DR. ELLIE CANNON: I wake up with night sweats… could this be a sign of blood cancer?

Most nights I wake up with terrible sweats. Sometimes my nightwear is damp and I need to put a towel underneath to protect the linens. My doctor said it could be a sign of blood cancer and ordered tests. Should I be concerned?

It is important to see a GP if you suffer from night sweats. They’re a common symptom that many people struggle with from time to time, such as during the summer or when you have an infection. But when there is no clear cause of the problem, checking is essential.

Night sweats can be a sign of something serious — including a type of blood cancer called myeloma. But most commonly, they’re caused by something not sinister, like menopause, an infection, the side effects of medication, or heavy drinking.

If the sweats are accompanied by weight loss, that’s a cause for concern. Together, these symptoms can point to the cancers myeloma and lymphoma, or even the bacterial infection tuberculosis.

Patients always undergo evaluations, which usually begin with blood and urine tests and a chest X-ray. It is possible that further tests are required in the hospital, e.g. B. an MRI scan and/or a bone biopsy.

Today’s reader seeks advice on whether her mysterious night sweats could be a result of blood cancer

Myeloma is a cancer of one of the types of blood cells that affects the immune system, bones, and kidneys. It may be more common in people with a family history of the disease, but the biggest risk factors are age, black ethnicity, and in some cases obesity.

Fortunately, the prognosis for myeloma is often very good. Treatments have also improved greatly over the past few decades. More than half of patients survive at least five years after diagnosis, according to Cancer Research UK.

I am very interested in your articles on depression and anxiety. My GP recently recommended that I start taking antidepressants. Can you tell me which of citalopram and escitalopram is better to take? She also thinks I should start therapy. I am 72 years old.

There are many different types of antidepressants. The family of drugs most commonly prescribed are called selective serotonin reuptake inhibitors, or SSRIs. They also treat anxiety, eating disorders, obsessive-compulsive disorder, and even irritable bowel syndrome.

Citalopram and escitalopram are two of the eight available SSRIs. These drugs increase levels of the brain hormone serotonin, which is thought to have an impact on our emotions and mood.

But they are not effective for everyone. Some people find that they get more benefit from therapy when they are on medication.

Citalopram is recommended for use in depression and panic. However, escitalopram has a broader scope of application. It can also be prescribed for OCD, panic, and social anxiety. They differ slightly chemically. This means you need higher doses of citalopram than escitalopram to treat depression.

Efficacy and side effects may also vary. It’s impossible to say if one antidepressant is better than another. Studies show that it is very difficult to predict how a person will respond to an antidepressant. It is worth remembering that part of the population will not find them helpful at all.

A GP should recommend testing one type for about six weeks before considering switching to another or changing the dose.

Shortly after a Covid refresher in December 2021, I developed a hacking cough that will not shift. My lungs often feel sore and irritated and I produce mucus. Doctors have tried everything – antihistamines, heartburn medication and inhalers – but nothing works. What can I do?

It can be very difficult when there is no simple explanation for a patient’s problem. The uncertainty brings with it a level of stress that can make symptoms worse. An example of this is a persistent, “wet” cough.

It is definitely worth arranging a referral to a respiratory specialist at the local hospital. This overproduction of mucus is what doctors call catarrh, which can result from a number of lung diseases.

Family doctors have recently seen many patients with this symptom, mainly as a result of a previous Covid infection. Chronic mucus production can also be related to acid reflux and postnasal drip — when mucus from your nose or sinuses drips down your throat. But both of these problems would quickly resolve with treatment.

A reader is concerned about a cough he developed after receiving the Covid booster shot

Doctors may want to test a sample of mucus to determine what type of infection is present in the lungs. These symptoms are common with chronic bronchitis, which is common in smokers.

Another important diagnosis to consider is bronchiectasis – a range of lung diseases in which patients produce mucus and cough persistently. Inflammation in the lungs causes damage to the airways, leading to a variety of problems.

In adults, bronchiectasis is often the result of childhood infections such as tuberculosis or pneumonia, but can also be triggered by autoimmune diseases and fungal allergies.

Bronchiectasis can also develop due to a Covid infection – a hospital respiratory expert could detect this.

Don’t ignore your gut test kit – it could save your life

Please don’t forget to take your colon cancer screening test if you have one.

In England, adults aged 60-74 receive a set, pictured left, in the mail every two years. It will now also be sent to the 56 and 58 year olds as the program expands. I support NHS England’s efforts to get people to actually take the test, sparked by research showing a third of those eligible don’t care.

There is no doubt that the tests are life-saving. Treatment is nine times more likely to succeed if the disease is caught early.

I saw this for myself a few weeks ago with a patient – ​​she had no symptoms but the cancer was caught at a very early stage thanks to her screening test.

It couldn’t be easier: Take a sample of your company with the stick, put it in the pot and send it back.

An analysis can detect traces of blood you wouldn’t see, which can indicate cancer.

My top tip is to put it next to the loo when it arrives – that way you don’t forget it.

There is no doubt that the tests are life-saving. Treatment is nine times more likely to succeed if the disease is caught early. I saw this for myself a few weeks ago with a patient – she had no symptoms but the cancer was caught at a very early stage thanks to her screening test

Minimal respect for the Covid study

According to a study published last week, the impact of the pandemic on mental health has been “minimal”.

I admit I was surprised to read this, but when I looked at the results I discovered that they simply confirmed what GPs have been saying all along: that adults in high-income countries like the UK only have a minor Deterioration experienced in mental health. However, women, the elderly and minorities were more affected.

You were more likely to be well if you were well and working, which makes sense. However, the study excluded those we know have been hardest hit by the pandemic: children, adolescents and anyone with existing mental health problems.

I take this study with a pinch of salt, as those whose policies have made our children’s lives miserable still have a lot to answer for.