21 September 2018
Vigilance in detecting neck and head cancer
Head and neck cancers, although not common, often go undetected. Ear, Nose and Throat consultant, Mr Andrew Moore, from The Montefiore Hospital in Hove, says it’s time to become more vigilant to improve patient outcomes.
“As with most cancers, head and neck cancers are more treatable the earlier they are detected. However, because of their relatively hidden location and little public awareness compared with other forms of the disease, it is hard for patients to connect a nagging sore throat or persistent mouth ulcers with something more sinister,” he said.
The last 10 years has seen an increase in head and neck cancers, especially among younger sufferers.
While I used to see patients in their 60s - typically heavy smokers and drinkers - I am now seeing an increasing number of patients in their 40s and even as young as mid-20s.
While the biggest risk factor remains alcohol and smoking, the Human Papillomavirus (HPV), a viral infection that is passed between people through skin-to-skin contact, has increasingly become a factor.
Genital HPV infections are common and highly contagious and there is a strong link between this and head and neck cancer in people with more past sexual partners.
Cancer caused by HPV tends to be found at the back of the throat, at the base of the tongue and around the tonsil areas.
Many young patients present late with symptoms as they think a persistent sore throat can’t possibly be cancer. Girls aged 12-13 in the UK are now vaccinated against HPV, which should in time both protect them from cervical cancers and – it’s believed – future partners from HPV-related oral cancers.”
- Around 85% of head and neck cancers are caused by smoking. Alcohol is also linked to this form of cancer, and if you drink and smoke you can increase the risk of mouth cancer by about 30 times.
- Exposure to the HPV-16 virus
Symptoms of head and neck cancer to look out for:
See your GP if you have had a persistent sore throat for longer than four weeks, particularly on one side, and pain in the ear; a croaky voice for more than four weeks; persistent mouth ulcers, any lumps or changes to longstanding lumps in the neck.
Have regular dental check-ups – your dentist should spend a few minutes feeling your neck and checking your mouth, gums and tongue for signs of cancer.
If you have been referred to an ENT consultant you will be given a fibre-optic endoscopy – a tiny camera which goes up the nose to gain a view of the back of the throat and voice box. That may be enough to reassure you there are no worrying signs. However, if the consultant has any concerns you may be sent for an MRI or ultrasound.
Treatment depends on the exact location of the tumour and the stage of the cancer. If the cancer is at an early stage, it may be treated by surgery alone.
The good news is that cancer caused by HPV tends to respond better to treatment than other types of head and neck cancer.
Mr Andrew Moore is an ENT consultant, specialising in head and neck cancers, and holds clinics at The Montefiore Hospital in Hove on Tuesday mornings.
Visit https://themontefiorehospital.co.uk/ or phone 01273 828 148.
First published in Brighton and Hove Independent on 21st September 2018.
17 August 2018
Tips to help look after your liver
Death and disability from liver disease is increasing and by the time you have any symptoms it is often too late. Dr Khaleel Jamil, Gastroenterologist and Hepatologist at The Montefiore Hospital in Hove, says it’s time to take action for our own health’s sake.
He said: “More than 90 per cent of all liver disease is preventable, but sadly three quarters of people are diagnosed in hospital when they already have cirrhosis, that is, scarring of the liver which can lead to liver failure.
“The biggest contributor is alcohol – four out of five deaths from liver disease are alcohol-related.
“You don’t have to be an alcoholic to risk damaging your health by drinking.
“Regularly drinking over the recommended levels can be harmful.
“The Brighton and Hove area is a hot spot for liver disease.
“The number of male deaths in the city from chronic liver disease is double the England average.
“But alcohol consumption is not the only contributor. Obesity is also a key factor.
“Around 25 per cent to 40 per cent of obese people have a fatty liver which, if left unchecked, can lead to liver failure.
“Fatty liver is also a harbinger for other life-threatening illnesses such as cardiovascular disease.
“The problem is two-fold – firstly, there is no national liver screening programme, unlike that for bowel or breast cancer.
“And secondly, liver disease has no symptoms in the early stages.
“By the time you get symptoms, such as jaundice and a fluid-filled tummy, it can be too late as the liver is in an advanced stage of damage.
“The good news though is liver disease caused by alcohol or obesity can be reversed with a change in lifestyle, if it hasn’t got too advanced.
“And even in advanced liver disease, there is good evidence to show that a change in lifestyle will improve liver function.”
How to help your liver:
- Aim to drink less than 14 units of alcohol a week and ensure you have three alcohol-free days.
- Limit the amount of processed foods, fat and sugar you are eating, and instead focus on fresh produce and lean meat. Even losing 10% of your total bodyweight has been shown to improve liver health.
- Take regular exercise – working out helps to reduce the amount of carbohydrates stored in the liver and so reducing fat.
- If you’re struggling to reduce your alcohol consumption, your GP or local addicition services can prescribe pharmaceutical drugs that can help with alcohol addiction
DR KHALEEL JAMIL
Dr Khaleel Jamil has introduced a liver screening service at The Montefiore Hospital in Hove on Wednesday afternoons. This includes blood tests and an ultra sound scan. For more information, visit www.themontefiorehospital.co.uk or telephone 01273 828 148.
First published in Brighton and Hove Independent on 17th August 2018.
10 August 2018
Hip pain syndrome can be a serious condition!
It’s the height of summer and adults are running around after their children and grandchildren, or enjoying a stroll along the seafront. Do you wish you were one of them? If hip pain is holding you back, a new medical procedure can help.
If you are suffering with a deep pain in your outer hip and struggling to sleep on your side at night, you may have what is known as lateral hip pain syndrome. It is more common in women, especially those aged over 40. It particularly affects people who have had long-term back pain or weak knees and ankles. The tendons in the hip may have been damaged and the pain may cause you to walk with a limp. Until now, there was no known cure. Traditionally, GPs may prescribe a steroid and local anaesthetic injection for bursitis (the medical name for the syndrome) and advise you to rest. This can work for some people, but if there is a problem with the actual tendon underneath, it may only provide temporary relief.
“The problem is the first injection will work really well but the effect will eventually wear off. The second injection won’t work quite so well, and the third one will barely make a difference,” says Mr Phil Stott, consultant orthopaedic surgeon at The Montefiore Hospital. “If not treated, the tendon can eventually tear or snap. If this happens, the pain will get better but suddenly you can’t walk properly and eventually this will lead to more back pain. Being able to sleep on your side is virtually impossible - I have seen this condition put a strain on relationships as couples can no longer share a bed.”
With his 23 years’ experience in orthopaedic surgery, Mr Stott has developed a new procedure to help repair the tendon. A donor Achilles’ heel tendon is weaved into the old hip tendon - a procedure similar to ligament reconstruction for knees. In the past, this operation was done using pig heart instead of donor Achilles’ tendon, but it had a 50% failure rate, with patients not being able to put weight on their feet for at least three months. There has not been a failure of the new procedure since it was developed five years ago. Also, patients can put some weight on their feet immediately and can be full weight bearing after six weeks with rehabilitation and physio.
“By the time they come to have an operation, people are often in a lot of pain and are desperate,” says Mr Stott. “This condition is better to catch early before the tendon snaps. If that happens, the muscles begin to give up and it is harder to repair. The person could end up always walking with a stick.”
If you suffer with outer hip pain:
- Make an appointment with your doctor who may prescribe a steroid injection, or severe conditions may be referred to a specialist. Physiotherapy is usually the first line of treatment.
- If you are a smoker – stop! Evidence has shown that giving up smoking can reduce and even cure the symptoms of this type of hip pain if the tendon hasn’t snapped.
- Avoid taking Nonsteroidal Anti-inflammatory Drugs such as ibuprofen and naproxen long term, as these can stop the tendon from healing. Try aspirin instead, with advice from your GP.
Mr Phil Stott, consultant orthopaedic surgeon, holds clinics on Thursday afternoons at The Montefiore Hospital, Montefiore Road, Hove. Visit www.themontefiorehospital.co.uk or for a non-obligation enquiry, phone 01273 828 148.
First published in Brighton and Hove Independent on 28th August 2018.
23 July 2018
Some tips to help you take control of your body
Being overweight can be insufferable in hot weather. If the recent heatwave has made you determined to shed the pounds, then bariatric surgeon Mr Goldie Khera shares some tips adopted by his weight loss patients.
“With temperatures reaching the 30s in recent weeks, I have noticed many of my pre-op weight loss patients struggling to cope with day to day chores. If you are overweight, your body generates more heat and reduces its ability to cool down. Obesity is also one of the biggest risk factors for cancer of the breast, bowel and prostate. It also increases the risk of you developing diabetes and heart problems. Excess weight also puts a strain and damages your weight bearing joints like your knees, hips and back.
So, lots of reasons to take control of your body. Weight loss surgery is not the easy option and all patients are thoroughly assessed before they have the operation and must commit to changing their lifestyle for the best results – the procedure can’t help them lose weight all by itself. Some of the healthy choices they adopt post-operation are also good tactics for anyone with an excess weight issue:
- Swap ready meals for homecooked versions. Patients of mine who have taken up home cooking have lost weight simply by understanding the ingredients going into their food. Make the recipes in bulk so you can have them on hand in the freezer which will break the cycle of `I can’t be bothered to cook tonight’.
- Instead of opting for diet versions of your normal fizzy beverage, drink fizzy or still water instead. I’ve noticed patients who have swapped their ‘full fat’ beverage for a diet version, lose weight more slowly than those who can swap to still or sparkling water.
- Overweight people are often caught in a vicious cycle of knowing they need to increase their activity levels to lose weight but at the same time not wanting to exercise in public. Try to simply go from zero to a walk with friends twice a week will make a massive difference. Or opt for single sex only gym session or, if you have the funds, a personal trainer. Or workout at home – try the various `coach potato to 5K’ fitness apps available to download onto your mobile.
- One of the newest and best motivators among my weight loss patients is a ‘Fitbit’ type device. It can track your activity, exercise, food, weight and sleep – patients regularly send me their Fitbit progress charts! I would also recommend that you find yourself a Fitbit buddy as swapping progress with a companion will help you to stick to your goals and give each other the motivation to succeed.
- So, enjoy this rare glorious English summer. Allow yourself a treat but when you do, don’t feel too guilty about it as that can derail everything. Just try and maintain your long term weight loss and healthy eating goals.
Mr Goldie Khera, laparoscopic and bariatric surgeon, holds a clinic on Wednesday evenings at The Montefiore Hospital, Montefiore Road, Hove. For more information about weight loss surgery, visit www.themontefiorehospital.co.uk or phone 01273 828 148.
First published in Brighton and Hove Independent on 20th July 2018.
19 June 2018
Dispelling myths surrounding kidney stones
If you’re a man, the thought of passing a kidney stone is enough to make your eyes water. Mr Andy Symes, urology consultant at The Montefiore Hospital in Hove, offers reassuring advice.
“There are lots of myths surrounding kidney stones (a build-up of crystals in the urine). For one thing, passing them when you go to the toilet is rarely painful and often goes unnoticed.
The most painful part is if the stone becomes stuck in the kidney or lodged in the ureter. Patients describe excruciating pain in the lower back and stomach coupled with nausea Called renal colic, it isn’t life threatening and most patients will be given pain relief and sent home from their GP or hospital to pass the stone naturally. It is important to see a urologist to make sure it has passed, and for advice about prevention.
More men than women suffer with kidney stones, but it is becoming increasingly common across the board, with the blame squarely on poor diets high in protein, salt and sugar. In the Brighton area, we see about 15-20 new renal colic cases a week. But there is a lot you can do to prevent kidney stones appearing or reoccurring.”
- Drink plenty of water. If you have had a kidney stone in the past, aim to drink around 2 to 2.5 litres of water a day. If you have been sent home from hospital to pass the kidney stone, drink normally as too much water may spark the pain again.
- Reduce salt in your diet.
- It’s a myth that citrus fruit dissolves kidney stones. However, it can help with prevention. Try a squeeze of lemon in a glass of water daily.
- many stones containing oxalate, a naturally occurring substance which can combine with calcium in the body to form kidney stones. Foods high in oxalates are - rhubarb, beetroot, spinach, nuts, bran flakes and chips. These should be eaten in moderation.
Increasingly, kidney stones are discovered during a hospital scan for another condition. Very small stones will pass out naturally in the urine undetected. However, if the stone is stuck in the kidney or the ureter, symptoms can develop suddenly. These are:
- intense pain in the back or side of the abdomen, or occasionally in your groin.
- blood in your urine.
- men may have pain in the testicles or scrotum
What can be done
See your GP or attend A&E. Blood and urine tests will be carried out to check for infection and you will be prescribed painkillers. You will be referred to a urologist and be given a CT scan, although often as an outpatient.
Once the pain is under control, eight out of 10 people will be sent home to pass the stone naturally. You can use a small sieve or tea strainer so that you know when the stone has passed. However, patients will be given a follow up scan to check the kidney stone has gone.
Large kidney stones will need surgical intervention. A ureteroscopy is a small scope which allows the surgeon to examine the upper urinary tract and remove the stone. Or the stone will be broken down into smaller pieces by ultra sound waves (called lithotripsy). A large stone stuck in the kidney may need keyhole surgery. Procedures can be done in day surgery.
Mr Andy Symes is a consultant urologist and holds clinics at The Montefiore Hospital in Hove on Wednesday mornings. For more information call 01273 828 148.
First published in Brighton and Hove Independent on 15th June 2018.
4 June 2018
Matt walks tall after his life-changing op
It’s National Walking Month, and while most of us are happy to go on a gentle stroll, one Horsham resident takes it to the extreme… despite having had a total hip replacement.
Matthew Isherwood has recently returned from walking the whole length of the Great Smoky mountain range, part of the Appalachian Trail in the USA - an 80-mile route, climbing up and down repeatedly to around 6,600ft, carrying a 26kg pack with kit and supplies on his back. Not forgetting the ice picks and crampons to negotiate the treacherous conditions.
He and two old school friends from Horsham had already walked the southern half of the Trail last year, sleeping in hammocks each night of a five-day mountainous trek.
“If you enjoy walking, then the Appalachian Trail is one of those lifetime goals,” says the 41-year-old father of two, “and The Great Smoky Mountain Range is probably the most challenging section.”
But before he had his hip operation, it was something he could only have dreamed of.
When he was 17, Matthew was run over by a coach, an accident which crushed his legs and dislocated his left hip. He was in hospital on traction for six weeks, crutches for six months and a walking stick for more than two years.
An active young man, he was determined to get his fitness levels back, so swam and cycled regularly. By his mid-20s, he was enjoying his love of walking again, playing sport and tackling treks across The Downs, in The Brecon Beacons and Snowdonia.
But the early trauma took its toll and he began to suffer with arthritis. His job as a Chartered Surveyor for Horsham-based firm, Acorn Surveyors, where he is a founding partner, means he is on his feet most of the day, up and down ladders and crawling into loft spaces to do inspections. While he says the pain didn’t stop him doing his job, he suffered afterwards.
As the pain became progressively worse, he was struggling with lack of sleep and admits he was becoming grouchy.
“It was not like me and I didn’t want to carry on like that, feeling irritable with the constant chronic pain. It wasn’t good for family life and I had also become less active and couldn’t do the long treks anymore.”
In 2011 he was told the hip joint had significantly deteriorated and that he needed a total hip replacement.
“I was only 35 so I put it off for as long as possible and started to take prescribed painkillers. It didn’t stop me doing things, but I really suffered afterwards, and the painkillers just didn’t touch the pain. They just made me feel groggy. It took me 18 months to get my head around having a hip operation, but by then I realised I needed to do something positive.”
Effectively self-employed, Matthew decided to privately fund his operation, so he could choose a quieter time of year to have the procedure, which took place in January 2013 at The Montefiore Hospital in Hove, under the care of orthopaedic consultant surgeon, Mr Philip Stott. Matthew was fitted with a titanium prosthesis with an over-sized ball joint to give him the mobility he needed for his active lifestyle.
He spent three nights in hospital and was up on his feet within hours of the operation. Back home, he embraced the physiotherapy, ensuring he built routines into his daily schedule. He was using an exercise spin bike within a few days of coming home.
Building on his rehabilitation and return to fitness, Matthew joined Evolution Fitness in Horsham, who greatly helped increase his mobility and build back wasted muscle through high intensity functional fitness training. Eighteen months post op, Matthew completed the Three Peaks Challenge in aid of Help The Heros, climbing the highest mountains of England, Scotland and Wales in under 24 hours.
“The sharp pains and chronic ache associated with arthritis went away following my operation – now I just ache like anyone else does after doing a tough challenge,” he says. “I found making the actual decision to commit to having the operation probably harder than the actual process itself. You know when you are ready for a hip operation, but it does take a while for the mind to process it. It’s the fear of the unknown, but I am so happy I had it done. Persevering and putting the effort in with the physiotherapy and exercise are vital in the rehabilitation process but you get out what you put in. Completing the entire Smoky Mountain Range was a real achievement for me, in tough sub-zero conditions, and one that I would not have even contemplated attempting prior to my operation.”
But the biggest benefit of the operation, he says, is being able to fully enjoy an active family life with his supportive wife and their two sons, aged ten and seven. An outdoorsy family, they are looking forward to a short break at Centre Parcs soon where Matthew will be on the climbing ropes alongside his sons.
“It is the little things that make a big difference and that you are most grateful for,” he adds.
First published in West Sussex County Times on 31st May 2018.
22 May 2018
Keeping active can help to improve knee pain
It’s National Walking Month, so don’t let knee pain hold you back says Mr Sandeep Chauhan, Specialist Knee Surgeon at The Montefiore Hospital in Hove.
Walking is good for you. It’s a painless exercise that brings physical and mental health benefits, but if you’ve started walking and find you are prone to twisting your knee or stumbling, then you may have poor muscle control in your legs. Improve this with simple quad exercises to build up the muscles and protect your knees from injury.
The most common knee pain for people aged 45-plus is caused by osteoarthritis. The cartilage in the knee joint gradually wears away, causing pain, stiffness, a grating or grinding sensation when you move the joint, and swellings. Crouching down or climbing into the car can be uncomfortable. Use ice to reduce the swelling and take over-the-counter anti-inflammatories. However, if the pain continues or increases, it is important to have this diagnosed. Often physiotherapy or a cortisone injection will settle things down. But don’t be tempted to hang up your walking boots – keeping active is key to better knee health.
Exercising the knees:
- You may be having pain just because you’re not used to walking, so condition the muscles around your knees with quadriceps exercises, calf raises, wall squats, hamstring curls and bike-based sport – cycling or using static bikes.
- If National Walking Month inspires you, start slowly. Try walking between Brighton’s two piers and gradually build up the distance. Wear shoes that have support, such as trainers, or walking boots if you are heading to the South Downs.
- If you are prone to flat feet, which will turn the knee inwards, wear insoles, available from specialist shoe shops and chemists.
- If you suffer with osteoarthritis of the knee, keep active but reduce the length of your normal walk.
- Get in the pool and walk! Have water at mid-chest height and walk across the width of the pool. This is a cheap version of an antigravity treadmill used in rehabilitation.
- Try exercises like Pilates to improve your core stability. These are the muscles in your front, back and sides which act as stabilisers for the entire body and so will support the knee joint.
Knee replacement has become the most common form of joint replacement surgery, but often patients are reluctant to undergo the procedure, and suffer with knee pain for several years. According to the National Joint Registry, success rates are high, and patients can return to the activities they once enjoyed. A new knee will keep you walking the South Downs for another 15 years at least.
Advice from Mr Sandeep Chauhan, specialist knee surgeon, who holds clinics at The Montefiore Hospital, Hove For more information visit www.themontefiorehospital.co.uk or phone 01273 828 030.
First published in Brighton and Hove Independent on 18th May 2018.
22 May 2018
Bowel Cancer Awareness – Mr Tony Miles
There are lots of pluses to living in the Brighton area and one of them is good for your health. An additional level of screening for bowel cancer has been rolled out across this region that will help save lives. In the middle of Bowel Cancer Awareness month, The Montefiore’s colorectal surgeon, Mr Tony Miles, urges people to take the test.
In America, going for bowel cancer screening is as natural as aging. As soon as people reach 50, they are offered a colonoscopy (a flexible camera test of the bowel) then again at 60 and 70 with an additional bowel scope test at 55, 65 and 75. Plus they have regular stool testing. It has become part of their normal GP and hospital visits.
This vigorous programme picks up signs of cancer early, ensuring more successful treatment, and treatments that are less invasive enabling survivors to lead normal lives.
Here in the UK, we have the postal screening test, sent every two years to people aged between 60 and 74, but still only about a third of people who receive it go on to complete it.
More recently, the NHS has begun to roll out an additional layer of testing for people aged 55, and the Brighton area is one of the first regions to go live.
It is called Flexible Sigmoidoscopy, or Bowel Scope Test, and although it only checks the left half of the colon, unlike the more complete colonoscopy, it still reduces the risk of developing cancer by 35%.
It is not a painful procedure and is over in less than 15 minutes. If you are registered with a GP, you will be sent an automatic invitation around your 55th birthday and I urge Brighton and Hove citizens that this is one invite they cannot ignore. According to Bowel Cancer UK, every 30 minutes someone dies from bowel cancer, but early diagnosis saves lives.
Look out for symptoms
As well as screening, look out for changes in your bowel habit. If you have looser stools that lasts for two weeks, or blood in your poo, make an appointment with your GP immediately.
The risk factors for bowel cancer include:
- Aged over 50.
- A strong family history of bowel cancer.
- A history of non-cancerous growths (polyps) in your bowel.
- Longstanding inflammatory bowel disease such as ulcerative colitis.
- An unhealthy diet and lifestyle
You can reduce your risk of cancer by:
- stopping smoking
- limiting your intake of alcohol and processed meats
- increasing the amount of fibre, fish, fruit and vegetables in your diet.
- Keeping your weight down
- Taking a junior aspirin every day from the age of 55 (if your GP agrees it is safe for you)
Early detection means better treatments:
Catching cancer early means patients have more options when it comes to treatment. Some early cancers can be removed leaving the colon or rectum intact, such as Trans Anal Minimally Invasive Surgery (TAMIS). This is a new procedure which can remove early cancers from the rectum via a local incision. The patient retains full function of their bowel and rectum after surgery with very much lower risk of complications. This technique is only suitable for early cancer and so early detection is very important.
Advice from Mr Tony Miles, consultant colorectal surgeon who holds clinics at The Montefiore Hospital, Hove on Mondays. For more information visit www.themontefiorehospital.co.uk or phone 01273 828 148
18 April 2018
Forward Facing – Memory Making Day – 9 April 2018
Video courtesy of Latest TV
18 April 2018
Magical memory-making day for children in need
A memory-making day for children who are bereaved or living with long-term illness put smiles on the faces of 80 youngsters and their families. Some of the children came from The Royal Alexandra Children's Hospital and the Demelza Hospice, and the idea of the event was to create a magical day of memories.
Children had their faces painted and were dressed up as animals so they could go on stage and sing some songs from Jungle Book with local youth actors.
There was a petting zoo in the morning including Tony the Pony from Big Brother fame and the show was held in the afternoon watched by parents and carers.
The day, organised by Brighton-based charity Forward Facing, was held at the Brighton Dome on Monday (April 9), and saw local companies donate equipment, food, or volunteer their time to help.
Forward Facing aims to give children and young people with life-threatening conditions, or who have experienced bereavement, the chance to forget their daily struggles and enjoy magical experiences to make lasting memories for themselves and their families.
Candice Konig from Forward Facing said: "It was an amazing day, all the children really enjoyed themselves. I want to thank the local companies and our volunteers for making this happen."
Julie Gore, a nurse at the Montefiore Hospital in Hove, said Forward Facing has helped her family feel normal again.
Julie’s 26-year-old daughter Tash has spent the past seven years undergoing 13 operations for a benign brain tumour which has brought on epilepsy, hearing loss and balance difficulties. Constant hospital visits have meant relaxed family time with her little daughter is rare.
And Julie’s youngest daughter, 24-year-old Jess, has MS. She has only just this month returned to work at The Montefiore Hospital as a health care assistant in the outpatients’ department following intensive treatment.
“The charity has helped to create fun days out for my daughter Tash and my granddaughter Aylah - something that has been so difficult to do over the past few years due to my daughter’s illness,” said Julie.
“Then, when my youngest daughter, Jess, was diagnosed with Multiple Sclerosis two years ago, Forward Facing included her in their memory making events. We all went to a donkey sanctuary – organised and paid for by the charity – which was a wonderful experience for all three of us to enjoy together. And Tash and Aylah have been up the i360 thanks to the charity."
To find out more about Forward Facing, visit: www.forwardfacing.co.uk
First published in Brighton and Hove Independent on 12th April 2018.
5 March 2018
Better to be safe than sorry and get tested for prostate cancer
March is Prostate Cancer Awareness month which puts the spotlight on this silent killer. Mr Andy Symes, consultant urologist at The Montefiore Hospital in Hove, urges men to recognise the risk factors and take control of their own health.
“In my experience, it is often the partners of men with a prostate problem who encourage them to finally go and see their GP. However, I know when I reach the age of 45-50, I will book myself in for prostate tests as part of a well man health check - whether I have a prostate problem or not.
There are very significant risk factors for prostate cancer and men need to be proactive if they are in a risk group. These include age, a family history of prostate cancer, and ethnicity - one in four black men will get prostate cancer at some point in their lives compared with the one in eight chance among other men. And obesity is now strongly linked with an increased cancer risk.
If you are worried about your risks or are experiencing any symptoms that are not normal for you, then book an appointment with your GP. They can discuss your risk factors and explain the tests available.
The prostate cancer is now the third biggest cancer killer in the UK. Until a reliable national screening programme is available, like it is for breast and cervical cancer, men need to take charge of their own health. Early detection saves lives.”
You may be more likely to get prostate cancer if:
- you are aged 45 or over – and your risk increases as you get older.
- you’re a black man over 45.
- your father or brother has had it. Or if your mother or sister has had breast cancer, particularly if they were diagnosed under the age of 60 and had faults in genes called BRCA1 or BRCA2
- you’re overweight or obese, you might have a higher risk of being diagnosed with prostate cancer that’s aggressive (more likely to spread) or advanced (spread outside the prostate).
Symptoms of a prostate problem – these could be a sign of cancer or more likely be the sign of an enlarged prostate which is also treatable.
- needing to urinate more often than usual, including at night
- difficulty starting to urinate
- straining or taking a long time to finish urinating
- a weak flow when you urinate
- a feeling that you’re not emptying your bladder fully
Tests for prostate problems:
- a urine test to rule out a urine infection
- a prostate specific antigen (PSA) blood test
- a digital rectal examination (DRE)
Don’t panic if your first PSA test is raised, it doesn’t necessarily mean cancer. Of those with a raised PSA level, only 30% are likely to have prostate cancer. Your GP may recommend further tests including an MRI scan.
Mr Andy Symes is a consultant urologist and holds clinics at The Montefiore Hospital in Hove. For more information visit www.themontefiorehospital.co.uk or phone 01273 828 148
First published in The Argus on 5th March 2018.
18 February 2018
Helpful tips to tackle the trauma of tinnitus
If you are suffering with tinnitus, then it helps to speak to someone who really knows what you are going through. Ears, nose and throat surgeon, Mr Mike O’Connell from The Montefiore Hospital in Hove, shares his own personal experience, and offers advice.
“It sounds almost ironic that for an ENT specialist I should suffer with tinnitus, but that is exactly what happened to me after a skiing accident,” he said.
“I lost my hearing for a while after the fall, but when it came back, I was left with tinnitus in my right ear, a horrible ringing sound that felt like I had a woodpecker in my head. The noise was so loud that I couldn’t sleep and had to take time off work because I felt exhausted.
“I knew that with self-management techniques, which included getting lots of relaxation and eating well, I could get through this. Tinnitus is a condition that is never cured, but with careful management, the brain can be tricked into blocking the noise out.
“My skiing accident was 16 years ago and although I would say I don’t suffer from tinnitus, very occasionally I can hear a faint ringing in my right ear. But I am always confident it will disappear.
“Treating tinnitus is very much about ‘mind over matter’. Having suffered with it, I have a huge amount of sympathy, and empathy, for patients, and the impact this can have on their quality of life.”
Around one-fifth of the population will suffer with tinnitus at some point in their life. For 85 per cent, it will disappear with self-management, and the rest will need medical intervention.
Self-help tips to cope with tinnitus:
- Look after yourself with a good diet.
- Make time for relaxation activities and exercise.
- Use noise to blot out the sound of tinnitus while you are trying to sleep – have a radio on low between stations, to provide `white noise’ that will stop you focussing on the tinnitus.
- Check your medication – certain drugs, such as aspirin, can trigger tinnitus.
- If you think wax is the cause, have your ears cleaned by a medical professional. Don’t be tempted to push earbuds into your ears.
- Use ear protectors to protect your ears from loud noises, such mowing the lawn, which can exacerbate tinnitus.
- See the useful tips on the British Tinnitus Association website.
- Reassurance from an ENT consultant that the noise is nothing sinister is enough to stop a patient from worrying - and in turn the tinnitus naturally becomes less intrusive.
- Tumours are rare – and even benign acoustic neuroma (which develop along the auditory nerve) affect less than 800 people a year.
- Your consultant may recommend a tinnitus masker, a tiny device which emits low levels of a sound that you choose, such as the sound of waves breaking on a beach. Wear the device for a few hours a day to trick the brain into not hearing the tinnitus.
- Cognitive behavioural therapy can help change your response to the tinnitus which in turn means it will become less irritating.
- Have your hearing checked – straining to hear can make tinnitus worse.
Advice from Mr Mike O’Connell, ENT surgeon who holds clinics at The Montefiore on Thursday evenings and Friday mornings.
For more information on the Montefiore Hospital, visit www.themontefiorehospital.co.uk or phone 01273 828 148.
First published in Brighton and Hove Independent on 18th February 2018.
12 February 2018
Health and Wellbeing - Head, shoulders, knees and…
Make sure you’re fighting fit for work and play this 2018. We have enlisted the help of specialists from The Montefiore Hospital in Hove to bring you a top-to-toe health guide. There are self-help tips for eight common problems and advice on when to seek medical help.
Falling asleep over your desk because either you or your partner snores at night? Then it’s time to take action. If your Body Mass Index (BMI) is greater than 25, losing weight might help. Alter your sleeping position - use pillows to prevent you from rolling onto your back where you are more likely to snore; eat earlier in the evening and reduce alcohol intake particularly before bedtime; and stop smoking. Treat nasal problems like allergies effectively as this may be causing the snoring.
One in ten people suffer from sleep apnoea and may stop breathing for several seconds while they are sleeping. Seek medical advice if you regularly wake feeling very tried as sleep apnoea can affect blood pressure leading to increased risk of heart attacks or stroke. You may be referred to a specialist for further investigation. Solutions to reduce snoring include topical nasal medications and devices which move the jaw forward and widen the airways. Surgery is a last resort but can eliminate snoring for good. Mr Simon Watts, Consultant Ear, Nose and Throat Consultant Surgeon
Do you suffer with heartburn and embarrassing belching? It is a common problem caused by acid reflux and can also make you feel nauseous and make your breath smell. Reduce the symptoms by losing weight or stop smoking. Don’t rush your meals and avoid food triggers such as onions, spicy food, fizzy drinks and alcohol.
Try to leave at least three hours after a meal before going to bed and sleep with your head propped up at night. Take antacids, available from the chemist, within an hour of eating or as soon as symptoms occur. If symptoms continue, your GP may prescribe acid suppression tablets such as ranitidine and more powerful drugs called 'proton pump inhibitors'. You may be referred for an endoscopy to assess whether there is inflammation of the gut and to rule out other problems such as stomach ulcers or gallstones. Dr Khaleel Jamil, Consultant Gastroenterologist
Be Breast Aware
Lumps in the breast are not the only signs of cancer. Keep an eye out for: nipple discharge, painful breasts, a rash on the skin or skin puckering, if the nipple has become pulled in or looks different, a swelling in the armpit or around the collarbone. Examine yourself regularly, around a week after your period. This is easier in a bath when the skin surface is soft and slippery to allow the flat of your hand to glide in a circular motion whilst examining the different areas of the breast. Never squeeze the nipples to check for discharge.
The key message is, if it is not normal for you, then see your GP. You will be given an urgent referral to a local breast unit, although the vast majority of ladies referred don't have a diagnosis of breast cancer. Lynette Awdry, Hospital Matron and specialist breast nurse
You don’t have to play tennis to suffer with this condition which causes pain around the outside of the elbow. It’s most common in 30-50 years old and is due to repetitive use of the forearm muscles, either at work or during sport. You might find it painful to fully extend your arm or grip small objects such as a pen.
The first step is to rest your arm and take anti-inflammatories. Hold a cold compress against your elbow for a few minutes every day. Your GP may also prescribe a cortisone (steroid) injection. Alternatively, blood-based injections help repair the damaged tendon and may provide a longer lasting solution to the problem than cortisone. Physiotherapy may also be recommended. Surgery to remove the damaged part of the tendon is reserved for severe cases. Mr Joideep Phadnis, Consultant Orthopaedic Surgeon and Specialist Shoulder & Elbow Surgeon
Arthritis in the Hands
Osteoarthritis in the thumb is the most common form of arthritis that affects the hand, and women are more likely to get it than men. It is particularly common among manual workers, and symptoms tends to start in later life, around the age of 60-plus. The pain, stiffness and swelling extend to where the thumb joins the wrist and can decrease your grip strength and affect your ability to do even simple tasks like turning a door knob.
Dietary supplements such as Glucosamine and fish oils may help, and hand exercises can improve the range of movement. Ice the joint to ease pain and take anti-inflammatories such as ibuprofen. Your doctor may prescribe a steroid injection, or recommend a thumb splint which will help decrease pain, encourage the correct position for your thumb, and rest the joint, especially at night. For more severe cases, surgery includes replacing the thumb joint with a plastic joint to give flexibility. Mr Chris Williams, Consultant Orthopaedic Hand surgeon
Are you the one in 10 women affected by endometriosis, the commonest cause of pelvic pain? This disease causes heavy periods, and affects the bowel and bladder, making it painful to go to the toilet. And it can also reduce your chances of getting pregnant.
Often women put off going to the doctor because they think the symptoms are normal. It is also difficult to diagnose, and there is often a long delay between a woman going to a doctor about her symptoms and being diagnosed – up to six years on average. An ultrasound examination or laparoscopy, where a small telescope is inserted into the tummy, will confirm a diagnosis of endometriosis.
Regular exercise and switching to a healthy balanced diet can help. Treatments can include the ordinary contraceptive pill or progesterone hormone to help with pain. For women with moderate to severe symptoms, or who are trying to become pregnant, keyhole surgery usually offers the best results in terms of pain relief and enhanced fertility. Mr James English, Consultant Gynaecologist
Anyone who has ever experienced sciatica knows how agonising it can be and how it can impact on daily life, even affecting their ability to work (5 million working days a year are lost to back pain). Pain radiates down the lower back into the buttocks, back of the legs to the feet, and it can cause numbness.
It is due to compression of the sciatic nerve in the spine, most commonly caused by a prolapsed disc. In most cases, symptoms will improve with rest, painkillers and time. Use hot and cold packs on the lower spine and try stretching exercises. Avoid lying or sitting for too long as this can worsen the condition.
For persistent sciatica, a nerve root block, injected under X-ray guidance, can reduce the painful inflammation. If this doesn’t help, surgery may be necessary. This involves removal of the disc prolapse which is compressing the affected nerve root. It can be done minimally invasively and usually involves a one-night stay in hospital. Mr Shuaib Karmani, Consultant Orthopaedic Spinal Surgeon
A quarter of all UK workers suffer from painful knees and surprisingly it affects those who are desk-bound as much as it does those whose jobs involve heavy manual labour.
Years of poor posture while sitting at a desk increase the potential for knee pain. It starts with pain doing simple activities, such as getting out of a chair or going up and down stairs, but these are warning signs that action should be taken. First, address the position of your chair and desk to prevent you from slouching. Regularly do simple stretching exercises for your hamstrings and quadriceps muscles while sitting at your desk. Maintain a healthy weight to take pressure off the knees when standing. Avoid high impact sports and try yoga or Pilates to make your joints more flexible. Use ice and elevate your knee when possible to reduce the pain, and take anti-inflammatories. If knee pain persists, then physiotherapy and a consultation with a knee specialist to rule out other problems, is advisable. Mr Sandeep Chauhan Consultant Orthopaedic Knee Surgeon
Advice from specialists at The Montefiore Hospital, Hove, which was recently awarded an overall ‘Outstanding’ rating by the CQC.
First published in Sussex Business Times, January 2018.
29 January 2018
Useful self- help tips to ease the agony of sciatica
Don’t start the new year in pain with sciatica. There are steps you can take to help yourself and more that can be done to relieve the problem. Brighton and Hove Independent talks to Mr Shuaib Karmani, consultant orthopaedic and spinal surgeon at The Montefiore Hospital in Hove.
Anyone who has ever experienced sciatica knows how agonising it can be. It is more common in people aged 30 to 50 and can greatly impact on their daily life. Even simple actions like walking, sitting or driving can be painful. The pain radiates down the sciatic nerve from the buttocks, down the leg to the ankle, and can cause numbness and weakness in the foot.
The most common cause of sciatica is a prolapsed disc. In eight out of ten cases, symptoms will improve with rest, painkillers and time – usually between six to eight weeks. For persistent sciatica, an injection of cortisone (a powerful anti-inflammatory) around the pinched nerve can help. Called a `nerve root block’, it is administered under X-ray guidance and can reduce swelling and bruising. If this doesn’t help, surgery may be necessary. This involves removal of the disc prolapse which is compressing the affected nerve root. It can be done minimally invasively and usually involves a one-night stay in hospital. But the first step is to try these self-help tips. If you have sciatic pain for more than six weeks, your GP may prescribe stronger painkillers, recommend physiotherapy, or refer you to a specialist.
Self-help for sciatica:
- Use hot and cold packs on the lower spine regularly and try stretching exercises.
- Avoid lying or sitting for too long as this can worsen the condition. If you are sitting at a computer, adjust your chair to give good back support. Take regular breaks and go for a walk around the office.
- Use over-the-counter painkillers such as ibuprofen (check with your pharmacist if you are on other medication).
- Ensure to bend your knees and keep your back straight when lifting objects.
- When driving, especially long distance, take regular stretch breaks. Have your hands at ‘nine to three’ on the steering wheel to keep the sides of your trunk balanced. When not changing gear, keep your left foot on the rubber pedal (a feature in most cars) to allow both legs to be in the same position to maintain a balanced pelvis.
- When in bed, lie flat on your back with knees slightly bent. Place a pillow behind the knees for support. If you prefer to sleep on your side, place a pillow between your knees to prevent your back from twisting.
Mr Shuaib Karmani, consultant orthopaedic and spinal surgeon, holds clinics on Mondays, Thursdays and Fridays at The Montefiore Hospital in Hove. For more information call 01273 828 148.
First published in Brighton and Hove Independent on Saturday 20th January 2018.
26 January 2018
‘DON’T MISS OUT’ - Campaign hopes to stop fall in screening numbers
The number of women attending potentially life-saving smear tests has hit a 20-year-low in the UK, according to NHS figures.
The figures reveal that cervical cancer screening coverage fell from 72.7% to 72% in the last year with 1.4million women missing their tests.
Now cancer charity Jo's Cervical Cancer Trust is hoping to increase awareness with a SmearForSmear campaign, encouraging women who have taken their test to picture themselves on social media with part of their make-up smeared across their face.
It will run throughout Cervical Cancer Prevention Week from January 22 to 28 with the charity hoping that one woman’s post might just provide encouragement to other women and remind them of the importance of being screened.
At The Montefiore Hospital in Hove Consultant Gynaecologist Mr James English said: “The single biggest risk factor for developing cervical cancer is not being regularly screened. It is a preventable disease. The signs that it may develop can be often be spotted early and it can be treated before it even fully starts.
“While around 750 women each year die from cervical cancer in the UK, it appears that nearly one-and-a-half-million women a year are missing out on their tests1.”
Women aged 25 to 49 are invited to attend cervical screening, or smear tests, every three years; those aged 50 to 64 are invited every five years. The screening can detect abnormal (pre-cancerous) cells in the cervix in order to prevent cervical cancer.
Mr English said: “It is important to get the message across that cervical screening is not a test for cancer, but instead allows for detection of abnormalities at an early stage.
“The routine of attending a cervical screening should be an important part of every woman’s health regime but for many women this message just isn’t getting through. Early detection is key to increasing survival rates so educating everyone about the disease, its symptoms and ways to prevent it is very important.”
1 Figures from Office of National Statistics
15 January 2018
Charity of the Year 2018 – Forward Facing
We are pleased to announce that we have chosen Forward Facing as our Charity of the Year, who we will be helping to raise money in a number of ways throughout 2018.
Forward Facing offer activities for children and and young people with long term or life threatening conditions, or have experienced bereavement in the South East. These activities give the children a chance to transform themselves, to have fun, express their personalities and make lasting memories for them and their families. To find out more about Forward Facing and what you can do to help, visit: www.forwardfacing.co.uk