Most nights I wake up in terrible sweats. Sometimes my sleepwear is damp and I have to lay down a towel to protect the bedding. My doctor said it could be a sign of blood cancer and ordered some tests. Should I be worried?
It is important to see a GP if you suffer from night sweats. This is a common symptom that many people struggle with from time to time, such as during the summer or when you have an infection. But if there is no clear reason for the problem, a check is essential.
Night sweats can be a sign of something serious, including a type of blood cancer called myeloma. But more often than not, they’re caused by something non-sinister, like menopause, an infection, side effects from medications, or heavy drinking.
If the sweats are accompanied by weight loss, this is cause for concern. Together, these symptoms can indicate the cancers of myeloma and lymphoma, or even the bacterial infection of tuberculosis.
Patients will still have tests, usually starting with blood and urine tests and a chest X-ray. Other tests in a hospital setting, such as an MRI and/or a bone biopsy, may be needed.
Today’s reader is investigating whether her mysterious night sweats could be the 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 main risk factors are old age, black ethnicity and, in some cases, obesity.
Fortunately, the prognosis for myeloma is often very good. Treatments have also improved dramatically over the past two 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 types of antidepressant medications. The family of drugs prescribed most often is called selective serotonin reuptake inhibitors or SSRIs. They also treat anxiety, eating disorders, OCD, and even irritable bowel syndrome.
More Dr Ellie Cannon for The Mail on Sunday…
Citalopram and escitalopram are two of the eight SSRIs available. These drugs increase levels of the hormone serotonin in the brain, which is thought to have some effect on our emotions and mood.
But they are not effective for everyone. Some people find that they benefit more from therapy when they take medication.
Citalopram is recommended for use in depression and panic. Escitalopram, however, has a wider field of use. It can also be prescribed for OCD, panic and social anxiety. They are slightly different chemically. This means that you need higher doses of citalopram than escitalopram to treat depression.
Efficacy and side effects may also be different. It is impossible to say whether one antidepressant is better than another. Studies show that it is very difficult to predict how a person will react to an antidepressant. It should be remembered that part of the population will not find them useful at all.
A GP should recommend that you try one type for around six weeks before considering switching to another or changing the dose.
Shortly after a Covid recall in December 2021, I developed a chest cough that won’t budge. My lungs are often sore and irritated and I produce mucus. Doctors have tried everything – antihistamines, acid reflux medications and inhalers – but nothing works. What can I do?
This can be very difficult when there is no simple explanation for a patient’s problem. Uncertainty brings a level of distress that can make symptoms worse. Continuous “fat” coughs are an example.
It is certainly worth pursuing a referral to a respiratory health specialist at the local hospital. This overproduction of mucus is referred to by doctors as catarrh, which can result from a number of lung conditions.
GPs have recently seen many patients with this symptom, mostly following a previous Covid infection. Chronic mucus production can also be linked to acid reflux and postnasal drip — when mucus from your nose or sinuses leaks down the back of your throat. But both of these issues would quickly resolve with treatment.
A reader worries about a cough he developed after receiving the Covid booster shot
Doctors may want to test a sample of mucus to see what type of infection may be present in the lungs. These symptoms are often seen in chronic bronchitis, a long-term lung disease commonly present in smokers.
Another important diagnosis to consider is bronchiectasis – a range of lung conditions involving patients producing mucus and coughing persistently. Inflammation of the lungs damages the airways, leading to various problems.
In adults, bronchiectasis is often the result of a childhood infection such as tuberculosis or pneumonia, but it can also be triggered by autoimmune diseases and fungal allergies.
Bronchiectasis can also develop from a Covid infection – respiratory experts at a hospital would be able to identify this.
Don’t ignore your gut test kit – it could save your life
Don’t forget to take your bowel cancer screening test, if you have had one.
In England, adults aged 60-74 receive a kit, pictured left, in the post every two years. It is now also being sent to people aged 56 and 58 as the program is expanded. I support NHS England’s drive to get people to take the test, sparked by research showing a third of eligible people don’t care.
There is no doubt that testing saves lives. Treatment is nine times more likely to be successful if the disease is detected early.
I was able to see this a few weeks ago with a patient, she had no symptoms but the cancer was detected very early thanks to her screening test.
Nothing could be easier to do: use the stick to take a sample of your business, put it in the jar and send it back.
A scan can detect traces of blood that you wouldn’t see, which could indicate cancer.
My best advice is to put it next to the toilet when it arrives – that way you won’t be able to forget it.
There is no doubt that testing saves lives. Treatment is nine times more likely to be successful if the disease is detected early. I was able to see this with a patient a few weeks ago, she had no symptoms but the cancer was detected very early thanks to her screening test.
Minimal compliance with the Covid study
The impact of the pandemic on mental health has been “minimal”, according to a study published last week.
I admit I was surprised to read this, but as I looked at the results I found that they simply confirmed what GPs had been saying all along: that adults in high-income countries, like the UK United, experienced only minor deterioration. in mental health. However, women, the elderly and minorities have been the most affected.
You were more likely to do well if you were well off and worked, which makes sense. But the study excluded those we know to be most affected by the pandemic: children, young people and anyone with existing mental health conditions.
I take this study with a grain of salt, because those whose policies have made our children’s lives hell still have a lot to answer.
