Is it worth worrying your doctor about?

IN yesterday's Evening Star, we reported on the poignant and tragic story of 33-year-old Steven Poulson. At the insistence of his wife, the father-of-two went to the doctor with a sore throat.

IN yesterday's Evening Star, we reported on the poignant and tragic story of 33-year-old Steven Poulson.

At the insistence of his wife, the father-of-two went to the doctor with a sore throat. Six weeks later he was dead from lung cancer.

But do you know what symptoms mean what? Should you worry about a headache? Does every cough mean pneumonia?

Today feature writer JAMES MARSTON finds out when you should, and when you shouldn't worry, with the Evening Star's essential health symptom checklist.

THE SYMPTOM: A PERSISTENT COUGH

Your response: “It's lung cancer. Or pneumonia…”

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The reality: The cough is far more likely to be the tail end of a cold or a chest infection. Chest infections are normally viral, so the only option is to wait it out. It's not unusual for the inflammation and accompanying cough from a chest infection to last up to eight weeks.

The treatment: Your GP will be reluctant to prescribe antibiotics, although they may be appropriate in a limited number of cases. Over-the-counter remedies will suppress, rather than cure, your symptoms. If you need to ease your cough, try codeine lintus.

When to worry: If the cough is still lingering after eight weeks, there may be a bigger problem. Coughs can be a sign of pneumonia, bronchitis, asthma, acid reflux from your stomach and lung cancer (though smokers are most at risk of the latter).

Lung cancer is the most commonly diagnosed cancer in the world - in the UK it is the second-most frequently occurring cancer, accounting for one in seven new cases.

The key symptoms of lung cancer are:

A persistent cough which gradually gets worse.

Shortness of breath.

A drop in the ability to exercise.

Persistent chest pain.

Coughing up blood.

A loss of appetite, weight loss and general fatigue.

If you are worried that you may have lung cancer, your doctor may order a chest x-ray which will allow them to look out for shadows on your lungs. Sometimes a more details series of x-rays called CT scans are ordered which may be followed by a bronchoscopy or mediastinoscopy, which means that a thin flexible telescope is put down the airways of your lungs, after which a biopsy of any suspicious area is performed.

THE SYMPTOM: BLOOD ON THE TOILET PAPER

Your response: “It must be colon cancer.”

t The reality: You've probably got piles. Piles, or haemorrhoids are caused by swollen veins in the rectum or anus and often cause fresh, bright red blood to fall on your toilet paper. Other conditions which may cause bleeding in this area include tears in the anus, infections of bacterial or fungal origin, colitis or proctitis.

The treatment: If you are concerned about bleeding from the back passage, always contact your doctor for advice. It's normal for piles to bleed for two to three days every month for years. This bleeding comes and goes spontaneously, but if it is heavy, you may need to have “banding” - minor surgery which involves having a tiny band put around the vein and compressing it until it disappears. Steroid creams can help and constipation can aggravate piles, so make sure you keep your fibre intake up (25 to 30g a day).

When to worry: If you have persistent abdominal pain, weight loss, dark blood mixed into your stool samples, hard lumps around your anus or sensation that something is still there after you've been to the toilet then these could be signs that you have colon cancer. Bear in mind, however, that colon cancer is unlikely unless your parents or siblings were diagnosed with the disease when they were 45 or younger. The good news is that many forms of colon cancer are easily treated if diagnosed early enough.

THE SYMPTOM: A LUMP UNDER YOUR ARM

t Your response: “It's breast cancer.”

The reality: The likelihood is that you have got a swollen lymph node. These can become inflamed and swollen if you've been fighting a bacterial or viral infection or if you're feeling stressed and run down. But even if you're feeling perfectly fine, glands can become inflamed. The lump could also be a small sebaceous cyst which are usually situated just under the skin and can easily become infected via a hair follicle.

The treatment: If you have a viral infection, you need to wait until the swelling subsides. The lump should gradually decrease over the course of a few weeks. However, if you have a bacterial infection (which may be accompanied by a temperature and general feeling of being unwell) you may need to see your doctor for a course of antibiotics. If you have a cyst, in most cases the infection will clear spontaneously, but sometimes antibiotics will be required and occasionally the infected cyst will need to be drained surgically.

When to worry: If you have a family history of breast cancer. If the lump hasn't disappeared in several months, it would be wise to see your GP. They will refer you to a specialist if they are concerned about the lump and you can expect to be seen within two weeks if your case is urgent and within 12 weeks if it's non-urgent. Don't panic about waiting - even a fast-growing cancer may have been in your breast for a year or more, undetected. A few more weeks won't make a difference to its growth.

THE SYMPTOM: A PERSISTENT HEADACHE

Your response: “I've definitely got a brain tumour.”

The reality: Brain tumours are very rare - you're more likely to have a migraine or problems with your eyesight which are causing headaches. Migraines are intense headaches which can last for up to three to five days and make you feel queasy, sensitive to light and sound and generally unwell. Women are three times more likely to suffer from migraines than men, particularly those aged between 30 to 50. Hormonal changes can trigger headaches, as can a deterioration in eyesight, which can be checked with an optician.

The treatment: Try soluble painkillers as they act faster than non-soluble ones. Over-the-counter remedies such as aspirin or ibuprofen are better than paracetamol because they're anti-inflammatory so help to ease muscle tension. Simple things like drinking enough water, eating regularly, sleeping well and cutting down on the stress-levels in your life can also help hugely.

When to worry: As the skull is made of bone, there is a fixed amount of space for the brain to take up. A growing tumour increases the pressure inside this fixed space. The increase in pressure causes headaches, sickness and drowsiness (although these are very common symptoms of many illnesses, or even pregnancy!). You should go to your doctor if you are getting very bad headaches, you have just started getting bad headaches and are getting them more and more often, you are getting headaches and sickness together and they last a long time. Inter-cranial pressure can also cause problems with your eyes, fits and changes in behaviour. If you have any of these symptoms, visit the doctor immediately.

THE SYMPTOM: SHARP PAINS IN YOUR STOMACH

Your response: “Dial 999 - I've got appendicitis.”

The reality: Not many of us need an ambulance to cope with trapped wind. Wind can stay trapped in our digestive systems for several hours and can cause severe discomfort, especially on your right side, where your appendix is. If the pain is sharp, but comes and goes, it is unlikely to be anything other than wind, although it could also be a urinary tract infection which tends to be felt low down in the centre of the abdomen and can cause a burning sensation when you go to the toilet. It could also be Irritable Bowel Syndrome which is characterised by abdominal pain and variable stools (hard one day, loose the next).

The treatment: Your first port of call will be the chemist's, where you can pick up an over-the-counter remedy such as Rennie. There is no cure for IBS, although your doctor may be able to help suggest various ways you can change your diet or lifestyle to help alleviate symptoms. You could try remedies such as Imodium for diarrhoea or alverine citrate if bloating is a problem. If your symptoms are really painful, you may be prescribed amitriptyline or citalopram.

When to worry: If the pain starts on your lower left side, spreads to the right and gets more severe over the course of a few days and is accompanied by a fever and loss of appetite, it may be appendicitis. Contact your doctor immediately.

USEFUL CONTACTS:

NHS Direct - 0845 4647, www.nhsdirect.nhs.uk

CancerBACUP - 0808 800 1234, www.cancerbackup.org.uk

The IBS Network - 0114 272 3253, www.ibsnetwork.org.uk

Breast Cancer Care - 0808 800 6000, www.breastcancercare.org.uk

The Migraine Association - 0870 050 5898, www.migraine.org.uk

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