Cervical Cancer Prevention Week 2018

This week is Cervical Cancer Prevention Week in the UK. Cervical cancer is a subject I frequently visit on this blog. This horrific cancer type is preventable through screening. Today's post will go over some things I have mentioned before but I really do think it is a hugely important issue and I hope this blog post persuades at least one woman to book her smear once she's finished reading.

More then 1/5 women ignore their invitation for screening - possibly because they feel shy, embarrassed or scared. Hopefully this post will persuade you that there is  NOTHING to be worried, scared or embarrassed about when it comes to a smear test!

The Cervix:

The cervix is basically the neck of the womb (uterus). It is the opening to the womb from the vagina. The cervix is a very strong muscle which is usually tightly shut but it does open during labour so the baby can come out. The outer surface of the cervix has a layer of cells which are almost skin-like. When these cells become cancerous it is known as squamous cell cervical cancer. There are glandular cells lining the inside of the cervix producing mucus. Cancer of these cells is called adenocarcinoma of the cervix. There is an area of the cervix known as the transformation zone. This is around the opening of the cervix leading onto a narrow passageway that runs into the womb. This zone is where cells are most likely to become cancerous.

Risks and Causes of Cervical Cancer:

* Human Pampilloma Virus (HPV) is the most common and biggest cause of cervical cancer. HPV is passed on from person to person via sexual contact. There are many different types of HPV and not all of them cause cervical cancer. One type causes genital warts but not cervical cancer. However other types are considered high risk. These types can lead to cells in the cervix changing and becoming cancerous. Most women who have HPV and develop cervical cancer will have had other infections caused by HPV in the past. However, not every woman with HPV will develop cervical cancer.

* Smoking can lead to cervical cancer; women who smoke are more likely to develop this type of cancer then women that do not smoke.

* Taking the pill can also increase your risk but the reason for this is not yet known

* Women that have bore a large number of children also have a slightly higher risk as are women with a weakened immune system.

Smear Tests:

Points to Consider:
You can have a smear test at several different places:
* Your GP’s surgery should offer them
* A family planning clinic
* A genito-urinary clinic
* An antenatal clinic
* A private health clinic
* Marie Stopes

You are well within your rights to request a female doctor or nurse performs your test but any male doctors will be chaperoned by a female staff member anyway. It is important to state if you require a female at the time of booking your appointment. 

A smear test should be scheduled whilst you are in the middle of your menstrual cycle (between periods) as it will be very difficult to see your cervix and get a cell sample whilst you are bleeding.

Age Limits:
There are varying age limits for women in the four nations of the UK.
* Women between the ages of twenty five and sixty four are screened every three to five years in England and Northern Ireland.
* In Scotland, cervical screening is offered to women aged between twenty and sixty.
* Wales offers cervical screening to women aged between twenty and sixty four.

Research has shown that screening every three years prevents 84/100 cases of cervical cancer that would develop if they weren’t caught by the smears. So getting a smear test every three years is recommended by the NHS up until you are fifty years old. Abnormal cells develop at a much slower rate in women over fifty so screening is recommended after five years for women in that age group. Your local primary care trust will contact you whenever it is time for a screening for you. I cannot stress the importance of attending these appointments enough – it could save you from a battle with cancer.

The Screening Process:
Cervical cancer is preventable. This is because pre cancerous cell changes can be picked up before they have a chance to develop. A cervical cancer screening test is known as a smear test. This involves a doctor or a nurse using a speculum to take a small sample of cells from the surface of your cervix. It sounds horrific and it can be very uncomfortable but I am going to try and explain it as clearly as I can!
You will need to take off your underwear and lie back on the couch/bed. Being as relaxed as you possibly can be will make the procedure less uncomfortable. 

Occasionally, the person doing the test will perform a vaginal examination first. This means they will place two gloved fingers inside your vagina to make sure your womb is in the correct position and that it feels like it’s a normal size. They will use their other hand to press down on your abdomen and gently feel your womb.
Then comes the actual smear test: The speculum is placed inside your vagina and has two arms which are used to spread the sides of your vagina apart so the cervix can be clearly seen. A small brush is then inserted and used scraped along the surface of your cervix to collect a sample of your cells. The brush and the cells are then sent to a lab in a pot of liquid and examined under a microscope. Any abnormal cells are reported and further investigation on these cells will be needed. 

The Results:
The important thing to remember with smear tests results is: DON’T PANIC!!! Cancer is not the only cause of abnormal cells or an abnormal result. Sometimes you may be asked to go back for a repeat test, again don’t panic, it could be because:
* You were on your period and the blood meant your cells weren’t visible enough
* Your cervix was inflamed and the cells weren’t visible enough
* An infection was blocking the view of the cells
* There were not enough cells collected in the first test

You may also be told that your test was borderline. This means cell changes have been noted but they were so very close to normal that they are probably nothing to worry yourself about and they will probably return to normal by themselves. You may be asked to go back and have another test in a few months to monitor the situation. You may also be offered a HPV test as HPV is a cause of cervical cancer. If you do test positive for HPV then you will probably been sent for more tests, including a colposcopy to monitor your cervix and the cell changes.

Cervical erosion can be picked up by smear tests. This is not cervical cancer. This means the glandular cells which are normally found inside your cervical canal are now visible on the surface of your cervix and it can be inflamed. This is a common condition for teenage girls, pregnant women and women on the pill. It can make you bleed slightly but it usually goes away by itself with no need for treatment.

Abnormal Tests Results:
Abnormal results are usually reported like this:
Mild Dyskaryosis or CIN 1(mild or slight cell changes)
If you are told that you have mild cell changes then you will probably be told to get a colposcopy straight away or to wait and have another smear in six months. Sometimes mild cell changes will go back to normal by themselves but it is important to monitor them and go back for any tests advised by your medical team. If a second test shows abnormal cells then a colposcopy is definitely needed to assess the situation. 

Moderate Dyskaryosis or CIN 2 (moderate cell changes)
Treatment will be needed if you have moderate cell changes but you only usually need it once. Then you will have follow up tests to monitor the cells in your cervix. If you have successful treatment after an abnormal smear and carry on having regular smears then you are unlikely to get cervical cancer. If you do not have treatment then you are at real risk of developing cervical cancer

Severe Dyskaryosis or CIN 3 (severe cell changes)
This is also sometimes known as carcinoma in situ (CIS) which sounds like cancer but it isn’t. This means some cells in your cervix look cancerous but are all found in the skin layer which covers your cervix. It won’t be “true” cancer until it breaks through the layer and starts to spread into the surrounding tissue. Urgent treatment is needed for this kind of smear result but if it is moved ASAP then cancer can be prevented.

All these results mean the cells found are pre cancerous meaning if they are left to go untreated, they could develop into cancer of the cervix. YOU DO NOT HAVE CERVICAL CANCER IF YOU ARE TOLD YOU HAVE ABNORMAL CELLS.

9/10 smears come back normal. 1/20 shows a borderline or mild cell change. Most of the time these cells will return to normal by themselves. 1/100 shows moderate cell changes whilst 1/200 show severe changes. Less than 1/1000 shows cancer. 

You don’t have to be over the age of twenty five to develop cervical cancer; some younger women do develop it as well. However, in the UK, smear tests are not encouraged until twenty five because your cervix is still developing in your teens and early twenties. This means the likelihood of you getting an abnormal result is more common but usually nothing to worry about. After Jade Goody’s horrifically young death, a campaign was launched to lower the smear test age limit but medical professionals do not agree with this. If you are under twenty five and are concerned about your cervical cancer risk – please do speak to your GP and get some advice. A private gynaecologist may allow you to have a smear test but it would depend on your individual circumstances.

PLEASE DO NOT BE SCARED TO HAVE A SMEAR TEST – THEY ARE UNCOMFORTABLE AND UNLADYLIKE BUT THEY DO SAVE LIVES! A FEW MINUTES OF DISCOMFORT IS BETTER THEN A BATTLE WITH CERVICAL CANCER!!!

It is also important to note that an abnormal smear result does not mean you have cervical cancer. If you are contacted and told your test was abnormal then please do not ignore it, go and see what your doctors have to say.

Symptoms:

Before I start listing the symptoms, please note that pre cancerous cells do not produce symptoms. This means having a smear test is hugely important – you can catch the cancer before it even develops. It is also important to know that the following symptoms do not instantly mean you have cervical cancer but it is important to go to your doctor if you have any of these symptoms:

* Bleeding between periods

* Bleeding during or after sex

* Bleeding at any time after the menopause

* Discomfort or pain during sex

Treating Abnormal Cells

Should you receive your smear test reveal abnormal cells then it is hugely important that you have treatment. Don't ignore the letter, although I'm sure you'll be terrified. Ask questions, speak to your doctor, seek support from your loved ones but please please please get yourself treated as soon as possible. These cells need to be sorted before they develop into cancer.

There are quite a few different ways to treat abnormal cervical cells. I’ll try to explain the various types of treatment here today. It’s important to remember that treatment is decided based on the type of cells, your own body and the stage the cells are at. If you do have abnormal cells then it is vital to get them treated as soon as you possibly can. Treatment will destroy the abnormal cells before they can become cancerous.

First Steps:

If you have mild cell changes then you may be told to wait six months and have a repeat test. This is because mild cell changes usually sort themselves out. If you have moderate to severe cell changes then you will probably be referred to your local hospital for a colposcopy. This is an outpatient procedure and it is basically a close examination of your cervix which doesn’t actually go inside your vagina. The doctor or nurse specialist uses something like a magnifying glass to look at the cells on your cervix in more detail and takes a biopsy to send to the lab for further examination.

Types of Treatment:

Laser Therapy (Laser Ablation): some cells can be burned away by a laser in an outpatient procedure. For this kind of treatment you will lie on a bed with your legs in stirrups whilst a doctor places a speculum into your vagina to hold it open whilst they point a laser beam at the abnormal areas. You will be given local anaesthetic to numb the area and prevent pain. The laser is a very strong and hot beam of light and it burns away the abnormal cells. This can cause a slight burning smell whist you are having the treatment but that just means the laser is working so try not to worry. You should be able to go home as soon as the treatment is finished. You may experience period type pains but they should go away with the normal paracetamol or ibuprofen and some bed rest.

Cold Coagulation: This name is a little misleading as the treatment isn’t cold at all! You lie on a bed with your legs in stirrups whilst a doctor inserts a speculum to hold your vagina open. A hot probe is then used to burn away the abnormal cells. You shouldn’t be able to feel the probe but it can cause some period type pains which should go away a few hours after the treatment has finished.

Cryotherapy: This is basically cold coagulation but with a cold probe instead of a hot one. The cold probe freezes the abnormal cells. The procedure is exactly the same as the cold coagulation.

Diathermy: This is done under local anaesthetic. An electronic current is used to cut away the tissue that contains the abnormal cells. It is a fairly quick procedure and it usually done as an outpatient case which means you should be able to go home afterwards. It can cause bleeding or discharge for about four weeks after the treatment but sanitary towels will have to be used as tampons have to be avoided for four weeks. Sex must also be avoided for four weeks following a diathermy procedure.

Cone Biopsy: This is a minor operation that can be used to diagnose cervical cancer or to treat abnormal cells. The entire area containing possible abnormal cells is removed. It is called a cone biopsy because a cone shaped area of tissue is removed from the cervix. This is called the transformation zone. This can be done under general or local anaesthetic.

Hysterectomy: If you are past menopause, or have had all your children, then your doctor may suggest removing your uterus. This is usually suggested if you have had abnormal cells more then once or if the cells are severely abnormal.

These treatments do sound rather uncomfortable and scary but it is massively important to have abnormal cells treated to prevent them developing into cervical cancer. Please do remember to book yourself in for a smear if you are due one. As I’ve said before, a little discomfort is nothing compared to a battle with cervical cancer.

If you are worried about HPV or cervical cancer then please contact your GP or visit www.cancerresearchuk.org for more information. If you are reading this and you are above twenty five but haven’t had a smear test for a few years, please book one ASAP. Too many women die from cervical cancer and knowing it is preventable makes their deaths even more tragic. Please don’t put your health at risk.

Jo’s Cervical Cancer Trust is also known as Jo’s Trust and it is the only UK based charity to focus solely on women that have been affected by cervical cancer and their families. They also help women dealing with cervical abnormalities. They aim to offer information, advice, friendship and support to these women, regardless of their age and status. They also try to educate women on the importance of cervical screening and to provide support for the women that have abnormal screening results or ladies that have a cervical cancer diagnosis.

Jo’s Trust has a mission: “Our mission is to see cervical cancer prevented, reduce the impact for everyone affected by cervical abnormalities."

The trust provides support groups, allowing women to come together, bond and share experiences. They also have a helpline to provide support, they have an online forum for people to come together in the comfort of their own home and a yearly meeting for women to get together and enjoy themselves. They also provide many helpful information leaflets which can be found on their website.

Jo’s Trust is a fabulous charity which does amazing things for women in the UK. I wholeheartedly agree with their mission and their core values and I would love to see them succeed and help make cervical cancer a thing of the past. Please do check out their website and find out ways to help them achieve their goals. You can also find them on twitter @JosTrust

Breast Cancer Awareness Month 2017

October is Breast Cancer Awareness Month so I wanted to use this blog post to raise awareness. Breast cancer is one of the most common cancers and I know many women (and men) that have suffered from this cancer type. This post is dedicated to all my friends that have been affected by breast cancer in some way. 

Whilst I may reference women in this post, it is hugely important that men be aware that they can also develop breast cancer. It appears to be a taboo subject but I personally know a man that was diagnosed with breast cancer and it is very important for men to also be aware to check for lumps.

The Breast:

Breasts are made up of fat, gland tissue and connective tissue which is divided into lobes. A network of ducts spread from these lobes towards the nipple. Breasts are not usually the exact same size as each other and they can also vary in size and shape throughout your monthly cycle. They also change with age – younger women have a lot more glandular tissue so their breasts are usually more dense. After the menopause this tissue is gradually replaced by fat, which is less dense.

Breast Cancer Symptoms:

As with all cancers; the earlier breast cancer is found, the easier it is to treat. This means ladies need to be aware of what is normal for their breasts. You need to regularly have a good old feel of your breasts so you become used to how they look and feel. That way it will be easy for you to spot any changes that may actually be cancer symptoms. Do not panic as about 90% of breast lumps are not cancerous but if you do think something is not right, it is vital that you visit your GP ASAP.

The most common symptoms of breast cancer is a lump or some thickened tissue in their breast. There are also other symptoms to watch out for:

• A change to the size or shape of one or both breasts
• Nipple discharge
• A lump in your armpit
• Dimpling on the skin of your breasts
• A rash on or around your nipples
• A change in how your nipple looks (for example it can become sunken or invert into your breast)
• A pain in your breast or armpit that is not period related

It is hugely important to know what is normal for your breasts so I fully encourage everyone to regularly feel their breasts. Just after a shower is probably the best time. 

KNOW YOUR BOOBS LADIES AND GENTLEMEN!!!

Types of Breast Cancer:

Lobular Carcinoma in Situ (LCIS)

This is not cancer. LCIS means cells changes have occurred inside your breast lobes and you have an increased risk of developing breast cancer in the future as a result. However most women with LCIS do not get breast cancer. LCIS is also found in men but this is very rare.

If you are diagnosed with LCIS then you will need to be monitored closely. Your doctor may suggest  breast examinations every six months and mammograms every year. You may also be offered hormone therapy to lower your risk of breast cancer. This monitoring is vital as cancer is easier to treat, the earlier it is diagnosed.

Ductal Carcinoma in Situ (DCIS)

DCIS is cancer that has developed inside some of your ducts but has not started to spread into the surrounding breast tissue. There is very little chance that this type of cancer will have spread to your lymph nodes or other parts of your body

In most cases, the main treatment for DCIS is surgery. Usually the area of DCIS and some healthy surrounding tissue will be removed. This is known as local excision. Radiotherapy may also be required after surgery to ensure any stray cells are caught and destroyed.

Tamoxifen may be prescribed for you after treatment. This is a type of hormone therapy which will help protect you from developing breast cancer again in the future.

Invasive Ductal Breast Cancer

This is the most common type of breast cancer. Around 70-80 out of every 100 breast cancer cases are invasive ductal breast cancer (80%)

This cancer will have started in the cells lining the breast ducts and it will have spread into the surrounding breast tissue.

Treatment varies depending on the staging and grading of the cancer. You may be offered surgery to remove the cancer and some surrounding healthy tissue. This will be followed by radiotherapy or chemotherapy to destroy any remaining stray cells. Radiotherapy or Chemotherapy may be used to shrink the cancer before surgery. You may also be offered hormone therapy. Your specialist will discuss the options with you as they vary for every patient.

Invasive Lobular Breast Cancer

About 10% of breast cancer cases are invasive lobular carcinoma. It is mostly found in women aged between 45 and 55. This type of cancer will have started in the cells that line the lobules of your breast. This type of cancer is also found in men but it is very rare. This type of cancer can be hard to diagnose as it does not always create a firm lump in your breast nor does it show up on mammograms.

Treatment for this type of breast cancer will usually involve surgery to remove the cancer and some surrounding healthy tissue.  This will normally be followed by radiotherapy or chemotherapy to destroy any stray cells left behind. Hormone therapy may also be recommended.

Inflammatory Breast Cancer

This is a very rare type of breast cancer, only about 4% of breast cancer cases are inflammatory breast cancer.  The breast tissue will have become inflamed and the cancer cells will be blocking the smallest lymph node channels in your breast. This will cause your breast to become swollen, hard, read and hot to touch. It can also be painful. It may also cause nipple discharge and your nipple may become inverted.

Chemotherapy is usually the first form of treatment and that is normally followed by surgery. Radiotherapy may also be an option.

Mammograms - Screening for Breast Cancer

The NHS Breast Screening Programme means women aged between fifty and seventy are invited for breast screening every three years in the UK. Each country within the UK has their own guidelines and screening programme but the age limits in the UK have been extended to cover women between forty seven and seventy seven whilst Scotland, Wales and Northern Ireland have stuck with the original age guidelines.

The aim of the programme is to discover breast cancer at an early stage to give sufferers a much better chance of survival. As I mention a lot – CANCER IS EASIER TO TREAT THE EARLIER IT IS DIAGNOSED.

Women at high risk of developing breast cancer or women that have discovered lumps or breast changes may also be invited to take part in the screening programme.

What is a Mammogram?

A mammogram is an x-ray of breast tissue and is used to identify early breast cancer. You have to remove all clothing on your upper body, including your bra to have a mammogram and are positioned so that both breasts are x-rayed individually. This means your breasts are gently squashed with a clear, flat plastic plate. This means you can get a clear picture whilst having a minimal amount of radiation. It can be uncomfortable but it doesn’t take very long. Most radiographers aim for two mammograms, at different angles, for both breasts.

A new technique is currently being introduced. This is known as digital mammogram and this uses computer imaging. This new technique has been shown to be better at picking up breast cancer in younger women and those with denser breast tissue.

Some Important Facts about Mammograms:

*Mammograms do not prevent cancer but they can discover a cancer that has already developed.

*Mammograms can be uncomfortable but this does not usually last long. Some women may be a little sore afterwards

*Mammograms involve x-rays which mean you will be exposed to a small amount of radiation, although it is not likely to be a harmful amount and as you only need a mammogram every three years it is unlikely to have a large effect in the long run.

*Can sometimes produce false positives which can cause a huge amount of unnecessary worry. Sometimes mammograms pick up on an abnormal area in the breast which later proves to be non cancerous.

*Occasionally mammograms need to be repeated due to blurry images, equipment failure or parts of the breast being missed by the original images.

*Mammograms are the most effective way of detecting early breast cancer but it is not 100% accurate at all times. Sometimes cancers are too small to be detected on a mammogram or the person reading it may miss a cancer, although this risk is reduced by having at least two people check the mammogram

*Women taking part of the programme may still develop breast cancer between mammograms. This is called interval cancer and the patient will have a mammogram done at the time of diagnosis so it can be compared to previous ones to notice any patterns. It is important to note that cure rates for women with interval cancer are a lot better then those for women that have never had screening.

Breast screening is hugely important, especially for women in the age group mentioned above as well as those at high risk of developing breast cancer. If you receive an invitation for a mammogram then please do have one! If you are worried about it then you should talk to your GP or nurse as soon as you can. A mammogram can save your life!

What is a Mastectomy?

A mastectomy is the removal of a whole breast. There are five different types of mastectomy:

Simple or Total Mastectomy - This concentrates on the breast tissue itself. The surgeon removes the entire breast but does not usually remove the lymph nodes located in the armpit (although this can happen occasionally if the lymph nodes are found in the breast tissue during the surgery). No muscles are removed from underneath the breast during this type of mastectomy.

A SIMPLE OR TOTAL MASTECTOMY IS USUALLY APPROPRIATE FOR WOMEN WITH LARGE AREAS OF DCIS OR MULTIPLE DCIS. IT IS USUALLY APPROPRIATE FOR WOMEN SEEKING PREVENTATIVE MASTECTOMIES.

Modified Radical Mastectomy – This involves removal of both the breast tissue and lymph nodes. The entire breast is removed by the surgeon and an axillary lymph node dissection is performed to remove level I and II of the lymph nodes in your armpit. No muscles from underneath the breast are removed.

PEOPLE WITH INVASIVE BREAST CANCER MAY HAVE A MODIFIED RADICAL MASTECTOMY SO THAT THEIR LYMPH NODES CAN BE EXAMINED AS THIS WILL ALLOW THE SPECIALIST TO DETERMINE IF THE CANCER HAS SPREAD BEYOND THE BREAST.

Radical Mastectomy – This is the most extensive type of mastectomy and involves removing the entire breast, level I, II and III of the armpit lymph nodes and the chest wall muscles found under the breast.

RADICAL MASTECTOMIES ARE ONLY RECOMMENDED FOR PEOPLE WHOSE BREAST CANCER HAS SPREAD TO THE MUSCLES UNDER THE BREAST. THIS USED TO BE A VERY COMMON TYPE OF MASTECTOMY BUT THE MODIFIED VERSION HAS PROVED TO BE JUST AS EFFECTIVE BUT FAR LESS DISFIGURING.

Partial Mastectomy – This involves removing the cancerous part of the breast tissue and normal margins of healthy tissue around it. This is kind of like a lumpectomy, although more tissue is removed.

Subcutaneous Mastectomy (Nipple Sparing) – This is seen as a controversial option by some specialists as  all of the breast tissue is removed but the nipple is not touched and as some tissue could be left behind and develop into cancer. It can cause distortion or numbness in the nipple.

Reasons to Have a Mastectomy:

A mastectomy is a huge surgical procedure with lifelong repercussions so it isn’t for everyone. It could be the best way forward for you if you fit any of the following criteria:

*If your tumour is over 5cm

*If your breast is small and a lumpectomy would leave very little scar tissue

*If you have already undergone multiple lumpectomies to try and remove a tumour and have been unable to obtain clear margins.

*If a lumpectomy and radiation is not an option for you

*If you believe total removal of breast tissue would give you better peace of mind then a lumpectomy

Breast Reconstruction Surgery:

It may be possible for you to have your breasts reconstructed during the same surgical procedure as the mastectomy. This is known as immediate reconstruction. An advantage of this may be sparing yourself the trauma of having an empty space where your breast used to be. However, the decision to reconstruct your breast on top of having a mastectomy may be too much emotionally and physically so you may also wait months or years to have your reconstructive surgery.

There are many different techniques available for breast reconstruction, including inserting an implant or tissue from another body part.

You Are Not Alone:

Lots of people have been through this procedure, some for preventative reasons and others because they have had breast cancer. In recent years celebrities such as Sharon Osbourne, Michelle Heaton, Giuliana Rancic and Christina Applegate have all had mastectomies.

If you are a breast cancer survivor, are currently undergoing treatment for breast cancer, are supporting a loved one or have lost someone you love then I'm sending you lots of love and dedicating this rather long post to you all xxxx

If you are worried about breast cancer then please do visit www.cancerresearchuk.org or make an appointment to speak with your GP ASAP.

Childhood Cancer Awareness Month 2017

September is Childhood Cancer Awareness Month in the UK. I don’t think I need to mention why this cause is so close to my heart but I do feel it is important to get the facts and figures out there for people to see. So here are some facts about childhood cancer for you:

The cancers seen in children are usually very different to those seen in adults and “childhood” refers to any child aged between birth and fourteen years old.

There are twelve main types of childhood cancer:

*Leukaemia

*Soft Tissue Sarcomas

*Kidney Tumours

*Brain and Central Nervous System (CNS)

*Bone Tumours (Like the one Georgie had)

*Carcinomas and Melanomas

*Retinoblastomas

*Gonadal and Germ Cell Tumours

*Liver Tumours

*Sympathetic Nervous System Tumours

*Other and Unspecified Tumours

Childhood cancer is quite rare and makes up 5% of all cancers. Around 1,600 children in the UK are diagnosed with cancer every year, which roughly works out at thirty one children per week. Around one in every five hundred children in the UK will be diagnosed with cancer.

The UK’s childhood cancer rates are amongst the lowest in Europe, with Northen Europe having the highest incidence rate.

Leukeamia is the most common childhood cancer. Two thirds of all childhood cancers are  leukeamia, brain and CNS tumours and lymphomas.

Surviving Childhood Cancer:

More children then ever are surviving cancer. The survival rate has doubled since the 1960’s and at least 5,600 MORE children now survive for more then five years after diagnosis.

Around 33,000 people in the UK have survived a type of childhood cancer and almost three quarters of children with cancer can now be cured of the disease.

For every ten childhood cancer sufferers – eight will now survive for more then five years after their diagnosis:

*Nearly all children diagnosed with retinoblastoma are cured.

*Survival rates for Hepatoblastoma have doubled since the 1960’s.

*Around six out of ten children diagnosed with neuroblastoma are cured.

*Eight out of ten children with kidney cancer survive the disease.

*Rhabdomyosarcoma survival rates have doubled since the 1970’s.

Childhood cancer deaths:

Cancer is the UK’s leading cause of death (from disease) in children aged up to fourteen. A fifth of all childhood deaths are down to cancer.

Brain and CNS tumours are the most common fatal type of childhood cancer.

Around two hundred and fifty children die from cancer every year in the UK.

Childhood cancer death rates have halved since the 1960’s.

Causes of Childhood Cancer:

We don’t know much about what causes childhood cancers but there are several things we do know:

*Rare genetic syndromes such as Li-Fraumeni Syndrome (what Georgie had) can greatly increase a child’s risk of developing cancer.

*Children with Down ’s syndrome have a greater risk of developing leukaemia.

*2/5 retinoblastomas are linked to a faulty gene that has been inherited.

*Children that have had radiotherapy or chemotherapy in the past are at greater risk of developing a second cancer (As Georgie did)

Having watched a loved one fight childhood cancer, my heart breaks for every family going through the same thing. Sending lots of love to all the incredible children out there fighting cancer. 

I will be doing more posts throughout the month to highlight childhood cancer. I will also be doing some blogs for Children with Cancer UK so look out for those too.

My aunt has written a book about Georgie and his story as a childhood cancer sufferer. I will warn you it is a difficult read, but it does give insight into life as a family affected by this horrific disease. If you would like to read it, the book is available on Amazon: https://www.amazon.co.uk/Love-George-Irene-Kappes/dp/1502741482/ref=sr_1_1?s=books&ie=UTF8&qid=1504421560&sr=1-1&keywords=For+the+love+of+George

A percentage of all sales goes to the George Pantizarka TP53 Trust, the charity founded by my family in Georgie's memory.

xx

Cancer Research UK Annual Review 2016/2017

This is one of my favourite blogs to do every year!

A frequent question myself and other CRUK volunteers are asked is "where does my donation go?" People are aware that millions are donated every year but many aren't aware of what these funds are spent on. CRUK have released their annual review and, as usual, I'm going to break it down so that people can see where the money is going.

Let me first explain that 80p of every £1 donated is spent on research. That is a huge amount and probably one of the best in the third sector. The other 20p is used to raise funds for the future

Let me first point out that CRUK does not receive any government funding for their research. Government funds for medical research are spent via the Medical Research Council and National Institue for Health Research. CRUK is an independent medical research charity so the money spent on our research is all generated by our supporters.

£647 Million was raised by CRUK Supporters between April 2016 and March 2017:

*£187 Million was raised by legacies (People leaving money in their wills)

*£190 Million was raised by regular donations (there are over 1 million people making regular donations)

*£102 Million was raised by trading (the CRUK shops)

*£65 Million was raised by over 600,000 people taking part in events (for example Race for Life, Shine, Dryathlon etc…..)

*92 Million was raised by Royalties and Grants (Royalties = generated from treatments developed by CRUK, Grants = received by CRUK institutes)

*11Million was raised in other forms – i.e. investments and rental income from the lease of a lab.

9/10 donations are less than £10 which goes to show that every penny really does count and giving what you can afford, even if it isn’t a lot, really can make a huge difference.

£432 Million was spent on Research between April 2016 and March 2017:

*112 Million was spent on researching the biology of cancer

*43 Million was spent on lung cancer research

*35 Million was spent on bowel cancer research

*33 Million was spent on breast cancer research

*22 Million was spent on prostate cancer research

*18 Million was spent on leukaemia cancer research

*17 Million was spent on pancreatic cancer research

*13 Million was spent on brain cancer research

*13 Million was spent on ovarian cancer research

*13 Million was spent on over 100 cancers including stomach and testicular

*12 Million was spent on oesophageal cancer research

*12 Million was spent on melanoma research

*9 Million was spent on non Hodgkin lymphoma research

*5 Million was spent on sarcoma research

*4 Million was spent on liver cancer research

*4 Million was spent on myeloma research

*4 Million was spent on bladder cancer research

*4 Million was spent on kidney cancer research

*4 Million was spent on neuroblastoma research

*3 Million was spent on cervical cancer research

*3 Million was spent on skin cancer (excluding melanoma) research

*3 Million was spent on pharyngeal cancer research

If you are upset or concerned that not enough is being spent on a particular cancer type, please be reassured that the National Cancer Research Institute (NCRI) is there to spread research throughout it’s partners and make sure research is not being duplicated by charities – so a cancer type particularly close to your heart may be receiving more research from another charity partner within the NCRI.

The rest of the CRUK funds for this financial year were spent like this:

*41 Million was spent on information and policy work such as early diagnosis, prevention, campaigning, communicating health messages and engaging patients, the public and health professionals

*108 Million was spent on fundraising such as marketing to engage new supporters and developing new ways to fundraise

*85 Million was spent on trading costs such as stock, rent, electricity and salaries for CRUK shops and their managers.

Improving Fundraising:

It is important to note that since July 2017 CRUK has become an opt in charity, which means supporters are asked if they wish to give the charity permission to contact them before asking for more support – if you choose to not give permission then you will not receive any marketing or fundraising requests from the charity.

Key Stats:

*over 40,000 volunteers (like me!) gave millions of hours to the charity during the last year.

*12,000 queries were answered by the Helpline nurses

*220 clinical trials were supported by CRUK across the UK

*12,000 face to face engagements with healthcare organisations took place during the year.4

*2.6 Million read the CRUK science blog

*15.7 Million pounds were raised during the third Stand Up To Cancer TV show.

*770 People (like me!) joined the Patient Involvement Network to help improve CRUK’s work

*116 PHD students started working for CRUK this year

If you would like to know more specific information, including the successes the charity had during this financial year, please check the annual review, which is available to download on the CRUK website.

A huge thank you to everyone that supports CRUK every year – we are making progress!!

Cancer Types – Neuroblastoma

I think most people have heard of Bradley Lowery by now, but just in case you haven’t, he was a young boy who touched the nation’s hearts as a young football fan stricken by a rare childhood cancer. He united the football world with “cancer has no colours” as many tried to create lovely experiences and memories for him during the last few months of his life.

Sadly Bradley passed away on Friday 7^th July 2017 at the age of six. Like so many other people across the UK, I have been touched by Bradley’s cheeky smile and he has inspired me to restart this blog. Today’s post is dedicated to this wonderful boy and his family.

What is Neuroblastoma?

Neuroblastoma is a rare childhood cancer, mostly affecting children under the age of five. In the UK there are around one hundred cases diagnosed per year. It is rarely seen in older children, teenagers or adults.

Neuroblastoma gets its name from the nerve cells it develops in – neuroblasts:

                *neuro = nerves

                *blast = early developed cells

                *oma = tumour

Neuroblastoma usually starts in the abdomen – in the adrenal glands or the nerve tissue found at the back of the abdomen. As with many cancers, it spreads to other parts of the body such as bones, liver and skin via the blood and lymphatic system. This is usually found in half of neuroblastoma sufferers.

Causes of Neuroblastoma:

Unfortunately not much is known about the causes of this cancer type at present, although research is being carried out. Around 1/100 cases will find a family history of this cancer type but this is very rare.

 Symptoms of Neuroblastoma:

Symptoms for this cancer type, like most of them, will depend on which part of the body the cancer has started in. If the cancer has already spread then symptoms may appear in more than one place.

As neuroblastoma usually develops in the abdomen the most common symptom is a lump in the tummy, which can cause the child’s stomach to swell and cause discomfort and pain.

In the occasion that it affects the spinal cord it can cause numbness and loss of movement in the lower body, as well as weakness.

On rare occasions it can appear as a lump in the neck and can cause breathlessness or difficulty swallowing.

Neuroblastoma tumours usually spread to the bones which can cause pain and swelling as well as difficulty walking.

Any of these symptoms should be urgently investigated by a doctor. It is hugely important that any lumps found in children, especially those in the abdomen, are referred to a specialist within 2 days of being presented at A&E or to your GP. If you are concerned by symptoms found in your child, please push your medical professional for an urgent referral.

Diagnosing Neuroblastoma:

As with most cancers, there are a variety of tests which can be used to diagnose the cancer as well as determine its stage. These tests are not normally painful but some may require sedation, especially for young children.

Tests could include:

*Blood tests

*Chest X Ray

*CT, MRI or Bone Scans

*A biopsy or bone marrow biopsy

*Urine tests

*MIBG –this is a particular scan to diagnose neuroblastoma as they absorb a substance called MIBG. The doctor will attached a small amount of radioactive iodine to MIBG and inject it into the bloodstream. The neuroblastoma cells pick up the MIBG and the iodine shows up on the scan.

Treating Neuroblastoma:

As with all cancers, treatment for neuroblastoma is dependent on the stage of the tumour, and the risk group of the patient – i.e. how likely is the cancer to return at a later date.

The most common treatment for this cancer type are:

*Surgery – the surgeon will try to remove the whole tumour, or as much as possible. If the tumour hasn’t spread then surgery may be the only treatment required, providing the surgeon is able to get the whole tumour and clear margins around it.

*Chemotherapy – This can be used to kill the cancer cells. Doctors may use two or three different types of chemo. The main side effects will include tiredness, hair loss, nausea and an increased infection risk. A central line will be inserted for the child to receive the chemo and will be kept in place for the duration of their treatment. We used to call Georgie’s his wiggly when he was little.

*Radiotherapy – Children with advanced neuroblastoma may require targeted radiotherapy, which is similar to the MIBG process I explained above. However, children needing this may require a stem cell transplant as the dose of radioactive iodine may damage the bone marrow.  A stem cell transplant is done by doctors who collect some blood stem cells from the patient before treatment and store them until the child is ready to have them injected back into their body after treatment.

*Immunotherapy - This is a type of drug treatment used to help the immune system kill cancer cells. It’s a biological therapy which is often used if there is a high risk of the child developing neuroblastoma again.

Recurrent neuroblastoma (where the disease had been treated previously but has returned) depends on a number of factors. This can be treated the same way it was treated previously but usually the treatment is much more intense and will include a number of the treatments mentioned above. Clinical trial treatments may also be offered.

Long Term Effects of Neuroblastoma:

Your specialist should talk to you about the possible long term effects of cancer on your child. As treatments improve these effects are lessening but they are still there. The risks include fertility issues, hearing problems, changes in the heart and kidneys, growth problems and the risk of developing a second cancer. Childhood cancer sufferers should be closely monitored as they grow up and should have access to doctors and information regarding these effects.

Research is being conducted into various issues surrounding this cancer type, including causes, diagnosis and improving treatments for it. It is a particularly cruel cancer as it affects young children and a lot of work is being put into trying to find out more about it to improve survival rates.

Obviously, your child being diagnosed with cancer is unimaginable and truly horrific. Should you be concerned then there are people that can help:

The Neuroblastoma Society is run by parents and grandparents of neuroblastoma sufferers and they have a befriending scheme for affected families.

The Children’s Cancer and Leukaemia Group (CCLG) produces booklets for parents and siblings of childhood cancer sufferers which can be incredibly helpful. I have very dear friends that are part of this group and can personally vouch for their dedication and knowledge.

You can also contact the Cancer Research UK information nurses on 0808 800 4040 between 9am and 5pm Monday to Friday. They can offer advice on what support is available. This is a Freephone number.

Regular readers of this blog will know that childhood cancer is something my family has been affected by, and a subject very close to my heart. I send lots of love and good wishes to all sufferers and their families.

xxx