Cancer and Daffodil Day

This Friday, 26^th August is Daffodil Day in Australia. Daffodil Day is the largest fundraising event of its kind in the Southern Hemisphere and aims to raise much-needed funds for cancer research, prevention and support services. It is run by the Cancer Council of Australia and this year they are celebrating 25 years of Daffodil Days. That’s a lot of daffodils!

The bright, sunny, yellow daffodil is the international symbol of hope for all those touched by cancer, and at this time of the year, daffodils are such a welcome sight after the cold, drab, grey months of Winter.

Cancer is a word which strikes absolute fear into the hearts of pretty much everyone. I don’t think there would be an Australian who hasn’t been affected by cancer in some way, whether it’s through personal experience or that of a family member, friend or colleague.

What are the facts? Well, last year in Australia alone, it is estimated that there were 114,000 new cases of cancer diagnosed. 1 in 2 Australians will be diagnosed with cancer by the age of 85. Cancer is a leading cause of death in Australia, with over 43,000 people dying from cancer in 2010. The most common cancers in Australia (excluding non-melanoma skin cancer) are prostate, colorectal (bowel), breast, melanoma and lung cancer.

Cancer does seem to be on the rise when you compare current figures with those from years ago, but this is largely due to population growth, ageing and improvements in screening and diagnosis. Despite the increase in the number of cancer deaths, the actual proportion of patients who die from cancer has fallen by 16% in the past 30 years.

The other good news is that the survival rate for many common cancers has increased by 30% in the past twenty years. More than 60% of cancer patients will survive more than five years after diagnosis.

Having worked as a pharmacist in a Chemotherapy Day Unit (a ward where patients are admitted for the day just to receive their chemotherapy), it is a fascinating, complex and incredibly busy area of the hospital. It would be impossible for me to cover everything about cancer in the one blog post, but I thought I'd give a brief summary on screening and treatments.

Cancer Screening

Clearly, it is much easier to treat a cancer if it is diagnosed in the early stages of disease. This is where the importance of screening lies. There are currently three national population-based cancer screening programs operating. These are:

• BreastScreen Australia Program - an x-ray of the breast (called a mammogram) is performed every two years to screen for early signs of breast cancer in women aged 50-69 years. Women should also check their own breasts for any changes each month.

• National Cervival Screening Program – a doctor takes a Pap Smear which is used to take a tiny sample of cervical cells to detect changes in the cervix which may lead to cervical cancer in women. Pap Smears should be done every two years either from the age of 18 years old or one or two years after sexual activity starts, whichever is later.

• National Bowel Screening Program – this involves placing a small sample of your stool on a special card in the privacy of your own home and sending the card to a laboratory for analysis. The test looks for the presence of blood in your stool which can be an early warning sign of bowel cancer. If you are turning 50, 55 or 65 between January 2011 and December 2014, the government will automatically arrange for a free test to be posted to you around your birthday. If not, BowelScreenAustralia™ test kits are available for purchase at Terry White Chemists Berwick and Terry White Chemists Eden Rise as well as many other pharmacies. Click here to find a pharmacy that sells the test kits near you.

Cancer Treatments

There are three main treatments for cancer and these can be used either on their own or in combination.

The first is surgery where the tumour itself and surrounding tissue is removed. This is used when the tumour is small and contained to one area.

The second option is radiotherapy which is where precisely targeted x-rays are used to destroy cancer cells. The length of treatment depends on the type, size and location of the tumour(s), but most patients have five treatments a week for a few minutes each time, for one to seven weeks.

The third option, and probably the one that most comes to mind when people hear think about treating cancer, is chemotherapy. Chemotherapy is the use of cancer-killing medicines which can be given in tablet or capsule form or, more commonly, straight into the bloodstream by an infusion (i.e. a drip). There are many different chemotherapy medicines and different doses and combinations are given depending on factors such as the type of cancer involved.

Chemotherapy is incredibly good at destroying cancer cells, but unfortunately, it can also harm healthy cells too which can lead to side effects such as fatigue, nausea, vomiting, mouth ulcers and loss of appetite. We often hear patients voice concerns about hair loss with chemotherapy, but this is dependent on the particular chemotherapy medications that they receive. Your doctors and pharmacists will try to work together to minimise these side effects, perhaps by giving you other medications. Patients should speak to their oncologist, family doctor and pharmacist about any worries they have regarding chemotherapy and any side effects.

We often have queries from patients regarding the safety and efficacy of complementary and alternative cancer treatments. Some treatments are perfectly safe to use and can help you to feel better, but others may interfere with your cancer treatment and should not be used. Always check with your pharmacist or doctor before taking non-prescribed medications, even if they are “natural”. The Cancer Council Victoria has a free book called Complementary and alternative cancer therapies which can be downloaded here.

How Can You Help?

Cancer really is a huge subject and one that needs awareness and public support. So this Friday, do your part and pop into Terry White Chemist Berwick or Terry White Chemist Eden Rise, Coles supermarket or another authorised seller and pick up a badge, teddy bear, pen or bunch of daffodils and feel good that you’re helping researchers find a cure for cancer.

References and further reading

• Cancer Council Australia website
• Cancer Council Victoria website
• Bowel Cancer Australia website 
• Peter MacCallum Cancer Centre website
• The Royal Children's Hospital Melbourne website

• Cancer Fact Sheet, Better Health Channel, published November 2010 (accessed online 23 August 2011)

• Cancer Screening Fact Sheet, Better Health Channel, published December 2010 (accessed online 22 August 2011)
• Cancer Treatments - Chemotherapy Fact Sheet, Better Health Channel, published November 2009 (accessed online 22 August 2011) 
• Cancer Treatments - Radiotherapy Fact Sheet, Better Health Channel, published August 2009 (accessed online 22 August 2011)

Sleep...and a lack of it!

Ask the question, “Who could do with some more sleep?” and just about everybody would put their hand up. But there is a big difference between having a few late nights and chronic sleep issues.

Both Darren and I are slightly obsessed with sleep at the moment, mainly because The Munchkin is going through “a phase”. She’s gone from being a wonderful sleeper, to one who wakes up six times a night and wants you to sit it her room until she falls asleep. Needless to say, we are really hoping this phase ends soon!

Sleep is essential for us to feel physically and emotionally well. People need varying amounts of sleep depending on their age, diet, lifestyle, personality and circumstances. According to his wife, Kevin Rudd, our ex-PM was getting by on only three hours of sleep per night! On average, however, adults need 7-9 hours sleep per night, teenagers need 9.5 hours per night and newborns up to 18 hours per day.

In addition to the tiredness and frustration felt, poor sleep can make us irritable, anxious or depressed and can make it difficult to concentrate and remember things.

There may be medical reasons for sleep problems. Conditions such as pain, restless leg syndrome, worry, pregnancy, anxiety, depression, drug or alcohol use, sleep apnoea (where the walls of the throat collapse during sleep, blocking airways and disturbing sleep) and even snoring can disturb sleep. Some medications such as prednisolone (commonly used for breathing difficulties or rheumatoid conditions) or pseudoephedrine (used as a nasal decongestant and found in flu tablets) can make you more alert, interfering with sleep.

Sleeping tablets can be useful short-term, but many of them have the side effects of both tolerance and dependence. Tolerance is when you need a higher dose to get the same effect and dependence is when your body starts to rely on them and can lead to withdrawal symptoms once they are stopped. If you do need to use sleeping tablets, take the smallest dose you can, for the shortest period of time and only use them when you really need to. Don’t forget that sleeping tablets can also make you feel drowsy, confused or unsteady the next day (like a hangover effect) so do not drive if you are affected and be careful as you may be more prone to falls.

Here are some important tips to help ensure a good night’s sleep

• Is your bedroom conducive to sleep? It should be dark (have a bedside lamp), warm (not too hot or cold), comfortable (perhaps spoil yourself and invest in a good bed, pillow and sheets) and quiet.

• If you have a television in your bedroom, get rid of it! The same goes for using laptops or ipads in bed. Removing these distractions will help your brain to realise that bed is for sleeping, relaxing and sex.

• Avoid napping during the day, but especially after about 3pm.

• If you’re a smoker, quit. The nicotine in the cigarettes acts as a stimulant to your body. There are lots of new products available in pharmacies to help you quit. Have a chat with your pharmacist.

• Try and do some exercise during the day, even if it’s just going for a brisk walk. Avoid doing strenuous exercise close to bedtime though.

• Avoid going to sleep with a full tummy. Try and have dinner at least a few hours before bed, but if not, have a smaller meal to allow some time for it to digest before sleep.

• Avoid caffeine close to bedtime (or cut it out altogether if you’re having real problems). Try a non-caffeinated drink like warm milk or green tea instead.

• Develop a bedtime routine and stick with it. Meditating or having a bath may be helpful. Try and have a reasonably consistent bedtime.

• If you can’t sleep, get up and go to another room and do something else. Wait until you feel sleepy again then return to bed.

• Although we all love a sleep-in, it’s better if you wake up at the same time every day.

You should see a doctor or pharmacist if:

• Your sleep problems are caused by illness, pain or discomfort

• You wake up coughing, wheezing or unable to breathe

• You snore, especially if you wake yourself or others

• You have been taking sleeping tablets regularly for more than four weeks

• You continue to be tired during the day.

Sleep is such a large part of our lives and essential to good health and wellbeing. If you’re having sleep problems, pop into Terry White Chemists Berwick and have a chat to our pharmacists. Make sure you pick up a free Self Care Card on Sleeping Problems and we also have one on Relaxation Techniques. We stock herbal and complementary medicines which can help to aid sleep.

In conjunction with Sleep Services Australia, Terry White Chemists Berwick also offer ‘at home’ sleep apnoea diagnosis and testing. We hire out Continuous Positive Airway Pressure (CPAP) machines to allow patients to try different masks and machines which you can then purchase. We stock the Fisher & Paykel range of Icon CPAP machines as well as a full range of replacement parts and fittings.

Here’s a clip that brought a smile to my face and made me wish everyone (especially The Munchkin) slept this well! Sweet dreams.

References and further reading

• Relaxation Techniques Self Care Card, Pharmaceutical Society of Australia, published August 2009
• Sleeping Problems Self Care Card, Pharmaceutical Society of Australia, published February 2011

• SleepHealth Foundation website

• SleepServices Australia website

• Sleep Apnoea Fact Sheet, Better Health Channel, published May 2011 (accessed online 3 August 2011)

• SleepHygiene Fact Sheet, Better Health Channel, published September 2009 (accessed online 3 August 2011)