DR ZOE
I’ve had a pain in my groin for six months and my friend say it could be serious. Help!
DR Zoe also helps a parent trying to find out more about a child's rare medical condition
EIGHT in ten women in the UK aren’t checking their breasts regularly and a third admit they never check themselves for signs of breast cancer, research by Estée Lauder found in 2022.
This is shocking as two-thirds of cases are detected in this way.
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I’m in my third year as an ambassador for its breast cancer campaign and we have been focusing on the groups that are least likely to check – including South Asian women, women under 40 and Black women.
Attending mammograms, women are invited between the ages of 50 and 71, is another way to spot breast cancer early. You can ask for mammograms after 71.
Aside from a lump in the breast, chest, collarbone or armpit, other signs to look and feel for are: changes to the skin or nipple, a rash, crusting or discharge around the nipple, or changes in size, shape or colour of the breasts.
See your GP for any changes so they can rule out cancer, or detect it as soon as possible.
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Here is a selection of what readers have asked this week. . .
SON’S REAR CONDITION
Q) CAN you please tell me anything about desmin myopathy?
My 51-year-old son has this condition but we are not being told anything about it and I am worried. It is awful to see him suffer in this way.
A) Desmin is a protein that helps maintain the structure and strength of muscles.
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Think of it as scaffolding that helps hold muscle fibres together, keeping them aligned and all working properly.
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Desmin myopathy (also known as myofibrillar myopathy) is a rare genetic condition that causes muscle weakness, typically in the legs first.
It can slowly spread to the body, neck, face, respiratory muscles and sometimes the heart muscle, causing cardiomyopathy.
The severity and progression of symptoms can vary greatly between individuals.
While this can be a genetic disease, it is not always inherited.
Sometimes the genetic mutation is sporadic, meaning it can arise in people without a family history of the disease.
It is very difficult to watch a loved one suffer, especially with a rare condition that isn’t well understood – the first case of desmin myopathy wasn’t identified until the late Nineties.
Does he have someone to attend hospital appointments with, and share the worry with?
Sometimes when we receive a diagnosis we try to shield our loved ones from information that might upset them. Letting your son know that you want to know everything so that you can help support him may help get some honest conversations started.
Think of ways in which you can offer support in the meantime – cooking meals, supporting childcare, shopping or housework if that is relevant.
I strongly recommend asking your son to engage with specialist nurses or therapists who are part of his healthcare team as they can provide more detailed care and support.
Physiotherapy, mobility aids, and respiratory monitoring are often used to manage this condition, and psychological support can be extremely helpful.
Please don’t hesitate to contact patient groups or charities, such as Muscular Dystrophy UK. They can offer valuable information and emotional support.
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Q) I AM a male, 67 years old, and for the past six months I have had pain in my left groin, particularly when walking or standing for a long time.
I have had four knee replacements on my right leg and have just finished radiotherapy for prostate cancer. I was previously very sporty. I am still playing golf regularly.
Many friends have mentioned this as a sign of needing a hip replacement.
Do you think it may be that, or could it be something else?
A) Osteoarthritis in the hip is a common cause of groin pain in men over 60 and could explain your symptoms.
For example, hip pain can sometimes worsen with walking or standing, and can even affect sleep when lying down.
The multiple knee surgeries may have chan-ged how you walk, putting extra strain on your hips, and potentially accelerating any wear and tear on the joint.
Radiotherapy itself is not linked to osteoarthritis, but the overall stress on your body from cancer treatments, such as hormonal therapy, could play a role in how you recover from or manage joint issues.
You mention having been sporty, and a lifetime of sports that involve high speeds, pivoting, kicking or high impact such as football, rugby, and running can increase the risk of hip osteoarthritis. Having said that, it is important to know that remaining active can help maintain the health of the joint now.
Furthermore, keeping the muscles strong can alleviate the pain.
In particular, lower-impact activities such as cycling, swimming and walking can be beneficial.
Being physically active has many other health benefits, so please do keep it up.
That said, the pain may not actually be coming from the hip joint at all.
Other causes should be considered, such as referred pain from the spine or pelvic region, or even lingering effects from radiotherapy.
An assessment by your GP or an orthopaedic specialist can help determine if this is a hip issue, or something else.
If surgery is a concern, non-surgical options like physiotherapy and pain management can help, and some lifestyle adjustments such as weight loss may also provide relief.
STOPPING MEDS WRECKED MY HAIR
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Q) I USED to be on vitamin D and alendronic acid for osteoporosis but after about six years, my doctor advised me to stop them.
Within a few months, most of my hair (body and head) fell out and now my fingernails are so brittle. If I mention any of my worries to my doctors they make me feel like a hypochondriac.
I’m not accepting “old age” and my once thick, healthy, shiny hair and lovely nails are gone.
A) I’d be interested to know why you were told to stop taking your treatment.
Most likely it’s the alendronic acid that’s been stopped, due to side effects including heartburn, swallowing difficulty or other issues with the gullet. It may also be stopped if your kidney function goes below a certain threshold.
I would guess that the vitamin D is fine to continue and you should check if it’s OK to restart this. Vitamin D is something we should all be supplementing with from October to March anyway, and for someone with osteoporosis, I would advise supplementing all year round.
Vitamin D deficiency can affect both hair and nail health. Iron, B12, folate, zinc and magnesium deficiency should be ruled out too. If you wanted to have this assessed further and have the funds to do so, you could see a hair and scalp specialist (trichologist).
They will use a special camera to look at the hair follicles and give you bespoke advice about supplements, hair products and lifestyle to optimise your hair health.
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I can understand you may feel fobbed off by your GP. It can be very difficult to give patients additional time when we are so limited if the issue is raised at the end of an appointment.
Our hair and nails do change as we age, but it should not be assumed to be all age-related, especially if there was a rapid change when you stopped taking the medication.
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