DR. ELLIE CANNON: My breast is not lumpy, but it itches. Should I be worried about cancer at age 72?

I have recently been suffering from an annoying itch in the middle of my left breast. I checked for lumps but can’t find anything out of the ordinary other than a white spot on the nipple. Should I see my doctor? I am 72 and on low dose HRT.

Breast changes in a woman over 70 should always be checked by a doctor. It’s unlikely to be cancer, but there’s always a chance it could be.

Typical symptoms are itching and a lump or changes in the size and shape of the breast. A difference in the appearance of the skin is also a problem, such as B. a rash or pitting of the skin.

Nipple changes are very important – look for color changes, discharge or if they turn inwards.

A rare type of breast cancer called Paget’s disease that specifically affects the nipple and causes skin changes that can look a bit like eczema.

Other types of cancer can also cause symptoms that affect the nipple. Therefore, these changes are always taken seriously in older women and usually lead to referral to a breast clinic.

Assessing potential breast problems involves more than a mammogram. An exam at a breast clinic will also include an ultrasound and possibly a biopsy. If you decide to have a mammogram alone, you run the risk of missing out.

Every three years, all women between the ages of 50 and 70 are entitled to a breast examination. People over 70 can request a mammogram by contacting local breast screening services, but the GP is the first point of contact.

Of course, like any other part of the body, the breast and nipple can be affected by minor skin problems. Itching can be caused by dry skin, dermatitis or irritation.

I suffer from terrible asthma and seem to get constant chest infections that make it hard for me to breathe. For about a week my back has been so bad that I have to lie down. Could the two things be related?

It is not uncommon for people with severe asthma to struggle with back pain, especially if they are prone to respiratory infections, which themselves can cause pain. This may be due to a complication of the infection itself. An example is pleurisy – when the layers that cover the lungs become inflamed.

People who suffer from severe asthma should be closely monitored medically, especially if they have frequent respiratory infections. Pulmonary function tests or a specialist assessment may be necessary.

Asthma can cause coughs, which can often lead to muscle tension and pain. It is also possible to get a bad back from lack of exercise and shortness of breath.

However, back pain is very common and is often caused by an awkward movement or tension, so it cannot be linked to asthma. Doctors refer to this as “simple” back pain to reassure patients that the pain is not serious.

Back pain usually lasts about six weeks per episode and it is common for patients to want to lie down, but doctors do not recommend bed rest – gentle exercise is the key to recovery. Helpful steps are detailed on the NHS website. Taking regular pain relievers is helpful because it allows you to move more comfortably. Non-medical pain relievers such as heating pads or acupuncture can also help.

Try seeing an osteopath or physical therapist for more support.

My 30-year-old daughter developed polycystic ovary syndrome in her late teens and has suffered from terrible facial hair growth ever since. I was wondering if there are any new treatments for these symptoms? The doctor prescribed a cream and the pill, but neither helped. Would removing her ovaries help?

Polycystic ovary syndrome, often known as PCOS, is a common condition in which multiple cysts develop on the ovaries. But cysts alone do not mean you have the condition.

Many women have cysts on their ovaries and have no symptoms. A diagnosis is made only when blood counts are abnormal and the patient suffers from irregular periods, excessive hair growth and fertility problems. The condition is also associated with weight gain.

Treatment is very dependent on what a patient wants, as symptoms vary greatly from person to person.

Removal of the ovaries will not be an option. This will plunge one into a sudden and extreme menopause, which is inappropriate for young women who may want to start a family.

PCOS is linked to problems with insulin – the hormone that helps our cells use glucose. A special type of eating plan called a low-GI diet can help women with PCOS. It focuses on lowering blood sugar and balancing hormones.

The diabetes drug metformin is approved for use in PCOS and can be prescribed by your GP. Other options target specific symptoms. For hair growth, a dermatologist can offer removal treatments, but these are not always available on the NHS.

Various types of hormone tablets can be used to stabilize the menstrual cycle. It can help with skin and menstrual problems. An endocrinologist who specializes in female hormone imbalances will advise you on the right type of pill to use.

Have you been left in your mouth without a dentist?

It seems to me that NHS dentistry has not become more accessible since the lockdown ended (stock image)

It seems to me that NHS dentistry has not become more accessible since the lockdown ended.

My practice is inundated with patients with dental problems who go to their GP because they cannot get an appointment with their dentist. And I keep coming across horrifying stories, like patients gluing their teeth together with superglue or sticking chewing gum in a hole.

Unfortunately, in most cases, GPs can do little, especially in emergency situations. We lack the expertise and it is entirely possible that we are doing something wrong.

We are often asked for antibiotics to help with infections in the mouth, but this is not always the right treatment, not to mention the well-known dangers of prescribing antibiotics unnecessarily.

If this issue affects you, I would like to know. Please write to me at the address below.

Relax, the therapy via zoom works!

Health chiefs have given the green light to digital psychological therapies (stock photo)

I was pleased to see health leaders giving the green light to digital psychological therapies.

While therapists have been seeing patients on Zoom for some time, digital apps and other online platforms are now officially endorsed by depression and anxiety watchdog NICE. Many of my patients are skeptical when I suggest using an app to improve their mental health.

In fact, there is a fair amount of high-quality evidence that this method—which usually involves online practice and long-distance calls with therapists—can be just as good as in-person therapy. Some patients, such as those with disabilities and social anxiety, often feel more comfortable not seeing someone in person.

Face-to-face counseling would be ideal, but we simply do not have enough psychologists – NHS or private – to meet the growing demand.