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Cancer: your questions answered

Transcript

Who are you?

Hi, I am Rita Trewartha

and I'm head of clinical services for Bupa UK Insurance.

I'm a nurse with over 40 years

experience, come and ask me about cancer.

What is cancer?

Cancer is essentially a group of abnormal cells.

So it starts in the cells in our bodies.

I try to explain it

that the cells are like tiny little building blocks

that make up our organs and tissues throughout our bodies

and for them to grow and divide

they get signals to do that.

And those signals also tell them when to stop growing

and dividing and to die because they're no use anymore.

But sometimes also those signals can go wrong

and the cell becomes abnormal.

And those abnormal cells may also keep dividing

and dividing more

and developing into essentially forming a lump.

Now, often you'll hear lumps referred to as tumours.

Now tumours aren't necessarily cancers, not all lumps,

not all tumours are cancers.

The way that we find out the difference is

by taking a biopsy or a small sample of cells from that lump

or that tumour to determine

what it's made up of, essentially.

So the tumour or the lump might not be cancer,

and that would be called a benign tumour.

It can still grow, but it doesn't spread anywhere else in

the body and it only causes problems

and needs treatment if it's pressing on a structure

or something nearby, a muscle or an organ.

If it's not doing that, it will live there quite happily

and not cause any harm whatsoever.

A tumour that is cancer is called a malignant tumour,

and that can grow into nearby tissues,

and that is called a primary cancer site.

But also what it can do is travel to other parts

of the body, and it can do that through the blood

or the lymphatic system in the body.

And if it does that,

then it can settle deposits elsewhere in the body,

which can form other lumps or tumours that can grow.

And that's called a metastatic cancer.

So a secondary cancer to the primary site,

but all part of the same cancer really.

I suppose the other thing to also mention is

that cancer can form in the blood cells or the bone marrow,

and that develops into what we call

as a group blood cancers.

So one of those that you might have heard

of quite frequently is leukaemia.

So in essence,

actually cancer is a group of abnormal cells.

How common is cancer?

So one in two of us will be diagnosed

with cancer in our lifetimes with the highest lifetime risk

for females being for breast, lung, and bowel cancer

and for males being prostate, lung, and bowel cancer.

And we have seen an increase over recent years in cases

that are being identified, but that's

because we are much more aware now of the risks

and we are being screened more regularly

through our national programmes.

So we are catching cancers much earlier.

For the 10 most common cancer types, more than 70% with

of those cases in the UK have been attributable

to known risk factors, and that includes lung

and melanoma, skin cancer, which are 2

of the 5 most common cancer types in the UK.

What can cause cancer?

When we think about causes of cancer,

we can't really just think about one thing.

I think it's really important to understand

that right at the outset.

So it could be, for example,

that there's been an inherited cancer gene variant.

So that's something a person inherits from a parent.

Now that doesn't mean you've got cancer,

it doesn't guarantee you are going to get cancer,

but it might mean that if you had some abnormal cancer cells

that would develop more rapidly than it would

for somebody without that gene variant.

And if that gene variant was common within a family,

as in more than one person in that family,

or several people had that gene variant in that family,

that could mean a certain type of cancer was more common in

that family than you would see somewhere else in

the larger population.

And I suppose we always need to throw in age as something

that is an increase in risk in terms of cancer.

But when we are thinking about that inherited gene variant,

it's really important to understand

that it's less than 5% to 10%.

So that's less than 5 to 10 people in every 100

that will actually carry that gene variant.

So lifestyle factors such as smoking, being overweight

or obese, drinking alcohol above recommended levels,

over exposure to UV radiation from the sun,

those are the things that are much more likely

to influence you or me on a day-to-day basis.

How do I know if I am at risk of cancer?

So a person's risk of developing cancer depends on lots

of different factors, including age, genetics,

and external risk factors.

So those more associated with lifestyle.

Understanding your risk means, for example,

understanding if there is any family history,

but also what those external risk factors are

and actually how they apply to your life.

So as we know, smoking and overweight

and obesity are the primary preventable risk factors,

and 35% of all cancers

that's about 135,000 cases every year are preventable.

So you can start to better understand your risk.

I think other things that help us understand risk include,

for example, that lung, breast, bowel,

and melanoma skin cancers account for almost two thirds

of preventable cancer cases in the uk. Over exposure to UV,

so the sunshine

and substances at work, drinking alcohol to excess,

and too little dietary fibre.

Each of those could be responsible for 3% to 4%

of cancer cases in the UK.

And then there's some lesser known exposure risks.

So ionising radiation, x-rays,

or eating processed food that can account for about 1%

to 2% of cases.

And then even smaller than that, air pollution

or doing too little physical activity

could cause about 1% of cancers in the UK.

What are the main forms of cancer?

Currently in the UK, more than half

of new cancer cases in males is prostate,

lung, or bowel cancer.

And in females, half of new cases are either breast,

lung, or bowel cancer.

Can cancer be prevented?

So research shows that 35% approximately

of cancers are preventable.

And we know that smoking is the largest single preventable

cause of cancer in the UK each year,

and that's according to Cancer Research UK.

And we also know that being overweight

or obese is the second highest preventable cause of cancer.

So these are what I would refer to

as modifiable risk factors.

So something we can try to influence or do something about.

Not always easy, it doesn't mean we can't try.

So stopping smoking, maintaining

or achieving a healthy weight through diet

and exercise, following the recommended alcohol intake

guidelines and protecting ourselves from those potentially

harmful UV rays

by simple things using sunscreen and covering up.

So there's lots that we can do to contribute

to the prevention of cancer.

What percentage of cancers are preventable?

According to Cancer Research UK, over 35%

of cancers are preventable.

There's been a lot of research on this

and the World Health Organisation estimate that figure is

between 30% and 50% worldwide.

The main point to remember is managing your risk factors

and watching for changes in your body or any symptoms.

Can vaccines help to prevent cancer?

So there's an awful lot of research going on in this area

at the moment that's looking really, really positive.

But one development that there has been is the vaccine

for HPV, that's the human papilloma virus

that was identified a number of years ago as certain strains

of it being responsible for a significant amount

of cervical cancers in women.

The HPV vaccine has now been rolled out as part

of a school's programme to 11 and 13 year olds,

and that has had a significant impact in terms

of the prevention of cervical cancer.

Does genetic testing help to prevent cancer?

No, but it can help to identify if you are at greater risk

of developing cancer.

Genetic testing is a really complex area

and the results can sometimes be very

difficult to interpret.

I think I would always recommend getting some advice

before getting any testing,

and then use that healthcare professional advice

to help you interpret the results.

Does the risk of cancer increase as you age?

Sadly, yes, but it's still important

to keep a healthy lifestyle.

Half of cancers in the UK are prevalent

in the over seventies.

It doesn't mean that you will get cancer, so

therefore it's still important

to manage those lifestyle risk factors,

and also important to access any screening

that you are eligible for,

and also seek health professional advice if you've got any

symptoms at all.

How can I protect myself against cancer?

So firstly, make sure

that you access your cancer screening programmes

as you become eligible

or any other routine health checks that are available

to you, either through your GP surgery

or possibly even through work.

But most importantly,

protecting yourself is about understanding

what the risks are and checking if there is anything in your

lifestyle that you can do to modify those risks.

We know, for example, smoking and being overweight

or obese are the leading risk factors,

and 1 in 20 cancer cases are caused

by being overweight or obese.

And that research identifies approximately 35 million people

in the country at the moment are overweight or obese.

Now, that's measured on the body mass index scale,

and A BMI of over 25 is considered overweight or obese.

So that's something easy that you can check.

So depending on your circumstances, there could be lots

of things that you can do to reduce your risk

of getting cancer.

Can I get cancer more than once?

Sadly, yes, it could be a recurrence

or it could be something new.

Follow-ups are important

and recurrent cancer starts with cancer cells

that the first treatment didn't fully remove or destroy.

Now, this doesn't mean

that the treatment you received was wrong.

It just means that a small number of cancer cells

survived the treatment and were too small

to show up in follow-up tests over time.

These then grew into tumours

or cancer that your doctor can now detect.

Sometimes a new type

of cancer will occur in people

who've had a history of cancer.

When this happens, the new cancer is known

as a second primary cancer,

and the second primary cancer is different

from a recurrent cancer.

A recurrent cancer can be localised,

so literally in the same place as the original cancer,

or it can be regional,

and that means it's grown into lymph nodes

and tissues near to the original cancer.

Or it can be a distant recurrence,

and this means that the cancer has spread to organs

or tissues far from the original cancer.

It's called metastatic cancer or metastases.

I've had cancer before can I prevent it reoccurring?

You can minimise the risk of recurrence.

So if you are on ongoing treatment

because you're in remission, sticking to that treatment

and having your regular follow-ups

is really, really important.

If you are completely in remission,

but you have lifestyle factors that might pose a risk.

So overweight

and obesity, exposure to UV radiation, sunshine,

it's about managing the risk factors associated

with a recurrence of cancer.

What are the most common misconceptions about cancer?

So I think the most common one is that it won't happen

to me or my family because there's no history,

but I think we all know somebody

that's probably been affected, so that just isn't true.

And then there's other myths around mobile phones

and the non-ionising radiation from those and burnt foods

and eating burnt foods.

Again, there's definitely no known link at this moment in

time in relation to cancer, plastic containers

and bottles drinking from them,

putting your food in plastic bags.

There's no evidence that increases your risk of cancer.

The same in relation to artificial sweeteners

and the same in relation to stress and pesticides

and genetically modified food.

None of those things have an increased link to cancer.

How can I check whether I have any cancer symptoms?

If you know what's normal for you, it's much easier

to notice anything that changes. So instead

of regular self checks doing the same thing the same

time on a regular basis.

Just be aware of what's normal for you

and listen to your body,

and if something doesn't feel right, then you need to go

and get that checked from a health professional.

Go and speak to someone.

Listen to your body and speak to that health professional

because we know if you spot cancer at an early stage,

that does save lives.

Now a lot of people do talk about those regular checks,

but there's no evidence that that really helps.

So think about if we are talking about bowel cancer,

for example, changes in that bowel habit.

How often you go to the toilet can be an indicator

and a symptom, but it's normal for you.

So if you normally go to the toilet twice a day

and everything's the same as normal,

then you don't need to speak to anyone.

But if you start going much, much more regularly

or you can't go at all,

or the consistency is different, then that's the time to go

and get some advice.

We try not to be too prescriptive of

how long those symptoms should be there

before you seek advice,

because what's normal for you

isn't necessarily normal for me.

So listen to what your body's telling you

and get that professional advice, even if it's only

to put your mind at rest.

What symptoms should I look out for?

So there are lots and lots of different types of cancers,

which means there's lots

and lots of different types of symptoms.

So it's really not easy to give a list

and not all of those might resonate with you

or ring true for you anyway.

So some symptoms are going to be really obvious.

You are going to have a lump somewhere

that you haven't had before.

You can see a mole that's changed and is different,

but other symptoms might be more vague than that.

So you might be off your food, you might have lost weight

when you're not trying to lose weight,

you might be tired all the time and not know why that is.

There might not be a really good rationale for that.

So it really is very much about you feeling

or seeing something different for you, or as a friend

or family member, notice something different.

Then go and get that checked out with a health professional.

What can I do if I think I have cancer symptoms?

So the first thing for me is be brave and speak up.

As soon as you can. Go and see a healthcare professional.

If you've had symptoms, write it down so that you know

what you're saying to the GP.

If you can take a friend with you to help you remember,

if nothing else, whatever the doctor says to you,

that's really, really helpful

because you'll come out of that appointment

and you'll have forgotten everything

that anybody's said to you.

So fundamentally, the really, really important thing

that you really must do is if you think you've got symptoms,

go and get it checked out.

When should I seek professional advice about cancer?

Trust your instinct.

If something isn't normal for you,

if you think you've got symptoms, please go

and seek some professional advice.

If you're a Bupa customer, we have our direct acts

to cancer service so that you can phone us up

and we can give you a direct referral

to a consultant without consulting a gp,

or you can see a GP through our digital GP service,

and we also have our 24 hour Anytime Healthline manned

by nurses 24 hours a day, seven days a week.

Also, if you're invited to NHS screening appointments such

as mammogram or bowel cancer screening,

or for testicular checks,

please make sure you keep those appointments.

And do remember, just

because you've been screened, that doesn't mean

that you don't need

to get checked if you develop new symptoms in

between those screening times.

So if you get any new symptoms, even between your screening,

please also go and get those checked.

What should I do before going to the GP?

So gather your information,

get some support if you want somebody

to accompany you to your appointment.

Remember, the more detail you can share, the better it is,

but it's also not a test.

You don't have to diagnose yourself.

That's what the doctor's going to do.

And think of the questions that you want to ask.

Take your time and don't be afraid to say

that you don't understand when you get

the answers from the doctor.

Just because they've explained it once doesn't mean they

can't explain it again.

Check what happens next.

If the doctor suggests you need some tests

or investigations,

make sure you find out when they're likely to happen,

when you are likely to get the results.

And I think another important thing to do is

to check what you need to do.

If you are waiting for any investigations

to happen, who do you contact?

Who's best to follow up with?

Where can I go for helpful information about cancer?

So there are lots of trusted resources out there,

Bupa's own website, .co.uk, the McMillan website,

and also Cancer Research UK.

And of course, the NHS has got

loads and loads of information.

But please, please make sure you use one

of those trusted websites.

But if you've got some symptoms

that you are actually concerned about for you right now,

it's really important to speak to a health professional

and get the reassurance you need.

How do I access support through Bupa?

If you're a Bupa customer,

we have our direct access service where you can get straight

through to see a consultant without a GP referral.

If you already have a GP referral,

you can call our member services line.

We will assess your eligibility

and guide you to the most appropriate special.

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View transcript

is what are the typical signs and symptoms

that we can look out for?

The commonest ones, commonest two are

bleeding from the bottom and change your bowel habit

and that normally means either more loose or more frequent.

So people often think it's constipation,

I'm bit constipated and that means I’ve got bowel cancer,

it's actually the opposite, It's actually looser

and it's actually more frequent.

So if that remains for a period of time,

obviously, we gone out for a night out

and we've had a curry the night before,

we're not talking about that

we're talking about a sustained period of time

where your bowels just become a little bit looser.

And there are other there are other symptoms,

you can get bloating, you can feel abdominal pain,

you can pass mucus from your button, but the two

commonest things,

bleeding from your bottom

and change your bowel habit towards looseness.

And how important is it to tackle these signs early?

So if anybody is noticing that they're having these symptoms,

how quickly should they act really,

It's really, really vital.

The earlier you pick up on these things,

the better your outcome will be.

Every single time.

So what we know is that bowel cancer,

colorectal cancer starts off life as a polyp.

So it goes from normal bowel to polyp to cancer

and there's a period of time between those different steps.

So if we can pick up something at the stage where

it hasn't become cancerous and it's a benign polyp,

then will prevent the cancer happening completely.

But even if it has become cancer, then the earlier you pick it up

the earlier you deal with it, the better the outcome,

you know, always

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Signs and symptoms of bowel cancer

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is what are the typical signs and symptoms

that we can look out for?

The commonest ones, commonest two are

bleeding from the bottom and change your bowel habit

and that normally means either more loose or more frequent.

So people often think it's constipation,

I'm bit constipated and that means I’ve got bowel cancer,

it's actually the opposite, It's actually looser

and it's actually more frequent.

So if that remains for a period of time,

obviously, we gone out for a night out

and we've had a curry the night before,

we're not talking about that

we're talking about a sustained period of time

where your bowels just become a little bit looser.

And there are other there are other symptoms,

you can get bloating, you can feel abdominal pain,

you can pass mucus from your button, but the two

commonest things,

bleeding from your bottom

and change your bowel habit towards looseness.

And how important is it to tackle these signs early?

So if anybody is noticing that they're having these symptoms,

how quickly should they act really,

It's really, really vital.

The earlier you pick up on these things,

the better your outcome will be.

Every single time.

So what we know is that bowel cancer,

colorectal cancer starts off life as a polyp.

So it goes from normal bowel to polyp to cancer

and there's a period of time between those different steps.

So if we can pick up something at the stage where

it hasn't become cancerous and it's a benign polyp,

then will prevent the cancer happening completely.

But even if it has become cancer, then the earlier you pick it up

the earlier you deal with it, the better the outcome,

you know, always

View transcript
Hello and thank you for joining us on this myth busting session on all things skin cancer. So Petra, to start off with what are the different types of skin cancer? Well, Zoe, we broadly define them into two groups. Melanoma skin cancer and non-melanoma skin cancer. Most people have heard about melanoma, skin cancer. These are the types that we talk to people about looking for changes in moles or new moles. But actually the much more common skin cancers of the non-melanoma skin cancers such as basal cell carcinomas and squamous cell carcinomas So three types that can be grouped into those two groups. Okay. And what sort of symptoms should people be looking out for when it comes to skin cancer? You mentioned the moles and I think people tend to be aware of that, but what else is there? So in addition to changes in moles, which I think people are very aware of, I think people are much less aware of the symptoms that you might see with the other two skin cancers which make up the vast majority of skin cancers we see. So things like new skin growths. So flesh coloured growths, particularly particularly on the face, head and neck that develop over weeks and months, they may get little blood vessels on them. They look kind of pearly. Those are things that need to get checked out. And the other things are skin lesions, ulcers, scratches that don't heal. So we're looking at things that change over weeks and months and things that don't heal after three or four weeks. That's not common and probably needs to get checked out. Brilliant. And then lifestyle factors. So what are the things that might increase the risk of somebody getting skin cancer? We know that obviously genetics play a role. We can't do anything about our genetics. But what are the lifestyle factors that we can adjust? Well, the main one is exposure to sunlight. All skin cancers have a relationship to sunlight. Sunlight is UV light and UV light damages the skin. So we know that sunlight is the major factor. So for that, that's two things, really, the amount of time you spend in the sun, which actually can be reflected on how brown your skin goes and whether you've had periods of sunburn. These are two factors when it comes to sun exposure that increase your risk of skin cancer. There are other things such as genetics. So if you've got a family history of skin cancer that can make you more likely to get it, especially if there's a family history of melanoma and for some people, if they're on certain medications, that can make you more likely to have some of these non-melanoma skin cancers. And what types of medications would they be? So things affect your immune system. So the immunosuppressants are the ones we need to be most cautious about. Okay. So you mentioned that about genetics. The next question we can probably do quite quickly is, is skin cancer hereditary? In most cases it isn't. However, if you have had someone in the family, particularly with melanoma, it is worth mentioning that especially if you have a change in a mole or a new pigmented mole type lesion that you need checked out. I guess another reason to be really, really careful about protecting yourself from the sun. Here’s one, quick one to deal with. Probably. You can only develop skin cancer by sunbathing. True or false? I guess the answer is false, but also a little bit true. So sunbathing is exposure to the sun, but it's not just lying on a sun bed. Is that is that the thing that makes you get skin cancer? Not at all. It's any exposure to the sun. So I think people need to change their mindset. So there are lots of people that work outdoors and they feel that because they're outdoors and they get a base tan, they're protected. They're actually much more at risk than someone that might spend just one week a year on a sunbed. So it's the amount of sun you get and not in what position you are when you get that sun exposure. And I'm sure you are the same in GP, often the type of patient we will see who's affected by skin cancer will be often men who've worked outdoors, who've never sunbathe, so they think they're fine. And it's places like the tops of the ears, the nose, those places are pointing up towards the sun for many, many hours. Yeah, absolutely. And if you've not got much hair so the top of your head. So you haven't noticed it, the chest area, shoulders, so really common, those kind of areas. And you're absolutely right people think because they've not been sunbathers that their immune from those problems but actually they've they've still got the same risks. So here's another one, something I often get asked. People with dark skin do not develop skin cancers. That true or false? Oh, you know, I wish that was true. Certainly it’s much less common to get melanoma type skin cancers and all skin cancers in people with darker skin because the melanin they have in their skin is a protective factor. It's the thing your skin produces to protect the skin from the UV rays, which is. Why we do get a tan when we are in the sun because the skin's desperately trying to protect itself. Absolutely. But but it doesn't mean you're protected. And we still get skin cancers if we have pigmented skin, and it can be harder to pick them up. And for some reason and we don't know why, it seems that for people that do get melanoma, particularly in pigmented skin, they tend to have worse outcomes. So we pick them up later and they're more aggressive. So it's even more important to keep an eye on your skin and no reason not to use sun protection if you have pigmented skin. And it also protects the skin from other things like ageing as well. And Bob Marley, not a lot of people know, but Bob Marley actually died of skin cancer, so he had a type of skin cancer that affected the sole of his foot. We call that area if you get skin cancer, an ankle skin cancer, and that's what he got. And really unusual. And people perhaps if they see a pigmented lesion on the palm of their hand or sole of their foot, it wouldn't occur to them that this could be a skin cancer. But I think if that happens and, you know, go and see a GP. And also on the nail, you can get a melanoma on the skin underneath the nail, so worth getting that checked out as well. Next question, tanning beds don't pose a skin cancer risk. True or false? I mean, I hope this is a well known fact that tanning beds are directly linked to skin cancer risk. And there is no doubt about that. The scientific community are really clear. I think there are lots of dermatologists and oncologists would love to see tanning beds entirely banned, and there are very strict rules around who can use it. And how long. And the risks are clearly explained to people. But unfortunately there's still lots of people using them. And the link is very clear that there should be no doubt about that. I mean, I think in the last couple of decades, we've seen a huge shift, from tanning beds to using fake tan. And, you know, hopefully that will continue and eventually tanning beds Will be a thing of the past. There is no health benefit from using a tanning bed and no real reason why you should ever need to use one. Absolutely. If your skin tans and you don't burn. So, yeah, you go out in the sun, you turn a lovely, beautiful brown without any burning. Then you don't need to wear sun protection. True or false? False. False. Again. So yeah, tanning is a sign of sun damage and we know that UV light causes DNA changes in skin that actually makes you predisposed to skin cancer. So the browner you are, the more sun damage your skin has got. So, unfortunately, a tan, if it's come from sunlight, means you're damaging your skin and you know, premature ageing and wrinkles. Definitely one of the outcomes but increased risk of skin cancer. So unfortunately also false. But if you are somebody who so whether you tan beautifully or whether you burn to a crisp, you know, the fact that you're exposing your skin to the sun and seeing changes is a sign that you're damaging your skin. But if you're somebody who does burn easily, is that damage more significant than somebody who tans? Well, there's two groups of people, I think. We know that people that burn or have have episodes of burning, even if you don't burn easily. We know that causes significant DNA damage to the skin and will make you more likely to have a skin cancer. But people that have long exposure also have increased risk of skin cancers, different skin cancers, admittedly, but still problems in the future. If you are someone with very fair skin and you do burn easily, however, your overall risk of skin cancer is higher than if you're someone who tans easily. So I think that may be where this information might be misunderstood. I tan easily, therefore it's protective. Not true. You tan easily. Maybe your risks are lower than someone who burns easier, but it doesn't mean it's protecting you. Brilliant. Great. And then what about choosing the SPF? The number? So the question is, a higher SPF means you can spend more time in the sun. SPF have been designed and explained in such a way that the higher the SPF, the longer you can stay in the sun before you burn. However, truthfully, the higher the SPF, the better protection you're giving your skin from sun damage. I mean, that's the simplest way. So really, you should use the highest SPF you can get your hands on for the best protection from the sun. And actually, if you do want to go a slightly brown colour, most people do when they've been on holiday, you will still tan through SPF 30 or SPF 50. You are just less likely to burn and there'll be less damage to your skin. So the higher the better. To continue with sun creams. Then the next question is my kids don't need some cream. A cotton t shirt in the sea or pool is fine. True or false? Oh, false. I wish it was true because putting sun cream on children is a giant hassle. But no, that's not enough sun protection. There are some clothes that have SPF and that's great, but my tips are put tons of sun cream on but do really early so before you even leave the house. So when you're getting your kids dressed to go to the beach, I used to get my kids pretty much naked and cover them in sun cream and then put their their swimmers on. And then you've covered all the areas. So sun cream early before you leave the house and then put it on really frequently and really liberally. Yeah. I mean, the temptation as a family is to try and eke out. It can be quite expensive. Exactly. But you need plenty on. So plenty on, nice and early in the day and reapply frequently. All the more reason actually then to buy the higher factor because they cost the same price. Whether you get in fact 15 or factor 50 and you're getting better protection with the factor 50. Okay. Next question. This is an interesting one. Do you need to put a sunblock or higher sunscreen on moles? Should you be spotting yourself ? A common misconception. So although some people with lots of moles are higher risk of skin cancer, it's not necessarily that it's the moles that will be affected. It's the whole skin. And actually, most skin cancers don't originate in a moles. So put your sun cream everywhere. And the same thickness all over. You don't need to look like you've put your calamine on chickenpox. Next one then is about moles. What signs should people be looking out for? What is a sign of concern? When should you go and see your doctor? So the things we're worried about as doctors are changing moles and changing over a short period of time, over days and weeks, many people's moles might change over years. That's not to be concerned about. It's changes in shape, colour and size, Any crusting or bleeding. And if the colour appears to be bleeding out of the mole or suddenly looking very dark and different. Some people call it the ugly duckling mole. It looks completely different to any of the mole that you've had before or currently have. And I think a good tip as well is if you're not sure, take a photograph of it. You know, cameras, just phone cameras. Now zoom in, take a photograph in good light and take, you know, do that weekly monitoring and then you can look at it, see if it's changing. But if in doubt. It's so helpful for the doctor, if you come with this was a picture three weeks ago, this now. And if you can put something next to it for a kind of size comparison, a ruler. A tape measure. And especially with all the virtual consultations, it can really mean that you can have a mole safely assessed if you've taken those pictures. So completely, agree, it’s a brilliant idea. What you can do, even if you have to wait a little while for your appointment, is send an econsult with the pictures, and as a GP you love that. This is brilliant. I've got all the information I need. And if there is concern, we're probably going to bring you in sooner. Thank you so much for joining us. I hope you found that both interesting and useful.

Inside Health

Skin cancer

Skin cancer | Signs and symptoms | Myth busting
Watch in 13 mins

Dr Zoe Williams is joined by Dr Petra Simic, Medical Director of Clinics at Bupa. Together, they discuss the signs and symptoms of skin cancer and debunk common myths about skin health.

Hello and thank you for joining us on this myth busting session on all things skin cancer. So Petra, to start off with what are the different types of skin cancer? Well, Zoe, we broadly define them into two groups. Melanoma skin cancer and non-melanoma skin cancer. Most people have heard about melanoma, skin cancer. These are the types that we talk to people about looking for changes in moles or new moles. But actually the much more common skin cancers of the non-melanoma skin cancers such as basal cell carcinomas and squamous cell carcinomas So three types that can be grouped into those two groups. Okay. And what sort of symptoms should people be looking out for when it comes to skin cancer? You mentioned the moles and I think people tend to be aware of that, but what else is there? So in addition to changes in moles, which I think people are very aware of, I think people are much less aware of the symptoms that you might see with the other two skin cancers which make up the vast majority of skin cancers we see. So things like new skin growths. So flesh coloured growths, particularly particularly on the face, head and neck that develop over weeks and months, they may get little blood vessels on them. They look kind of pearly. Those are things that need to get checked out. And the other things are skin lesions, ulcers, scratches that don't heal. So we're looking at things that change over weeks and months and things that don't heal after three or four weeks. That's not common and probably needs to get checked out. Brilliant. And then lifestyle factors. So what are the things that might increase the risk of somebody getting skin cancer? We know that obviously genetics play a role. We can't do anything about our genetics. But what are the lifestyle factors that we can adjust? Well, the main one is exposure to sunlight. All skin cancers have a relationship to sunlight. Sunlight is UV light and UV light damages the skin. So we know that sunlight is the major factor. So for that, that's two things, really, the amount of time you spend in the sun, which actually can be reflected on how brown your skin goes and whether you've had periods of sunburn. These are two factors when it comes to sun exposure that increase your risk of skin cancer. There are other things such as genetics. So if you've got a family history of skin cancer that can make you more likely to get it, especially if there's a family history of melanoma and for some people, if they're on certain medications, that can make you more likely to have some of these non-melanoma skin cancers. And what types of medications would they be? So things affect your immune system. So the immunosuppressants are the ones we need to be most cautious about. Okay. So you mentioned that about genetics. The next question we can probably do quite quickly is, is skin cancer hereditary? In most cases it isn't. However, if you have had someone in the family, particularly with melanoma, it is worth mentioning that especially if you have a change in a mole or a new pigmented mole type lesion that you need checked out. I guess another reason to be really, really careful about protecting yourself from the sun. Here’s one, quick one to deal with. Probably. You can only develop skin cancer by sunbathing. True or false? I guess the answer is false, but also a little bit true. So sunbathing is exposure to the sun, but it's not just lying on a sun bed. Is that is that the thing that makes you get skin cancer? Not at all. It's any exposure to the sun. So I think people need to change their mindset. So there are lots of people that work outdoors and they feel that because they're outdoors and they get a base tan, they're protected. They're actually much more at risk than someone that might spend just one week a year on a sunbed. So it's the amount of sun you get and not in what position you are when you get that sun exposure. And I'm sure you are the same in GP, often the type of patient we will see who's affected by skin cancer will be often men who've worked outdoors, who've never sunbathe, so they think they're fine. And it's places like the tops of the ears, the nose, those places are pointing up towards the sun for many, many hours. Yeah, absolutely. And if you've not got much hair so the top of your head. So you haven't noticed it, the chest area, shoulders, so really common, those kind of areas. And you're absolutely right people think because they've not been sunbathers that their immune from those problems but actually they've they've still got the same risks. So here's another one, something I often get asked. People with dark skin do not develop skin cancers. That true or false? Oh, you know, I wish that was true. Certainly it’s much less common to get melanoma type skin cancers and all skin cancers in people with darker skin because the melanin they have in their skin is a protective factor. It's the thing your skin produces to protect the skin from the UV rays, which is. Why we do get a tan when we are in the sun because the skin's desperately trying to protect itself. Absolutely. But but it doesn't mean you're protected. And we still get skin cancers if we have pigmented skin, and it can be harder to pick them up. And for some reason and we don't know why, it seems that for people that do get melanoma, particularly in pigmented skin, they tend to have worse outcomes. So we pick them up later and they're more aggressive. So it's even more important to keep an eye on your skin and no reason not to use sun protection if you have pigmented skin. And it also protects the skin from other things like ageing as well. And Bob Marley, not a lot of people know, but Bob Marley actually died of skin cancer, so he had a type of skin cancer that affected the sole of his foot. We call that area if you get skin cancer, an ankle skin cancer, and that's what he got. And really unusual. And people perhaps if they see a pigmented lesion on the palm of their hand or sole of their foot, it wouldn't occur to them that this could be a skin cancer. But I think if that happens and, you know, go and see a GP. And also on the nail, you can get a melanoma on the skin underneath the nail, so worth getting that checked out as well. Next question, tanning beds don't pose a skin cancer risk. True or false? I mean, I hope this is a well known fact that tanning beds are directly linked to skin cancer risk. And there is no doubt about that. The scientific community are really clear. I think there are lots of dermatologists and oncologists would love to see tanning beds entirely banned, and there are very strict rules around who can use it. And how long. And the risks are clearly explained to people. But unfortunately there's still lots of people using them. And the link is very clear that there should be no doubt about that. I mean, I think in the last couple of decades, we've seen a huge shift, from tanning beds to using fake tan. And, you know, hopefully that will continue and eventually tanning beds Will be a thing of the past. There is no health benefit from using a tanning bed and no real reason why you should ever need to use one. Absolutely. If your skin tans and you don't burn. So, yeah, you go out in the sun, you turn a lovely, beautiful brown without any burning. Then you don't need to wear sun protection. True or false? False. False. Again. So yeah, tanning is a sign of sun damage and we know that UV light causes DNA changes in skin that actually makes you predisposed to skin cancer. So the browner you are, the more sun damage your skin has got. So, unfortunately, a tan, if it's come from sunlight, means you're damaging your skin and you know, premature ageing and wrinkles. Definitely one of the outcomes but increased risk of skin cancer. So unfortunately also false. But if you are somebody who so whether you tan beautifully or whether you burn to a crisp, you know, the fact that you're exposing your skin to the sun and seeing changes is a sign that you're damaging your skin. But if you're somebody who does burn easily, is that damage more significant than somebody who tans? Well, there's two groups of people, I think. We know that people that burn or have have episodes of burning, even if you don't burn easily. We know that causes significant DNA damage to the skin and will make you more likely to have a skin cancer. But people that have long exposure also have increased risk of skin cancers, different skin cancers, admittedly, but still problems in the future. If you are someone with very fair skin and you do burn easily, however, your overall risk of skin cancer is higher than if you're someone who tans easily. So I think that may be where this information might be misunderstood. I tan easily, therefore it's protective. Not true. You tan easily. Maybe your risks are lower than someone who burns easier, but it doesn't mean it's protecting you. Brilliant. Great. And then what about choosing the SPF? The number? So the question is, a higher SPF means you can spend more time in the sun. SPF have been designed and explained in such a way that the higher the SPF, the longer you can stay in the sun before you burn. However, truthfully, the higher the SPF, the better protection you're giving your skin from sun damage. I mean, that's the simplest way. So really, you should use the highest SPF you can get your hands on for the best protection from the sun. And actually, if you do want to go a slightly brown colour, most people do when they've been on holiday, you will still tan through SPF 30 or SPF 50. You are just less likely to burn and there'll be less damage to your skin. So the higher the better. To continue with sun creams. Then the next question is my kids don't need some cream. A cotton t shirt in the sea or pool is fine. True or false? Oh, false. I wish it was true because putting sun cream on children is a giant hassle. But no, that's not enough sun protection. There are some clothes that have SPF and that's great, but my tips are put tons of sun cream on but do really early so before you even leave the house. So when you're getting your kids dressed to go to the beach, I used to get my kids pretty much naked and cover them in sun cream and then put their their swimmers on. And then you've covered all the areas. So sun cream early before you leave the house and then put it on really frequently and really liberally. Yeah. I mean, the temptation as a family is to try and eke out. It can be quite expensive. Exactly. But you need plenty on. So plenty on, nice and early in the day and reapply frequently. All the more reason actually then to buy the higher factor because they cost the same price. Whether you get in fact 15 or factor 50 and you're getting better protection with the factor 50. Okay. Next question. This is an interesting one. Do you need to put a sunblock or higher sunscreen on moles? Should you be spotting yourself ? A common misconception. So although some people with lots of moles are higher risk of skin cancer, it's not necessarily that it's the moles that will be affected. It's the whole skin. And actually, most skin cancers don't originate in a moles. So put your sun cream everywhere. And the same thickness all over. You don't need to look like you've put your calamine on chickenpox. Next one then is about moles. What signs should people be looking out for? What is a sign of concern? When should you go and see your doctor? So the things we're worried about as doctors are changing moles and changing over a short period of time, over days and weeks, many people's moles might change over years. That's not to be concerned about. It's changes in shape, colour and size, Any crusting or bleeding. And if the colour appears to be bleeding out of the mole or suddenly looking very dark and different. Some people call it the ugly duckling mole. It looks completely different to any of the mole that you've had before or currently have. And I think a good tip as well is if you're not sure, take a photograph of it. You know, cameras, just phone cameras. Now zoom in, take a photograph in good light and take, you know, do that weekly monitoring and then you can look at it, see if it's changing. But if in doubt. It's so helpful for the doctor, if you come with this was a picture three weeks ago, this now. And if you can put something next to it for a kind of size comparison, a ruler. A tape measure. And especially with all the virtual consultations, it can really mean that you can have a mole safely assessed if you've taken those pictures. So completely, agree, it’s a brilliant idea. What you can do, even if you have to wait a little while for your appointment, is send an econsult with the pictures, and as a GP you love that. This is brilliant. I've got all the information I need. And if there is concern, we're probably going to bring you in sooner. Thank you so much for joining us. I hope you found that both interesting and useful.
View transcript
to recognise the many different and often subtle symptoms of lung cancer, so that we can act quickly. Today I'm here with John Burke, Bupa's Medical Director. Let's start off by talking about some of the signs and symptoms that potentially could be lung cancer. We know that actually there might not be any at all, especially in early stages of the disease, but what are some of the things that people should be looking out for? That's right, Zoe, I mean the classical signs of lung cancer are things like a cough that doesn't go away after a number of weeks, or some short period of time. Coughing up blood would be another sign to be very worried about, an ache or a pain even when coughing or breathing, and then unexplained tiredness or a form of breathlessness that isn't shifting, sort of persistent breathlessness. Sad to say as well sometimes people suffer weight loss, and so the weight loss could be attributable to cancer of the lung. I wanna talk about persistent cough and persistent breathlessness. How long should people leave it before they get it checked out? Well, the guidance for GPs in the UK is around three weeks. So if the cough hasn't gone away by then, then you know one could just book in to see the GP or contact the GP surgery, because that's what NICE guidance says, the National Institute for Care and Excellence. So ya, it's always good to keep that in mind. And those are some of the more common symptoms, but there are some lesser known symptoms that could indicate lung cancer as well. Can you tell us a bit about those? People might not realise, but you know, hoarseness of the voice for example, can be related to the development of lung cancer, swelling of the neck or the face, sometimes it can be quite subtle, could also be a sign, finger clubbing, that means thickening of the fingertips is something to to watch out for, although it's rare these days I must say, and much more commonly is, you know, recurrent chest infections, just something that can't be shifted. And when we're talking about lung cancer in this way, we're talking about primary lung cancer. What's the difference between primary and secondary? So primary lung cancer is one that originates in the lung, in the respiratory system. That's what people typically mean by lung cancer. Secondary's spread from another form of cancer let's say breast cancer into the lungs, that's somewhat different, you could call that secondary lung cancer, or it's secondary spread. So thinking about the primary lung cancer which is our main focus, is there anything that people can do to reduce their risk, and you know, potentially prevent themselves from getting lung cancer? Prevention is the key. I mean, smoking is the greatest risk factor for developing lung cancer. And you know, it can be very difficult, as I'm sure you're aware Zoe, to give up smoking, it can take several attempts, but any reduction in the amount of smoking, whether it's cigars or cigarettes or anything else that is really fantastic to do. It's known that over time that after 12 years of not smoking, a smoker can reduce their risk of cancer to half, by 15 years they're down to the level of a non-smoker, so it's always worthwhile. Coming back to prevention again, good diet, you know, high fibre, lower fat, and even exercise can help to prevent not just lung cancer but other cancers. I think that's so motivating for people to know that actually, you know, even though you may have smoked for many, many years, if you quit now after 15 years, your lungs can actually recover and your cancer risk goes back down. I always say to patients as well, just to sort of set their expectations, there are lots of services to help them with smoking. You can access it through your pharmacist, through your GP, just to say that, you know, you're not gonna face somebody who's gonna say you must stop smoking today. 'Cause for many people that's just too unrealistic. It might be that you plan to gradually reduce and quit in six months or quit in a year, but taking that first step to sort of, almost planning how you might reduce or quit is really, really important, isn't it? It is, and it's there for free as well. You know, there's help available. So you know, everybody's very incentivized in the healthcare system, professionals at the NHS itself to try to help people to move away from tobacco products. And if you don't succeed the first time, it's okay, you can try again, you can try again. Do you think that sometimes these symptoms can get confused with other conditions like asthma, and hay fever and you know, Covid, chest infections, and how can people differentiate between these sort of common other illnesses as something that could be lung cancer? I mean taking asthma that you mentioned as an example, cough is quite a sign for asthma as well, not just wheezing, and shortness of breath occurs in asthma as well, so it can be subtle. Again, I'd sort of mention, make the mention of the GP surgery to help guide people with their regular asthma checks, and then when the need arises that they would have, you know, maybe the idea of mentioning risk of lung cancer to their GP and the team around the GP, so that those extra examinations can be performed. Yeah, because people with these sorts of long-term lung conditions should be under regular review. And I guess it's any change, isn't it? If there's been a real significant change, and there's no obvious reason for that, then you should definitely let the GP know. Important question for you, is it just smokers that get lung cancer? Can people who've never smoked, people who regularly exercise and take really good care of themselves get lung cancer as well? So smoking is the highest risk for lung cancer and that sort of cancer is known as most commonly squamous cell cancer. A type of, it's in a group of cancers known as non-small cell lung cancers. Non-smokers then tend to get adenocarcinoma, again in the same family of cancers, but unfortunately there are people out there who develop lung cancers, who have never smoked. And it's somewhat, you know, almost at random really. It's tied to genetics, it can be tied to environmental factors as well. And also important to say that if you are experiencing these symptoms, doesn't necessarily mean that it is cancer. In fact there are many other conditions that are more common than lung cancer that can cause breathlessness and cough. Can you tell us about some of those? Yeah, breathlessness, as you mentioned, is you know, reasonably common. So if somebody has a heart problem, or if they've become somewhat unfit for whatever reason, then that breathlessness could be due to that, asthma as we've discussed as well, but what comes to my mind now is chronic obstructive pulmonary disease. So that's basically in two parts, emphysema, which is where there's damage to the air sacs in the lung, or chronic bronchitis where there's inflammation of the airways deep down in the lungs. So I think I guess the bottom line here is if somebody's worried, if they're having these symptoms, it's not for you to make the diagnosis, it's really important to go and see your GP. You can get some information from Bupa as well. But if they do go and see their GP, what can they expect to happen? What will the GP do? Will they be sent for any tests? And ultimately, how will they find out whether or not it is cancer? You're right, Zoe, I mean, primary care is the first step to finding that sort of thing out. GPs are trained to distinguish between what's normal and what's abnormal. And in doing that, they'll take a history, find out what's the concern, and perform a physical examination and then weigh the risk factors that's presenting. So ultimately a GP can decide to order a chest x-ray, or even refer to a specialist or to a chest clinic as it's called. Great. Well John, thank you so much for a really interesting discussion. I think it's so helpful for our viewers to understand a bit more about signs and symptoms that could potentially be lung cancer. And if you want more information on this topic, please do visit the Bupa website, bupa.co.uk.

Inside Health

Lung cancer signs and symptoms

Lung cancer | Signs and symptoms
Watch in 8 mins

In this episode, Dr Zoe WIlliams is joined by Bupa’s Medical Director, Dr John Burke. Join us as they explore how to recognise the very different, and often subtle, signs of lung cancer.

to recognise the many different and often subtle symptoms of lung cancer, so that we can act quickly. Today I'm here with John Burke, Bupa's Medical Director. Let's start off by talking about some of the signs and symptoms that potentially could be lung cancer. We know that actually there might not be any at all, especially in early stages of the disease, but what are some of the things that people should be looking out for? That's right, Zoe, I mean the classical signs of lung cancer are things like a cough that doesn't go away after a number of weeks, or some short period of time. Coughing up blood would be another sign to be very worried about, an ache or a pain even when coughing or breathing, and then unexplained tiredness or a form of breathlessness that isn't shifting, sort of persistent breathlessness. Sad to say as well sometimes people suffer weight loss, and so the weight loss could be attributable to cancer of the lung. I wanna talk about persistent cough and persistent breathlessness. How long should people leave it before they get it checked out? Well, the guidance for GPs in the UK is around three weeks. So if the cough hasn't gone away by then, then you know one could just book in to see the GP or contact the GP surgery, because that's what NICE guidance says, the National Institute for Care and Excellence. So ya, it's always good to keep that in mind. And those are some of the more common symptoms, but there are some lesser known symptoms that could indicate lung cancer as well. Can you tell us a bit about those? People might not realise, but you know, hoarseness of the voice for example, can be related to the development of lung cancer, swelling of the neck or the face, sometimes it can be quite subtle, could also be a sign, finger clubbing, that means thickening of the fingertips is something to to watch out for, although it's rare these days I must say, and much more commonly is, you know, recurrent chest infections, just something that can't be shifted. And when we're talking about lung cancer in this way, we're talking about primary lung cancer. What's the difference between primary and secondary? So primary lung cancer is one that originates in the lung, in the respiratory system. That's what people typically mean by lung cancer. Secondary's spread from another form of cancer let's say breast cancer into the lungs, that's somewhat different, you could call that secondary lung cancer, or it's secondary spread. So thinking about the primary lung cancer which is our main focus, is there anything that people can do to reduce their risk, and you know, potentially prevent themselves from getting lung cancer? Prevention is the key. I mean, smoking is the greatest risk factor for developing lung cancer. And you know, it can be very difficult, as I'm sure you're aware Zoe, to give up smoking, it can take several attempts, but any reduction in the amount of smoking, whether it's cigars or cigarettes or anything else that is really fantastic to do. It's known that over time that after 12 years of not smoking, a smoker can reduce their risk of cancer to half, by 15 years they're down to the level of a non-smoker, so it's always worthwhile. Coming back to prevention again, good diet, you know, high fibre, lower fat, and even exercise can help to prevent not just lung cancer but other cancers. I think that's so motivating for people to know that actually, you know, even though you may have smoked for many, many years, if you quit now after 15 years, your lungs can actually recover and your cancer risk goes back down. I always say to patients as well, just to sort of set their expectations, there are lots of services to help them with smoking. You can access it through your pharmacist, through your GP, just to say that, you know, you're not gonna face somebody who's gonna say you must stop smoking today. 'Cause for many people that's just too unrealistic. It might be that you plan to gradually reduce and quit in six months or quit in a year, but taking that first step to sort of, almost planning how you might reduce or quit is really, really important, isn't it? It is, and it's there for free as well. You know, there's help available. So you know, everybody's very incentivized in the healthcare system, professionals at the NHS itself to try to help people to move away from tobacco products. And if you don't succeed the first time, it's okay, you can try again, you can try again. Do you think that sometimes these symptoms can get confused with other conditions like asthma, and hay fever and you know, Covid, chest infections, and how can people differentiate between these sort of common other illnesses as something that could be lung cancer? I mean taking asthma that you mentioned as an example, cough is quite a sign for asthma as well, not just wheezing, and shortness of breath occurs in asthma as well, so it can be subtle. Again, I'd sort of mention, make the mention of the GP surgery to help guide people with their regular asthma checks, and then when the need arises that they would have, you know, maybe the idea of mentioning risk of lung cancer to their GP and the team around the GP, so that those extra examinations can be performed. Yeah, because people with these sorts of long-term lung conditions should be under regular review. And I guess it's any change, isn't it? If there's been a real significant change, and there's no obvious reason for that, then you should definitely let the GP know. Important question for you, is it just smokers that get lung cancer? Can people who've never smoked, people who regularly exercise and take really good care of themselves get lung cancer as well? So smoking is the highest risk for lung cancer and that sort of cancer is known as most commonly squamous cell cancer. A type of, it's in a group of cancers known as non-small cell lung cancers. Non-smokers then tend to get adenocarcinoma, again in the same family of cancers, but unfortunately there are people out there who develop lung cancers, who have never smoked. And it's somewhat, you know, almost at random really. It's tied to genetics, it can be tied to environmental factors as well. And also important to say that if you are experiencing these symptoms, doesn't necessarily mean that it is cancer. In fact there are many other conditions that are more common than lung cancer that can cause breathlessness and cough. Can you tell us about some of those? Yeah, breathlessness, as you mentioned, is you know, reasonably common. So if somebody has a heart problem, or if they've become somewhat unfit for whatever reason, then that breathlessness could be due to that, asthma as we've discussed as well, but what comes to my mind now is chronic obstructive pulmonary disease. So that's basically in two parts, emphysema, which is where there's damage to the air sacs in the lung, or chronic bronchitis where there's inflammation of the airways deep down in the lungs. So I think I guess the bottom line here is if somebody's worried, if they're having these symptoms, it's not for you to make the diagnosis, it's really important to go and see your GP. You can get some information from Bupa as well. But if they do go and see their GP, what can they expect to happen? What will the GP do? Will they be sent for any tests? And ultimately, how will they find out whether or not it is cancer? You're right, Zoe, I mean, primary care is the first step to finding that sort of thing out. GPs are trained to distinguish between what's normal and what's abnormal. And in doing that, they'll take a history, find out what's the concern, and perform a physical examination and then weigh the risk factors that's presenting. So ultimately a GP can decide to order a chest x-ray, or even refer to a specialist or to a chest clinic as it's called. Great. Well John, thank you so much for a really interesting discussion. I think it's so helpful for our viewers to understand a bit more about signs and symptoms that could potentially be lung cancer. And if you want more information on this topic, please do visit the Bupa website, bupa.co.uk.

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View transcript

The first thing is to really understand your personal risk.

And broadly, the older you are, the higher your risk of cancer.

In general terms.

If you're a smoker, if you're overweight, if you've got a strong family history

of some cancers, that may increase your risk of cancer, but often not always.

And if you drink more than the recommended

guidelines, these are all things that could increase your risk of cancer.

So the first thing I say is know your own risks and then know your own body.

People are aware of their bodies and knowing when there's a change.

And that's unusual for you, but importantly, persistent changes.

So if we were to talk about bowels, for example, many people's bowels change

all the time.

It depends on what they have eaten,

how stressed they are, how much exercise they've had, how much water they've

drank, as GP's what we're interested in is a persistent change in normal for you.

And broadly that applies to most cancers

and probably the most worrying symptom that worries all of us as GP’s

if someone has persistent unexplained weight loss is one of those things

that should not be happening and definitely needs to be checked out.

Then there's the skin lesions that aren't healing

or unexpected lumps or bumps or growths, and particularly

if they're growing over a short period of time.

Things that grow over a short period of time,

it's really important to get those checked out.

So I think

there's the six ways that I would say that we could tackle this

so that the most important is to stop smoking.

That is the most preventable cause of cancer for for all types of

cancer is implicated in 70% of lung cancers.

So definitely that would be my number one.

Number two try and reduce the amount of alcohol that you drink.

We know that that is implicated in a lot of cancers too.

Try and maintain a healthy weight, weight is implicated in that endometrial cancer,

as we've just heard, but also breast cancer and bowel cancer as well.

Try and have a healthy diet.

Try not to stay in the sun too long.

That would increase

our risk of skin cancers and, you know, move, move as much as you can.

So exercise.

We talk about the importance of exercise, not just to prevent cancers,

but also to reduce our risk of heart disease as well.

There's so many benefits to that.

So ensuring that we do get out every day and get some resistance

exercise as well and just keep moving.

The two probably main things are checking for breast cancer and skin cancer

would be the two things

that you're most able to do because there a kind of looking and touching thing.

And so, you know, for

for breast health, really, again, very important to know your own body.

So get really familiar with what your breasts look like and what they feel like.

And the best time for women to do that is often

when they're about to jump in the shower or jump in the bath.

So take a moment just to pause and look in the mirror in your

in your bedroom or bathroom, just to see if your breasts

look what they look like, if you're not really familiar with them.

But to make sure there's been no changes in appearance and the kind of things

we want to know about as GP's is does it suddenly look uneven?

It's not the same shape as before, and normally that would be on one side

more than the other. Is there any dimpling?

Are there any skin changes around the nipple?

Sometimes eczema over the nipple can be a sign of something

more worrying going on deeper within the breast.

And then what I tend to recommend women do is just get familiar

with how their breasts feel often, so we all wash on a regular basis.

That's a really good time to feel your breasts and know how they feel

because especially with the water in the soap, it's a really smooth surface

and I tend to recommend people think about when they think about examining breasts.

Women often worry that they

don't know how to do it, and actually breasts can be hard to examine.

The glandular tissue.

They're not smooth, they're not meant to be smooth.

And if you feel them with kind of a poking

motion, everyone's breasts will feel very uneven.

So it's about imagining that you've got I've tried to tell people to imagine

a kind of a Ziploc bag of jelly, and you've hidden a marble in it

and you're trying to find the marble in the jelly.

You wouldn't go like that because you'd keep you'd keep losing it.

What you do is you press it against a flat surface and run your hand.

So it's the same kind of process with examining your breast, pushing

the breast tissue against your chest wall with the flat of your hand.

And what I try to reassure women is that

if there is something abnormal there that is very worrying, it's

highly likely you might find it because they're not very subtle.

So it might feel like a small hard pea or a cherry or a stone.

You know, the kind of lumps we expect

women to find are quite different from normal breast tissue.

But if you find anything that makes you worry, it's

even if it's the same, both sides then come and see the GP.

Let us examine you. Let us have a feel.

And sometimes it's a case of especially if you're still having periods

come back after your period and we'll examine you again.

But if there is a lump there, then absolutely

we should be looking into that with either a mammogram or an ultrasound scan

and your GP should be making that happen for you.

And then mole checks again, quite simple, looking at your skin,

being familiar with your moles.

And when we're thinking about melanoma, we're thinking about moles that change

rapidly over a period of 6 to 8 weeks, growing crusting, bleeding

and being aware of that, sometimes even taking pictures of it,

and then going back a few weeks later and taking another picture,

maybe with something to reference the that can be a really good way

of reassuring yourself It's not growing over that period of time.

The same message.

If you're worried, go and go and talk to someone else, share the worries,

and then you can explore whether anything else needs to be done.

There's

no specific evidence to say that we should avoid certain foods

or have more certain foods at the moment in a particular type of food.

And and we'd worry maybe that people would become deficient

in certain nutrients if they did avoid food groups.

But having a healthy diet, lots of fruit and vegetables, high fibre,

trying to avoid some processed foods because we do know

that that is linked to bowel cancer and red meat as well.

So keeping that to the minimum, but making sure we get lots of those good proteins.

So, our white meat our chicken our fish and pulses

and that sort of thing is a lot better for us.

So we do say for men and women to try

and have less than 14 units of alcohol a week,

it doesn't matter what type of alcohol it is with regards to your cancer risk.

And it also doesn't matter whether that's spread out or whether it's

sort of binge drinking as such when we're looking at cancer risk.

I mean, it's obviously different

in other circumstances, but from that cancer risk point of view,

it's just staying below that 14 units a week

Inside Health

Reducing the risk of female cancer

Reducing cancer risk | Awareness and prevention

Watch in 7 mins

Join Dr Petra Simic and Dr Samantha Wild as they explore factors that may increase your risk of cancer. Together, they explain preventative measures you can take to help reduce your cancer risk and maintain a healthy, happy lifestyle.

The first thing is to really understand your personal risk.

And broadly, the older you are, the higher your risk of cancer.

In general terms.

If you're a smoker, if you're overweight, if you've got a strong family history

of some cancers, that may increase your risk of cancer, but often not always.

And if you drink more than the recommended

guidelines, these are all things that could increase your risk of cancer.

So the first thing I say is know your own risks and then know your own body.

People are aware of their bodies and knowing when there's a change.

And that's unusual for you, but importantly, persistent changes.

So if we were to talk about bowels, for example, many people's bowels change

all the time.

It depends on what they have eaten,

how stressed they are, how much exercise they've had, how much water they've

drank, as GP's what we're interested in is a persistent change in normal for you.

And broadly that applies to most cancers

and probably the most worrying symptom that worries all of us as GP’s

if someone has persistent unexplained weight loss is one of those things

that should not be happening and definitely needs to be checked out.

Then there's the skin lesions that aren't healing

or unexpected lumps or bumps or growths, and particularly

if they're growing over a short period of time.

Things that grow over a short period of time,

it's really important to get those checked out.

So I think

there's the six ways that I would say that we could tackle this

so that the most important is to stop smoking.

That is the most preventable cause of cancer for for all types of

cancer is implicated in 70% of lung cancers.

So definitely that would be my number one.

Number two try and reduce the amount of alcohol that you drink.

We know that that is implicated in a lot of cancers too.

Try and maintain a healthy weight, weight is implicated in that endometrial cancer,

as we've just heard, but also breast cancer and bowel cancer as well.

Try and have a healthy diet.

Try not to stay in the sun too long.

That would increase

our risk of skin cancers and, you know, move, move as much as you can.

So exercise.

We talk about the importance of exercise, not just to prevent cancers,

but also to reduce our risk of heart disease as well.

There's so many benefits to that.

So ensuring that we do get out every day and get some resistance

exercise as well and just keep moving.

The two probably main things are checking for breast cancer and skin cancer

would be the two things

that you're most able to do because there a kind of looking and touching thing.

And so, you know, for

for breast health, really, again, very important to know your own body.

So get really familiar with what your breasts look like and what they feel like.

And the best time for women to do that is often

when they're about to jump in the shower or jump in the bath.

So take a moment just to pause and look in the mirror in your

in your bedroom or bathroom, just to see if your breasts

look what they look like, if you're not really familiar with them.

But to make sure there's been no changes in appearance and the kind of things

we want to know about as GP's is does it suddenly look uneven?

It's not the same shape as before, and normally that would be on one side

more than the other. Is there any dimpling?

Are there any skin changes around the nipple?

Sometimes eczema over the nipple can be a sign of something

more worrying going on deeper within the breast.

And then what I tend to recommend women do is just get familiar

with how their breasts feel often, so we all wash on a regular basis.

That's a really good time to feel your breasts and know how they feel

because especially with the water in the soap, it's a really smooth surface

and I tend to recommend people think about when they think about examining breasts.

Women often worry that they

don't know how to do it, and actually breasts can be hard to examine.

The glandular tissue.

They're not smooth, they're not meant to be smooth.

And if you feel them with kind of a poking

motion, everyone's breasts will feel very uneven.

So it's about imagining that you've got I've tried to tell people to imagine

a kind of a Ziploc bag of jelly, and you've hidden a marble in it

and you're trying to find the marble in the jelly.

You wouldn't go like that because you'd keep you'd keep losing it.

What you do is you press it against a flat surface and run your hand.

So it's the same kind of process with examining your breast, pushing

the breast tissue against your chest wall with the flat of your hand.

And what I try to reassure women is that

if there is something abnormal there that is very worrying, it's

highly likely you might find it because they're not very subtle.

So it might feel like a small hard pea or a cherry or a stone.

You know, the kind of lumps we expect

women to find are quite different from normal breast tissue.

But if you find anything that makes you worry, it's

even if it's the same, both sides then come and see the GP.

Let us examine you. Let us have a feel.

And sometimes it's a case of especially if you're still having periods

come back after your period and we'll examine you again.

But if there is a lump there, then absolutely

we should be looking into that with either a mammogram or an ultrasound scan

and your GP should be making that happen for you.

And then mole checks again, quite simple, looking at your skin,

being familiar with your moles.

And when we're thinking about melanoma, we're thinking about moles that change

rapidly over a period of 6 to 8 weeks, growing crusting, bleeding

and being aware of that, sometimes even taking pictures of it,

and then going back a few weeks later and taking another picture,

maybe with something to reference the that can be a really good way

of reassuring yourself It's not growing over that period of time.

The same message.

If you're worried, go and go and talk to someone else, share the worries,

and then you can explore whether anything else needs to be done.

There's

no specific evidence to say that we should avoid certain foods

or have more certain foods at the moment in a particular type of food.

And and we'd worry maybe that people would become deficient

in certain nutrients if they did avoid food groups.

But having a healthy diet, lots of fruit and vegetables, high fibre,

trying to avoid some processed foods because we do know

that that is linked to bowel cancer and red meat as well.

So keeping that to the minimum, but making sure we get lots of those good proteins.

So, our white meat our chicken our fish and pulses

and that sort of thing is a lot better for us.

So we do say for men and women to try

and have less than 14 units of alcohol a week,

it doesn't matter what type of alcohol it is with regards to your cancer risk.

And it also doesn't matter whether that's spread out or whether it's

sort of binge drinking as such when we're looking at cancer risk.

I mean, it's obviously different

in other circumstances, but from that cancer risk point of view,

it's just staying below that 14 units a week

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