Melanoma – Are You At Risk?

Melanoma - Are You At Risk?

Transcript of Podcast Episode 5: Melanoma – Are You At Risk? Includes an interview with Jordan Hill, who had a melanoma at age 24.

Introduction

Welcome to the BRCA gene mutation and cancer awareness podcast.  I am Christina Henry of Midlifestylist.com.  I am a Registered Nurse with a BRCA2 gene mutation.  My podcast will raise awareness of BRCA 1 and 2 gene mutations and their link to an increased cancer risk.  BRCA gene mutations affect males and females equally, but there isn’t a lot of awareness in the community of the cancers that male carriers are at risk of.  My podcast aims to change that.  I will also discuss other topics of interest such as genetic counselling and testing, cancer screening and prophylactic surgery.  If you would like to know more about BRCA 1 and 2 gene mutations, this podcast is for you.  Thanks for joining me.

Melanoma – Are You At Risk?

Many people do not realise that a BRCA 2 gene mutation increases your risk of melanoma.  This episode is to raise awareness of melanoma, not just for BRCA2 mutation carriers, but for the general public as well.

Australia has one of the highest rates of melanoma in the world, with one person diagnosed every 30 minutes.  Melanoma is the deadliest form of skin cancer, and the most common cause of cancer in 15 to 39 year olds.  It is the third most common cancer in Australian men and women.

In the US, the lifetime risk of getting melanoma is about 2.6% (1 in 38) for whites, 0.1% (1 in 1000) for Blacks and 0.6% (1 in 167) for Hispanics.  For BRCA2 carriers, the risk is 3-5% in both males and females.

Family History of Melanoma and Genetic Mutations

Familial malignant melanoma is a genetic condition, usually identified when 2 or more first degree relatives such as a parent, sibling and/or child have a melanoma.  About 8% of people diagnosed with a melanoma have a first degree relative with one.  About 1-2% have 2 or more close relatives with a melanoma.  My family is high risk because my sister, brother and son have all had melanomas.

Two genes have been linked to familial melanoma – CDKN2A and CDK4.  A mutation in either of these genes increases your risk of melanoma, and may also increase your risk of pancreatic cancer.  Another gene, MC1R, is important for regulating pigment in the body.  Variations in this gene have been associated with freckling and red hair, and an increase in the risk for melanoma.

Xeroderma Pigmentosum (XP) is a rare disorder in which people have a mutation in a gene needed for repair of UV radiation induced DNA damage.  People with XP have an extremely high rate of skin cancer, including melanoma.  Scientists believe that there are other genes not yet identified that also increase the risk of melanoma.

Genetic Testing

Genetic testing for mutations in the CDKN2A gene is available.  However, genetic test results are unlikely to change care for people who have had melanoma or people with a strong family history of melanoma.  That is why the genetic counselor told me that there is a high probability of a genetic link for melanoma in my family, but there was little point in doing further testing to find it.  It wouldn’t alter the fact that my family needs ongoing screening.

Interview with Jordan Hill, Melanoma Survivor

Christina Henry, Interviewer with Jordan Hill, Melanoma survivor
Christina Henry, Interviewer with Jordan Hill, Melanoma survivor

My special guest today is my son Jordan Hill, who was diagnosed with a melanoma at age 24.  Welcome to my podcast, Jordan.

Jordan:  Thanks for having me.

Christina:  Can you tell us how you came to be diagnosed with a Stage 1 Melanoma at the age of 24?

J:  Well for several years you got me to go and have skin tests as a family and there were two or three doctors before we finally landed on this one at Mermaid Beach Practice.  They didn’t see anything wrong with this particular dot I had on my hand.  It started as a freckle.  Over time it started growing black and started looking really nasty.  I had random people come up to me in shops (because I work at Officeworks).  I had customers pointing out to me “Oh that doesn’t look very good” when I pointed out an item that they noticed on my hand and they commented on it.  I guess I never thought anything of it and for about two or three years it was like that. 

It was slowly getting worse and looking more black and violent.  So you started getting more checks done because we were still figuring out what it was.  So we had two skin doctors check and neither of them found anything wrong with it.  They just said it was nothing, and that it was no concern.  But the third skin doctor took one look at it and he zoomed up on it with this little device and it looked really gnarly.  So he took a biopsy out of it.  Within a few days I got a phone call and he said it was a Stage 1 Melanoma.

C:  What were the signs that this was not just an ordinary mole?  What did it look like compared to other moles?

J:  Well, all freckles are pretty faded and brown looking but this one started out as just a regular freckle but then over time it just went black and it was this black dot and it kept growing and growing.

C:  And it was jagged on the edge too wasn’t it?

J:  Yea

C:  I’ll put a photo up on my website Midlifestylist.com of how that melanoma looked.

What did the doctor actually do?

J:  Well he gave me a little local anaesthetic on the hand and he cut a little incision out of it.  It wasn’t so deep. It was only a little deep.  What I noticed when he had cut it out, there was still a tiny little black dot there.  When it was healing over the next week it wasn’t healing very well.  It was kind of struggling.  It was very “pussy” and I had to go back and get it cleaned.  But when it came back as a Stage 1 Melanoma I noticed that there was some black still there and so we needed a Plastic Surgeon to fully remove it and dig deeper into the tissues to make sure that it was all gone.

C:  So Jordan actually rang me.  I was on holiday in New Zealand and because, luckily I’m a nurse and I work with Plastic Surgeons I rang and made an appointment for Jordan to see a Plastic Surgeon that I knew.  He got him in the following week and within a week Jordan had plastic surgery to remove this.  They had to take a full thickness to remove the whole melanoma.  It’s about the size of a 50 cent piece and they had to take a graft from beneath his arm to cover that deficit.  So that can’t be just any doctor.  It had to be a plastic surgeon.  Once they did that the margins were clear.

My son's melanoma
My son’s melanoma before it was removed

So what kind of recovery did you need after that?

J:  It was a complete month off, not doing much with your hand basically.  They had a cast and bandaged up and everything.  I couldn’t move it.  I couldn’t do the things I usually do like work and play drums and guitar and all that.

But it gave me a lot of time off to think about how lucky I was to survive cancer basically.  And even though it didn’t look too threatening at the time, when I found out what it really was and what it entailed, and what it would have meant if it kept growing, because they said thankfully it was a very slow growing melanoma, if I’d left it for another year or two it would have gotten to a Stage 3 or 4 which is the deadly one where it spreads through the body, and I could have been dead basically by now.  So in that recovery time it gave me a second look on life and I feel much more grateful to be here because of that.

Jordan's hand showing the scar from the skin graft after his melanoma was removed
Jordan’s hand showing the scar from the skin graft after his melanoma was removed

C: Yea, it changes you hey?

J:  It does.  And because of that I now get my skin checked every six months and it doesn’t bother me.  I just go do it.  Even though the skin doctor I regularly go see says “oh, you don’t have to come back for another year or so”  I just go “No I still like to come every six months because I just like to be on top of it no matter what.”  It doesn’t phase me and it just makes me much happier to know that I’m free of any cancers on my skin.

C:  I took my kids to see the skin doctor from the time that they were really young and I know that that’s not a typical thing for people to do with children but because I work in that field of plastic surgery I’m quite paranoid about melanoma and skin cancer.  But also Jordan has very fair skin and red hair and that alone puts him at risk.  Plus the fact that his aunty and uncle both had melanomas.

J:  The thing was when I was about 10 or 12 I had cousins over for the day. We were in the pool all day in the sun and I had no sunscreen on, no shirt.  I remember how brutally bad I got sunburnt over my back.  That night you were just there putting all this cream and stuff on and it was the most painful …

C:  I put burn cream on but it was blistered .  I probably should have taken him to the Emergency Department at the hospital because he had second degree burns all over.

J:  Absolutely and I’ll never forget how brutally painful that was.

C:  I always kept the Silversadine Cream which is a burn cream on hand.  At the moment we use Solugel for any little sunburn or anything and it takes the redness away straight away.

What precautions do you take now to protect your skin?

J:  Well just going back to when I was sunburnt those many years ago I always from that point on always made sure I had some sunscreen or had jumpers on or hats just to make sure I’m as sun protected as possible.  If I was out in the open I’d try and find any shade possible and just try and make sure I was as under cover as possible, and not so much out in the sun.  But I think that it’s also too that the Australian sun is just much more stronger.  I went to Europe a few years ago and I barely got burnt and I was out in the sun almost every day.  I still put sunscreen on and everything and you can still get burnt but I find that in Australia the sun’s way more stronger and you can burn so easily. 

I can just walk out on the beach and within ten minutes I’d be burning and you could see I’m burning right in front of you.  But we also figured out too that, because I haven’t been really that sunburnt over the years, we figured out that the melanoma developed on the back of my hand from driving.  From the sun beaming in through the window.  You wouldn’t really think much of it but it makes sense.  That would be the only possible reason that I got the melanoma on the back of my hand.

C:  What advice would you give to other people?

J:  Definitely get your skin checked every couple of years at least.  If you’ve got fair skin like me or especially red hair at least once a year or two.  Just make sure you check your skin often.  If you notice weird bumps or weird changes to your freckles or anything just go and get them looked at.  It’s not worth just pondering around it because I never thought anything of the one I had and you know, I’d just get straight on to it.  I wouldn’t beat around the bush.

C:  And you’ve got to go to an actual skin doctor because they’re trained to look properly.

J:  They grab all these magnifying glasses and all this special equipment to look deep into any freckle or any mole and they can see all these different colours and they can tell whether it’s cancer or not straight away.

C:  They do mole mapping and he writes it all into his computer, any moles that he’s had a look at.  The one that we found that actually identified Jordan’s melanoma, we just stick with him.  We go to the same doctor every six months and he knows us.  He knows our skin.  He remembers lesions.  I point out everything, but I also check my skin regularly, more than once a week.  I’d say it was virtually every day.  I’m always having a good look on my skin.

J:  It doesn’t take that much effort to do it.

C:  Yea, but there’s areas that you can’t see yourself like your back and your scalp.

J:  Yea, that’s exactly why you go and get your skin checked.  It doesn’t matter about age as well, being 24 I didn’t think it would be a melanoma.  As a kid growing up you go to the doctor’s and you see all the skin charts with all the markings and stuff and you think it’s just what older people get and people in their 40s or 50s or older.  And while that is true, look, I was 24.  I never saw it coming.

C:  So that’s our message, to get your skin checked.  It doesn’t take long as Jordan said.  It’s a ten minute visit to your doctor regularly.  Especially if they’ve found any type of skin cancer in your family, that’s important:  to go get checked.  

Thank you Jordan, that was really great.

J:  No worries.

Screening for Melanoma

Anyone with a parent, sibling or child who has had a melanoma should be carefully monitored for melanoma themselves.  Skin examinations should be performed every 3 – 6 months by a specialist skin doctor to monitor any pigmented lesions.  It is important to watch moles closely for any signs of change in shape, size or colour.

Dermatologists may photograph moles, known as mole mapping, or view moles with a hand-held device called a dermatoscope.  This will assist the doctor to identify changes over time.  Any suspicious moles or other skin changes should be removed by a doctor so that the tissue can be analysed under a microscope.

Children should begin screening by age 10.  Regular self-examinations should be done monthly to look for skin changes.  

What to Look For

Moles are usually round or oval, an even coloured black, brown or tan spot on the skin.  They usually stay the same for many years.  Almost all moles are harmless, but any changes may indicate a melanoma is developing.  Look for any changes in shape, size or colour, or new moles on your skin. 

Watch for the following:

A – Asymmetry:  One half of the mole does not match the other;

B – Blurred:  The edges are irregular, ragged, notched or blurred;

C – The colour is not the same all over and may include different shades of black or brown, and sometimes have patches of pink, red, white or blue;

D – Diameter: The spot is larger than 6mm (4 inches) across, although some melanomas are smaller than this;

E – Evolving:  The spot is changing in size, shape or colour.

The ABCDEs Of Detecting Melanoma: Asymmetry, Border, Colour, Diameter, Evolving
The ABCDEs Of Detecting Melanoma: Asymmetry, Border, Colour, Diameter, Evolving

Other warning signs are:

  • A spot that doesn’t heal;
  • Spread of pigment from the border into the surrounding skin;
  • Redness or a new swelling beyond the border of the mole;
  • Change in sensation such as an itch, tenderness or pain;
  • Change in the surface of the mole:  scaliness, oozing, bleeding, or a lump.
Warning signs of melanoma:
A spot that doesn't heal
Spread of pigment from border into surrounding skin
Redness or new swelling beyond border of mole
Change in sensation e.g. itch, tenderness or pain
Change in surface of mole:  scaliness, oozing, bleeding or a lump
Warning Signs of Melanoma

Show your doctor any changes such as these.  A yearly (six monthly if you are high risk) specialist skin check should be done because they will thoroughly check all the areas you are unable to see yourself such as your scalp and back.  Melanomas can appear in unusual places such as inside your mouth or on the coloured part of your eye, so it is important to show your doctor anything that you are concerned about.

Avoid Skin Exposure to Ultra Violet Rays

People who are high risk should avoid sun exposure and take steps to protect themselves when outdoors.  Man-made UV rays such as tanning beds should be avoided.  They are banned in Australia but may still be available overseas.

Avoid manicures and pedicures that use UV rays to set the nail art.  They have been known to cause melanomas in the nail bed.  The curing lamps used to dry shellac and gel during manicures expose nails to UV rays.  The UV rays you receive during a manicure are brief but intense, four times stronger than the sun’s UV rays.  Only 1.4% of melanomas occur on finger or toe nails.  Watch for any darkening of skin around the nail, infections or nails lifting, sensitivity or nodules under the nail.

Protect Your Skin From the Sun

Remember to use sunscreen with a high SP factor, preferably 50 plus.  Cover all exposed skin while in the sun and remember you can still get burnt in the winter.  Wear a hat and avoid the sun during the hottest part of the day.  Protecting your skin from the sun helps you to avoid UV damage which may cause wrinkling and age spots, and expose you to developing melanoma and other skin cancers.

Thank you again to Jordan Hill for telling his story of how he was diagnosed with a melanoma at the age of 24.  Photos and more information will be on the website.

My next episode will focus on pancreatic cancer.  Many people, even those with a BRCA 1 or 2 gene mutation, are unaware of the increased risk of pancreatic and other cancers.  Because my dad passed away from pancreatic cancer it is a subject dear to me.  Thankyou for listening.

Outro

Do you want to learn more about BRCA gene mutations and cancer awareness?  Find me at Midlifestylist.com where you can read about this and living a healthy lifestyle.  Please subscribe to the podcast so that you don’t miss an episode.  If there is a topic you would like me to talk about you can contact me via Midlifestylist.com.  Thank you for listening.  

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I will GO PINK for Cancer Research

GO PINK for Cancer Research

I do some strange things while scrolling through my phone at night. My insomnia keeps me awake for hours sometimes with only my screen for company. I wake up the next day with buyer’s remorse, usually because I’ve bought shoes or clothes that never fit me, or an appliance that never gets used. But this time I woke up with a sinking feeling in my gut because I had signed up to GO PINK, and agreed to dye my hair pink for breast cancer research.

I’m pretty conservative and have never dyed my hair any shade that could be considered flamboyant or radical. As an introvert I hate to stand out in a crowd. The thought of it makes me blush so I’ll probably end up looking like a flamingo with cheeks to match my hair. I needed some courage and that came in the form of my beautiful niece Ally who LOVES to stand out in a crowd and possesses such a lively spirit that she’ll boost my confidence when I need it the most. Ally has been a wonderful support to me over the last few months. She was the person I turned to when I knew I was having my mastectomies because she’s been through breast surgeries herself. Having someone to talk to who has been through this has been a blessing.

My Niece Ally and I.  We will be fundraising together for the GO PINK for cancer research event.  Ally has been a wonderful support for me
My niece Ally and I. We will be fundraising together for the GO PINK for cancer research event. She’s been a wonderful support to me over the last few months

Why Breast Cancer Research is Important to Me

I’m doing this challenge because it’s to fundraise for a cause that is very special to me. I have written about my genetic disorder BRCA2 which increases my risk of breast, ovarian, pancreatic and prostate cancers and melanoma. I inherited it from dad who died from prostate and pancreatic cancer (both caused by BRCA2). I’m at home recovering from bilateral prophylactic mastectomies. It is a risk reducing surgery along with the removal of my ovaries which I had done in March.

The very fact that I could have risk reducing surgeries is entirely due to the discovery of BRCA2 in the mid 1990’s. Before that, entire families were devastated by breast and ovarian cancer striking again and again through multiple generations. It’s now commonplace for family members to be tested for genetic conditions when there appears to be a genetic link. Discovering this gene mutation in 1995 was a game-changer for breast cancer research.  It allowed people like me to discover their inherited risk for cancer and do something about it.  Increased screening, prophylactic surgery and medications to reduce the risk are all possible now thanks to breast cancer research.

My Family History of Cancer and BRCA2 Gene Mutation

In my case there were few cases of breast cancer in my family. That alone prevented me from being tested ten years ago. It’s not as well known that men can have the genetic mutation too. Prostate cancer and melanoma have cropped up in our family through multiple generations, including my 24 year old son who had a melanoma. My cousin was diagnosed with BRCA2 about 10 years ago. Because of that I could be tested for free. The cost used to be extremely high. Improved testing methods mean that more people can now be tested under Medicare. My sons and any other close relatives are also eligible for free testing.

I am passionate about research into genetic causes for cancer and other diseases. I signed up to the GO PINK campaign because it raises funds for breast cancer research by the National Breast Cancer Foundation. If dying my hair pink raises awareness and funds, then I’ll do it. Even though I’m feeling anxious about looking weird with pink hair! The big day is this Friday. If you would like to donate to this cause via our team The Tough Titties the link is below. (The name is Ally’s idea, because people who have cancer have to be tough).

https://fundraise.nbcf.org.au/fundraisers/thetoughtitties

https://fundraise.nbcf.org.au/fundraisers/thetoughtitties

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Beating BRCA2 – How it has Affected My Life

I have had my own challenges while the World’s focus has been on the Coronavirus. This is a personal account of how the BRCA2 gene mutation has affected my life.

While the World Has Been Focused on the Coronavirus, I’ve Been Beating Cancer

The World around us changed dramatically between my birthday and my best friend’s birthday three days later. We spent the weekend together with our husbands, the four of us celebrating by staying in a resort and drinking, eating and laughing together. After we went home the restrictions started suddenly so that it would no longer be possible to socialise in that way. Our last weekend together from 20-22 March is the last time we could eat out at a restaurant or cafe, drink in a hotel or even spend time together. It seems like the distant past now.

We still can’t eat out at restaurants together, although restrictions in our State have begun to be lifted. We are unable to cross the border to visit my family who live just an hour south. Social isolation has added another layer to my own health battles that began to unfold this year.

BRCA2 Gene Mutation and Cancer Risk

I was diagnosed with the BRCA2 gene mutation in March. You may have heard about Angelina Jolie having BRCA1 and undergoing bilateral prophylactic mastectomies and a total abdominal hysterectomy a number of years ago. BRCA2 is similar – it increases my risk for breast and ovarian cancer dramatically. It’s a case of not if I develop these cancers, but when.

I knew there was a chance of inheriting this gene about 10 years ago when I nursed my cousin who told me she has the gene. I had genetic counseling back then but it was not very obvious that the gene was on my side of the family as there wasn’t a high number of family members with cancer, especially breast and ovarian cancer. The genetic counselor thought my cousin probably inherited it from her father (no blood relation to me). Consequently, I didn’t get tested and opted for more stringent screening instead.

I’m a huge advocate for screening. I have been having early mammograms and ultrasounds for the last 10 years. Every six months I get my skin checked. My son’s melanoma was picked up during a routine skin test. This was possible because I starting taking my sons for skin checks from a very young age. My son’s melanoma was diagnosed when it was just a stage 1 cancer. Many people ignore things until they’re advanced but that’s not me. I get every little bump checked out because I’ve seen too many invasive cancers as a nurse.

My son's melanoma.  He was only 24 years old when it was diagnosed.  It was a stage 1 melanoma.  Surgery completely cured him
My Son’s Melanoma – He was Only 24 Years Old when it was diagnosed.
It was a stage 1 melanoma. Surgery completely cured him

The last few years have produced more cases of cancer in our family – my son, brother and sister have all had melanoma and my father had prostate and pancreatic cancer. It was always in the back of my mind that I should probably get tested for BRCA2. I went back to the genetic counselor to be tested. Results showed I did have the BRCA2 gene mutation. I inherited it from dad – I had a 50% chance of having it and my sons then had a 50% chance of inheriting it from me. My first reaction was not for myself, but rather for my sons – “I’ve given them a death sentence”.

BRCA2 Affects Males Too

Telling them was difficult. It would have implications for when they want to start a family, and it might even be a deal-breaker for some women who wouldn’t want to have the risk of having children with a genetic disorder. They surprised me with their reaction, however. Their response was that they’d rather know if they had the gene or not. They were now aware of screening and get any changes in their bodies checked out early. They underwent genetic counseling and were tested for the BRCA2 gene mutation. The results came back negative. We were surprised and ecstatic at the results. Even my son who had a melanoma was clear which is even more surprising).

Risk Reducing Surgery

My first response to finding out I have BRCA2 was to swiftly decide to have prophylactic risk-reducing surgeries. That involves removing the organs most at risk of developing cancer – ovaries (I have a 20-40% chance of getting ovarian cancer) and breasts (60-80% chance). Having nursed women with ovarian and breast cancer for most of my nursing career, I know how devastating those cancers are and I want to avoid them as much as possible.

I had the first surgery on March 30th – a laparoscopic bilateral oophrectomy (keyhole surgery to remove my ovaries). This surgery is low-risk and most people bounce back quickly, with very little complications. Then there’s me. I seem to have the worst luck when it comes to complications to procedures – I went into complete heart block after an angiogram and required CPR. One medication landed me in hospital from a severe allergy. So to have complications after this small operation, while not surprising for me, was a shock to the system all the same.

Complications

I bruised. My abdomen became extremely distended. A lot of pain and nausea. But the worst thing – I couldn’t pass urine. I ended up going home with an indwelling catheter and it unearthed a problem with my bladder that’s probably been there for a long time but wasn’t apparent until I had pelvic surgery. I had follow-up surgery to fix it last week. While there was an improvement, there will be ongoing issues for a long time because my kidney and bladder have been damaged. All my back pain was from my kidney, not my spine after all.

BRCA2 Gene Mutation.  While the world has been focused on the Coronovirus pandemic, I have been battling my own health dramas

My next challenge is Bilateral Prophylactic Mastectomies

This week I will undergo my biggest challenge yet – a bilateral prophylactic mastectomy. After my previous operations I’m scared of having this surgery. I’m more scared of breast cancer though. Someone said to me that I’m brave to do this – I don’t feel brave. In fact I feel just the opposite. The women who have breast cancer are brave. Imagine going through this operation as well as radiotherapy, chemotherapy and medications for life. That’s brave to me.

I feel like I’m cheating cancer by doing these surgeries, but there’s still the risk of getting a different type of cancer because of this gene mutation. BRCA2 causes pancreatic, prostate and renal cancer as well as melanoma so I’ll still have to remain vigilant. Of course I can’t get prostate cancer, but pancreatic cancer is hard to detect. My dad’s was too far advanced to have any treatment. Pancreatic cancer ravaged his body. He only lasted for 7 months after it was diagnosed. Poor bugger, it was a horrible way to die.

How the Coronavirus Has Impacted Me

Attention has been on my own health issues while the world has been focused on coronavirus. I have found it hard to cope at times because it has restricted my ability to interact with the people who are my confidantes and support system. Talking on the phone is not the same. Even when I was in hospital I could only nominate one visitor for the whole hospital stay. My husband was sent away from the hospital and could only visit for 2 hours once a day. Going through mastectomies will be daunting without him there for my support. The thought of it upsets me a great deal. I won’t be able to have my sons and best friend visit at all.

Elective surgeries were cancelled in March. I feel really lucky that I knew the surgeons personally and my first operation was pulled forward. Any later it would have been impossible. I feel a little guilty that I could get this preferential treatment but there has to be some perks for nursing alongside these doctors for the last 20-30 years.

Other Concerns

Having to tell my brothers and nephews over the phone and Messenger that they too have a 50% chance of inheriting this really sucks. Social distancing sucks when you have to have these very full-on conversations. Worrying that I may get the coronavirus affects my health too, because I have co-morbidities that would mean I’d be one of the cases most likely to end up really sick from it. It’s been a very stressful time, and I’ll be glad when this is all over and we’re out the other side. The world will be a changed place when this pandemic is over.

Beating BRCA2.  While the world has focused on the Coronavirus, I have been beating cancer.  BRCA2 gene mutation increases my risk of breast, ovarian and pancreatic cancer.

Note to my followers: I’ll be out of action for a while due to my surgery this week. I may be able to post short updates via my mobile phone but my usual blog posts will be on hold for a few weeks. Thank you all for your support, I really appreciate it.

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Signs you need to see a doctor

When should you see a doctor? What signs to look for

Signs and symptoms that need to be checked by a doctor

Updated 14 August 2020

People are delaying seeking a doctor’s advice because of the pandemic. A delay in the diagnosis and treatment of disease leads to poorer outcomes in some instances, especially cancer. There are some signs and symptoms that should not be ignored, and need to be checked by a doctor.

I’ve been a Registered Nurse for over 30 years and unfortunately many of the patients I see have a “head in the sand” approach to health. They are aware of signs and symptoms, but they’re too scared to go to the doctor so they leave it too late. Many of the diseases we see can be cured if they’re diagnosed and treated early enough, but because the person is too scared to see a doctor, it is too late to do anything about it. Unfortunately we also see patients who have been fobbed off or treated for the wrong thing as well. If you’re not happy with what you’re told by one doctor, seek another opinion. You are the best advocate for your own health so keep in tune with your body and don’t ignore signs that there’s something wrong.

What predisposes us to disease?

A doctor I worked with once said to me “if everyone gave up smoking I’d be out of a job”. That’s not strictly true, however, because even though the smoking rate has gone down since awareness campaigns and Government restrictions on the sale of cigarettes, there are still other risk factors that can predispose us to disease. These include hereditary factors, lifestyle, age and sex, environmental factors and socioeconomic status. We can’t do much about our hereditary factors, age or sex, but we can control our lifestyle, environment and socioeconomic status to a certain degree.

Don’t ignore these symptoms

Another thing we can control is our awareness of signs and symptoms that could warrant a trip to the doctor, such as:

  • changes in bowel or bladder habits
  • shortness of breath, wheeziness
  • a cough that produces yellow or green sputum, or is blood tinged
  • chest tightness or pain
  • spots that have changed on your skin
  • lumps and bumps
  • bleeding, e.g in your urine or faeces, or a wound
  • hoarse voice or difficulty swallowing
  • dizziness or fainting
  • pain not controlled with over the counter medications
  • weakness in a limb, especially when it’s down one side of your body and you also have a drooping mouth
  • very high fevers, 38 degrees C or above
  • discharge or oozing, especially when it has a strong odour
  • swelling
  • a cut or sore that won’t heal
  • severe thirst but still have a dry mouth
  • unexpected weight loss and loss of appetite over a period of time
  • snoring and breath holding at night, and still feeling exhausted during the day
  • changes in your vision, crustiness in your eyes, or red and painful eyes
  • yellowing of skin and eyes
  • palpitations or fluttering in your chest
  • fractures or sprains
  • severe vomiting
  • confusion or mood changes
  • reactions to medications or treatment
  • Knocks to the head, especially ones where you lose conciousness or see stars, or are confused afterwards
  • epileptic fits

This list is only a sample of things to watch out for. Some of these are medical emergencies – don’t hesitate to call an ambulance if you have chest pain, weakness down one side of the body, severe bleeding and serious accidents. If you have a pre-existing medical condition, make sure you are informed of what signs and symptoms to look for, and when to see your doctor for follow-up appointments.

Misdiagnosis can lead to poor health outcomes

I have worked in Plastics and Reconstructive surgery wards for many years and even then I have a personal example of misdiagnosis with skin cancer. Because I am aware of the risks of skin cancer I have had a yearly skin check for at least the last 20 years. My sons have had the same checks since they were small children. This is partly due to the high incidence of melanoma in my family (my brother and sister) but also because of seeing the effects of melanoma spread in patients.

I was on holiday in New Zealand and my son phoned me to say he’d had his skin check and the doctor had biopsied a spot on the back of his hand and it had come back as melanoma. It’s hard to convey how devastated I was at hearing this and not being at home to support him. He was only 24 at the time and we’d been going to the same skin doctor for years. This doctor had told him at least twice before that the spot was fine, and we had trusted him. This time it was a different doctor – we had recently moved to a new surgery.

Melanoma, stage 1, on my 24 year old son's hand.  Required excision and flap graft.
My son’s melanoma

If my son had left it for another year it would have spread. We were lucky it was Grade 1 and hadn’t spread at all. I phoned one of the Plastic Surgeons I worked with and made an urgent appointment and my son was in surgery the following week. He had to have a full thickness flap done, about 3cm in diameter, to his hand but he’s cancer free which is the best outcome we could have had. He’s proud to show his scar because he’s a survivor and he’s brought awareness to many of his friends and acquaintances about the need for skin checks. We both have to have 6 monthly skin checks now for the rest of our lives.

This is the scar on his hand now. He had a skin flap removed from his upper arm to graft on to his hand

Be Your Own Health Advocate

My message today is that I want you to see a doctor if you’re concerned about anything, but keep pushing for more if you’re not happy with what they tell you. That niggling feeling that something isn’t right should not be ignored so pay attention to your body!

Note: this article is for informational and educational purposes only and should not be substituted for professional advice from a Registered Medical Practitioner. Please see the full disclaimer statement by clicking on the heading Disclaimer on the Home page. I am unable to answer specific questions from readers – if you are concerned, please see your doctor.

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