NOTE: Due to workload pressures we are experiencing a delay in this service. Please bear with us.
Our Advisor, Dr X, is a health professional with many years experience. He specialises in laboratory medicine and has a background in academic research in addition to his duties in the NHS and private practice.
If you have a question for Dr X, please email us and we will post your answer here. You can remain anonymous if requested. Dr X regrets he cannot enter into personal correspondence and that, due to the volume of questions, he cannot reply to everyone.
He’s also taken the time to let you know some excellent sites to visit – no quack sites here!!
Just click on the section or question you’d like to see…
What does a blood gas test involve and why do I need one?
A test for blood gasses will measure the amount of dissolved oxygen and other gasses in your blood, and is useful for your doctor to know how efficiently you are transporting these around your body, and thus how well you are able supply the tissues of your body with the oxygen they need to work effectively. Your doctor will be able to explain ‘why’ it is required in your particular case.
Is all bone marrow liquid? Or can it be solid too?
The term ‘bone marrow’ is a little bit vague since there are two types of bone marrow. The first type, the ‘yellow bone marrow’, is a fairly inactive solid fatty material and this helps to fill out and give strength to the medullary cavity (the shaft part) of the bone. The ‘red bone marrow’ is the active
(useful) type of marrow which is the site of production for all of the blood cells in the body. Once the blood cells have been made and matured in the red bone marrow, they are released into your cirulation to replace old ones which get lost or worn out. The red bone marrow is a liquid in consistency, like your blood is but a little thicker, but it can clot just like your blood can. Therefore your bone marrow can be both solid (yellow) and liquid (red, but only when it is fresh and anticoagulated), depending upon which type you are referring to. The following BBC website has a simple diagram that may help you to understand it better: http://www.bbc.co.uk/schools/gcsebitesize/pe/anatomy
What is haemofiltration?
Haemofiltration is a form of haemodialysis, a technique which is often used to filter the blood of patients who have kidney failure and thereby keep them alive until a suitable donor organ can be found for them. Haemofiltration may also be used in an intensive care setting where it is indicated in circumstances of fluid overload, or when the patients biochemistry is worsening or the patient has ‘acidosis’ which means that the patients blood has become more acidic than is usual. There is also evidence that PHVHF (a type of haemofiltration) is a promising technique for the treatment of severe sepsis in an intensive care setting. A link describing the use of PHVHF in this context follows: http://ccforum.com/content/9/4/R294
I’ve been told I have CD20 markers, what are they and what do they mean in relation to my cancer?
CD20 is the name for a molecule on the surface of a white blood cell known as a B Lymphocyte and it plays a role in the development of these cells into plasma cells, which are the white blood cells which produce antibodies. Cancer cells become cancer cells when a normal cell in the body loses its control mechanisms and begins to grow and reproduce uncontrollably. It helps your doctors to diagnose what type of cancer you have by knowing what type of cell the cancer came from originally, and the presence of markers like this can help them to find out. Measuring the number of normal cells with these markers can also tell your doctors how your immune system is coping, both as your disease progresses, and throughout and following your treatment.
Alison asks two questions about blood:
If I have cancer and I have treatment why am I not allowed to give blood? Surely if I am cured I would be OK? Doubts are raised if I’m really cured if I’m not allowed.If you have any questions about the donor selection policy of the National Blood Service the following website should be able to help http://www.blood.co.uk/pages/flash_questions.html
What is blood composed of? What are the different parts for?
The National Blood Service website has a number of pages which will help to answer this question for you – check out: http://www.blood.co.uk/pages/e17compn.html
Why are there different blood transfusions and what do they all do?
A blood transfusion is essentially receiving red cells to rectify a deficiency (called anaemia), whether this is caused by acute blood loss (bleeding internally or externally), or chronic blood loss (as in some disease states), or even when the person is unable to produce enough normal red cells for themself. A transfusion boosts the body’s ability to carry oxygen to the cells, and obviously this is essential to life. You may receive blood from another person (called an Allogeneic transfusion) or from yourself (called an Autologous transfusion). Allogeneic transfusions are the most common. Autologous transfusions may involve red cell salvage (see below), or a pre-donated unit of their own blood a few weeks before an operation. The latter option is available because donated blood has a shelf-life of approx 30 days, so if you know you are going to have an operation within this time you may be able to donate some of your own blood beforehand (your body will begin to replace it naturally). Then when you have your operation you may be able to receive your own blood back, and not someone else’s. This type of transfusion is only suitable in some cases though, and is not very common. For more information on blood and blood transfusions you can visit the national blood service (NBS) website at http://www.blood.co.uk
What is red cell salvage?
If a patient has an operation, and during the course of the operation they lose some blood, this blood may need replacing. Although the blood supply in this country is the safest in the world, there are always small risks assosiated with transfusing blood from another person. Receiving blood is like receiving a transplanted tissue, and in much the same way that a transplanted kidney may be rejected, the blood may also be rejected by the body. Human red blood cells have lots of different ‘blood groups’ not just the common ABO and Rhesus-D group that most people are familiar with. This is purely because of differences in the genetic constitution between the person who donated the blood, and the person receiving it. The more frequently a person receives a unit of blood, the greater the chances that this will happen. Red cell salvage is one way to reduce the amount of donated blood that a person may require during an operation, and thus may help to reduce the risk associated with a traditional transfusion. It is also more acceptable to certain religious groups who disagree with receiving donated blood from another person. Essentially during the operation the blood the patient loses is sucked-up by a machine by the surgeon (or rather, by one of his assistants) and it is washed in a special machine and collected in a bag. Your own blood is then transfused back into you, should you need it, and thus it reduces the need to use blood from another person. For more information on blood and blood transfusions you can visit the national blood service (NBS) website at http://www.blood.co.uk
What is and does paraprotein do?
‘Paraprotein’ is the term given to abnormal proteins that may occur in the blood, urine and tissues. A good article to read would be:- http://www.ukmf.org.uk/paraproteins.html
What is a Dentritic Cell and what does it do?
Dendritic cells are rare, numerically speaking, but very important cells nevertheless. They are characterised by their dendritic morphology (microscopic appearance), their potent antigen presenting skills, and the lack of lineage specific markers such as CD3, CD19, CD16 and CD14, which distinguish them from T cells, B cells, NK cells and monocytes (respectively).
The crucial part is that they are extremely potent ‘antigen presenting cells’. What does this mean in simple terms. Well, for your immune system to recognise that something is wrong (and therefore action is needed), it must be able to distinguish between normal healthy tissues and “foreign” tissues or “invading organisms”. It must be able to sense when a foreign bacterium (infection causing organism) is present, so as to attack it and kill it. Similarly, when a cell becomes cancerous some of the molecules the cell expresses on its surface are unique to the type of cancer it is, and would not be seen on a normal cell. To stop cancers before they start, or to effectively treat a cancer once it has become established, it is important for the immune system to recognise these cells as ‘bad’ and to attack them, and kill them.
Unfortunately, because cancer cells are the ‘body cells gone wrong’ they will, in many cases, still look very much like normal body cells to the immune system, and so it is not always easy for the immune system to ‘recognise’ that something is wrong with them. Antigen presenting cells, such as dendritic cells, are good at recognising these bad cells or foreign invaders, but they are not perfect and they will not be able to detect everything. However, once they do think something is wrong they will ‘present’ part of what they recognise to be a ‘foreign substance’ to other cells in the immune system to activate them to the danger, effectively telling them to ‘attack anything that looks like this’, and so mobilise the immune system against the problem.
There is research going on at the moment which hopes to take cells, such as dendritic cells, out of a patient (or out of a healthy donor) and effectively activate them in a test tube outside of the body, or in other words “train them in what to look for”, and then (re)infuse them into the patient. The idea being that the (re)infused cells can then activate the immune system to go “seek and destroy” the cancer cells in the patient – now that they know what they are looking for. Obviously it is early days yet, and there are substantial risks involved with any trial, risks which your consultant will be able to discuss with you, but the positive side is that we believe cellular based therapies such as this have a great potential for the future.
Joe asks two questions:
How long does it show in a blood test that you have cancer before being diagnosed or does it depend on the type of cancer?
It depends very much upon the type of cancer.
What about recurrence, will this show in a blood test? How long before it shows?
Not necessarily, it depends upon the type of cancer.
Can you lose weight through determining your blood group or is that a myth hyped by celebs?
It is a myth. The only way to lose weight is to expend more energy (in
calories) by exercise and daily activity than you consume (as food). For example, if you burn off the equivalent of 2,500 calories a day, but you only eat 1,000 calories, then the balance of 1,500 calories must be found from bodily stores, which usually means you burn a little of your fat reserves. If you eat more calories than you burn, then you gain weight. Your blood group has nothing to do with this process. There is no magical alternative to this, although many people wish there was. People who tell you otherwise are deluded.
What is a B cell? What does it do in the body?
It is a type of lymphocyte, which is a type of white blood cell, and it helps to produce antibodies. The following website has a quite simple explanation of how a B lymphocyte interacts with the immune system, the little animation is quite good. http://www.cellsalive.com/antibody.htm
I’ve been told I’m borderline on high blood pressure, what can I do to help reduce the symptons and what should I look out for to warn me trouble is coming?
You should always consult your GP if you are worried about any aspect of your health. I am sure your GP would advise you to look at reducing any obvious areas of excess stress in your life, lose any excess weight which you might carry, take appropriate and regular exercise and to eat a healthy balanced diet which is low in fat and includes plenty of fresh fruit and vegetables. These are the major common sense areas in which you can help yourself to maintain a normal blood pressure. The best way to monitor your condition would be to get regular check-ups, on a frequency that your doctor or health professional recommends.
What is the difference between hypertension and hypotension?
‘Hyper’tension is when your blood pressure is ‘above’ what is considered to be normal, and ‘hypo’tension is when this is considered to be ‘below’ the normal range.
US Researchers have found a link between an increase in brain tumours and a rise in the consumption of Aspartame – are they all working on different research? Why not talk to each other!
You mean the media have reported an apparent increase… Researchers do talk to each other, sometimes directly, but mostly through conferences (when we get together to discuss recent discoveries) and the medium called ‘peer reviewed journals’ which allow them to see what others are doing, and the conclusions other groups have made, and they have all the details at hand to ‘repeat’ the work and check that it is indeed genuine. This is how scientists and researchers keep a check on each other and how the scientific ‘knowledge base’ progresses and grows. Very occasionally a paper will be published which is not entirely correct, and subsequent work will not agree with the findings of that particular study. In such cases scientists look at it again, use larger groups (so the statistics are more reliable), and arrive at a definitive answer. It is important to have these checks and balances because scientists are humans too, and on occasion need to revise or rethink. So we have an extremely stringent ‘scientific process’ to ensure that the truth will be discovered, and it is also very important to keep the drug companies ‘in line’ so that they focus on the truth about a product and not just the profit – see http://www.guardian.co.uk/medicalscience/story/0,,549562,00.html for an example.
The problem occurs when journalists get access to papers and try to interpret them without having the background experience or knowledge that doctors and scientists have, then it is all too easy for them to draw the wrong conclusions, or to mis-interpret a statistical anomaly as fact. A journalist will also write from a particular ‘angle’ depending upon the audience they are writing for, so at times you might get a warped view of scientific reality. The lazy journalists will try to interpret the work themselves, or try to create sensationalism where there is none, the sensible ones will ask a (government registered) professional in that field what it means. In the case you mention a study might show that if you force feed mice X grams of aspartame every day over their entire lives, some get a brain tumour. A journalist might immediately jump to the wrong conclusion and shout “Shock Horror, Aspartame causes Cancer!” but if they had asked a scientist they could have explained that it was a poorly thought-out experiment and those ‘conclusions’ could not be drawn because the dose they fed the mouse was equivalent to a human drinking the equivalent of XX gallons of fizzy pop a day, for their entire life… so providing your dose of aspartame remains below this level, it is as safe as it can be – in just the same way that if you take too many medicines it can be harmful.
Very often this is why the media put out mixed messages about various research, some of them have a very lazy approach to checking their facts and ‘never let the truth stand in the way of a good headline’. A very good newspaper columnist for medical and scientific topics, who I would personally reccommend, would be Ben Goldacre of the Guardian newspaper. See link http://www.guardian.co.uk/life/badscience/
James asks two questions:
What is cancer and why do some people get it and some don’t?
Cancer is when the control systems in a normal cell go wrong, and the cell grows, reproduces and spreads uncontrollably. The reason they are dangerous is because they interfere with the other cells, tissues and organs of the body, and eventually disrupt the normal working of the body. This is why they must be killed. Cancers can be caused by genetic factors, making the control systems weaker for some people, or they can be caused by environmental factors that can damage your cells, such as exposure to some chemicals, either in a single exposure, or repetitive exposures such as with smokers. Cancers may also be caused by over exposure to sunlight and types radiation, and some cancers have even been linked to infections with particular bacteria and viruses, which can cause damage to your cells and weaken them. The reason that some people do get cancers, and some don’t, is that our exposure to all of these environment factors is different, and we all have a different genetic heritage, so our unique combination of all these factors will determine what our chances of getting a cancer might be.
Is there anything I can do to ensure it doesn’t return?
If you are in remission from cancer the best thing you can do to avoid it returning is to follow your doctors advice in relation to any medications you are on, and to lead as healthy a life as possible. Try to minimise your exposure to any of the factors which might increase your risk of cancer. For example, you might want to consider quitting smoking if you are a smoker, avoid using recreational drugs and alcohol, taking appropriate exercise and making sure you eat a sensible and well balanced diet with plenty of fresh fruit and vegetables. By doing these things you give your body as much help as possible to stay healthy.
I’ve read about a new drug called Siomycin A, which causes cancer cells to ‘commit suicide’ – where can I find out more about research into cancer?Siomycin-A is an antibiotic which has shown some promising activity against cancer cells. You can read more about this here http://www.drugresearcher.com/news/ng.asp?n=70978-cancer-siomycin-a-side-effects
I’ve just read chemotherapy has only a 3%-9% overall cure rate – is this correct? I thought it was better than that…
I would say that statement is highly generalised and therefore inaccurate at best. The success of a treatment depends upon the type of cancer you have, how far progressed it is, how well you respond to the treatment regime, and a whole host of other factors including your age, genetic disposition and general wellbeing. Therefore the success rate for a cancer in one patient may be vastly different for another patient who might have a different type of cancer, and at a different stage of the disease, and undergo a different treatment regime. This is why it is important to speak with your consultant about your particular case, because they will be able to give you the prognosis that is right for you. The other thing to remember is that a ‘cure’ is when the cancer is completely killed off, permanently. Obviously this is the ‘best case scenario’ and there is a very real chance this can happen, and it does. However, even in cases where chemotherapy does not ‘cure you’ completely, but say it gives you an extra 10 or 15 years of life which you would not otherwise have had, is this a success or failure ?? The fact is that without chemotherapy, and other such treatments, many people simply would not be here at all.
If I’ve got one type of cancer, what are the chances of the treatments causing different cancers later on?
Some of the treatments used to kill off cancer cells, such as chemotherapy and radiotherapy, will also cause some damage to healthy tissues. This damage may slightly increase your risk of getting other forms of cancer in later life, but without these treatments there is no way of killing off an existing cancer now. Most people would agree that dealing with an immediate threat is much better than leaving it, otherwise you may not have a future at all.
Karen asks (Yes this is me!)
What does microscopically disease free mean compared to cure?
Microscopically disease free means that no cancer cells “are visible” using the microscope. This might mean that they have all been killed (in which case it is a cure), or it might mean that so many have been killed that we can no longer see them… but it may be possible that a few may be lurking around which we cannot see. Remember that in theory you only need 1 cancer cell to survive for a cancer to “come back”. A cure means that “as far as we can tell” we have killed off all of them, and they are all gone.
My friend was told he was cured and his cancer returned. How can that happen?
See answer above.
What do malignant and benign mean?
A benign tumour will essentially stay in the same place and not invade surrounding tissue or metastasise, i.e. spread to other parts of the body. A malignant tumour will do these things, and as such poses a greater threat to the patients health because it has more potential to disrupt the normal function of the body.
What is metastasis?
When a malignant tumour will spread to other parts of the body. It happens by cells breaking off from the main (primary) tumour and spreading through the body and then stopping at other locations or in different organs and those cells then grow and divide to become a new tumour (a secondary tumour) in that location.
Why do some people have CHOP and some CHOP-R – what is the difference and is one better than the other?
There are many different types of chemotherapy regime and the type that is suitable for you is selected by your consultant according to the type of cancer you have and the stage or progression of your disease. As with all questions relating to a specific treatment, the best person to ask is the healthcare professional who is dealing with your case. However, for general advice the Christie Hospital in Manchester publishes a good patient guide to chemotherapy, and can be downloaded from their website, as well as details about the different types of chemotherapy regimes available. http://www.christie.nhs.uk/patientinfo/booklets/chemo_index.htm
I’ve recently received an email about ‘Inflammatory breast cancer’ which is not easily detected. How do you check for that as it’s not a ‘lump’ as such.
Inflammatory Breast Cancer (IBC) is a fairly rare but aggressive form of breast cancer, comprising less than 5 percent of all breast cancer cases. It is caused by cancerous cells blocking the lymph vessels in the skin of the breast, and gets its name from the swollen or ‘inflamed’ appearance. The website of the US National Cancer Institute has a very good page on this type of cancer, and the symtoms to look out for.
Where can I find cancer statistics on my particular cancer?
The US National Cancer Institute SEER (Surveillance Epidemiology
End-Results) website publishes this kind of data, which I understand is available to download.
In the UK the Cancer Research UK website also has statistics available for various types of cancer
PSA Testing – How safe is it? “At present the one certainty about PSA testing is that it causes harm.” That quote comes from a British Medical Journal editorial published almost three years ago. And yet some doctors and many men still consider the prostate specific antigen test to be a reliable predictor of prostate cancer – true or false?
I can categorically state that PSA testing causes no harm to the patient, and it is a reliable test. However, the important thing is how the results of the test are interpreted. One fact of life is that as men get older their prostate begins to wear out, and if every man lived for long enough (i.e. if other things did not kill him first) then every male would develop prostate problems leading to prostate cancer. The PSA test is a sensitive and reliable test that can detect early changes to the prostate, changes which indicate that the prostate cells are beginning to deteriorate.
However, and this is the important thing, this can be a slow process for some men and in these cases medical intervention may not actually be required for many years to come. The damage can arise when your doctor decides to treat your prostate “too early”, and the side effects of this treatment (such as varying degree of incontinence and/or impotence) may have been avoided because the treatment itself could have been put on hold for a number of months or years. It is therefore sometimes better to monitor a patient who has a positive PSA test, and to treat them when other conditions dictate, rather than begin treatment too early. Therefore the PSA is an extremely good test, and it gives us a good “early warning”.
The important thing is not to ‘necessarily’ take this early warning as a sign that something needs to be done right now… for some patients it may be more appropriate to monitor the patient and be prepared to take action a little later. It all depends upon the other clinical details of the patient, and as with any of these things if you have any questions about your own health you should consult your GP.
How long does the fatigue last after chemotherapy? Or radiotherapy?
How a patient responds to a treatment such as radiotherapy depends very much upon the individual patient (some respond better than others), plus other factors such as the intensity of the therapy regime they have undergone, and how far progressed their disease is. Your own consultant would be better able to advise, because they would know the particulars of your case.
Amy asks two questions on Aspartame:
A friend sent me an email about the risks of aspartame and Lymphomas. Is this real? I have a can of diet drink most days, is this something I should be worried about? Is there anything you can recommend which is better and obviously low sugar?
There is nothing to worry about, consumption of moderate levels of aspartame (e.g. 2 cans of soda per day) does not increase your risk of cancer. This was a scare story based on a dodgy study by some Italian researchers. See the following website for reassurance: http://www.cbsnews.com/stories/2006/04/05/health/
US Researchers have found a link between an increase in brain tumours and a rise in the consumption of Aspartame – are they all working on different research? Why not talk to each other!
See answer above.
Researchers in Australia have discovered that exposure to natural sunlight reduces the incidence of Non-Hodgkin’s Lymphoma (NHL). The researchers were trying to find out if exposure to the sun really does cause this type of cancer; instead, they found that it actually protects people from the disease. Is this right?
The danger with these types of study is that they can be badly designed, and therefore the results can be very misleading. I suspect this is one such case. Other studies in the UK (British Medical Journal) and Sweden (Internation Journal of Cancer) on sunlight and NHL have shown the direct opposite (see URLs below). In my experience I would agree that no link exists. We do know, however, that over exposure to solar radiation, i.e. sunlight, can actually cause cancers because of the damage it does to the skin. But the skin does need some exposure to light to remain healthy, and to help us make endogenous vitamin D, etc. As with all things, the human body is designed to operate most effectively when we do things ‘in moderation’. See below for the research papers mentioned.
Why do some people have chemotherapy and radiotherapy and others just have one treatment?
It can depend upon the type of cancer you have, and the location. Think of it like this: Radiotherapy alone works well for some cancers, but because the radiation has to be ‘aimed’ at a specific area of tissue, generally the more compact that area is the better, because less damage is done to surrounding tissues. Essentially its easier to hit a single lump in a smaller area than lots of small lumps over a larger area. Because chemotherapy is good at targetting the whole body, rather than specific areas, it might stand a better chance off killing of stray cancer cells that radiotherapy could miss, depending of course upon the type of tumour (some are more resistant to chemo than others), its location, and how far progressed it is. The judgement of which regime is best therefore depends upon a lot of factors, which are different for each patient, which is why your consultant will decide upon the most appropriate regime for you.
Karen asks (yes me again!):
What do you recommend for cramp? Someone said it’s a lack of potassium, is that correct? How many bananas would I need to eat or is it better to take supplements?It depends what causes the cramp. A good place to learn about the different types of cramp, and what causes them, would be http://www.medic8.com/healthguide/articles/musclecramps.html
There are three types of muscle in the body, namely:
(under concious control, makes skeleton move about which is kinda useful)
(not under conscious control, very clever muscle, found in heart)
(mostly not under conscious control, controls passage of food through gut, swallow reflex, constriction/dilation of blood vessels, etc.)
Warfarin has been given to me, what is it and should I worry as someone told me it was rat poison?
The warfarin you take is a specific dose which is therapeutically suited to you, and is as safe as any medicine can be. It helps to thin the blood to prevent small clots forming in those patients in high risks groups where there is an increased risk that this might happen. It may also be given to patients who have had this happen to them in the past, and they wish to reduce the risk of it happening again. A different type of warfarin is used in rat poison at much higher doses to kill the rat. It thins the blood of the rat so much that it cannot clot, and the rat dies of internal bleeding. The important thing to remember is that any medicine can be harmful when taken in excess. As with any medication you must never exceed the dose prescribed, and always follow the guidance of your doctor and/or pharmacist.
What side effects do zolendronic have?
I assume you mean zolendronic acid, see the following study report :- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db =pubmed&c md=Retrieve&dopt=abstractplus&list_uids=16490909
How does the Lymphatic System work and why does the body need Lymph Fluid?
The Cancer Research UK website (see link below) has a very good explanation of what the lymphatic system is http://www.cancerhelp.org.uk/help/default.asp?page=117
MEDICAL MYTHS – TRUE OR FALSE?
Is it true phlegm is poisonous?
The word ‘Phlegm’ is sometimes mis-used by different people to mean different things. To me it means a sticky mucous secretion you might cough-up if you have a cold, and is either swallowed or spat out. It is not ‘poisonous’.
Can you go out with a wet head and not get a cold?
Colds (i.e. the influenza virus) are caught from other people – the old saying ‘coughs and sneezes spread diseases’ is very true. Colds do not magically appear as the result of wet hair or cold winds. Contrary to popular belief going outside helps you to avoid catching one, because you are in fresh well ventilated air. The reason more people catch colds in winter than in summer is that people tend to congregate indoors much more in winter, where it is warm and away from the elements, hence the interaction and exposure to other people in a confined environment increases, and thus so does the chance of catching a cold. This is why we catch more colds in winter, it is due to the weather driving us all indoors, not because of the weather itself.
Marijuana is good for cancer pain and other diseases – right or wrong?
Some people report that substances in the marijuana plant may help to alleviate their pain. Scientists are currently working on ways to extract the pain relieving substances from the plant to form medicines which may be used for pain relief, so that patients can experience maximum benefit and not be exposed to the other (more dangerous) substances that are also present in this plant.
You shouldn’t go swimming after eating? Why not?
Cramp. After a meal the blood flow to your stomach increases so that it can help to provide more oxygen to stomach muscles to help churn, process, and move along the food you have eaten. The increased blood flow to the digestive system also aids in transporting the nutrients away from the site of digestion to other parts of the body. Once you have eaten something the body has to do this, it has no choice. However, if you go swimming after eating (or participate in any strenuous exercise), you are forcing the skeletal muscles of the body to work harder, and they also need extra blood to supply fuel and oxygen for the extra activity to keep your arms and legs moving to keep you afloat. This diverts some blood away from the digestive system, where it is needed, and the stomach and digestive muscles may begin to cramp as they are deprived of the blood and oxygen they need. The arms and legs are also not getting as much blood as they need either, which means you are probably not able to swim as effectively. The stomach cramp is also extremely painful and makes it extremely difficult (and sometimes
impossible) to continue swimming, and many people drown because of it. This is why it is so important not to eat before swimming.
You need to drink 8 glasses of water per day to stop being chronically dehydrated
You need to consume an adequate amount of fluids each day to remain healthy and hydrated, and to balance the amount of fluid your body loses naturally each day (as the result of sweating, metabolism and excretion). This can obviously vary, so to a certain extent it depends upon your individual lifestyle and metabolism. Ideally this replacement of fluid should be plain water (tap water or bottled) drunk in small quantities at regular intervals, certainly not large volumes of sugary or fizzy drinks, and not even the sport drinks advertised as ‘isotonic’. People whose diets contain plenty of fresh fruit and vegetables (which have a high moisture content) will naturally consume more moisture through their diet than those people who have a less healthy diet (i.e. one which contains more processed foods, or fatty ‘fast foods’ such as pizza’s, chips, pies, pastry, etc). Therefore, whilst for some people the 8 glasses per day is perhaps not required, it is certainly more important for people who do not have a healthy diet to drink appropriate fluids, because they might not be getting the fluid in other ways. Certainly a bad diet with a lot of processed or ‘fast foods’ may cause constipation, and drinking plenty of fluids will help to alleviate this to a small extent (constipation and dehydration is a dangerous combination). However, it is also important to stress ‘everything in moderation’. It can also be dangerous to drink too much water (many litres per day), if you are consuming it at a faster rate than you can safely excrete the excess. As with any health matters, if you are concerned about how much you need to be drinking, or other aspects of your diet in relation to your health, you should always ask your GP, or a professional nutritionist who is government registered.
If you swallow an apple pip a tree will start to grow in your stomach
No. It will be killed by the stomach acid and digested along with everything else. However, I do not advise eating the pips of apples or pears, or the kernels of plums, peaches and apricots because they contain chemical compounds which may result in cyanide posioning if eaten in large quantity. Some ‘quacks’ promote a potentially dangerous product called ‘laetrile’ (which is derived from fruit kernels) and peddle it as a ‘cure all’ for many diseases. Actually it is potentially very dangerous (and sometimes deadly) for just this reason.
Chewing gum stays in the stomach for ‘x’ years
It should pass out again with the normal passage of waste… however I would not recommend swallowing it, especially if you suffer from constipation.
Cracking your knuckles causes arthritis later on
Rheumatoid arthritis is an inflammatory condition where the bodies immune system inappropriately causes inflammation of the body’s own joints, resulting in pain and chronic damage, and ultimately reduced function and movement. I am not aware of any link between cracking your knuckles and the onset of arthritis, and even if there were I fail to see how the occasional mechanical manipulation of a joint (or joints) would cause a chronic immunological response in later years.
Having a flu jab causes flu
Having a flu jab exposes you to a relatively harmless dose of parts of the flu virus, so that your body will recognise it quickly and be better protected should it be exposed to the real thing at a later date. This is the principle of vaccination. Some people may develop the mild symptoms of flu-like illness after the injection, because their immune system is responding to the vaccine, or possibly the adjuvant (the adjuvant is the presence of other chemicals which may be present in a vaccine to help activate the immune system and thereby make the vaccine more effective).
Feed a cold and starve a fever
In both cases ensure the person is resting comfortably, ideally in a well ventilated room (but not draughty), and they are warm (but not too warm) and they get plenty of fluids. Starving a person when they are fighting an illness is never a good idea, because the body is expending a lot of energy in its battle to get well again. However the person may not feel upto eating ‘solid foods’ in either scenario, and should not be forced to eat ‘solids’ if they do not wish to do so. However a clear hot broth (like chicken soup) is excellent because it provides them with both fluids and some nutrients to help fuel their body in its battle. Hot lemon drinks with honey are also a popular and traditional remedy, they also provide clear hot fluids and some natural sugars, all helping to support the body in its fight to get well.
When you sneeze your heart stops beating
No, it keeps on going!
Mercury fillings are dangerous
I am not a dentist, therefore these are my personal opinions rather than professional advice. As I understand it the ‘official advice’ is that they pose no additional risk. However common sense might suggest otherwise and I would sympathise with anybody who feels that they might pose a slight additional risk, especially if the person consumes a lot of fizzy pop or acidic drinks. The thing to bear in mind is that the oral health and hygiene risks posed by ‘not filling a cavity’ are far greater, so in years gone by it was the only option. Fortunately these days there are alternatives to mercury fillings, and you can discuss the options with your dentist. One thing to bear in mind is that if you already have mercury fillings it may be better to leave them in. The reason I say this is because drilling them out is likely to expose you to more mercury (by the accidental swallowing of drilled debris) than might occur by any gradual leaching process over time, if indeed this happens at all. Whilst existing fillings may be more risky to remove than to leave in-situ, you may wish to ‘play it safe’ and explore non-mercury options for future fillings, especially for young children. As with any questions you may have on dental or oral health, I would advise discussing your options and concerns with a qualified and properly registered dentist.
As a medical professional what are your thoughts on animal experimentation and research into new drugs using animals?
This is a very emotive subject on which many people hold strong views, and some of the arguments put forward by both sides are valid. The opinions I give are my own, and you may agree with them, or you may disagree with them, but in a free society I have that right. As a compassionate human with strong religious and moral beliefs I never like to see any creature in unnecessary pain or distress, animal or human, and it is work that I could not personally pursue. I certainly do not condone the testing of cosmetic products, such as lipstick or shampoo, on animals under any circumstances. However, I do understand the importance of developing safe medicines for the future, medicines for humans and medicines for animals (a lot of veterinary medicines also come from this type of work too). The fact is that billions of people and animals have had their lives saved, their pain relieved, and their diseases treated or cured because of the medicines that have been developed over the years. The basis of my own religion, Christianity, is that one person suffered and died so that many billions could potentially be saved. I think this is a principle that should not be overlooked, and I think there are 2 very important things to bear in mind :-
(a) There are very strict regulations today which limit what can and cannot be done, and any procedures which are carried out are actually done very humanely and under the approval of a specific ethics committee. Despite what they say, the horrible pictures you see wielded by protestors were mostly taken back in the 1960s and 1970s when there was virtually no regulation on such things. I agree that those experiments were despicable and of little scientific merit. However, it is important to understand that this type of thing does not happen today because of the very strict legislation that has been in place for a number of years.
(b) Scientists are currently working very hard to develop alternatives, such as cell based assays and other such methods, which mean the number of animals that need to be used for any given experiment is decreasing each year simply because the number of alternative ways to test a new medicine is increasing. However, it will be several years yet before scientists can completely and totally rely on “animal free” methods. Unless research continues – for the timebeing – this objective will never be realised, and those methods never fully developed. In my opinion it is something we need to continue doing, under the very strict legal guidelines we have at present, until such time as we have developed these alternative methods to a point where they are reliable enough to work using them alone. As soon as we can achieve that, then I agree, we should stop using animals altogether. It seems to me this is the only way to minimise the use of animals, and at the same time deliver safe and effective medicines to future generations.
Readers may like to visit the website for NC3Rs (URL below) and see how scientists are ultimately trying to put a stop to animal testing. As stated in their website, the NC3Rs is a National Centre dedicated to the 3Rs – Replacing, Refining and Reducing the use of animals in research. Total ‘Replacement’ is the ultimate aim for the Centre, but as long as the use of animals continues to be necessary, every effort must be made to minimise the numbers used and improve their welfare. Optimal laboratory animal welfare is critical for important scientific, legal and ethical reasons.
The Home Office website also has an excellent FAQ section you might like to check out, it’s at:
What do you think of euthanasia? Does it go against medical ethics or should the individual have the right to chose?
This is another emotive topic on which many people hold strong opinions. Death is a natural part of the cycle of life, and it is one of the few things that we will all experience, every one of us. I personally believe that if society recognises it to be humane to euthanase an animal because it is suffering, and has lost all quality of life and dignity, then we should afford these same rights to a human if they wish to die with some dignity at a time of their choosing. It seems to me that the only person who has a right to decide how they live their life, and the manner in which they end it, is the person whose life it is. A protestor waving a placard does not have this right, only the patient does. In principle I would support their right to choose for themselves, and providing that they are capable of making a clear and informed decision that is not affected by clinical depression, then I wholeheartedly support their right to choose.
Do you recommend complementary therapies and which ones are best for me?
Complementary therapies largely rely upon a phenomenon called the “placebo effect”. It is akin to Victorian days when people would visit a quack practitioner and would be given ‘coloured water’ to drink, but were told it was a fabulous health tonic. They would feel good about it, and would report feeling ‘much better’, even though the coloured water did absolutely nothing. It was, purely and simply, the ‘belief’ that it could work that made them feel better. Not the product itself. That is the important bit. The product itself was useless.
A positive outlook and an optimistic “glass is half full” attitude to life is really the best “complementary therapy” available. Scientific studies have shown that high levels of stress and/or a depressed mood and feelings of desperation will also depress your body’s immune function. Your immune system is very important in the healing process, so a ‘positive attitude’ to life makes it much more likely you will heal more quickly and more effectively. Do not believe all the gimmicks on vitamin supplements about ‘boosting your immune system’ with this herbal remedy or that. A healthy balanced diet, a positive outlook on life, and a healthy work-life balance is all you need to optimise your health. Many of my Christian friends and patients find that their faith helps them to achieve this positive outlook. If I were personally to recommend one form of therapy that is “complementary” to traditional medical treatment, it would be to have a strong faith and the power of prayer. I have seen many instances where this has, more than anything else, provided peace-of-mind and hope for a patient.
Do you believe cancer can be cured? Or will it always come back? What are the chances of a recurrence? Are we just living on borrowed time?
We are all living on borrowed time, even the most healthy among us are going to die. In answer to your question though, yes cancer can be cured, and we’re working on the ‘how’ bit right now. You see, cancer is caused by a body cell dividing out of control, if you can find a way to target all of those out-of-control-cells, and kill them, then you have an effective way to cure cancer. Understanding the body and how it works, right down to the molecular level, is the most important thing, because only when you know how something works can you begin to understand how to put right any malfunctions, like cancer and other diseases. This is why you should never never never listen to people who peddle ‘alternative’ or ‘complementary’ therapies, and who claim these therapies are effective, or offer a potential ‘cure’. If a mechanic doesn’t know how a car works, how can he know what will fix it? The best hope I can see for success for beating cancer (in the future) is a combination of targetted therapeutics (medicines) and cellular based therapies, such as activating immune cells to cancer specific markers to allow the immune system itself to police the cells of the body more effectively. Scientists are currently trying to perfect these kinds of treatments, so it may be a few years away yet, but the potential is good.
You often hear of ‘this now causes cancer”, or “this has an increased risk of cancer”, how do I know who to believe?
Ask the Furry Monkey !!!!
Failing that look at the official websites for organisations such as Cancer Research UK, (found at http://www.cancerhelp.org.uk/ and http://www.cancerresearchuk.org/), who usually provide a comprehensive list of information, or would be the people to contact if not. Never trust the word of some self-styled ‘health guru’ promoting some Quack remedy, even if they appear on a TV program… don’t assume that just because its been on TV it is true.
Very often these Quacks will ‘buy’ their mickey mouse degree’s from ‘non-accredited’ U.S. colleges (if you’re too incompetent to get a ‘real one’ just pay ’em the money and get a certificate!) see article at http://www.quackwatch.org/04ConsumerEducation/dm0.html. This is why an accredited ‘real’ degree is very different to a non-accredited ‘mickey mouse’ degree. The following articles by Ben Goldacre, a highly recommended scientific and medical correspondent who has an article http://www.guardian.co.uk/life/badscience/ with the Guardian newspaper, may interest you if you want to know who to listen to, and who to switch off… I was particularly interested to read about the qualifications and academic backgrounds of some of the ‘popular’ TV health guru’s he has investigated and written about… http://www.badscience.net/?p=304 and http://www.badscience.net/?p=326 and http://www.badscience.net/?p=258#more-258 and http://www.badscience.net/?p=345.
Just because someone expresses an opinion on TV it doesn’t mean they’re worth listening to. TV producers, it would appear, wouldn’t know a Quack if they were pecked by one!
A US cancer clinic is claiming remarkable results for Gerson therapy, the diet-based anti-cancer regime – quack or cure?
In my professional and personal opinion it is a Quack therapy, especially if they are promoting it as a cure for cancer. An extremely good site to learn about quack therapies, and how quacks prey on vulnerable patients, is http://www.quackwatch.org
Gerson therapy is listed (along with many others) at http://www.quackwatch.org/00AboutQuackwatch/altseek.html
How do you find out if a website is authorised or just a ‘quack’ site. I’ve found a website that says it can cure me and want to check it out?
Common sense is the best way to know if a website is not telling you the truth about a product, especially one which claims to “cure” or treat certain medical conditions more effectively than traditional medicine. As a rule of thumb, the more claims made about a product (and the larger and more diverse conditions they claim it ‘cures’) the less likely it is to be true. Put simply one product will not treat or cure dozens of different ailments, they purely want to sell you snake oil and try to make it appeal to as many ‘paying customers’ as possible, and they do this by having as wide and as diverse a number of ‘cures’ for it as they can think of. However, some ‘Quacks’ can be very persuasive, especially if you have a serious medical condition and are desperate for a cure. You may then be inclined to believe their unproven statements and warped view of how the body works, because to believe in them offers some small amount of hope. Unfortunately this hope is mis-placed, and many alternative therapies actually do more harm than good.
There is an excellent website, setup by a medical colleague in the USA, called www.quackwatch.org which exposes the fraudulent health claims made by modern day snake-oil salesmen. I strongly urge everyone to consult this website, and speak with your own doctor, before believing anything that ‘alternative health gurus’ tell you, or try to sell you. Quack remedies kill and disfigure people every day, and this website has stories of real people whose lives have been lost or ruined because of dangerous ‘alternative’ therapies. www.quackwatch.org is a good resource to help identify quack therapies, and gives characteristics to look for which are common to many claims made about quack products and therapies.
The best analogy to think of goes like this: if your car has a problem, do you take it to a qualified mechanic who has served a recognised training program and actually knows ‘how’ the car works. Or do you take it to a backstreet cowboy who doesn’t have a clue how it really works. Your body is the same. You should trust your doctor and ‘real medical professionals’, not self-appointed practitioners who don’t even know how the body works when it is healthy, and therefore have no real idea how to fix it if it goes wrong. That car is your body, the most important and complex machine you will ever operate. Sometimes you will only get one chance at fixing it properly. Go to the professional to get it fixed, not the cowboy.
I will be working closely with Karen over the coming weeks to help her setup a quackwatch section on the Furry Monkey website, which we hope will answer many of your questions on such topics.
The important principle to remember is that registered healthcare professionals, such as your GP or consultant, are highly trained professionals that know how the body works, and they have gone through a highly structured government approved training program, spanning many years, to ensure that they offer the best and most effective treatments available.
Treatments that have been proven to work by thorough, rigorous and reliable testing. Treatments that give you, the patient, the best chance of getting well again.
Steve asks a lot about stem cells:
What are stem cells? How are they transplanted?
In all of the tissues and organs of your body you have lots and lots of different types of cells that have different functions and roles to play. Ultimately all of the cells came from one cell, the fertilised egg. Think of the whole process as you might consider a tree. The fertilised egg can be regarded as the trunk of a tree (afterall there is only 1), but this divides into lots and lots of cells (branches), which in turn divide again into smaller branches, which in turn divide again into twigs, and these divide again into leaves. The leaves comprise the majority of the “final cell types” that you see in all the tissues and organs of your body, in much the same way that when you look at a tree from a distance you see mainly leaves. Now stem cells are cells which can divide to form a whole selection of other cells, so in this example they would be the twigs and branches. The more primitive a stem cell the closer it is to the trunk of the tree, and the bigger the number of smaller branches and leaves it can have growing from it (i.e. the more cell types it can make). Scientists are currently investigating how to take these stem cells and how to grow them up so that they can supply the cells needed to help treat a range of diseases. In our analogy this would be like taking a small section from a large branch and working out how to keep it alive outside of its natural environment (the tree) and how to stimulate it so that smaller branches and leaves can start growing out from it in large numbers. Other stem cells, for example from the bone marrow, can be transplanted directly from one patient to another. Once in the recipient the cells would grow as normal, and would provide a source for all of the blood cells which the recipient was lacking. In the analogy this would be like grafting the branch of one tree onto the limb of another. The grafted branch would integrate itself with the recipient tree and would produce smaller branches and leaves of its own, leaves and branches which the original tree may not have been able to produce by itself.
Christopher Reeve and Michael J Fox are/have campaigned for stem cell research, is it for other diseases as well as cancer then?
Stem cells could potentially help many diseases, disease where some types of cells have become damaged or have ceased to work, and where replacement cells (provided by the introduction of appropriate stem cells) would correct this and allow the person to lead a healthy and otherwise normal life.
Can anyone with cancer have a stem cell transplant? What are the risks involved?
Not every type of cancer needs to be treated by stem cells, it depends upon the type of cancer and the stage of your disease. You would need to discuss the options with your doctor or consultant.
What is stem cell immunology and how will it help me?
Stem cell immunology is the study of stem cells and their role and interaction with the body’s immune system. Stem cell therapies have got enormous potential to help treat many diseases in the future, and ultimately as well as treating diseases stem cells could be utilised to provide a source of perfectly matched tissues for transplantation, i.e. organs grown to order. There may only be very limited ways in which stem cells can help you and others today, but the potential to help your children and grandchildren is enormous.
Does the NHS get a financial incentive for getting patients on trials?
It depends if you mean a direct or indirect financial incentive. If a new cure it makes a patient better, then ultimately yes the NHS will benefit, but indirectly not directly (there are no brown envelopes). For example, let us assume that the NHS spends XXXX millions of £’s treating patients with “XYZ-Disease”, but the NHS is also investing time and money collaborating with scientists to find a cure. Suddenly, one day, one of their studies comes up with a cure for “XYZ-Disease”. The NHS is happy because instead of paying XXXX millions to treat patients who have an incurable disease, with very expensive and time consuming supportive therapy, the NHS can now cure them of the disease for a lot less cost (a one-off cost for the drugs rather than an ongoing cost). The patients are happy because they are cured. The NHS is happy because it has cured them, and waiting lists have come down, and the money they would once have had to spend on lifelong supportive treatments can now be spent in different areas, and spent on research to help find the next cure… and so on… it is a system that works in favour of the patient in the longrun. Even if you think about the bigger picture – if the scientists find a cure, the patient goes back to work and they pay more taxes instead of filling a hospital bed, so ultimately it benefits the whole economy, which in-turn benefits the NHS as a whole because the NHS is paid for out of those taxes. The only reason we have cures for some diseases today is because at some time in the past somebody asked ‘what if’, and some patient was the very first one to reap the benefits of it. If we want more cures in the future, and we want to do this as safely and as reliably as possible, then we need clinical trials.
I’ve had an ECG – what do the results mean? Can you deciper what the numbers mean?
The heart is a very complex and clever muscle, having its own ‘pacemaker’ to generate a regular impulse, and a series of specialised cells to transmit this impulse accross the heart so that the muscle can beat in an efficient and co-ordinated manner. An ECG (ElectroCardioGram) measures the electrical activity of this impulse, plus the activity associated with the heart muscle contraction and relaxation, and all this activity will have a characteristic “normal” pattern.
To understand the pattern you must first understand the physiological and electrophysiological changes that occur in a normal heart. Similarly, interpretation of an abnormal pattern requires an understanding of what can go wrong with the heart and how these changes will impact upon the ECG pattern measured. Cardiac physiology is certainly too complex a topic to answer simply in a forum such as this. As with many aspects of healthcare only trained professionals should attempt to read or interpret an ECG readout, and if you have any questions you should direct them to your own cardiology consultant.
However, if you are interested to learn more about the ECG and how it works, you may find the following websites informative.
The British Heart Foundation website provides a link to the following “Patient Plus” pages all about the ECG procedure.
As with anything medical, if you have specific questions about your own health or treatment regime, the best person to speak to is your own consultant or the medical professional who is in charge of your case, or the experimental trial.
QUACKERY!!! – NEW SECTION COMING SOON…
You really need to watch out for ‘quack’ sites when you have a cancer diagnosis. Sometimes you feel pretty desperate and will try whatever someone says works and will cure you. Please please please only go to legitimate sites.
One good website to check things out on is: