Bloating is the urgent cancer symptom women are ignoring in lockdown, say experts

Written by Katy Harrington

A new survey shows that less than two in 10 women say they would book an urgent GP appointment if they were experiencing persistent bloating, which is a key symptom of ovarian cancer. 

Women’s lives are being put at risk because urgent cancer symptoms are being overlooked during the pandemic, according to new research by the UK’s leading ovarian cancer charity.

A warning has been issued by Target Ovarian Cancer ahead of ovarian cancer month in March. A new survey shows that less than two in 10 women (17%) say they would book an urgent GP appointment (within a week) if they were experiencing persistent bloating.

This is not the case with other, better known cancer symptoms such as an unexplained lump, or a mole that has changed shape, with over 50% of women saying they would take those symptoms seriously and get to their GP within a week.

According to Target Ovarian Cancer, the Covid-19 pandemic is having an impact on early diagnosis of ovarian cancer with women hesitant to contact their GP unless for anurgent appointment. Yet many fail to recognise some symptoms as urgent. The resulting delays could make them at greater risk of being diagnosed with late-stage cancer.

Currently, two thirds of women are diagnosed late, when the cancer has already spread and is much harder to treat successfully. If diagnosed at the earliest stage, nine out of 10 women will survive for five years or more. When diagnosed at the most advanced stage just 13% will survive.

Marie Foord, 49 from Hastings, was diagnosed with ovarian cancer in 2020. She began to experience symptoms such as bloating and bowel symptoms but was reluctant to contact the GP because of the pressure being faced by the NHS in the early part of the pandemic.

Eventually, Marie contacted her GP in May last year and got a diagnosis of stage IIIc ovarian cancer, and, unusually, an additional diagnosis of womb cancer. She continued to have four rounds of chemo, followed by surgery in October 2020, more chemo, and finished her treatment in December 2020. She is now taking medication and is feeling well.

Marie told Stylist: “Nobody I know would associate bloating with ovarian cancer, and in fact it never crossed my mind before I was diagnosed. I want people to take it seriously and give your GP a call if you’re concerned. This pandemic can make us all nervous about going to the GP, but our health is so important. My GP was amazing and supportive throughout my diagnosis.”

Dr Alison Wint GP and Clinical Lead for Cancer at NHS Bristol, North Somerset and South Gloucestershire CCG said: “Cancer is not going away just because of Covid-19. GPs want to know. In fact, it’s as important as ever to come forward with urgent cancer symptoms such as persistent bloating, feeling full quickly or loss of appetite, tummy pain, needing to wee more often or more urgently, change in bowel habits or weight loss. Take it seriously and talk to your GP.”

Annwen Jones OBE, chief executive of Target Ovarian Cancer, said: “It is absolutely vital that women know persistent bloating needs to be checked out by a GP. The pandemic can make it hard to put ourselves first, and people are worried about putting pressure on the NHS. But getting ovarian cancer symptoms checked out promptly and starting treatment quickly makes all the difference.”

Symptoms of ovarian cancer

• Persistent bloating – not bloating that comes and goes

• Feeling full quickly and/or loss of appetite

• Pelvic or abdominal pain (that’s your tummy and below)

• Urinary symptoms (needing to wee more urgently or more often than usual)

Occasionally there can be other symptoms such as: 

• Changes in bowel habit (eg diarrhoea or constipation)

• Extreme fatigue (feeling very tired)

• Unexplained weight loss

Any bleeding after the menopause should always be investigated by a GP.

Symptoms will be:

• Frequent – they usually happen more than 12 times a month

• Persistent – they don’t go away

• New – they are not normal for you 

If you experience the symptoms listed above contact your GP immediately or call the NHS 111 for advice. Target Ovarian Cancer is the UK’s leading ovarian cancer charity, working to raise awareness for Ovarian Cancer Awareness Month this March. 

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Symptoms of Gynecomastia

Gynecomastia describes the swelling of breast tissue in males, caused by a decrease in the level of testosterone compared with the level of estrogen. The condition can affect one or both breasts and can develop in newborns, during puberty or in older men, usually as a result of normal hormonal changes.

In infants, gynecomastia affects over half of males born due to the effect of their mother’s estrogen and the swollen breast tissue usually disappears within three weeks after birth. During puberty, hormonal changes commonly cause gynecomastia and in the majority of cases, the issue resolves independently after six months to two years. In older individuals, the condition is more likely to develop between the ages of 50 and 80, with a quarter of this age group being affected. As men become older, their testosterone level tends to decrease and they also tend to gain weight. The lowered testosterone can cause the breast glands to enlarge and the weight gain means fatty tissue accumulates under the breast, leaving the man with a larger quantity of glandular tissue and more fat in the breast. As fat cells are estrogenic, this additional fat can further disrupt the balance between testosterone and estrogen.

Gynecomastia is not generally a serious issue, although it can be difficult to cope with as it can be painful and cause feelings of embarrassment. The condition can resolve independently of any intervention but if it persists, medication or surgery may be recommended.

Aside from natural hormonal changes, the use of certain medications can cause gynecomastia and examples of these include anabolic steroids, androgens, anti-androgens, anti-anxiety medications, antibiotics, chemotherapy, heart medications and drugs used to treat AIDS. Other causes include the use of substances such as alcohol, marijuana, methodone, heroin and amphetamines; health conditions including hyperthyroidism, kidney failure, liver disease and malnutrition and the use of herbal products such as shampoos, lotions or soaps containing tea tree or lavender.

The symptoms of gynecomastia include the following:

  1. The main symptom of gynecomastia is enlargement of either one or both breasts. The enlarged glandular tissue usually occurs in both breasts but in some cases it is unilateral. The breast growth may be uniform or uneven with respect to the nipple. It may feel rubbery or firm. The growth may appear just behind the nipple.
  2. The breast or nipple may be painful or tender when touched.
  3. In boys, there may be a breast bud in one or both breasts that is around the size of a quarter or nickel. These commonly occur in boys during puberty and can persist for up to two years.
  4. It is important to distinguish gynecomastia from male breast cancer. When cancer is present, only one breast is usually affected and the tissue is not necessarily hard or firm. Cancer may also be associated with dimpling of the skin, nipple discharge, retraction of the nipple and enlarged lymph nodes under the arms.
  5. Another problem that can cause male breast swelling is a breast abscess, although this is rare in men. Affected individuals may develop a fever or chills. The swelling may be very painful and hot to touch and skin across the swelling may appear reddish in color.

Evaluation of symptoms

When examining a male patient with enlarged breasts, a doctor will want to clarify the duration of the enlargement; whether or not secondary sexual characteristics are fully developed; any association between puberty and onset of the enlargement; breast symptoms such as nipple discharge or pain and whether any genital symptoms are present such as erectile dysfunction or lowered libido.

When evaluating the patient, the doctor will look for symptoms that could indicate the potential cause of the enlargement such weight loss or fatigue which could be caused by kidney disease or hyperthyroidism; discoloration of the skin which could indicate liver or kidney disease; cognitive or mood changes indicative of hypogonadism and hair loss, which could suggest malnutrition.

The patient’s medical history will also be reviewed to check for any disorders that could cause gynecomastia and the use of any medications that may trigger the condition.

Treatment

Gynecomastia usually resolves without any treatment being required, but if the cause is an underlying health condition such as liver disease or hypogonadism, that condition will need to be treated before the breast symptoms resolve. Among teenagers where there is no apparent cause of the gynecomastia, a doctor may advise evaluations every three to six months to check whether symptoms are improving. If the condition does not improve after two years or if it is causing significant pain or embarrassment, treatment may be required. A medication to adjust the hormone imbalance such as an anti-oestrogen or aromatase inhibitor may be prescribed.

If a patient still experiences bothersome symptoms after monitoring or initial treatment, surgery may be advised. Liposuction may be recommended to remove the breast fat or mastectomy may be recommended to remove the breast gland.

Outlook

Gynecomastia is not usually associated with long-term problems, but people who develop the condition are at around five times the risk of developing male breast cancer compared with the population in general. This is probably because the hormonal changes that result in gynecomastia are also the changes that increase the risk of male breast cancer.

Sources

  1. http://www.medicinenet.com/gynecomastia/page2.htm#symptoms
  2. www.mayoclinic.com/health/gynecomastia/DS00850/DSECTION=symptoms
  3. http://men.webmd.com/tc/gynecomastia-topic-overview
  4. http://www.webmd.com/men/features/male-breast-enlargement-gynecomastia
  5. https://www.nlm.nih.gov/medlineplus/ency/article/003165.htm
  6. http://www.medicinenet.com/gynecomastia/page2.htm
  7. http://www.emedicinehealth.com/gynecomastia/page4_em.htm
  8. www.msdmanuals.com/…/gynecomastia

Further Reading

  • All Gynecomastia Content
  • What is Gynecomastia?
  • Gynecomastia Causes
  • Gynecomastia Diagnosis
  • Gynecomastia Treatments

Last Updated: Aug 23, 2018

Written by

Sally Robertson

Sally has a Bachelor's Degree in Biomedical Sciences (B.Sc.). She is a specialist in reviewing and summarising the latest findings across all areas of medicine covered in major, high-impact, world-leading international medical journals, international press conferences and bulletins from governmental agencies and regulatory bodies. At News-Medical, Sally generates daily news features, life science articles and interview coverage.

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New mammogram measures of breast cancer risk could revolutionise screening

World-first techniques for predicting breast cancer risk from mammograms that were developed in Melbourne could revolutionise breast screening by allowing it to be tailored to women at minimal extra cost.

Published in the International Journal of Cancer, the University of Melbourne-led study found two new mammogram-based measures of risk.

When these measures are combined, they are more effective in stratifying women in terms of their risk of breast cancer than breast density and all the known genetic risk factors.

Researchers say if successfully adopted, their new measures could substantially improve screening, make it more effective in reducing mortality and less stressful for women, and therefore encourage more to be screened. They could also help address the problem of dense breasts.

Since the late 1970s, scientists have known that women with denser breasts, which shows up on a mammogram as having more white or bright regions, are more likely to be diagnosed with breast cancer and to have it missed at the screening.

Collaborating with Cancer Council Victoria and BreastScreen Victoria, University of Melbourne researchers were the first to study other ways of investigating breast cancer risk using mammograms.

Using computer programs to analyse mammogram images of large numbers of women with and without breast cancer, they found two new measures for extracting risk information. Cirrocumulus is based on the image’s brightest areas and Cirrus on its texture.

First, they used a semi-automated computer method to measure density at the usual, and successively higher levels of brightness to create Cirrocumulus.

They then used artificial intelligence (AI) and high-speed computing to learn about new aspects of the texture (not brightness) of a mammogram that predict breast cancer risk and created Cirrus.

When their new Cirrocumulus and Cirrus measures were combined, they substantially improved risk prediction beyond that of all other known risk factors.

Lead researcher and University of Melbourne Professor John Hopper said that in terms of understanding how much women differ in their risks of breast cancer, these developments could be the most significant since the breast cancer genes BRCA1 and BRCA2 were discovered 25 years ago.

“These measures could revolutionise mammographic screening at little extra cost, as they simply use computer programs. The new measures could also be combined with other risk factors collected at screening, such as family history and lifestyle factors, to provide an even stronger and holistic picture of a woman’s risk,” Professor Hopper said.

“Tailored screening – not ‘one size fits all’ – could then be based on accurately identifying women at high, as well as low, risk so that their screening can be personalised. Given mammography is now digital, and our measures are now computerised, women could be assessed for their risk at the time of screening – automatically – and given recommendations for their future screening based on their personal risk, not just their age,” Hopper added.

Professor Hopper said this information could be used to ease pressure on BreastScreen, which had to close for a period during the COVID-19 pandemic and is looking for ways to best handle the backlog while continuing to provide a valuable service with limited resources.

He said the current breakthrough could not have occurred without the extraordinary support his mammogram research had received from the National Breast Cancer Foundation, starting with its first funding round more than 20 years ago.

“Only around 55 per cent of Australian women aged 50-74 currently present for screening aimed at detecting breast cancers early,” he said.

“Knowing that screening could also give an accurate risk prediction could encourage more women to take up the offer of free screening. Women with high risk based on their mammogram would also benefit greatly from also knowing their genetic risk,” he added.

Adjunct Associate Professor Helen Frazer, Clinical Director of St Vincent’s BreastScreen Melbourne, said that improvements in assessing a woman’s risk of breast cancer would be transformative for screening programs.

“Using AI developments to assess risk and personalise screening could deliver significant gains in the fight against breast cancer,” Adjunct Associate Professor Frazer said.

(This story has been published from a wire agency feed without modifications to the text. Only the headline has been changed.)

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Why My Beauty Routine Was So Important During My Battle With Breast Cancer

This story is part of Survivor's Guide, a series on navigating the impact of breast cancer through beauty and self-care.

One in eight women in the United States will be diagnosed with breast cancer in their lifetime. I am one of those women and I've learned that breast cancer can only be defined by uncertainty. While it's a different journey for everyone, one thing always holds true: It doesn't affect only the person who is diagnosed. Whether you're going through it yourself or supporting someone else, it's difficult. Rarely are there definitive answers. With a cancer diagnosis, life changes in an instant and you have no choice but to persevere through every unknown. 

But amid unimaginable ups and downs, I found one constant: my beauty routine. I was fortunate enough to have my mom (my ultimate beauty queen) by my side through it all. She knew exactly how to help me keep a smile on my face. While I was recovering, we would do face masks and manicures together. Or when I couldn't lift my arms after my mastectomy, she'd blow-out my hair and help me swipe on my signature red lipstick. And when I looked in the mirror, I saw myself. 

The impact of beauty should not be underestimated.

Different things — a touch of lip balm, the feeling of a fresh face, a spritz of scent — might spark a similar feeling for you. Regardless of what that ritual might be, the impact of beauty should not be underestimated. Being able to feel like yourself is one of the most powerful treatments of all. It is not being vain. It is not superficial. It's not for anyone else. When you look like yourself, you feel like yourself. 

I hope the stories and tips from Allure's Survivor's Guide bring you happiness even if it's just for a moment. And survivor to survivor, no diagnosis will ever define you. You are beautiful just the way you are.

Take what you need from our survivor's guide: skin-care advice, courage, help with hair loss, or just the knowledge that you are never alone.

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NBC's Kristen Dahlgren Says Losing Feeling in Her Chest a 'Constant Reminder' of Her Mastectomy

After eight rounds of chemotherapy, 25 rounds of radiation and a mastectomy, Kristen Dahlgren is thrilled to be in remission from breast cancer. But she’s been surprised by what ended up being one of the “hardest” side effects from her mastectomies — losing feeling in her chest.

The NBC correspondent, who announced in April that she is now cancer-free, said the numbness in her chest is “a constant reminder” of her ordeal.

“For now, life has returned to a semblance of normal, and I am trying to enjoy every second,” Dahlgren, 47, wrote in an essay for Today about her treatment and recovery. “There is, however, a constant reminder of what I have been through and what is yet to come. It hits me every time I take a deep breath, or get a hug, and especially when my daughter lays her head on my chest. That’s when I really ‘feel’ the toll the breast cancer has taken. It’s discomfort and numbness all at once."

“Of all of the side effects of treatment, for me, this may be the hardest.”

Dahlgren, who discovered her breast cancer in Sept. 2019 after reporting on unusual signs of the disease and then noticing symptoms herself, said it wasn’t an issue she ever anticipated.

“Before breast cancer, I never realized that women who have mastectomies lose feeling in their chests. It makes sense, of course — since the nerves are cut during the surgery — but it’s not something that is often talked about,” she said. “After all, the most important thing in the surgery is removing all of the cancer and saving your life. So, numbness is something I thought I would just have to live with.”

Dahlgren asked if she’ll ever regain the feeling in her chest, and plastic surgeons have said it’s not possible just yet. But she also found one surgeon, Dr. Constance Chen, who performs “flap” reconstruction to reconnect the nerves in the chest, with encouraging results — one patient said she’s back to 80 percent feeling in her chest.

Dahlgren will undergo reconstruction with Dr. Chen later this year, and while the surgeon has warned that “there are no guarantees,” she’s hoping for similar results.

“I’d really just love to feel a hug — or my little girl cuddled up against me on the couch,” she said. “If it doesn’t work, life certainly goes on, but like I have so often in the past year, for now, I am hanging on to hope.”

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