again find myself spending a lot of time both reading and commenting
Everything is very open with a clear clarification of the challenges. It was truly informative. Your site is very helpful. Thanks for sharing!
Good day! Do you know if they make any plugins to safeguard against hackers? I’m kinda paranoid about losing everything I’ve worked hard on. Any recommendations?
Howdy! This post could not be written any better! Reading this post reminds me of my old room mate! He always kept talking about this. I will forward this post to him. Fairly certain he will have a good read. Thank you for sharing!
I’ll right away grab your rss as I can not find your e-mail subscription link or e-newsletter service. Do you’ve any? Kindly let me know in order that I could subscribe. Thanks.
This is a really good site post, I’m delighted I came across it. I’ll be back down the track to check out other posts that
Great web site you have got here.. It’s difficult to find high quality writing like yours nowadays. I seriously appreciate people like you! Take care!!
Thank you for writing this excellent content. I will return to read more.
Acquiring the appropriate hyperlink developing support can assist you to improve your web page position and popularity inside a small span of time.
After I originally commented I seem to have clicked the -Notify me when new comments are added- checkbox and from now on each time a comment is added I get 4 emails with the same comment. There has to be a way you can remove me from that service? Thanks.
you have a wonderful weblog here! do you want to make some invite posts in this little blog?
Your style is so unique compared to other folks I have read stuff from. I appreciate you for posting when you’ve got the opportunity, Guess I’ll just book mark this page.
Excellent web site you’ve got here.. It’s difficult to find good quality writing like yours these days. I honestly appreciate individuals like you! Take care!!
Everyone loves it when folks get together and share opinions. Great blog, stick with it.
Hello there! I know this is somewhat off topic but I was wondering which blog platform are you using for this site? I’m getting sick and tired of WordPress because I’ve had problems with hackers and I’m looking at options for another platform. I would be awesome if you could point me in the direction of a good platform.
I enjoy reading through an article that will make men and women think. Also, many thanks for allowing me to comment.
This can be an inspiration to many people. Very good job
Oh my goodness! an amazing post dude. Thanks Nevertheless I’m experiencing issue with ur rss . Do not know why Struggle to subscribe to it. Possibly there is any person acquiring identical rss problem? Anyone who knows kindly respond. Thnkx
This blog was… how do you say it? Relevant!! Finally I have found something that helped me. Thanks!
Way cool! Some extremely valid points! I appreciate you penning this write-up and the rest of the website is really good.
What i do not understood is actually how you’re not actually much more well-liked than you might be right now. You’re so intelligent. You realize thus considerably relating to this subject, produced me personally consider it from numerous varied angles. Its like men and women aren’t fascinated unless it is one thing to do with Lady gaga! Your own stuffs great. Always maintain it up!
I love reading a post that will make men and women think. Also, thanks for allowing me to comment.
Yes a ton of sod in the back of a hot wheels tonka truck will break the axel-happy you’ve all learned s/t for the day but can u please drive|ShrakeCulture|
bookmarked!!, I really like your blog!
Greetings! Very useful advice within this article! It is the little changes that make the most important changes. Many thanks for sharing!
I have to thank you for the efforts you have put in penning this blog. I am hoping to check out the same high-grade blog posts by you in the future as well. In truth, your creative writing abilities has inspired me to get my own, personal site now 😉
Everything is very open with a very clear clarification of the challenges. It was really informative. Your website is extremely helpful. Many thanks for sharing.
Hello, I think your blog could be having web browser compatibility issues. When I take a look at your site in Safari, it looks fine however when opening in I.E., it’s got some overlapping issues. I simply wanted to provide you with a quick heads up! Apart from that, wonderful blog.
Immigration Lawyers… […]the time to read or visit the content or sites we have linked to below the[…]…water delivery
Your style is so unique compared to other folks I have read stuff from. Thank you for posting when you have the opportunity, Guess I will just book mark this blog.
Great job with the blog, I’ve been stopping by here for quite some time, just wanted to let you know!
quite interesting article. however, in some cases it still needs improvement.
if you want a great wedding decoration, just fill them up with lots of flowers and laces.,
At this time it looks like WordPress is the best blogging platform available right now. (from what I’ve read) Is that what you are using on your blog?
Pretty nice post. I just stumbled upon your weblog and wished to say that I have really enjoyed browsing your blog posts. In any case I will be subscribing to your rss feed and I hope you write again soon!
Hello there! I just want to give you a big thumbs up for the excellent information you’ve got right here on this post. I will be returning to your web site for more soon.
Pretty nice post. I just stumbled upon your blog and wished to say that I have truly enjoyed surfing around your blog posts. In any case I will be subscribing to your feed and I hope you write again very soon!
Hi there would you mind sharing which blog platform you’re working with? I’m going to start my own blog in the near future but I’m having a difficult time deciding between BlogEngine/Wordpress/B2evolution and Drupal. The reason I ask is because your design and style seems different then most blogs and I’m looking for something unique. P.S Sorry for getting off-topic but I had to ask!
Wow! This can be one particular of the most useful blogs We’ve ever arrive across on this subject. Basically Wonderful. I’m also an expert in this topic therefore I can understand your effort.
I’ll right away take hold of your rss feed as I can’t find your e-mail subscription link or e-newsletter service. Do you have any? Kindly permit me realize in order that I could subscribe. Thanks.
Amazing this kind of guide is definitely incredible it really aided me and also our kids, thanks a lot!
your writing really helped me I know what steps to take.
I must say, as a lot as I enjoyed reading what you had to say, I couldnt help but lose interest after a while. Its as if you had a wonderful grasp on the subject matter, but you forgot to include your readers. Perhaps you should think about this from far more than one angle. Or maybe you shouldnt generalise so considerably. Its better if you think about what others may have to say instead of just going for a gut reaction to the subject. Think about adjusting your own believed process and giving others who may read this the benefit of the doubt.Jobs offered
My brother recommended I might like this web site. He was entirely right. This post actually made my day. You cann’t imagine just how much time I had spent for this info! Thanks!
Hello my friend! I wish to say that this post is awesome, nice written and include almost all vital infos. I would like to see more posts like this.
This can be an inspiration to many people. Very good job
This site is amazing. I’ll return soon to see more. Thanks so much! Have a great day!
Enjoy this site. I’ll be back to read more of your stuff.
Hi there, I discovered your blog by means of Google while searching for a related topic, your web site got here up, it appears to be like good. I have bookmarked it in my google bookmarks.
you’re really a good webmaster. The website loading speed is amazing. It seems that you’re doing any unique trick. Also, The contents are masterwork. you have done a magnificent job on this topic!
Hi there! I could have sworn I’ve visited your blog before but after going through a few of the posts I realized it’s new to me. Anyways, I’m definitely pleased I found it and I’ll be bookmarking it and checking back frequently!
Great info. Lucky me I recently found your website by accident (stumbleupon). I’ve book-marked it for later!
Having read this I believed it was really enlightening. I appreciate you finding the time and effort to put this article together. I once again find myself personally spending a significant amount of time both reading and commenting. But so what, it was still worthwhile.
An intriguing discussion is worth comment. I do think that you ought to publish more about this issue, it may not be a taboo matter but usually folks don’t talk about these topics. To the next! Cheers.
I was just searching for this information for some time. After six hours of continuous Googleing, at last I got it in your web site. I wonder what is the lack of Google strategy that do not rank this kind of informative web sites in top of the list. Usually the top websites are full of garbage.
Thanks a lot for sharing this with all of us you really know what you’re talking about! Bookmarked. Please also visit my site =). We could have a link exchange contract between us!
Wow that was unusual. I just wrote an really long comment but after I clicked submit my comment didn’t appear. Grrrr… well I’m not writing all that over again. Anyway, just wanted to say superb blog!
hello there and thank you on your information – I have certainly picked up anything new from proper here. I did however expertise some technical points the use of this web site, as I skilled to reload the website a lot of times previous to I could get it to load properly. I had been considering if your hosting is OK? Now not that I’m complaining, however slow loading circumstances occasions will often have an effect on your placement in google and can damage your high quality score if ads and ***********|advertising|advertising|advertising and *********** with Adwords. Anyway I am including this RSS to my e-mail and could look out for a lot extra of your respective interesting content. Make sure you update this again soon..
May I simply just say what a comfort to discover somebody who genuinely knows what they’re talking about over the internet. You certainly know how to bring an issue to light and make it important. More people ought to look at this and understand this side of your story. I was surprised that you are not more popular given that you most certainly have the gift.
Your style is unique compared to other people I have read stuff from. I appreciate you for posting when you have the opportunity, Guess I will just bookmark this web site.
This site was… how do you say it? Relevant!! Finally I have found something that helped me. Thank you!
Oh my goodness! Amazing article dude! Thank you so much, However I am having difficulties with your RSS. I don’t understand the reason why I am unable to join it. Is there anyone else getting similar RSS issues? Anybody who knows the solution can you kindly respond? Thanks!!
When I initially commented I clicked the “Notify me when new comments are added” checkbox and now each time a comment is added I get three emails with the same comment. Is there any way you can remove me from that service? Bless you!
I blog frequently and I genuinely appreciate your content. This article has really peaked my interest. I am going to take a note of your site and keep checking for new information about once a week. I subscribed to your Feed as well.
Write more, thats all I have to say. Literally, it seems as though you relied on the video to make your point. You obviously know what youre talking about, why waste your intelligence on just posting videos to your site when you could be giving us something informative to read?
I was extremely pleased to discover this page. I wanted to thank you for ones time for this wonderful read!! I definitely enjoyed every part of it and I have you saved as a favorite to check out new things in your web site.
I have been reading out many of your stories and i must say pretty nice stuff. I will definitely bookmark your website.
I’m not that much of a internet reader to be honest but your blogs really nice, keep it up! I’ll go ahead and bookmark your site to come back later on. Cheers
I like this post, enjoyed this one thank you for putting up. “The reward for conformity was that everyone liked you except yourself.” by Rita Mae Brown.
Hey there just wanted to give you a brief heads up and let you know a few of the images aren’t loading correctly. I’m not sure why but I think its a linking issue. I’ve tried it in two different internet browsers and both show the same outcome.
Thank you for every other informative blog. Where else may I am getting that kind of information written in such a perfect manner? I’ve a challenge that I am just now operating on, and I have been on the look out for such info.
This is the perfect site for anyone who wants to understand this topic. You understand so much its almost tough to argue with you (not that I actually would want to횜HaHa). You definitely put a brand new spin on a subject that’s been written about for ages. Excellent stuff, just wonderful!
Hi there! This is my first visit to your blog! We are a group of volunteers and starting a new project in a community in the same niche. Your blog provided us useful information to work on. You have done a extraordinary job!
Everything is very open with a clear explanation of the challenges. It was definitely informative. Your site is very helpful. Many thanks for sharing!
I’m so happy to read this. This is the kind of manual that needs to be given and not the random misinformation that’s at the other blogs. Appreciate your sharing this best doc.
It’s actually a great and useful piece of info. I’m satisfied that you shared this useful information with us. Please keep us informed like this. Thanks for sharing.
There is noticeably a lot to identify about this. I assume you made some good points in features also.
Thanks a lot for sharing this with all of us you actually know what you’re talking about! Bookmarked. Kindly also visit my website =). We could have a link exchange agreement between us!
I’ve read some good stuff here. Definitely worth bookmarking for revisiting. I surprise how much effort you put to create such a wonderful informative site.
Thanks for the sensible critique. Me and my neighbor were just preparing to do a little research about this. We got a grab a book from our local library but I think I learned more clear from this post. I am very glad to see such wonderful info being shared freely out there.
I have been browsing on-line greater than 3 hours lately, but I never discovered any interesting article like yours. It抯 pretty value sufficient for me. In my opinion, if all website owners and bloggers made just right content as you probably did, the web might be a lot more helpful than ever before.
Just wish to say your article is as astounding. The clearness for your submit is just nice and that i could suppose you are knowledgeable in this subject. Fine along with your permission allow me to grab your feed to keep updated with approaching post. Thank you 1,000,000 and please carry on the gratifying work.
I was recommended this website by my cousin. I am not sure whether this post is written by him as no one else know such detailed about my trouble. You’re wonderful! Thanks!
Heya i am for the first time here. I came across this board and I find It truly useful & it helped me out much. I hope to give something back and help others like you helped me.
Having read this I believed it was rather enlightening. I appreciate you taking the time and effort to put this article together. I once again find myself spending way too much time both reading and leaving comments. But so what, it was still worth it!
I’m not that much of a internet reader to be honest but your sites really nice, keep it up! I’ll go ahead and bookmark your website to come back later. Cheers
I am just commenting to let you understand of the superb experience my cousin’s child found studying yuor web blog. She discovered too many issues, most notably what it’s like to possess an excellent teaching character to get men and women without problems fully understand several problematic matters. You truly did more than our expected results. Thanks for coming up with the powerful, healthy, revealing as well as cool tips on your topic to Emily.
This was an impressive blog post. I’ll come back to see more great stuff.
My partner and I absolutely love your blog and find a lot of your post’s to be just what I’m looking for. Do you offer guest writers to write content available for you? I wouldn’t mind composing a post or elaborating on a number of the subjects you write related to here. Again, awesome site!
Hello are using WordPress for your blog platform? I’m new to the blog world but I’m trying to get started and set up my own. Do you need any html coding expertise to make your own blog? Any help would be greatly appreciated!
you will have an important weblog here! would you wish to make some invite posts on my blog?
This is really interesting, You are a very skilled blogger. I have joined your rss feed and look forward to seeking more of your fantastic post. Also, I’ve shared your website in my social networks!
Aw, this was a really good post. Taking the time and actual effort to create a top notch article… but what can I say… I procrastinate a lot and never manage to get nearly anything done.
An interesting discussion is definitely worth comment. I do think that you need to write more about this subject, it may not be a taboo matter but typically people don’t talk about such topics. To the next! Kind regards.
Everything is very open with a really clear explanation of the issues. It was definitely informative. Your site is very helpful. Many thanks for sharing!
After checking out a number of the blog posts on your website, I really appreciate your way of writing a blog. I bookmarked it to my bookmark webpage list and will be checking back in the near future. Take a look at my website as well and let me know what you think.
I really appreciate this post. I have been looking all over for this! Thank goodness I found it on Bing. You’ve made my day! Thx again
5 Lies About Bleeding Gums Health https://bit.ly/36rfzdB
You completed a number of nice points there. I did a search on the issue and found nearly all people will have the same opinion with your blog.
Hi, I do think this is a great site. I stumbledupon it 😉 I am going to come back once again since i have saved as a favorite it. Money and freedom is the best way to change, may you be rich and continue to guide others.
This actually answered my drawback, thanks!
Hello There. I found your weblog the use of msn. This is a very neatly written article. I will make sure to bookmark it and return to read more of your helpful information. Thanks for the post. I’ll definitely comeback.
you have got a terrific blog right here! would you prefer to make some invite posts on my weblog?
Good – I should certainly pronounce, impressed with your website. I had no trouble navigating through all the tabs as well as related information ended up being truly simple to do to access. I recently found what I hoped for before you know it at all. Quite unusual. Is likely to appreciate it for those who add forums or anything, website theme . a tones way for your client to communicate. Nice task..
I was suggested this blog via my cousin. I’m now not sure whether this submit is written through him as nobody else recognize such targeted about my trouble. You’re incredible! Thanks!