Latest news with #oncologist
Sky News
02-06-2025
- General
- Sky News
'He didn't understand he was dying from cancer': Anonymous nurse reveals what her job is like
Dreaming of a new career? Each week, we speak to someone from a different profession to discover what it's really like. Today, the Money team chats to an NHS learning disability nurse - we agreed to make them anonymous so they could provide an unfiltered view of the job. I worked with a man with a severe learning disability who was dying of cancer... He didn't understand what this meant and just wanted to feel well and looked after. I worked with the oncologist, GP and local palliative care service to arrange a professionals meeting, advocating for the unique needs of this man. We were able to arrange for him to be at his "best" health for one last holiday, before being supported into a planned palliative care community bed with staff he knew, where he was supported to die with dignity in minimal pain. Without my support advocating on his behalf, he would have died in a hospital bed, without known staff, scared and alone, and would never have had the chance to have his last holiday. I will truly never forget him; it was humbling to be able to help in any way I could. You start on £30,000... Entry-level nurses start at NHS pay band 5, which equates to £29,970 (rising to £36,483). Progression is, of course, possible through developing skills and expertise, with experienced senior nurses earning £50,000+. The NHS pension is generous... Depending on salary, we can pay from 5-12% of our salary into pension, with the employer putting in 14.4% for all pensions. Pension and financial advice is also available to support retirement planning. This job is so varied... Learning disability nurses work with people who have a learning disability (and with their families and carers) to help them stay as healthy as possible throughout their lives. I could be supporting someone to understand and manage their diabetes or other complex health issues, helping someone to safely express their emotions or any distress, or supporting with future planning, which could be related to dementia, or their end-of-life wishes, and all this just in one day. A wide range of clinical skills is also required - including those relating to epilepsy, complex physical health, mental health, autism, forensic risk, dementia, and positive approaches to behavioural support. The NHS is really good with flexible working... There are so many different jobs... it can really work for different lifestyles. I work part-time currently (four days). On holidays, you start with 27 days, and after 10 years, you have 32 (plus bank holidays on top). One person I worked with had been in a hospital environment for 20 years... She described herself during that time as a flower that hadn't been watered. One of the most rewarding parts of the job is helping people to move back to their local area and live in community settings, ensuring the best support is available to maintain this. After successfully moving out of hospital, the woman later described herself as like a garden full of beautiful flowers in full bloom. If I could change one thing, it would be for people to know who we are... Learning disability nurses have the same clinical skills as other branches of nursing registrants but it is a lesser-known specialism and few people understand what we do. This means that fewer people enrol to be a learning disabilities nurse, making vacancies harder to fill. People with learning disabilities often have communication needs, anxieties, past negative experiences or other barriers to accepting help... As learning disability nurses, we pause, reflect and then try again using adapted and creative approaches to meet individuals' specific needs. Learning disability support does not get enough funding... this is a fundamental requirement if we are to support individuals to lead longer, happier and healthier lives. Capacity is always an issue... with increased demand being placed on services. Similarly, challenges in social care provision often have an impact on people's health and wellbeing, and, as a result, pressure on health services increases. There is also often a reliance on families and care providers to implement recommendations that have been made, which can prove challenging, as is ensuring that appropriate levels of support are in place. There continues to be inequitable access to healthcare generally, which learning disability nurses are instrumental in challenging to improve health outcomes for those with a learning disability. Laughter and smiles are more common than tears... when working with people who have a learning disability! One of my most memorable success stories... was supporting a young lady who needed eye surgery due to her failing eyesight. Initially, this lady declined surgery, but by using accessible information, she was able to understand why surgery was important and the impact that not having this could have on her quality of life. We discussed her fears, undertook some desensitisation work, and I worked with the hospital teams to make sure that her fears were listened to, and that adjustments to her treatment plan were made too. The operation was a success, and the lady regained some of her sight. A common misconception... is that people who have a learning disability are not able to learn new skills and are not able to make their own choices. With the right support, individuals are more than able to achieve positive change and have their voice heard.
CTV News
16-05-2025
- Health
- CTV News
Melanoma is on the rise and young people aren't using enough sunscreen, doctors say
A woman helps a man apply sunscreen as they relax at Britannia Beach in Ottawa on Tuesday, June 18, 2024. THE CANADIAN PRESS/Justin Tang TORONTO — When Christie Garofalo's husband asked her about a mole on her abdomen, she thought she'd always had it. But after looking through old photos, she realized it was relatively recent and made an appointment with her family doctor just to be safe. After the mole was removed and biopsied, she was shocked when her doctor told her it was melanoma. 'I collapsed in her office because you hear cancer and immediately you go down a terrible rabbit hole,' said the 50-year-old mother of five children in Vancouver. Garofalo said she had used sunscreen but 'not religiously' — applying it if she was on a tropical vacation but not on a day-to-day basis at home. While talking with her oncologist, she also remembered that she had used tanning beds once a week as a teen in the late 1980s. Garofalo had to undergo some painful lymph node surgery to prevent the cancer from spreading, but is grateful she has a clean bill of health almost five years later. 'I am good about sunscreen (now),' she said. Dermatologists say that despite awareness of skin cancer risk, it's not translating into action and melanoma cases are on the rise. They're especially worried about young people because, like Garofalo, unprotected exposure to ultraviolet (UV) radiation from the sun in their youth comes back to haunt them when they are older. A variety of factors, including misinformation and cost, are to blame for inadequate use of sunscreen and other sun protection measures, they say. 'Unfortunately we're showing very dangerous, very concerning trends with respect to skin cancer and melanoma,' said Dr. Ivan Litvinov, an associate professor of dermatology at McGill University. According to Melanoma Canada, an estimated 11,300 people were diagnosed with the potentially deadly skin cancer in 2024 — up by 17 per cent from the previous year. In a study published in BMJ Public Health in April, Litvinov and his colleagues found that almost 60 per cent of Canadians aged 18 to 29 spend two or more hours in the sun at a time, but were significantly less likely to use sunscreen than people aged 30 to 59. The data also showed that younger Canadians were more likely to get sunburned. Although the data analyzed in the study was collected in the Canadian Community Health Survey between 2011 and 2018, Litvinov said there is no reason to believe that more young people are using sunscreen now. 'People don't think this is serious. Our winters are harsh. When the summer comes, people are going out and enjoying the sun, right? Enjoying too much to the point of getting burned,' said Litvinov, whose clinical practice is at St. Mary's Hospital Centre in Montreal. Dr. Monica Li, a dermatologist in Vancouver, said there are 'alarming trends' of misinformation on social media that discourage the use of sunscreen. They include claims that the chemicals in sunscreen cause cancer, which is false, she said. 'We need to basically tailor education and knowledge perhaps towards the younger demographics to debunk some of the stuff that they're seeing online,' said Li, who is a clinical assistant professor of dermatology and skin science at the University of British Columbia. It's also important to raise skin cancer awareness among different ethnic groups because there's a 'long-standing' misconception that people with darker skin don't need sunscreen, she said. Even though more richly pigmented skin has more natural protection than lighter-coloured skin, it's not enough, Li said. Last July, Health Canada issued a warning against using 'homemade' sunscreen — a trend that circulates on social media. 'Making and using homemade sunscreen products presents risks, as they are unlikely to be effective at protecting you from the sun's harmful UV rays,' says the warning posted on the agency's website. Health Canada also called out false claims that sunscreen ingredients are harmful to the skin and can cause cancer. 'All authorized sunscreens on the market are safe when used as directed,' it said. There are two types of approved sunscreens: mineral sunscreens, which use zinc oxide or titanium dioxide to create a physical barrier to reflect ultraviolet (UV) radiation; and chemical sunscreens — also called 'organic' sunscreens — which absorb UV radiation and convert it to heat. Using a mineral sunscreen is a good option for people who find other sunscreens aggravate their acne, said Li. Litvinov said he uses mineral sunscreen on his kids because it doesn't burn their eyes when they sweat. He noted some people have expressed concern about chemical sunscreens affecting marine life, so those who are worried might opt for mineral sunscreen as well. Whichever sunscreen people choose, it should be at least 30 SPF and protect against both UVA and UVB rays. Another myth that is amplified online is that forgoing sunscreen helps people get enough vitamin D, the Canadian Cancer Society and dermatologists say. If there are concerns about vitamin D deficiency, people should talk to their primary-care provider about vitamin D supplements, said Li. 'That's a much safer and consistent way' to get the vitamin, she said. Nancy Wirtz, manager of cancer prevention at the Canadian Cancer Society, said even when people do use sunscreen, they often don't apply enough of it. The average adult needs about a teaspoon of sunscreen to cover their face and neck and another two to three tablespoons to cover their body. That's about the size of a golf ball in total. Sunscreen should also be reapplied every two hours and even more frequently if you are swimming or sweating, Wirtz said. Litvinov noted that any sun exposure resulting in a tan causes skin damage. 'We talk actually about the 'sunscreen paradox,'' he said, which is when people want a tan, but they understand there's something unhealthy about it. 'So how are they going to reconcile the two? Well, they put (on) a thin layer of sunscreen and then they go and they get a tan. And unfortunately, because of the sunscreen paradox, people are getting more skin cancer.' Litvinov's study showed that people with lower incomes are less likely to use sunscreen — and he says other research has confirmed there's inequitable access to what is often a high-cost product. 'People have told us that sunscreens are more or less a luxury item,' he said, noting that unlike many countries, sunscreen is taxed in Canada. Li agreed that when people use the recommended amount of sunscreen, 'the cost really adds up quickly.' 'If they can't afford it and it's choosing sunscreen or food on the table, then of course sunscreen is not going to be something that is going to be chosen.' Dermatologists and the Canadian Cancer Society emphasize that in addition to sunscreen, it's important for people to take other measures to stay safe outside, including seeking shade, wearing sun-protective clothing, a wide-brimmed hat and sunglasses, and minimizing sun exposure in the peak hours of 11 a.m. to 3 p.m. This report by The Canadian Press was first published May 16, 2025. Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content. Nicole Ireland, The Canadian Press
CTV News
16-05-2025
- Health
- CTV News
Melanoma is on the rise and young people aren't using enough sunscreen, doctors say
A woman helps a man apply sunscreen as they relax at Britannia Beach in Ottawa on Tuesday, June 18, 2024. THE CANADIAN PRESS/Justin Tang TORONTO — When Christie Garofalo's husband asked her about a mole on her abdomen, she thought she'd always had it. But after looking through old photos, she realized it was relatively recent and made an appointment with her family doctor just to be safe. After the mole was removed and biopsied, she was shocked when her doctor told her it was melanoma. 'I collapsed in her office because you hear cancer and immediately you go down a terrible rabbit hole,' said the 50-year-old mother of five children in Vancouver. Garofalo said she had used sunscreen but 'not religiously' — applying it if she was on a tropical vacation but not on a day-to-day basis at home. While talking with her oncologist, she also remembered that she had used tanning beds once a week as a teen in the late 1980s. Garofalo had to undergo some painful lymph node surgery to prevent the cancer from spreading, but is grateful she has a clean bill of health almost five years later. 'I am good about sunscreen (now),' she said. Dermatologists say that despite awareness of skin cancer risk, it's not translating into action and melanoma cases are on the rise. They're especially worried about young people because, like Garofalo, unprotected exposure to ultraviolet (UV) radiation from the sun in their youth comes back to haunt them when they are older. A variety of factors, including misinformation and cost, are to blame for inadequate use of sunscreen and other sun protection measures, they say. 'Unfortunately we're showing very dangerous, very concerning trends with respect to skin cancer and melanoma,' said Dr. Ivan Litvinov, an associate professor of dermatology at McGill University. According to Melanoma Canada, an estimated 11,300 people were diagnosed with the potentially deadly skin cancer in 2024 — up by 17 per cent from the previous year. In a study published in BMJ Public Health in April, Litvinov and his colleagues found that almost 60 per cent of Canadians aged 18 to 29 spend two or more hours in the sun at a time, but were significantly less likely to use sunscreen than people aged 30 to 59. The data also showed that younger Canadians were more likely to get sunburned. Although the data analyzed in the study was collected in the Canadian Community Health Survey between 2011 and 2018, Litvinov said there is no reason to believe that more young people are using sunscreen now. 'People don't think this is serious. Our winters are harsh. When the summer comes, people are going out and enjoying the sun, right? Enjoying too much to the point of getting burned,' said Litvinov, whose clinical practice is at St. Mary's Hospital Centre in Montreal. Dr. Monica Li, a dermatologist in Vancouver, said there are 'alarming trends' of misinformation on social media that discourage the use of sunscreen. They include claims that the chemicals in sunscreen cause cancer, which is false, she said. 'We need to basically tailor education and knowledge perhaps towards the younger demographics to debunk some of the stuff that they're seeing online,' said Li, who is a clinical assistant professor of dermatology and skin science at the University of British Columbia. It's also important to raise skin cancer awareness among different ethnic groups because there's a 'long-standing' misconception that people with darker skin don't need sunscreen, she said. Even though more richly pigmented skin has more natural protection than lighter-coloured skin, it's not enough, Li said. Last July, Health Canada issued a warning against using 'homemade' sunscreen — a trend that circulates on social media. 'Making and using homemade sunscreen products presents risks, as they are unlikely to be effective at protecting you from the sun's harmful UV rays,' says the warning posted on the agency's website. Health Canada also called out false claims that sunscreen ingredients are harmful to the skin and can cause cancer. 'All authorized sunscreens on the market are safe when used as directed,' it said. There are two types of approved sunscreens: mineral sunscreens, which use zinc oxide or titanium dioxide to create a physical barrier to reflect ultraviolet (UV) radiation; and chemical sunscreens — also called 'organic' sunscreens — which absorb UV radiation and convert it to heat. Using a mineral sunscreen is a good option for people who find other sunscreens aggravate their acne, said Li. Litvinov said he uses mineral sunscreen on his kids because it doesn't burn their eyes when they sweat. He noted some people have expressed concern about chemical sunscreens affecting marine life, so those who are worried might opt for mineral sunscreen as well. Whichever sunscreen people choose, it should be at least 30 SPF and protect against both UVA and UVB rays. Another myth that is amplified online is that forgoing sunscreen helps people get enough vitamin D, the Canadian Cancer Society and dermatologists say. If there are concerns about vitamin D deficiency, people should talk to their primary-care provider about vitamin D supplements, said Li. 'That's a much safer and consistent way' to get the vitamin, she said. Nancy Wirtz, manager of cancer prevention at the Canadian Cancer Society, said even when people do use sunscreen, they often don't apply enough of it. The average adult needs about a teaspoon of sunscreen to cover their face and neck and another two to three tablespoons to cover their body. That's about the size of a golf ball in total. Sunscreen should also be reapplied every two hours and even more frequently if you are swimming or sweating, Wirtz said. Litvinov noted that any sun exposure resulting in a tan causes skin damage. 'We talk actually about the 'sunscreen paradox,'' he said, which is when people want a tan, but they understand there's something unhealthy about it. 'So how are they going to reconcile the two? Well, they put (on) a thin layer of sunscreen and then they go and they get a tan. And unfortunately, because of the sunscreen paradox, people are getting more skin cancer.' Litvinov's study showed that people with lower incomes are less likely to use sunscreen — and he says other research has confirmed there's inequitable access to what is often a high-cost product. 'People have told us that sunscreens are more or less a luxury item,' he said, noting that unlike many countries, sunscreen is taxed in Canada. Li agreed that when people use the recommended amount of sunscreen, 'the cost really adds up quickly.' 'If they can't afford it and it's choosing sunscreen or food on the table, then of course sunscreen is not going to be something that is going to be chosen.' Dermatologists and the Canadian Cancer Society emphasize that in addition to sunscreen, it's important for people to take other measures to stay safe outside, including seeking shade, wearing sun-protective clothing, a wide-brimmed hat and sunglasses, and minimizing sun exposure in the peak hours of 11 a.m. to 3 p.m. This report by The Canadian Press was first published May 16, 2025. Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content. Nicole Ireland, The Canadian Press
The Guardian
06-05-2025
- Health
- The Guardian
My patient's cancer was curable but for years she endured painful sex as a result. This story is all too familiar
I t is not often that a cancer patient promises to regale her oncologist with 'wild stories about my sexual adventures', but this might just be my favourite promise of late, both for the exuberant proclamation and the prolonged heartache that preceded it. The first part of the story is all too familiar. A young woman develops breast cancer and modern advances declare her cured. Exhibiting patience and perseverance, she tackles the sequelae, including weight gain, mood fluctuations and body image issues, alongside existential questions. The second part of the story is also familiar. One day, I am reviewing her medical history from a time before I knew her, when my eyes fall on a passing mention about sexual difficulties. Her problems were noted as 'expected for age and anti-oestrogen treatment'. The patient's chief complaint was dyspareunia, which in plain language means painful sex. The severity of the problem led to abstinence, with implications for her partner. After the disclosure, she had bounced between different clinicians but those appointments, seemingly underwhelming, had tapered off. I wonder whether and how to revisit this sensitive topic, my concern being that I don't know what I'd do with the answer. Like most oncologists, my training in mentioning, let alone managing, the sexual health implications of cancer is practically zero. But I am also uncomfortably aware of the sentiment that gratitude for having survived cancer ought to preclude any expectation of being sexually whole. Of course, no one articulates this sentiment but, like the air one breathes, you know it exists. Feeling tense, I casually mention to my patient that many cancer survivors experience sexual concerns that never get discussed in appointments, so I am just checking in. At this briefest of encouragements, she provides a despondent account of her pain and her fading hope that she will ever obtain help. When she says that she is reconciled to things but feels bad for her partner, something about her wistfulness moves me. I am troubled by this heavy, unadvertised cost of cancer treatment that no one wants to own. Doubtful of doing any better, I nevertheless quietly make it my mission to try. By a stroke of luck, I share space with some excellent gynaecologists who give me some free advice. But when my referral to the public hospital is triaged as 'non-urgent' and the patient reports that she might not be seen for up to a year, I feel disheartened. Advocating for her makes me feel guilty about all the unseen patients. When she is seen, it takes a gynaecologist all of 10 minutes to clinch the diagnosis. What's more, her problem is easily remediable. But now, the elective surgery waitlist stands in the way. She might be waiting a year or two but at least, she says, there is a glimmer of hope. She leaves me pondering the cognitive bias that labelled her cancer as curable but her sexual difficulties as incurable. Ironically, her major issue is eventually treated with a minor procedure. For the first time in years, sex is not painful and life beyond cancer feels open with opportunity Up to 90% of women (and between 40 and 85% of men) with cancer encounter sexual health problems including loss of desire, arousal and pleasure. Unlike other problems such as fatigue or pain, sexual concerns can persist and lead to long-term distress affecting personal and social wellbeing. Alas, many white papers on the topic haven't stopped patients from suffering in silence. In one study (like many others), 87% of cancer patients reported sexual concerns but less than 30% were asked about sexuality by a medical practitioner. Then there is the gender bias that tinges many aspects of healthcare. Women with cancer are significantly less likely than men to be asked about sexual health (22% v 53%). In one study, sexuality was assessed at 89% of prostate cancer consultations but in only 13% of cervical cancer cases – despite sexual dysfunction and related distress being ubiquitous in affected women. Patients can sense provider disinterest when it comes to sexual concerns. Oncologists cite a lack of training, time pressures and awkwardness around conversations about sex. The status quo must change. However, I wouldn't hold my breath for oncologists to lead the charge amid the competing demands on their time. But what we could do is harness social and digital media, and fund nurse navigators and sexual health counsellors to provide a mix of anonymous and in-person advice, in an approach that recognises that one size does not fit all. One day in clinic, I brace myself to feel more of my patient's pain and frustration. Instead, with a catch in her voice, she asks if she can hug me before sitting down. Tearfully, she throws her arms around me and says 'thank you'. Not for treating her cancer but taking her sex life seriously. For the first time in years, sex is not painful and life beyond cancer feels open with opportunity. There is a lightness to her being – and as I look at this new woman, I don't know how to respond to her unexpected compliment except to say that things really shouldn't have been so difficult. But she knows that she is one of the 'fortunate' ones. Most patients will resign themselves to their problems as the price to pay for having a serious illness. Sexual health is one of the most affected – and woefully ignored – quality of life indicators in cancer patients. Which is a reminder that for all our vaunted advances, there are elements of the cancer experience that we must doggedly shine a light on. Ranjana Srivastava is an Australian oncologist, award-winning author and Fulbright scholar. Her latest book is called A Better Death
