Ask the Doctor

Sunday 29th August - Cancer

I am due to attend with my father for his first oncology appointment. What questions should I ask? George, Edinburgh

Dr Mark Zahra is a Consultant Clinical Oncologist at Spire Murrayfield Hospital.

Cancer is a common disease that affects up to one in three people. It is important to know what type of cancer your father has, where it started and whether it has spread. This information will determine what treatment options are available.

You should ask what the intention of the treatment is, whether it is curative or palliative (to control the disease for a period of time). Cancer treatment can involve chemotherapy (drug treatment) or radiotherapy (X-ray treatment) or a combination; you may want to ask about new emerging treatments and their availability. It is important to know about possible side-effects and how to deal with them.

This information will allow the patient and their family to make an informed decision regarding the treatment and also help to cope with any side-effects. Many patients find it useful to have a written list of questions prior to attending a consultation.

Sunday 22nd August - Breast reconstruction

My surgery for breast cancer has been very successful but I have been left with an imbalance that I find very frustrating.  Can anything be done? Elizabeth, Livingston

Mr Cameron Raine is a Consultant Plastic Surgeon at Spire Edinburgh Hospitals.

In a nutshell, the answer to this question is most commonly yes.  The surgery for breast cancer frequently involves lumpectomy, however, where mastectomy is required, increasing numbers of women are choosing to undergo total breast reconstruction.  Although every effort is made to achieve the best possible result in both of these circumstances, breast asymmetry can be a problem.  For many women the differences are small and no corrective surgery is requested.  For others, however, the problem can significantly impact their quality of life.  Fortunately there are a variety of ways that plastic surgery can help.  In some circumstances the appearance of the treated breast itself can be improved while in others it is the opposite side that may benefit from adjustment.  In a further group of women a treatment plan involving both breasts may give the best result.  It is the nature and extent of the asymmetry that will influence the type of surgery involved.

Sunday 15th August - Sleep apnoea

My husband’s snoring is driving me up the wall. It gets louder and louder until he wakes himself up too. What can we do? Anne, Crammond

Dr Tom Mackay is a Consultant Respiratory Physician at Spire Murrayfield Hospital.

Snoring, night-time breath holding episodes and excessive daytime sleepiness are characteristic of the Sleep Apnoea Hypopnoea Syndrome (OSAHS), a common condition affecting approximately 4% of middle aged men and 2% of middle aged women. It is caused by a combination of factors during sleep in people who have a narrow throat and is partly due to the natural throat shape, throat muscle relaxation overnight and weight gain.

The narrowed throat vibrates producing snoring, disturbing the partner’s sleep, and the throat walls are sucked closely together during deep sleep causing the person to waken up briefly and repeatedly overnight leading to poor quality sleep and subsequent excessive daytime sleepiness.

Once diagnosed, OSAHS can be treated effectively in most cases by using either a custom made gumshield device or by use of a small mask linked to a pressurised box called CPAP in addition to encouraging weight loss if indicated.

Sunday 8th August - Psoriasis

I've been diagnosed with psoriases. Will I have to live with it for the rest of my life and what treatments are available? William, Rosyth

Dr Alex Holme is a Consultant Dermatologist at Spire Murrayfield Hospital in Edinburgh.

Psoriasis is one of the commonest skin disorders affecting 2% of the population at any age and in both sexes equally.  It is not infectious or scarring.  Patches of psoriasis are red, covered by silvery-white scales, and can affect any area of skin, but most usually on the knees, elbows, trunk or scalp.  Some people are more likely to develop psoriasis if there is a history of it in their family.  Events can trigger psoriasis, such as a throat infection, stress or an injury to the skin, but for most, there is no obvious cause.  Sunlight improves psoriasis, though occasionally it makes it worse (especially if the skin gets burned).  A high alcohol intake and smoking can worsen psoriasis, as can some medicines.  Although psoriasis cannot be cured, it can be treated in a number of ways including creams, light therapy, tablets and injections, which reduce scalyness and redness, in some people to the point at which the skin can look completely normal.