Health

Some cancer patients have PTSD years after diagnosis, study finds

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Becki McGuinnessImage copyrightCarine Bea
Image caption Becki McGuinness suffers from PTSD after her cancer treatment left her infertile

A fifth of cancer patients experience post-traumatic stress disorder (PTSD), a Malaysian study has found.

About one-third of these still had consistent or worsening PTSD four years after diagnosis.

The researchers said PTSD needed to be identified, monitored and treated early.

Becki McGuinness, who was diagnosed with bone cancer, said the resulting PTSD and depression were the biggest challenges for her.

Becki was treated with chemotherapy after being diagnosed at the age of 21. When it didn’t work, she was told she would need radiotherapy.

“By the time I’d finished radiotherapy, and a few months passed, my periods were stopping.

“It wasn’t until I was 23 that I found out that I’d gone through the menopause and was infertile,” she said.

‘I could have saved your fertility’

Becki was devastated – even more so when she found out it could have been prevented.

“I was waiting a whole month for my treatment. I later saw a gynaecologist who said, ‘If you’d only been sent to me I could have saved your fertility.'”

It left her with depression and PTSD, which she still lives with seven years on.

“I could take all the physical stuff. I could take even that I might die but when something’s taken away and it’s not your choice, that’s what I find quite stressful.

“If you take that person’s choice away, it’s like saying you’re not worth picking for yourself what you want for your future.”

Image copyrightCarine Bea

The team followed 469 patients with various types of cancer at one referral centre in Malaysia.

They tested them for PTSD after six months and then again four years after they’d been diagnosed. At six months, 21% had PTSD. This dropped to 6% four years on.

“Many cancer patients believe they need to adopt a ‘warrior mentality’, and remain positive and optimistic from diagnosis through treatment to stand a better chance of beating their cancer,” said the study’s lead author, Caryn Mei Hsien Chan.

“To these patients, seeking help for the emotional issues they face is akin to admitting weakness.

“There needs to be greater awareness that there is nothing wrong with getting help to manage the emotional upheaval – particularly depression, anxiety, and PTSD post-cancer.”

While the association between PTSD and cancer hasn’t been studied in the UK, government data shows one in five people with cancer report having moderate to severe mental health issues. Macmillan Cancer Support estimates this to be about 530,000 people with cancer in the UK.

Living in fear

Dr Chan also stressed that many patients lived in fear that their cancer may return.

The fear and depression can cause them to skip appointments as they trigger negative memories, which can be detrimental to their health.

The study also found patients with breast cancer – who received special dedicated support and counselling at the centre studied – were almost four times less likely to develop PTSD in the short term.

Dr Chan said: “We need psychological evaluation and support services for patients with cancer at an initial stage and at continued follow-ups because psychological well-being and mental health – and by extension, quality of life – are just as important as physical health.”

Dany Bell from Macmillan Cancer Support said: “It is tragic, but sadly not surprising, that so many people with cancer suffer from PTSD.

“While a common perception is that people should feel ‘lucky’ to have survived cancer, we often hear from people who felt that the support they received ‘dropped away’ when their treatment ended. The health and care system has a long way to go in terms of supporting people after cancer treatment.”

Campaigning

Becki couldn’t agree more. She said her mental health support was inadequate and the consequences remain with her.

“You see children and you try and block it out but realise the depression is something that will keep popping up,” she said.

Her cancer is now in remission but she stills lives in a lot of pain that prevents her from working.

She devotes time to campaigning for awareness for fertility preservation, to make sure others don’t have to go through what she has.

Becki said: “That’s given me the empowerment to deal with it a lot better than if I’d been sitting at home, thinking about it.

“I’ll keep raising the issue to make sure young people get their needs met.”

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Women advised to sleep on side to help prevent stillbirth

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Pregnant woman sleeping on her sideImage copyrightScience Photo Library

Women are being advised to sleep on their side in the last three months of pregnancy to help prevent stillbirth.

A study of just over 1,000 women found the risk doubles if women go to sleep on their backs in the third trimester.

The study looked into 291 pregnancies that ended in stillbirth and 735 women who had a live birth.

Researchers say the position in which women fall asleep in is most important – and they should not worry if they are on their back when they wake up.

About one in 225 pregnancies in the UK ends in stillbirth and the study authors estimate that about 130 babies’ lives a year could be saved if women went to sleep on their side.

The MiNESS study, published in the British Journal of Obstetrics and Gynaecology (BJOG) is the biggest of its kind, and confirms findings from smaller studies in New Zealand and Australia.

Is waking up on your back a problem?

Prof Alexander Heazell, clinical director at the Tommy’s Stillbirth Research Centre at St Mary’s Hospital in Manchester, who led the research, advises women in their third trimester to sleep on their side for any episode of sleep, including daytime naps.

“What I don’t want is for women to wake up flat on their back and think ‘oh my goodness I’ve done something awful to my baby’.

“The question that we asked was very specifically what position people went to sleep in and that’s important as you spend longer in that position than you do in any other.

“And also you can’t do anything about the position that you wake up in but you can do something about the position you go to sleep.”

Tips for going to sleep on your side

  • Put a pillow or pillows behind your back to encourage side-sleeping
  • If you wake during the night, check your position and go back to sleep on your side
  • Pay the same attention to sleep position during the day as you would during the night
  • If you wake on your back during the night, don’t worry, just roll on to your side
  • The study didn’t find a difference in risk between right or left side

Source: Tommy’s charity

Researchers can’t say for certain why the risk of stillbirth is increased – but there is a lot of data that suggests when a woman is lying on her back, the combined weight of the baby and womb puts pressure on blood vessels which can then restrict blood flow and oxygen to the baby.

Edward Morris, from the BJOG, said the new research was “extremely welcome” .

“This is an important study which adds to the growing body of evidence that sleep position in late pregnancy is a modifiable risk factor for stillbirth.”

The pregnancy charity Tommy’s has started a campaign to raise awareness of the study and to encourage women to sleep on their side.

Image copyrightFamily photo
Image caption Michelle Cottle is 36 and lives in London – she is a clinical psychologist and writes an award-winning blog Dear Orla

Michelle Cottle’s baby Orla was stillborn at 37 weeks in 2016 after a healthy pregnancy where there were no signs that anything was wrong.

She writes a blog “Dear Orla” and hears from women who have been through the same experience.

Michelle, whose daughter Esme was born a year later, says practical advice like this for mothers is important to make them feel more in control.

“I really think it helps to empower people, as it feels like something you can go away and do with the hope of having a more healthy pregnancy and a better outcome than sadly lots of people do have.

“I look back now and I actually feel quite traumatised by my (second) pregnancy because it was a bit like living your worst nightmare every single day.

“Every time there’s maybe a quiet moment and you don’t know whether your baby is alive or not is absolutely terrifying.

“Night-time is the worst as well because a lot of people would say they believe that their baby died maybe when they were sleeping. I think that’s really scary because you have to sleep.

“So I think having clear things that can help you feel a bit more in control is really important for women.”

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Thousands run in Delhi ‘smogathon’

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Some 30,000 people have taken part in the Delhi half marathon, held amid high levels of air pollution.

However conditions were better than during last month’s hazardous smog, which forced the Indian government to declare a public health emergency.

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Why Andy Cole climbed Ben Nevis every day for a month

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A man who climbed the UK’s highest mountain every day for a month has told 5 live Breakfast how it helped improve his mental health.

Andy Cole decided to climb Ben Nevis after his doctor, who was treating Andy for depression, told him to do more outdoor activity.

The forklift driver said: “The natural endorphins started to release, the medication intake was lowered – I’ve gained so much out of the natural outdoors.”

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Social care: MPs seek cross-party group to ‘sustain’ NHS

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Woman helps man walk with a stickImage copyrightGetty Images
Image caption The MPs argue that only a cross-party approach can deliver a sustainable settlement

Ninety MPs have signed a letter calling on the prime minister to set up a cross-party convention on the future of the NHS and social care in England.

They say a non-partisan debate is needed to deliver a “sustainable settlement” to fund social care costs.

The letter to Theresa May and Chancellor Philip Hammond said patients were being “failed” by the system.

A government spokesperson said it was “committed” to making the sector sustainable.

The government had already provided an additional £2bn to social care over the next three years, the spokesperson added.

Non-partisan approach

One-third of the MPs who have signed the letter are Conservative.

They include Sarah Wollaston, chair of the health select committee, former education secretary Nicky Morgan and Andrew Mitchell, a minister under the last government.

Tories George Freeman, former policy adviser to Mrs May and Sir Nicholas Soames, are other signatories.

Labour MPs to sign include Liz Kendall, Chuka Umunna, Hilary Benn, Frank Field and Caroline Flint.

Among the Liberal Democrats to have signed are Sir Vince Cable, Sir Ed Davey, Tim Farron and Norman Lamb.

A similar initiative with a much smaller group of MPs launched earlier in the year demanded “swift” action – and resulted in a meeting with Downing Street officials.

The latest letter, now backed by a broader range of senior parliamentarians, said the general election had interrupted these plans.

“The need for action is greater now than ever,” it said.

Image copyrightReuters
Image caption MPs told Mr Hammond and Mrs May that people needing care were “too often failed”

The letter argued that only a cross-party NHS and social care convention – a forum for non-partisan debate – could deliver a sustainable settlement for these services where conventional politics had failed to do so.

“We understand that fixing this is immensely challenging and involves difficult choices,” the MPs said.

“We all recognise, though, that patients and those needing care are too often failed by a system under considerable strain.”

The letter urges the government to address short-term pressure in the health system in next week’s Budget – and to establish a cross-party process to work out longer term solutions.

Councils have complained that the government has not given them enough money to plug shortfalls in social care funding.

A growing older population, and greater demand for care and nursing homes, has put pressure on local authorities.

‘Kicked down the road’

The government said MPs were already going to be consulted on social care, ahead of it publishing a green paper policy statement next year.

A government spokesperson said: “We have announced a cross-government green paper on care and support for older people with input from a group of independent experts.

“We recognise that there is broad agreement across parliament that reform for social care is a priority and look forward to hearing a range of views.”

NHS Health Check: Which local services are under threat?

But Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare system, said promises to reform funding were being “kicked down the road”.

He said: “The government promised reform before the election, then said there would be a green paper before Christmas.

“Now it has been put off until summer next year – and even then we are not being promised firm commitments.”

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Are grandparents spoiling kids?

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A study says grandparents tend to give high-sugar snacks as treats.

The University of Glasgow found that this is having a bad effect on children’s diet and weight.

We asked some grandparents if they were guilty.

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Dog owners have lower mortality, study finds

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Golden RetrieverImage copyrightGetty Images

Dog owners have a lower risk of death from cardiovascular disease or other causes, a study of 3.4 million Swedes has found.

The team analysed national registries for people aged 40 to 80, and compared them to dog ownership registers.

They found there was a lower risk of cardiovascular disease in owners of dogs, particularly of hunting breeds.

While owning a dog may help physical activity, researchers said it may be active people who choose to own dogs.

They also said owning a dog may protect people from cardiovascular disease by increasing their social contact or wellbeing, or by changing the owner’s bacterial microbiome.

The microbiome is the collection of microscopic species that live in the gut. It’s thought a dog may influence its owner’s microbiomes as dogs change the dirt in home environments, exposing people to bacteria they may not have encountered otherwise.

Image copyrightGetty Images

The researchers said dogs had a particularly protective effect for those who live alone.

“The results showed that single dog owners had a 33% reduction in risk of death and 11% reduction in risk of heart attack,” compared to single non-owners, said lead study author Mwenya Mubanga of Uppsala University.

People who live alone have been shown previously to be at a higher risk of cardiovascular death.

Dr Mubanga said: “Perhaps a dog may stand in as an important family member in the single households.”

For their study, published in Scientific Reports, the team looked at data from 2001 to 2012. In Sweden, every visit to a hospital is recorded in national databases – while dog ownership registration has been mandatory since 2001.

Owning a dog from breeds originally bred for hunting, such as terriers, retrievers and scent hounds, was associated with the lowest risk of cardiovascular disorder.

Image copyrightNick Triggle/Amber Evans

Dr Mike Knapton of the British Heart Foundation, said: “Owning a dog is associated with reduced mortality and risk of having heart disease. Previous studies have shown this association but have not been as conclusive – largely due to the population size studied here.

“Dog ownership has many benefits, and we may now be able to count better heart health as one of them.

“However, as many dog owners may agree, the main reason for owning a dog is the sheer joy.

“Whether you’re a dog owner or not, keeping active is a great way to help improve your heart health.”

Tove Fall, senior author of the study, said there were some limitations: “These kind of epidemiological studies look for associations in large populations but do not provide answers on whether and how dogs could protect from cardiovascular disease.

“There might also be differences between owners and non-owners already before buying a dog, which could have influenced our results, such as those people choosing to get a dog tending to be more active and of better health.”

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Dog owners lowers early death risk, study finds

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Golden RetrieverImage copyrightGetty Images

Dog owners have a lower risk of death from cardiovascular disease or other causes, a study of 3.4 million Swedes has found.

The team analysed national registries for people aged 40 to 80, and compared them to dog ownership registers.

They found there was a lower risk of cardiovascular disease in owners of dogs, particularly of hunting breeds.

While owning a dog may help physical activity, researchers said it may be active people who choose to own dogs.

They also said owning a dog may protect people from cardiovascular disease by increasing their social contact or wellbeing, or by changing the owner’s bacterial microbiome.

The microbiome is the collection of microscopic species that live in the gut. It’s thought a dog may influence its owner’s microbiomes as dogs change the dirt in home environments, exposing people to bacteria they may not have encountered otherwise.

Image copyrightGetty Images

The researchers said dogs had a particularly protective effect for those who live alone.

“The results showed that single dog owners had a 33% reduction in risk of death and 11% reduction in risk of heart attack,” compared to single non-owners, said lead study author Mwenya Mubanga of Uppsala University.

People who live alone have been shown previously to be at a higher risk of cardiovascular death.

Dr Mubanga said: “Perhaps a dog may stand in as an important family member in the single households.”

For their study, published in Scientific Reports, the team looked at data from 2001 to 2012. In Sweden, every visit to a hospital is recorded in national databases – while dog ownership registration has been mandatory since 2001.

Owning a dog from breeds originally bred for hunting, such as terriers, retrievers and scent hounds, was associated with the lowest risk of cardiovascular disorder.

Image copyrightNick Triggle/Amber Evans

Dr Mike Knapton of the British Heart Foundation, said: “Owning a dog is associated with reduced mortality and risk of having heart disease. Previous studies have shown this association but have not been as conclusive – largely due to the population size studied here.

“Dog ownership has many benefits, and we may now be able to count better heart health as one of them.

“However, as many dog owners may agree, the main reason for owning a dog is the sheer joy.

“Whether you’re a dog owner or not, keeping active is a great way to help improve your heart health.”

Tove Fall, senior author of the study, said there were some limitations: “These kind of epidemiological studies look for associations in large populations but do not provide answers on whether and how dogs could protect from cardiovascular disease.

“There might also be differences between owners and non-owners already before buying a dog, which could have influenced our results, such as those people choosing to get a dog tending to be more active and of better health.”

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Autism concern over home schooling rise in Wales

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Father helping his daughter with homeworkImage copyrightGetty Images

The number of pupils being taken out of school to be taught at home has doubled in four years – with many of them believed to be autistic.

Some 1,906 pupils were removed in 2016-17, up from 864 in 2013-14, according to council data.

National Autistic Society Cymru said many were autistic children who were struggling to cope in school.

The Welsh Government said it was committed to creating an inclusive education system for all learners.

Children’s Commissioner for Wales, Sally Holland, said she was concerned some schools wanted autistic children removed to improve their results.

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Media captionMeleri Thomas: “A lot of parents have no option”

Erika Lye, who has three autistic sons, runs a home education group in Rhos, Neath Port Talbot.

She said 80% of the children who attended were on the autistic spectrum and many were not there through choice.

“It’s easier to send your child to school,” she said.

“Nobody would choose this if there was a better system. If the state worked then we would be putting our children into school.”

By law, a child has to receive an education but it does not have to attend school or follow a set curriculum.

The council figures – received by BBC Wales by all but one council following a freedom of information request – found the highest number of pupils leaving school to be home educated was among older secondary school pupils.

In 2016-17 there were 332 children aged 15 taken out of school, compared to 156 children aged 11.

The figures do not include children who are home schooled but who have never been registered.

Meleri Thomas, from the National Autistic Society Cymru, said the school environment often proved too challenging for some autistic children.

She said: “A lot of parents are finding themselves in positions where they have no options and the only thing they can do to help their children is to educate them at home even though they might not feel fully equipped to do that or want to.”

Sally Holland said she was also concerned: “Some parents have told me they have been encouraged to home educate because their child might be affecting the school or local authority’s performance data around exam results or attendance figures.”

‘Lack of support’

The latest report by the Special Educational Needs Tribunal for Wales showed families with autistic children lodged more appeals about the lack of support their child is receiving in school than those with other learning needs.

National Autistic Society Cymru has called for mandatory training on autism awareness in schools.

A Welsh Government spokesman said if passed, its Additional Learning Needs (ALN) Bill would overhaul the system for supporting learners with additional learning needs.

The spokesman added it had agreed extra funding for the collection and analysis of local authority data on elective home education to investigate why some parents choose to do it.

He said it hoped this would identify trends so councils could consider what measures, if necessary, could be put in place to support families when children are still in school.

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