July 17 Be Clear on Lung Cancer

July 17  Earlier diagnosis improves both survival and quality of life for those with the condition.

Lung cancer is the UK’s third most common cancer with over 46,000 new cases a year and more than 21,000 of those in women (2nd only to Breast Cancer).  But over 2/3rds are already too advanced fur curative treatment by the time they are diagnosed, so it’s really important to act on early symptoms – even if you’re young and don’t smoke.

CAUSES  Almost 90% of cases are linked to tobacco smoke, including past, passive and cannabis smoking;  it’s also linked to a wide range of environmental, workplace and indoor pollutants and toxins, including asbestos, and radon gas in high-granite areas.

Around 9% may be linked to eating too little fruit and veg, and you’re more at risk if a parent or sibling had lung cancer or if you have immune-system problems.  But 10% of cases affect Non-smokers, and although it’s more comment with age, a quarter of lung cancers are diagnosed before the age of 65.

THE SYMPTOMS  These can be caused by many other conditions, so it can be tempting to blame a ‘smoker’s cough’ or a lingering virus, and ignore a cough or breathlessness.  But if these are severe, or last more than 3 weeks, see your GP to rule out lung cancer, asthma, chronic obstructive pulmonary disease (COPD, which encompases chronic bronchitis and emphysema) and other lung or heart problems.

Your cough may be new, or have changed (for example, because it sounds different, occurs at different times of day, there is more or less phlegm, it’s harder to suppress, or you seem to have recurrent ‘chest infections’).  You may cough up some red or brown blood (always report this) and/or get out of breath more easily than you used to.  Or you may notice unusual tiredness, sudden unexpected weight loss (with or without reduced appetite), pain in your chest, back or shoulder or other ‘non-specific’ symptoms.

TESTS YOU MAY NEED  As well as heart, lung and blood pressure examination, your GP may suggest blood tests, including your oxygen levels, and ‘blowing’ tests (peak flow meter or Spirometry to assess your breathing capacity), a chest X-ray and a heart tracing (ECG) and/or scan (echocardiogram).  But if you’re over 40, and/or she can’t rule out cancer, she’ll refer you to be seen by a Lung Specialist within 2 weeks.  You may need a CT scan and a Bronchoscopy (telescope examination of your windpipe and lungs, taking tissue samples if necessary, using a local anaesthetic).

THE TREATMENT  This depends on a lung cancer’s type and grade (aggressiveness), and how far it has spread (for example, to lymph noes, the gullet,chest lining, or distant organs/bones).  Small, localised tumours can sometimes be fully surgically removed along with some or all of the nearby lung tissue (its possible to manage with one lung).  More advanced cancers may be treated with radiotherapy, chemotherapy, or a combination of the two, with additional treatment for more distant spread as needed.  If treatment isn’t successful, good palliative care and Macmillan (type) of Cancer Support can relieve distress.

(In Cyprus PASYKAF Home Care Nurses)


Don’t smoke – not smoking has lots of other benefits, too, and smoking outsidecan still affect people indoors.

23  If you work with substances that could be hazardous to health, follow protective advice

Avoid inhaling home cleaning and other products by ensure the room is well-ventilated; use the extractor fan when frying or cooking on the hob.

Wear a mask for dust-producing DIY;  Always check first for asbestos risks

Maintain a healthy weight with a balanced diet and plenty of fruit and veg

6  b as far away as you can from vehicle exhausts (use backstreets and avoid rush hour if you can

10)  Aug 17  Breast Cancer in the Family

Should you worry about Breast Cancer in the Family? – most forms aren’t hereditary, but there’s new drug advice for women with a family history

Breast cancer is one of the commonest cancers – new cases each year (including MEN), almost one in eight women will face this diagnosis.  Rates have increased since the 1990s; around a 1/4 may be preventable and almost 1/2 occur in women  over the age of 65.  But survival rates are increasing too, thanks to earlier diagnosis and better treatments; almost 90% live at least 5 years after being diagnosed, while many live for 20 years or more.

CAUSES – Enviroment/lifestyle factors can trigger gene mutations that lead to cancer, but some may be avoidable.  Almost 1 in 10 cases are linked to excessive body weight, possibly because it affects hormone levels; 1 in 16 are linked to alcohol Inactivity is another factor; smoking may increase some women’s risk.  Starting periods early or a late menopause, increase our risk, but childbearing and breastfeeding reduce it.  Risks increase while taking hormone replacement therapy (HRT) or the oral contraceptive pill, but fall to normal 5 to 10 years after stopping.

FAMILY HISTORY – Almost 90% of women with an affected first-degree relative (parent, sibling, child) won’t develop breast cancer.  However, some of us (few than 1 in 400) carry abnormal genes, such as TP53, PALB2 and PTEN, that significantly increase risk.  Up to 2/3 of women who carry the BRCA1/BRCA2 gene mutations develop breast cancer by the age of 70.  Your personal risk may be affected if you have Jewish ancenstry, an affected male relative, or a relative who has had breast cancer on both sides, ovarian cancer, a brain tumour, or a childhood adrenal gland tumour, or relatives who developed cancers at an early age.

If you’re worried, find out as much as you can before consulting your GP.  If you’re sure no one in your family has any of these, and you have just one affected first-degree or second-degree (grandparent, aunt, uncle niece,nephew or grandchild) relative, whose breast cancer developed after the age of 40, you may not need to worry, although you still need to be breast aware (see 5 Symptoms to Report)

TESTS and TREATMENT – If your family tree suggests you could have inherited high-risk genes you’ll be counselled about genetic testing.  Depending on your age and any results, you may be offered more frequent tests, such as MR scans, ultrasound or mammography.

You may also be offered risk-lowering treatment, ususally anti-oestrogen hormones such as Tamoxifen if you;re pre-menopausal; if you’re post-menopausal taking Anastrozole for at least 5 years.  These drugs can have side effects including bone-thinning osteoporosis, so you’ll need calcium/vitamin D supplements and regular bone scans.  Some women at very high risk are offered double mastectomy and/or ovary removal.


1  Any change in your breast shape, outline or skin (for example, dimpling/puckering)

2  Any new lump, lumpiness, thickening, or different ‘feel’ in your breast, nipple or armpit.

3  Persistent pain in your breast or armpit

4  Persistent change in the skin around your nipple – a rash, dryness, redness, weeping – or a change in the shape/direction of your nipple, including being drawn in.

5  Discharge from the nipple (clear or bloodstained)