I can’t stop worrying thatcancer runs in my family– and I’ll be next

MY MUM died of bladder cancer at 70, and my dad had stomach cancer. My uncle and aunt both died of cancer and my husband also has it. So I’m constantly worrying that it’s going to catch up with me, too. Am I eligible for any kind of special screening or monitoring that might help put my mind at rest?

CANCER isn’t one disease, it’s many. So, for example, the causes and characteristics of bladder cancer are quite distinct and not connected to those of stomach cancer or other cancers.

For this reason, clusters of cancers that occur in families can simply be down to chance. And given that, statistically, one in two of us will develop cancer at some point in life, it’s not even that much of a coincidence.

Sometimes we see a family cluster of cancer because families tend to do similar things or live a certain way. We might see lots of lung cancer in a family if there are a lot of smokers. Or a cancer which may be related to working in a chemical factory can affect a family if they all worked there.

That said, specific cancers are known to be hereditary and occur more commonly in families who share genetic faults.

For example, there are families with a genetic problem called Lynch syndrome who have more chance of getting bowel, womb, stomach and liver cancers.

Special screening for those known to be at a genetically high risk does exist for certain cancers – breast and bowel cancers, for instance.

Anyone concerned about a high rate of cancer within their family should discuss this with their GP and, if appropriate, ask for a referral to a screening programme. Referrals can also be made to geneticists to look for specific faulty genes and advise on monitoring.

For anyone, even those with a family history, lifestyle factors such as weight loss and avoiding carcinogens such as smoking will always be a key part of preventing cancer.

I HAVE been on an osteoporosis drug called alendronic acid for ten years. After three years, my doctor suggested I take a break from it, which I did. But the pain in my hips and back that I’d suffered before returned, so I went back on it. I’m worried as I’ve now been taking it for seven years straight. Is it time for another break?

ALENDRONIC acid is one of the commonly used medications for treating osteoporosis – a disease where thinning of the bones means that fractures become much more likely.

Osteoporosis itself does not cause pain but the damage and fractures to the bones do. Treatment depends on one’s risk of having a bone break rather than any pain or symptoms.

Alendronic acid is a weekly tablet which is prescribed only if someone has a high risk of a break.

Individuals at a lower risk are usually told to do exercises such as weight training, as this can help improve bone density, as well as eat a diet rich in calcium and Vitamin D. Quitting smoking is important too.

The Royal Osteoporosis Society offers excellent lifestyle advice. Calcium supplements may also be prescribed if necessary, and hormone replacement therapy can help post-menopausal women reduce the chance of fractures.

A rare type of thigh bone fracture can occur in patients taking alendronic acid.

For this reason, any thigh, hip or groin pain while on these medications should be discussed with the GP.

There are also rare but potential issues with damage to the jaw from medication, which is why dental checks are so key when prescribed this treatment.

Usually doctors review the need for medication after five years, when they check that the benefits continue to outweigh any risks.

Sometimes a pause would be recommended for one to three years before another reassessment. This may involve a further bone scan.

FOR the past few days I’ve suffered terrible headaches and a sore throat. I feel I’m coming down with something but I am scared it’s Covid – I’m going on

holiday next week and don’t want to test positive. Do I have to take a test?

YES! Part of living with Covid means regular testing and being vigilant about symptoms that may be illness.

This does mean cancellations and missing out on lots of things.

The classic symptoms of Covid are a high temperature, cough and a loss of sense of taste and smell, and having any of these should prompt anybody to take a PCR test, which you can get sent to you at home for free on the NHS and Government websites.

If you don’t have classic symptoms, you have to speak to your GP first – but they’ll doubtless recommend having a PCR anyway. Don’t use a lateral flow, as these are for people who are totally asymptomatic.

Many patients in my clinic have tested positive for Covid having suffered what seems like a summer cold.

This would include headache, sneezing, runny nose and a sore throat – very similar to sinusitis.

Testing for Covid remains crucial. It’s a legal requirement to self-isolate if you test positive. But not testing, to avoid this, then going on holiday – and sitting in a plane or train – is morally questionable, given the numbers of people one could infect.

Do the right thing.