DR ELLIE CANNON: I fear my prostate cancer will spread if just rely on check-ups

After being diagnosed with prostate cancer, I expected to be thrown into treatment, but my urologist has told me to just go for checkups every four months. My fear is that the cancer will spread to my lymph nodes or bones during that time. Will I pay for a prostatectomy to put my mind at ease? i am 72.

When people find out they have cancer in a part of their body, they often want that part removed. It is only natural and completely understandable.

But with prostate cancer, there are two main reasons why doctors don’t always do this.

First, while removing the prostate — known as a prostatectomy — removes the tumor, it can cause other problems that affect quality of life, including problems with sexual function, going to the toilet, and bowel problems. Sometimes a man who has undergone a prostatectomy may say that these problems meant the treatment was not worth it.

Second, prostate cancers grow slowly. Sometimes specialists call it a “mild” disease. This may sound strange – given that it is cancer – but many men live with the disease for a very long time and die from other causes.

A doctor’s decision about whether or not to treat prostate cancer can depend on many factors, including how likely it is to spread. This is measured using something called a Gleason score. In general, anything below a score of seven is not considered high risk.

For a low-scoring tumor, it’s not worth putting a patient through the risks of surgery and its side effects. Blood tests and scans every four months are enough to catch changes quickly for slow-growing cancers.

But living with cancer is not easy. It’s worth speaking to Prostate Cancer UK or your GP for support.

I recently noticed a slight change of color in my underarms. It’s not painful, but it’s a bit strange that this has suddenly appeared. Do you have any idea what could be causing this? I have no underlying health problems.

It is not normal for the skin in the armpit to change color. When it does, it is usually due to a fungal or yeast infection of the skin, which can thrive in the armpits because they are warm and moist from sweating.

A yeast infection would cause redness or itching, and yeast infections of the skin can make the skin darker in someone with white skin, or lighten in someone with brown or dark skin.

It’s worth trying an over-the-counter antifungal cream for a week or two and see if there is any improvement. There are no risks involved and you would soon find out if that was the problem.

Erythrasma is another possibility. This is a bacterial skin infection that causes scaly pink or brown patches and often affects the armpits.

A doctor can prescribe antibiotic creams or detergents to get rid of it. You can also prevent it by using antibacterial soap.

Skin conditions such as eczema and dermatitis can also cause the skin to change color, as can irritation from cosmetics such as deodorant.

Or sometimes the skin may darken in response to a rash or itchy skin. This is because the skin develops more pigment and can thicken, making it appear darker.

It is especially a problem for dark skin, and some, such as antimalarial tablets or antibiotics, can make it worse.

If both armpits darken, you may have a condition called acanthosis nigricans. It is more common in people with polycystic ovarian syndrome, obesity, or type 2 diabetes, and medications such as steroids and the birth control pill can increase the risk of developing it.

For dark-skinned people, acanthosis nigricans sometimes appears for no apparent reason. Get it checked out by your GP, as it could be due to an underlying condition, but sometimes it doesn’t need medical treatment.

For about a month now I have been having bouts of pins and needles in my left arm reaching all the way to my hand. My doctor couldn’t find anything wrong with me. Any idea what it could be?

Pins and needles may seem like a non-serious problem, but it should be checked if it persists. Normally it is an indication that something is wrong with a nerve. This is why the sensation comes on when you lean on your arm for too long – because there is too much pressure on the nerve.

Any health problem or injury that affects the nerves can cause pins and needles, including a herniated disc in the neck, a sprain in the arm, or a pinched nerve.

Diabetes, multiple sclerosis, and vitamin B12 deficiency can cause it, as can some medications. It is also common in people who drink a lot of alcohol.

An examination by the doctor is essential to find out whether the cause is minor or more serious. They can run blood tests for B12 and iron deficiency, as well as signs of inflammation and diabetes. They also check the pulse in your arm and whether parts of the nerve are working properly.

There are other symptoms associated with nerve problems, such as numbness, weakness, and sensitivity to hot or cold temperatures. If any of these are true, tell your GP.

A common cause of tingling in the hands is carpal tunnel syndrome, where a nerve becomes compressed.

In this case, the feeling usually starts in the fingers and sometimes moves up the arm.

‘Skinny jab’ is not a fast-fix diet

A few weeks ago I wrote about my skepticism about the new ‘skinny jabs’ – injections of the drug semaglutide being given by the NHS to obese people.

They have been hailed as a panacea for obesity and related diseases. But I wasn’t convinced – all treatments have side effects and we still don’t know what happens when patients stop taking this drug.

Now we have learned that I was right about my doubts.

There are reports of patients developing unwanted sagging skin around their neck. This is a result of losing fat quickly – it also disappears in places where you actually want it, such as the face.

Semaglutide injections are great for obese people who have health problems such as type 2 diabetes. But if you’re looking for a quick fix for a bikini diet, I’d steer clear.

Measles can kill – so protect your children NOW

I am increasingly concerned about the number of children getting measles. Government figures show there have been 49 cases so far this year, compared to 54 in all of 2022.

It’s a problem that has been brewing for some time now, with more parents deciding not to vaccinate their children against this deadly disease thanks to scary stories they read online.

Now it’s worse than ever, mainly due to missed shots during lockdowns. Uptake of both doses of the MMR jab, which protects against measles, mumps and rubella, is at 85 percent of the population — far less than the 95 percent it takes to eradicate the disease.

It is vital to keep children up to date on their jabs before summer begins. As children go on vacation, the risk of an outbreak increases. All under 18s can get a free catch-up shot if they’ve missed it – just ask your GP.

Don’t take any chances and leave your children unprotected. Trust me when I say it’s not worth it.