Newsletter "Your Health"
- Free bowel cancer screening
- Skin cancer. New treatments for BCC
- Surgery for weight loss
- Cervical cancer vaccine approved
- Typhoid fever. New oral vaccine
- Childhood vaccination. 5 common questions
- Taking a child’s temperature. How & why
- How can I remember to take my pills?
- Are medical expenses tax-deductible?
- Where can I get more information on cancer?
- Funny bones
Australia’s first free bowel cancer screening program is now operating. Bowel cancer is the most common internal cancer in Australia and kills about 90 people each week.
Bowel cancer is a malignant tumour that develops on the lining of the large bowel (colon) or rectum. Most develop from tiny growths called adenomas (polyps). The risk increases from the age of 40 years, rising sharply from 50.
What is ‘screening’?
Testing for cancer in healthy patients, before symptoms develop, is called screening. Polyps or bowel cancers often release small amounts of blood into the bowel motion which can be detected with a simple chemical test called a 'faecal occult blood test’ (FOBT). Testing is usually performed in the privacy of your home. Using a special brush or probe, you simply transfer a small sample of bowel motion to the test kit on two separate occasions. Then post the kit to the laboratory for analysis.
In a recent Australian pilot study, 1 in 10 people had a positive test result (blood in the stool sample). Of these, 1 in 5 were found to have an advanced polyp or bowel cancer on further testing. What if I have symptoms? Symptoms often appear only when the disease is more advanced. They include:
- Bleeding from the bowel
- A change in bowel habit
- Unexplained weight loss or tiredness
- Abdominal pain
If you have any of these symptoms, see your doctor immediately. A colonoscopy is usually advised: under sedation, a narrow tube with a tiny camera attached is inserted into the bottom to examine the inside of the large bowel.
The national screening program
Australians turning 55 or 65 years of age between 1 May 2006 and 30 June 2008 and those previously involved in the pilot program will be invited to participate in the free bowel cancer screening program. Eligible patients will be mailed a FOBT test kit to use at home. If your test is positive, your GP will arrange further investigation, usually a colonoscopy during which polyps can be removed. If a cancer is found it will usually require surgery.
What if I don’t qualify?
Screening for bowel cancer is recommended by the National Health and Medical Research Council for all Australians over 50. If you do not qualify for the free screening program you can still be tested. Your doctor can arrange this.
For more information, please visit www.cancerscreening.gov.au
Skin cancer. New treatments for BCC
New therapies are now available for treating BCCs (basal cell carcinomas), the most common skin cancer.
BCCs occur mostly on sun exposed areas, particularly the face and neck, and typically affect fair-skinned adults who have had a lot of past sun exposure.
BCCs are usually either ‘nodular’ (a flesh coloured or pearly lump, often with small blood vessels or a crust on the surface) or ‘superficial’ (a flat, pink, scaly patch).
BCCs grow slowly over months or years. They rarely spread to other areas but can become very large and destroy nearby tissues.
New non-surgical treatments
Most BCCs are surgically removed. Other methods are freezing, curetting (scooping out with a sharp spoon) and radiation. Two new non-surgical treatments are now available and are useful when ¬surgery is inappropriate, such as for large or ¬multiple BCCs or for ‘cosmetically sensitive’ areas where less scarring is wanted.
- Imiquimod cream is applied directly to superficial tumours and activates the body’s own immune system to attack and destroy the cancerous cells. You use it yourself at home 5 times per week for 6 weeks. The cream is generally well tolerated, but may cause redness and scaling of the skin with itching and burning. Imiquimod can be purchased on a private script and may be eligible for health fund rebates. It is subsidised by Veterans Affairs.
- PDT (photodynamic therapy) involves applying a cream to the BCC followed by exposure to a special red light. Two sessions are usually needed 1-4 weeks apart. PDT can be used for superficial and nodular BCCs.
See your GP for a check if you have a suspicious spot. Your GP is well qualified to assess and treat most skin conditions. Skin Cancer Clinics are manned by GPs and offer no advantage over your doctor’s care.
For more information, please visit www.dermcoll.asn.au and/or www.dermnetnz.org
No matter how hard they try, many people simply cannot lose weight with diet and exercise. For those who remain very obese, weight loss surgery can help achieve permanent weight control.
After surgery, most patients lose between 50-60% of their excess weight and get major health benefits e.g. over two-thirds of people with type 2 diabetes no longer need treatment and high blood pressure resolves in 60% of cases. The weight is generally kept off over time.
There are several different operations, but ‘gastric band surgery’ is the safest and is used in over 90% of cases. A silicone band with an inflatable balloon is placed around the upper part of the stomach to create a small stomach pouch. This restricts the amount of food you can eat, so you feel satisfied after eating less.
The procedure is done through key-hole surgery (laparoscopy) and usually involves an overnight hospital stay. The tightness of the balloon can later be adjusted by injecting saline into a reservoir under the skin.
The risks from gastric band surgery are small, but infections and blood clots can occur. About one in 20 patients will require further surgery later due to complications, such as the band slipping. After surgery, patients must eat smaller meals and need monitoring for adequate nutrient levels. Consider surgery if your BMI is over 35 and you cannot lose weight by other means, particularly if you have a related medical condition such as diabetes or heart disease.
What is your BMI?
Your BMI is your weight (kg) divided by your height2 (m)
- <20 Underweight
- 20-25 Healthy weight range
- 25-30 Overweight
- >30 Obese
- >35 Seriously obese
Speak to your doctor or for more information, please visit www.weightlosssurgery.com.au
Cervical cancer vaccine approved
The world’s first vaccine to prevent cancer of the cervix (the neck of the womb) is now available. It was developed by the Queensland scientist and Australian of the Year, Professor Ian Frazer.
Cervical cancer is caused by an infection with a virus called HPV (human papilloma virus). There are about 40 types of HPV which affect the genital area.
The virus is passed on during normal sexual activity and affects 4 out of 5 women at some time in their lives. In most women, the virus is cleared from the body in a year or two. However, in some cases it may persist and lead to cancer.
New vaccine now available
The vaccine is given as a course of 3 injections by your GP over 6 months and is expected to cost about $153 per dose from the pharmacy.
It provides excellent protection against HPV types 16 and 18 which cause 70% of cervical cancers as well as types 6 and 11 which cause about 90% of genital warts.
The vaccine works best when given before girls begin having sex and are exposed to HPV. However, it is still beneficial for those already sexually active. It is approved for use between the ages of 9 and 26 years.
Side effects are usually minor and include pain, tenderness or soreness at the injection site and mild fever. There is a very small risk of a serious allergic reaction.
Do I still need Pap tests?
After vaccination, you should still continue to have 2-yearly Pap tests until the age of 70 (unless you have a hysterectomy). The the vaccine does not provide protection against the HPV types not in the vaccine.
For more information, please visit www.cervicalcancer.com.au.
Typhoid fever. New oral vaccine
An oral (by mouth) vaccine for typhoid fever is now available and means one less needle for travellers.
Typhoid fever is an infection with a bacterium called Salmonella typhi. It causes fever, stomach pains, rash, headache, fatigue and constipation or diarrhoea.
Although uncommon in Australia, typhoid is life-threatening if untreated, with a death rate of 10-20% due to bleeding from the bowel, bowel rupture or blood poisoning.
Typhoid is spread by contaminated food and drink, especially in Asia, Africa, Oceania and Central and South America. To reduce your risk in these areas, remember to ‘cook it, boil it, peel it or leave it’. Try to follow these rules:
- Drink only bottled drinks or boiled water.
- Avoid ice.
- Avoid raw vegetables, salads and fruits that cannot be peeled.
- Avoid foods from street vendors.
- Wash your hands before eating.
- Hot, cooked foods are generally safe.
Capsules or injection ?
The ‘new’ typhoid capsules have actually been available overseas for over 20 years. They are suitable for adults and children above 6 years of age. A course of 3 capsules is taken on days 1, 3 and 5, one hour before meals.
The treatment is effective from 2 weeks after the first dose and gives 70-95% protection. A repeat course is recommended 3 yearly.
The capsules have proven to be well tolerated. Side effects are very uncommon and include constipation, abdominal cramps and nausea.
Typhoid injections are also available. A single injection is required every 3 years and gives 70-90% cover. Typhoid injections occasionally cause swelling and pain at the injection site and fever.
For more information, please visit www.cdc.gov or www.tripprep.com
Childhood Vaccination. 5 common questions
1. Can too many vaccines overload the immune system?
Children are exposed to a large number of antigens (foreign substances) every day and the immune system deals effectively with these. Studies have shown that the body can easily cope with the small number of extra antigens in vaccines.
Combined vaccines (2 or more vaccines given together) are just as effective as when given individually, with no greater risk of side effects.
2. Isn’t natural immunity better?
Immunity from catching a disease is usually lifelong. However, natural diseases have a much higher risk of serious complications and occasionally death.
Protection from vaccination may decrease with time but both children and adults can be reimmunised if their immunity falls to a low level.
3. Are vaccines really safe?
Vaccines are many times safer than the diseases they prevent. Most side effects are minor and temporary, e.g. a sore arm or mild fever. More serious effects occur rarely. There is no evidence that vaccines cause sudden infant death syndrome (cot death), autism, asthma, multiple sclerosis, ‘mad cow disease’ or diabetes.
4. When should vaccines be delayed?
Vaccination is safe for a child with a minor cough or cold without fever or one receiving antibiotics while recovering from an illness. If the child is sicker, e.g. with vomiting, tiredness or a fever over 38.50C, vaccination should be postponed.
5. Do vaccines always work?
No vaccine is 100% effective and a small number of children will still remain unprotected. For example, 5% of children may still catch measles after vaccination. However, the disease is usually much less severe in these cases.
For more information, please visit http://immunise.health.gov.au/myths_2.pdf
Taking a child’s temperature. How & why
A child has a fever when his or her temperature is over about 37.50 C.
Most fevers in children are caused by harmless viral infections. The fever helps the body fight the infection and generally does no harm. A fever under 400 C does not require treatment unless the child is uncomfortable.
The important question is ‘What is causing the fever?’
Is it just a head cold or could it be something more serious, such as pneumonia or meningitis?
There are 3 places to check for fever:
1. Under the arm (all ages)
2. In the mouth (over about 5 years)
3. In the ear (all ages)
Plastic tape thermometers on the forehead are not reliable.
How can I remember to take my pills?
Try these strategies:
1. Link them with something that you do every day, like brushing your teeth. Keep tablets to be taken with food on the kitchen table (but out of the reach of children!).
2. Set the alarm on your mobile phone, watch, alarm clock or set up a reminder on your computer.
3. Put a reminder note on the fridge, phone or bathroom mirror.
4. Use a special pillbox or ‘dosette’ with a space for each day’s pills.
5. Use a written chart or calendar.
Are medical expenses tax-deductible?
Any out-of-pocket medical costs for your family over $1,500 in a financial year are tax deductible at 20 cents in the dollar.
Out-of-pocket expenses are medical bills you have paid minus any refunds from Medicare or your private health fund. Payments to all doctors are included, such as your GP, pathologists, radiologists and other specialists (except cosmetic services). Dental, optometry, pharmaceutical and hospital fees can also be counted.
For more information, visit www.ato.gov.au or ring the Tax Office on 132 861.
Where can I get more information on cancer?
Speak to your GP or medical specialist first. If you need further information, ring the Cancer Council Helpline on 13 11 20 from 9am – 5pm, Monday to Friday (for the cost of a local call). This is a free, confidential service.
Specially trained staff can answer questions on all aspects of cancer, recommend appropriate services and post written materials.
For reliable online information:
www.cancercouncil.com.au
www.cancer.org (US)
www.cancerbackup.org.uk (UK)
Bird Flu
A bear, a lion and a chicken meet.
Bear says: ‘If I roar in the forests of North America, the entire forest is shivering with fear.’
Lion says: ‘And if I roar on the great plains of Africa, the entire savannah is afraid of me.’
Says the chicken: ‘Big deal. I only have to cough, and the entire planet wets itself.’
Eye Test
Count every ‘F’ in the following text:
‘FINISHED FILES ARE THE RESULT OF YEARS OF SCIENTIFIC STUDY COMBINED WITH THE EXPERIENCE OF YEARS.’
How many? 3? See bottom of page.
Aspirin. Wonder drug
Patient: ‘I woke up this morning and felt so bad that I tried to kill myself by taking a thousand aspirin.’
Doctor: ‘Oh really, what happened?’
Patient: ‘After the first two, I felt better.’
An Easy Diagnosis
Doctor: ‘You need new glasses.’
Patient: ‘How do you know? I haven’t told you what’s wrong with me yet.’
Doctor: ‘I could tell as soon as you walked in through the window!’
The Amazing Brain
The brain is a wonderful organ. It starts working the moment you get up in the morning and does not stop until you get into the office.
Eye Test Answer
There are 6! The reason is that the brain cannot process ‘OF’. Incredible? Go back and look again!
