The health checks that can save your life – part 1
Women have never been healthier – our life expectancy has almost doubled in just one century. That’s good news, but it also means our bodies have to last a lot longer, so it’s up to us to make sure they’re fit for the task by keeping a careful watch on our health and lifestyle and noting any changes.
National screening programmes have been a success in saving many lives. Breast screening (mammography) has cut breast cancer mortality by almost half, and cervical smear screening currently saves 4,500 lives a year in England alone. The new bowel cancer screening programme, currently being rolled out around the UK, aims to detect the disease in its very early stages, even before symptoms appear, as earlier treatment improves cure rates substantially.
All of which means it’s important to go for screening checks when you’re invited. It’s also essential that you monitor your body yourself regularly – that way, you’ll know when something has changed and can get it checked out with your GP without delay.
Heart disease is falling in the UK, thanks to improved prevention and treatment, but it’s still our number-one killer and the problem is that many of us still think heart disease is something only men get. However, statistically, women are four times more likely to die from heart disease than breast cancer. Fortunately, even in middle age, changing our lifestyles can make a real difference.
Coronary heart disease causes the heart’s arteries to get furred up and narrowed by cholesterol deposits. This leads to pain (angina) when the heart needs more oxygen – for example, during exercise. Complete blockage of the arteries results in a heart attack – permanent damage to part of the heart muscle – which may trigger unstable rhythms, sudden cardiac arrest or death. Blocked or leaking heart valves, infections, excess alcohol, some prescribed/street drugs, and certain medical conditions can also strain the heart.
- Has your mother, sister or daughter had heart problems before the age of 65 or your father, brother, or son before the age of 55? This increases your own risk by up to 50 per cent.
- Is your blood pressure 140/90mmHg or less? Raised blood pressure increases the risk of heart attack by 22 per cent.
- Is your waist circumference more than 80cm (31½in)?
Being apple-shaped increases heart disease risks.
- Is your total cholesterol level less than 5mmol/l and your low density (LDL) cholesterol less than 3mmol/l? (Or 4mmol/1 and 2mmol/1 if you’ve had a stroke or diabetes, heart disease or kidney disease.) Whether you need treatment will depend on a combination of factors, which your GP will work out for you.
- Is your blood sugar normal? People with diabetes are more at risk of heart disease.
- Do you smoke? If so, stop.
- Do you drink alcohol excessively? If so, cut down.
- Do you exercise for 30 minutes five times a week? If you can’t, try exercising in ten-minute chunks instead.
- Do you eat a balanced diet? Aim for fjve portions of fruit and vegetables daily, low fat, high fibre, low salt, plenty of nuts and seeds and two to four portions of oily fish a week, such as mackerel or salmon
If you don’t eat enough oily fish, you’ll be prescribed omega-3 supplements for up to four years after a heart attack. Remote-access catheter labs guide magnetic-tipped catheters through the heart using giant magnets instead of X-rays, allowing doctors to treat more complex problems and higher risk patients.
Whats happens next?
You’ll need an ECG (heart tracing) and exercise tolerance (treadmill) test, and perhaps an ultrasound scan or myocardial perfusion (myoview) scan (a small injection of radioactive molecules to reveal oxygen patterns in the heart). If these suggest severely blocked arteries, you’ll need X-rays to check (a dye is injected via a catheter, inserted through the groin). It may be possible to clear blockages during this test (an angioplasty), but you may need full coronary artery bypass graft replacements. You’ll also be given medication to lower cholesterol and blood pressure, plus aspirin or another drug to make your blood less ‘sticky’ and less likely to clot.
- Heavy, tight or crushing pain across the front of the chest, which may spread to the back, arms or jaw. Call 999 if pain lasts more than ten minutes or is linked to breathlessness, sweating or faintness.
- Ankle swelling
Eyes and ears
Our sight and hearing are already starting to deteriorate by our late 40s, so it’s important to preserve what we can.
As we age, we’re more likely to develop eye conditions, such as glaucoma, age-related macular degeneration (AMD) and cataracts.
The ageing process can also affect our hearing. As we get older, we’re more at risk from tinnitus (ringing in the ears), hearing loss and Ménière’s disease, which is a balance disorder caused by an abnormality found in the inner ear.
- Get an eye test at least every two years; they’re free for people with diabetes or for those with a close family history of glaucoma, both of which can cause blindness.
- Ask the practice nurse to check for wax if you notice hearing loss – it’s the most common and treatable cause.
- Are you eating plenty of red, yellow, orange, green and blue-black fruit and vegetables? These can protect against AMD, the most common cause of sight loss in the UK.
NICE (the National Institute for Health and Clinical Excellence) agrees that sufgerers from ‘wet’ age-related macular degeneration (the type that can develop quickly) can be treated with Lucentis, an injected medicine, to prevent blindness.
Whats happens next?
Your GP will refer you for more tests and treatment, if necessary, according to your symptoms.
- Sudden deterioration in vision, flashing lights or deep eye pain are emergencies. See your doctor or go to A&E at your nearest hospital.
- Deafness accompanied by earache, tinnitus, vertigo or discharge may threaten your hearing. See your doctor.
Breast cancer is the most common women’s cancer in the UK. More than 125 women are diagnosed every day – that’s more than 45,000 a year. Four out of five are diagnosed in women aged 50-plus, but in younger women, whose breasts are more dense, cancer can be harder to spot. However, survival rates have been improving for the past 20 years, and now 87 per cent of women with the disease are predicted to live for at least five years after diagnosis.
- Be breast aware – feel and look at your breasts regularly, so you know what’s normal for you. If something seems suspicious, your GP can arrange for you to see a specialist within two weeks.
- Know your family history – your risk of breast cancer may be increased if your mother, sister, daughter, or a male relative has had the disease. Talk to your GP, who may refer you for closer monitoring.
- Go to your three-yearly mammogram. The programme now covers women aged 47 to 73 (older women can request screening via their GPs).
Blood tests for cancer/tumour markers have now been developed to detect cancer activity in the body. Proteins and circulating tumour cells are two types of markers that can be measured. A cancer tumour often produces a specific protein in the blood that serves as a marker for the cancer. Circulating tumour cells are cells that break ofg from the cancer and move into the blood stream. Protein markers and circulating tumour cells can be measured with simple blood tests.
Whats happens next?
There will be a triple assessment — mammogram, ultrasound and fine needle aspiration (a sample obtained with a very fine needle). If a lump is cancerous, a CT or MRI scan and/or a bone scan will check whether it has spread. A sentinel node biopsy will reveal if glands in the armpit need to be removed. Most women then receive chemo and radiotherapy, followed by hormone treatment, including Herceptin.
- A breast lump
- Changes in breast size or shape
- Breast skin looks dimpled
- Changes in the nipple skin or shape, especially going inwards
- Nipple discharge – clear or bloodstained
- Armpit swelling or lump