Every June, the focus is on men’s health, and this year’s campaign was on P for Prostate, emphasising the importance of men sharing their stories. When King Charles gave his health update earlier this year, the NHS website’s ‘enlarged prostate’ page received 16,140 visits compared to 1,141 visits the previous day. Prostate Cancer UK had almost double the number of users for its online risk checker.

The Men’s Health Forum has been working hard to shed light on three common conditions affecting men: prostate enlargement, prostatitis, and prostate cancer. The symptoms of these three conditions can be very similar, so seeking medical advice and organising a prostate check as soon as possible is critical.

Prostate enlargement

This is a widespread condition, typically associated with ageing, as research suggests more than one in three men over the age of 50 will have some symptoms related to prostate enlargement. Symptoms include changes to urination patterns, such as needing to pee more frequently or suddenly.

It isn’t caused by cancer, and the medical term is benign prostatic enlargement (BPE). Another term is benign prostatic hyperplasia (BPH), which means an increase in the number of cells, causing the prostate to become enlarged.

Prostatitis

Prostatitis is an infection or inflammation of the prostate gland, another non-cancerous condition affecting the prostate. It can develop in men of all ages. There are four main types:

  • chronic pelvic pain syndrome (CPPS)
  • acute bacterial prostatitis
  • chronic bacterial prostatitis
  • asymptomatic inflammatory prostatitis

CPPS is the most common type of prostatitis – around 19 out of every 20 men with prostatitis have it. The definitive cause is unknown as it’s not caused by a bacterial infection unlike the other forms of prostatitis. Potential causes include urine getting into the prostate or problems with the pelvic floor muscles, and it might also be linked to other conditions such as IBS. As a result, it can be challenging to diagnose and treat.

Prostate cancer

Here in the UK, prostate cancer is the most common cancer affecting men, with approximately 30,000 new diagnoses a year. Risk factors are age, family history and also ethnicity, with black men much more likely to get prostate cancer.

There’s no single, definitive test for prostate cancer. Your GP may examine your prostate by performing a digital rectal examination, taking a urine sample to check for infection, and testing for prostate-specific antigen, known as a PSA test. An MRI scan of the prostate may then be carried out and a biopsy performed if a problem is discovered.

Until now, there has been no national screening programme for prostate cancer, but Prostate Cancer UK has launched a ‘ground-breaking’ trial known as Transform, which will compare the efficacy of various screening methods.

Previous trials found that PSA tests and biopsies to screen for the disease prevented between 8% and 20% of deaths, depending on screening regularity. Prostate Cancer UK hopes that Transform has the potential to reduce deaths by 40%.

The first phase will involve about 12,500 men and will compare current NHS diagnostic methods with PSA tests, genetic testing and a faster version of the MRI scan – known as a Prostagram – against

The second stage, involving up to 300,000 men, will focus on the most promising methods discovered in stage one. Initial results are expected in three years.

To arrange your prostate check, call +44 (0)20 4580 1152 or email [email protected] to organise a consultation.

If you have been feeling increasingly thirsty, need to urinate frequently or are unusually fatigued, you may be experiencing the early symptoms of type 2 diabetes. A recent study has found that treating type 2 diabetes as early as possible helps to reduce the risks of future complications.

Scientists from Oxford and Edinburgh Universities analysed data spanning over 40 years from the UK Prospective Diabetes Study (UKPDS). The results revealed that there was a significant and lasting legacy of early intervention in managing type 2 diabetes.

Benefits of early intervention in diabetes

Treatment with insulin or sulphonylurea tablets immediately after a diabetes diagnosis led to 17% fewer heart attacks, 26% fewer complications associated with diabetes, like kidney failure and vision loss, and 10% reduction in mortality. Compared to managing type 2 diabetes through diet, early treatment with metformin led to 31% fewer heart attacks and 20% fewer deaths.

Data collected over four decades is now revealing that protective effects are long lasting. The researchers believe that effectively reducing blood sugar levels early on creates a ‘memory’ effect even if blood sugar levels rise at a later date.

“People may have type 2 diabetes for several years before being diagnosed as they may have few symptoms until their blood sugars become substantially elevated… Playing catch-up with blood glucose control is not sufficient.”

The importance of regular diabetes health checks

This week is Diabetes Awareness Week in the UK and this year the focus of the campaign is the importance of diabetes health checks in preventing serious complications arising. These include:

Blood tests

This is a regular test that checks your average blood sugar levels over the preceding months, your cholesterol levels to see how much fat is in your blood and your kidney function. A urine sample is also taken to check for signs of kidney disease.

Physical examination

Your blood pressure will be measured as well as your weight and height to assess your BMI.

Diabetic eye check

Not an annual check necessarily but an eye check involves photos taken of your eyes to see how diabetes is affecting them, as it can damage the blood vessels and cause diabetic retinopathy.

‘Knowing your numbers’ is essential. Our annual health checks include a blood test for HbA1c which checks for type 2 diabetes as well as assessing your blood pressure, cholesterol and glucose levels, and they are recommended from 45 years onwards.

For more advice on diagnosing and treating early type 2 diabetes call +44 (0)20 4580 1152 or email [email protected] to organise a consultation.

Concerns have been raised about the potential number of people in the UK who are at risk of experiencing a stroke, with figures set to increase by more than 50% by 2035. The impact on the NHS and the economy regarding healthcare costs and lost productivity is predicted to be £75bn a year.

This stark prognosis from the Stroke Association is based on trends of worsening physical health, rising obesity levels, and an ageing population. They warn that the impact on our healthcare system and the country’s financial well-being would be ‘unsustainable’ in a decade.

May is Action on Stroke Month, which aims to raise awareness of stroke in terms of prevention and management.

The Stroke Association is calling on the Department of Health and Social Care (DHSC) to publish a funded stroke prevention plan to support people of all ages to reduce their risk of stroke. A DHSC spokesperson commented: “We’re committed to improving stroke prevention, treatment, and recovery for all. We are also taking action to encourage better lifestyle choices, including creating a smoke-free generation and reducing salt intake through food to help prevent the risk of strokes.”

5 steps to prevent stroke

Public Health England estimates about 80% of strokes in people under 75 could be prevented. Age is a factor, as does a family history of stroke. You can’t reverse the years or escape your genes, but there are positive steps you can take to reduce your risk of stroke.

  1. Lower blood pressure

High blood pressure remains the most significant stroke risk factor, so monitoring and treating hypertension is one of the most important changes you can make. Steps you can take include reducing salt in your diet and exercising more.

  1. Lose weight

Obesity greatly raises your odds of having a stroke. Exercise contributes to weight loss and helps you manage complications such as diabetes and high blood pressure.

  1. Eat a healthy diet

Nutrition goes beyond just weight loss; some diets have been shown to decrease the risk of stroke. The Mediterranean diet focuses on fruits, vegetables, whole grains, fish and nuts while cutting back on foods high in saturated fats and trans fats, which helps to lower cholesterol.

  1. Quit smoking

Smoking raises your stroke risk in several and quitting is one of the most powerful lifestyle changes you can make to reduce this risk. It is important to remember that most smokers require several goes at quitting – see each attempt as bringing you closer to success.

  1. Reduce alcohol consumption

Even more than two drinks per day increases your stroke risk significantly so drink in moderation. If you do want a tipple, reach for the red wine, as recent research that analysed health data from 32 different countries found evidence that drinking red wine in moderate amounts could be associated with a reduced risk of having a stroke.

For more advice and support on making these important lifestyle changes, get in touch to arrange a private GP appointment with one of our team. Call +44 (0)20 4580 1152.

As temperatures rise and summer beckons, it’s unsurprising that May’s focus is skin cancer and sun awareness. The British Association of Dermatologists has long campaigned for greater knowledge of sun safety, and this year, their particular focus is informing the public about non-melanoma skin cancer and how best to check your skin.

Although most of us are aware of melanoma, the deadliest form of skin cancer, recent research has found that more people are now dying of non-melanoma skin cancer (NMSC) than malignant melanoma.

Conducted by researchers in France, the study analysed data collected by the World Health Organisation and found that non-melanoma skin cancer accounted for more deaths worldwide. Worryingly, they thought this number could even be higher as NMSC is sometimes left out of national cancer registries’ figures as it is considered less serious than other types of cancer.

What is non-melanoma skin cancer?

As with melanoma, NMSC is linked to exposure to UV rays through the sun or tanning beds. Over the last decade, melanoma skin cancer rates have increased by a third and NMSC by 42% in the UK as our attitudes to tanning and sun exposure have changed.

“It is vital we protect our skin from UV rays whether it is from sunlight or sun beds. In my opinion sun beds should have a health warning, considering the risk they carry,” comments GP London W1’s Dr Ravi Brar.

Melanoma is caused by mutations in skin cells called melanocytes, whereas NMSC usually develops in cells in the epidermis, or outermost layer of skin. The two most common types of non-melanoma skin cancer are basal cell carcinoma, accounting for about 75% of skin cancers, and squamous cell carcinoma, accounting for about 20% of skin cancers.

Signs of non-melanoma skin cancer

Whether for melanoma or non-melanoma skin cancer, early detection is critical. More than 75% of NMSCs are first noticed by patients or people close to them, so it is vital to recognise the early warning signs.

  • appearance of a lump or patch on the skin that doesn’t heal after a few weeks
  • cancerous lumps are typically red, firm, and shiny
  • cancerous patches are often flat, scaly, and irregularly shaped
  • a sore that won’t heal
  • a growth with raised edges
  • a wart-like growth that might bleed or crust over
  • a skin lesion that itches

Certain risk factors, such as a family history, pale skin that burns easily, and a large number of moles or freckles, can increase one’s chances of developing NMSC.

“Mole mapping serves as a valuable tool for monitoring individuals who have numerous moles and skin lesions, especially those that are large or have irregular shapes, as well as individuals with a personal or family history of skin cancer,” Dr Brar explains.

“If a patient has concerns with any of their skin lesions, it is important for them to seek appropriate guidance. With the aide of dermoscopy, these lesions can be assessed at higher magnifications thus helping with its diagnosis.”

“I developed an interest in skin and skin health about five years ago. The skin is our largest organ, and it’s the first thing everyone sees. If you’re unwell in any way, changes to your skin are often the first sign. The skin is amazing, and it is important knowing how and when to protect it and when to seek help.”

If you’ve noticed any concerning skin changes, book an appointment with one of our GPs.

Research commissioned by Mind, the UK’s leading mental health charity, found that work is the most stressful factor in people’s lives. More than one in three said their work life was either very or quite stressful.

Work-related stress experienced over a long period of time can lead to physical, mental, and emotional exhaustion, which is commonly known as burnout.

April is Stress Awareness Month, and this year’s campaign focuses on how even the smallest steps towards stress reduction can yield improvements in mental health. It is critical to be aware of the warning signs and make manageable adjustments as soon as you spot them.

5 steps to manage and prevent burnout

  1. Break things down: if your workload starts to feel overwhelming, it can often help to break down big jobs into more manageable tasks so you can achieve a series of specific goals.
  2. Learn to delegate: knowing what and when to delegate is often essential to prevent burnout.
  3. Take regular breaks and try to limit working after hours: if you’re very busy at work, it can be tempting to skip lunch or work late, but if this becomes a regular occurrence, you increase the risk of burnout.
  4. Set boundaries: taking on too many commitments can quickly lead to feeling overwhelmed, so set limits on the time you can give to others to prevent burnout proactively.
  5. Embrace self-care: when you’re stressed, it’s easy to fall into bad habits and stop looking after yourself. Exercising regularly, eating healthily, and prioritising sleep are all important for reducing mood swings, improving focus, and boosting your sense of well-being so you can cope with work-related stress.

How employers can support their employees

Work-related stress can significantly impact an employee’s performance and relationships with colleagues. It’s also a significant cause of long-term absenteeism.

“Burnout is an issue we’re increasingly seeing, and over the last 12 months, we’ve seen several employees signed off with burnout due to the chronic workplace stress that has not been successfully managed,” Dr Caroline Wall explains.

Ideally, employers should approach work-related stress proactively and focus on prevention and early intervention rather than responding to a situation that has affected performance or resulted in short- or long-term absence.

Approaches can include:

  • Flexible working options
  • Stress risk assessments
  • Reduce or eliminate sources of stress based on these assessments
  • Training for line managers
  • Stress management training for the whole workforce
  • Increase support during periods of change or uncertainty

For more advice on how occupational health can help prevent and manage work-related stress, call +44 (0)20 4580 1152 to arrange a discussion with one of our team.

April marks both IBS and Bowel Cancer awareness months, and these two conditions also share many similar symptoms as they affect the same part of the body.

Our health is shaped by a complex interaction between many factors, especially when conditions have overlapping symptoms, which can often lead to anxiety and confusion. Consulting a healthcare professional at an early stage is essential, as they can accurately distinguish and diagnose different conditions and help you manage your health effectively.

What are the symptoms of IBS?

Irritable Bowel Syndrome, or IBS, is a chronic condition affecting the large intestine. The bowel or large intestine is at the end of your digestive tract or colon.

The most common symptoms of IBS are changes to regular bowel movement, whether that is constipation or diarrhoea. Other symptoms can include abdominal pain, bloating, and a sensation that bowel movements are incomplete. Mucous in the stool is very common and is often whitish.

Even though it is a long-term condition, symptoms often fluctuate in frequency and severity. Certain foods can trigger symptoms of IBS, as well as stress, anxiety and hormonal changes.

Mild to moderate IBS is usually managed with lifestyle changes. Severe symptoms that are affecting quality of life may require medication.

IBS is typically diagnosed by taking a comprehensive medical history and reviewing your symptoms. This will cover your medications and if you’ve had any recent infections or periods of stress. A family history will also be taken to see if there are any instances of celiac disease or colon cancer. Testing is usually to rule out other conditions.

What are the signs and symptoms of colon cancer?

Symptoms of colon cancer can include changes to your bowel habits that last for more than a few days. This could be the following:

  • abdominal pain
  • cramping
  • diarrhoea
  • constipation
  • iron deficiency anaemia
  • blood in your stool or rectal bleeding
  • narrowing of the stool
  • mucous in the stool, usually bloody or dark black
  • the feeling that bowel movements aren’t complete
  • the urge to have a bowel movement when there is no need
  • fatigue
  • unexplained weight loss
  • weakness

Colon cancer will be diagnosed by taking a complete medical history as well as checking whether there is a family history of colon cancer. Risk factors include colorectal polyps, type 2 diabetes and ulcerative colitis, as well as a poor diet and lack of physical activity. In addition to a physical examination, diagnostic tests include blood and stool tests, a colonoscopy, tissue biopsy, and imaging tests, such as an X-ray or CT scan of the colon and rectum.

Can IBS lead to colon cancer?

This is a common concern, but although IBS can be very uncomfortable, it rarely leads to more severe health problems. Unlike inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn’s disease, IBS does not cause inflammation, a critical factor in colorectal cancer risk.

However, this doesn’t mean you should ignore symptoms and should seek immediate medical advice if you’re experiencing new symptoms such as unexplained weight loss or rectal bleeding.

March is Ovarian Cancer Month and the focus this year is about raising awareness of the symptoms of ovarian cancer.

According to data released by Target Ovarian Cancer, a woman’s chance of surviving ovarian cancer if diagnosed at the earliest stage, more than doubles from just 46% to more than 90%. However, less than a third of women in the UK are confident they know the symptoms and often they can be mistaken for symptoms of other, much less serious illnesses such as irritable bowel syndrome or polycystic ovary syndrome.

Ovarian cancer affects the ovaries. These are the organs inside the body which produce eggs and release them every month. Most women diagnosed with ovarian cancer are 50 or older, and have been through the menopause, but it is becoming more common in teenagers and young adults.

Ovarian cancer risk factors

Although it is not known what causes this type of cancer, risk factors for ovarian cancer include:

  • Age: more than 50% of ovarian cancers develop in women over the age of 65.
  • Hormonal factors: it’s suspected that the number of times an ovary releases an egg may be linked to ovarian cancer risk because there is evidence that having children, breastfeeding, and taking the contraceptive pill reduces the risk.
  • Hormone replacement therapy (HRT): taking HRT after the menopause slightly increases the risk of ovarian cancer.
  • Breast cancer: if you have had breast cancer, you may be more likely to develop ovarian cancer as it is thought that they can be caused by the same cancer genes.
  • Other health conditions: some conditions increase your risk including diabetes and endometriosis.
  • Lifestyle factors: being overweight and smoking can increase your risk of certain types of ovarian cancer.
  • Family history: if a close family relative has had ovarian cancer, your risk may be up to three times higher, particularly if they were diagnosed at a young age.
  • Inherited genetic conditions: it is now known that certain genetic mutations – the most commonly affected genes being BRCA1 and BRCA2 – greatly increases your risk of ovarian cancer, as well as breast, bowel and womb cancers.

Ovarian cancer symptoms

There are four main symptoms of ovarian cancer to be aware of:

  • Pain in the lower stomach area
  • Bloating or a swollen tummy
  • Difficulty eating and/or feeling full more quickly
  • Needing to wee more frequently

Other symptoms can include:

  • Indigestion
  • Back pain
  • Passing urine more often or needing to pee urgently
  • A change in your normal bowel function, either diarrhoea or constipation
  • Unexplained weight loss
  • Post-menopausal vaginal bleeding
  • Fatigue

If any of these symptoms are persistent or frequent and out of the ordinary, make an appointment as soon as possible with your GP. Keeping a record of any symptoms can be really useful.

If you are aged 50 and over and you suspect you are experiencing IBS, you should ask for further tests; IBS also causes bloating and changes in bowel function, but it does not usually present for the first time after the age of 50.

Please call +44 (0)20 4580 1152 to make an appointment.

Did you know that from the moment you stop smoking your body starts to repair the damage? Within 20 minutes, your pulse and blood pressure start to reduce and within eight hours of having your last cigarette, oxygen levels in your blood return to normal. By the second day, carbon monoxide in your blood will be gone completely. And now, research has shown that stopping smoking at any age reduces the risk of cancer.

A major new study, analysing medical data from nearly 3 million Koreans between 2002 and 2019, found that the chances of developing cancer halved in people who had quit for at least 15 years, compared to those who continued to smoke.

The study also showed that the younger you are to quit, the greater the benefits. Smokers who quit before the age of 50 had their risk of lung cancer fall 57% compared to smokers, while those who quit at 50 or older experienced a 40% reduction in lung cancer risk over the same time period.

What happens when you quit smoking?

After 1 day

  • Carbon monoxide is one of the hundreds of noxious chemicals present in cigarette smoke; it replaces the amount of oxygen in your blood, depriving the body of this nourishment. Within the first 24 hours, the carbon monoxide and oxygen levels in your blood return to normal

After 1 week

  • You may notice a heightened sense of smell and taste as the previously damaged nerve endings that control these senses start to regrow
  • You may feel breathing is easier as the bronchial tubes relax
  • Energy levels increase

After 1 month

  • Lung function improves as the cilla, tiny hair-like structures which move mucous out of the lung, begin to work normally
  • Circulation improves as blood pumps through the heart and muscles more easily

After 9 months

  • After 9 months, a person’s lung function increases by 10%

After 1 year

  • Smoking damages your heart by limiting oxygen flow and damaging the lining of the arteries. Quitting smoking reverses these effects and after one year your risk of a heart attack and coronary heart disease becomes half of that of someone who still smokes

After 5 years and more

  • Your risk of certain cancers including lung cancer is significantly reduced
  • At the 15-year mark, your chance of a heart attack becomes equal to a person who has never smoked

For more advice and support in quitting smoking, call +44 (0)20 4580 1152  to arrange a GP consultation with one of our GPs.

At any time, one in six adults in the UK will be experiencing a mental health condition – ranging from anxiety and stress to medically diagnosed conditions such as depression. 

Occupational health focuses on how work and the work environment impact employees’ health, both physical and mental and how this can negatively affect their ability to do their job. GP London’s Dr Caroline Wall explains how often simple workplace adjustments can facilitate job retention and return to work.

Dr Caroline Wall at GP London W1

We’re seeing a lot of patients absent from work with anxiety and depression currently. One of the take-home points of the occupational health diploma is that it’s better to be in work than out of work from a mental health perspective. Our role is to managing return to work without causing a worsening of their symptoms.

The first step is an assessment, either face-to-face or on Zoom, with the with the employee. We discuss what they feel they could manage. We then must offset that with what the employer wants which is usually for them to return to full-time work as soon as possible. But often a phased return is more likely to succeed than jumping back into full-time work.

This can mean rest days in between to help people ease in, particularly if they’ve had a long time off. We might look at reduced working hours initially to avoid traveling at peak times, which can be a big trigger particularly for those suffering from anxiety. Another option is working from home which can mean avoiding many of the stressors within the office environment.

Recently, there’s been much media attention on the explosion in adult ADHD diagnoses – recent research indicated a 20-fold increase in adult diagnoses and nearly 50-fold increase for men aged between 18 and 29.

Men and women who have developed coping strategies to ‘mask’ ADHD in their earlier years, often find it becomes problematic in the workplace, so we create strategies for them to cope. These adjustments can be software changes that help make screens more readable, providing quiet space where interruptions are minimised and frequent work or movement breaks throughout the day so they can manage their symptoms.

We are not acting as their GP but if they are experiencing certain symptoms or difficulties in the workplace, we can signpost them to the right places, either via their NHS GP or, if they have insurance, there are psychologists we can refer them to for a formal ADHD assessment.

Dyslexia is another issue that can be addressed with workplace adjustments such as dictation or note-taking software. Often, they’re relatively inexpensive, but can make quite a significant difference.

Burnout: an ‘occupational phenomenon’

Burnout is an issue we’re increasingly seeing, and over the last 12 months we’ve seen several employees signed off with burnout due to the chronic workplace stress that has not been successfully managed. Although not formally classified as a medical condition, it is now recognised as an ‘occupational phenomenon’ and is characterised as:

  • feelings of energy depletion or exhaustion
  • increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job
  • reduced professional efficacy

The value of early intervention in occupational health

Early intervention would be best but often we get referrals when an employee has already been signed off work and we’re trying to manage their return to work after a period of absence. However, if we were able to intervene at the first signs that an employee is struggling, it may be possible to keep them happy, healthy and productive and reduce absenteeism.

Please call +44 (0)20 4580 1152 to discuss our Occupational Health Services.

Heart attacks could be better prevented in those suffering unexplained chest pain, according to recent research funded by the British Heart Foundation into cardiovascular disease risk factors.

It is thought that over a million UK adults visit their GP every year due to chest pain, but for many the cause remains a mystery despite undergoing diagnostic tests.

However, people who suffer from this type of ‘unattributed’ chest pain are a higher risk of developing heart problems and researchers at Keele University have now identified the key risk factors that increase the likelihood of this occurring.

Published in the European Journal of Preventive Cardiology, the study was based on data from over 600,000 GP records of patients that had experienced unattributed chest pain between 2002 and 2018 and followed them up for at least five years.

Their analysis showed that one year after first presenting to their GP with mystery chest pain, patients were 25% more likely to have a ‘cardiovascular event’. This increased heart attack risk persisted for the next ten years.

Cardiovascular disease risk factors identified in study:

Diabetes

Diabetes significantly amplifies the risk of cardiovascular disease, even with well-managed glucose levels. You are twice as likely to have heart disease or a stroke than someone who doesn’t have diabetes, and typically at a younger age. The longer you live with diabetes, the more likely you are to have heart disease.

Regular check-ups, healthy eating habits, weight control and consistent physical activity are essential for diabetes management.

High blood pressure

High blood pressure increases cardiovascular risks by overburdening the heart, leading to muscle thickening and stiffness. This abnormal functioning increases the chances of stroke, heart attack, kidney failure, and congestive heart failure. When coupled with obesity, smoking, high blood cholesterol or diabetes, high blood pressure elevates the risk of heart-related incidents.

Smoking

Nicotine, found in both cigarettes and e-cigarettes, accelerates heart rate and raises blood pressure, promoting clot formation and arterial plaque build-up. Smokers are not only more likely to experience heart attacks, strokes and angina than non-smokers, but at a much younger age.

Obesity

Excessive body fat, especially around the waist, contributes to an increased risk of heart disease and stroke, independent of other risk factors. Overweight and obese individuals with cardiovascular risk factors can implement lifestyle changes to shed excess weight and address issues like high blood pressure, cholesterol, and blood sugar.

Steps to reduce heart attack risk

The team at Keele University hope these findings will assist doctors to spot those at high risk so they can offer preventative treatments and lifestyle advice. Modelling showed that if all current smokers living with obesity were supported to lose weight and quit smoking, the mean 10-year risk in this group would fall from nearly 22% to around 16%.

Please call +44 (0)20 4580 1152 to make an appointment with one of our GPs to discuss your heart attack risk.