Rethinking ‘self care’

Cervical screening

Cervical screening is offered to all women and people with a cervix aged 25-64 to check the health of cells in the cervix. It is offered every three years for those aged 25-49, and every five years from the ages of 50-64, and is one the most effective tools for preventing cervical cancer.

However, despite saving thousands of lives every year, Siobhán Hallmark, spokesperson for Jo’s Cervical Cancer Trust, says: “Almost one in three [people] are not up to date with their cervical screening and coverage has been on a downward trend for over twenty years, with the most recent coverage in England reported at just 68.7 per cent, compared with 84 per cent 25 years ago.”

Siobhán says that there are many barriers that can make cervical screening difficult or impossible to access for some, including people who work or who have childcare commitments struggling to get a convenient appointment, as well as lower uptake for physically disabled women, survivors of sexual violence and trauma, and for women from black, Asian and minority ethnic backgrounds, as well as those living in areas of high deprivation.

As a result, Jo’s Cervical Cancer Trust is urging Government and policy leaders to ensure that all of the barriers and inequalities in accessing screening are addressed so that there is greater flexibility in where and when people can access cervical screening, with Siobhán adding: “If someone is unsure about whether their screening history is up to date, a call to their GP surgery should confirm when their next appointment is due.”

Breast screening

Breast screening is a vital tool that enables some breast cancers to be detected early, before there are any signs or symptoms. It is offered to women aged 50-70 to detect early signs of breast cancer, and women over 70 can self-refer.

“It is important to offer women information and support about breast screening and encourage eligible women to attend their mammograms when invited, as it’s an integral part of self care because the sooner breast cancer is diagnosed, the more effective treatment is likely to be,” says Sally Kum, Breast Cancer Now associate director of Nursing and Health Information.

Since people may approach pharmacy staff about possible symptoms of breast cancer, Sally says pharmacy teams are ideally placed to have conversations with patients about the importance of breast checking and the possible signs of breast cancer, calling it “vital” that staff know to suggest people see their GP to get anything new or unusual checked out.

“Common symptoms of breast cancer include a lump or swelling in the breast, upper chest or armpit, a change to the skin, such a puckering or dimpling, a change in colour to the breast, nipple change, a rash or crushing around the nipple, unusual liquid from either nipple and changes in size and shape to the breast,” says Sally. Adding: “Breast checking only takes a few minutes and it could be a part of women’s self care routine, while getting dressed, showering or applying moisturiser. There's no wrong way to check, and at Breast Cancer Now we say it’s as simple as TLC: Touch, Look, Check.” 

Bowel cancer screening

There are around 44,100 new bowel cancer cases in the UK every year, and survival rates are much higher when it is diagnosed at its earliest stage.

Bowel cancer screening aims to detect bowel cancer at an early stage before symptoms have a chance to develop. It reduces death from bowel cancer and may also help to prevent bowel cancer through the identification and removal of pre-cancerous polyps or adenomas.

There are separate bowel screening programmes for the different UK nations which invite eligible people for bowel cancer screening every two years:

• England: people aged 56-74 years who are registered with a GP. The NHS in England is lowering the age that people can get a screening home-testing kit to 50 over the coming years
• Northern Ireland: people aged 60-74 years who are registered with a GP
• Scotland: people aged 50-74 years with a Community Health Index (CHI) number
• Wales: everyone aged 51-74 years who is registered with a GP and living in Wales.

Dental

Although not cost-free to everyone, it’s also important to encourage customers to keep up their regular dental check-ups.

Tooth decay can be painful and lead to fillings, crowns or inlays. If left untreated, the nerve of the tooth can become infected and die, causing an abscess which in turn could require root canal treatment or even mean the tooth has to be removed. Gum disease is also common and, if left untreated, may lead to bone loss around the teeth as well as loose teeth and tooth loss.

A simple twice-daily brushing routine with a fluoride toothpaste can help prevent most dental problems, alongside cleaning between the teeth with ‘interdental' brushes or floss at least once a day, having sugary foods and drinks less often, and attending regular dental check-ups to remove any build-up on teeth and treat any gum disease that has already appeared.

Eye health check ups

Pharmacy teams can also advise customers to visit an optometrist and have an eye examination at least once every two years to check their eye health and determine if spectacles are required to help improve their vision.

“As part of the sight test, optometrists will check the health of the eyes to look for signs of eye conditions, such as cataract and glaucoma,” says Aishah Fazlanie, clinical adviser at the Association of Optometrists. “Sometimes, optometrists can even detect signs of underlying general health conditions, such as diabetes and hypertension. If any additional investigation or tests are needed, the optometrist will refer the patient by either writing to their doctor or the eye hospital.”

Some patients are entitled to help towards their health costs and may be eligible for an NHS funded sight test and a voucher towards spectacles or contact lenses, and they can visit the NHS website to check if they qualify.

“While the optometrist can detect and monitor your eyes for signs of eye disease or injury, prevention is better than cure", adds Aishah, “and eating a healthy balanced diet with omega-3 fats and vitamins, staying active, not smoking and being aware of family history of eye conditions are also important”.

Joined-up care

With the launch of Pharmacy First, Numark lead information services pharmacist, Kenny Chan, says pharmacy teams can expect to see patients coming to the pharmacy for a wider range of issues, so it’s worth knowing where to refer when necessary.

“Oftentimes, following initial diagnostics and tests, community pharmacy teams can refer patients to services – such as the 12 week online NHS weight management programme – to help them manage their health themselves,” he says.

Since community pharmacists and their teams are so well placed to advise on health tests, and continue to support customers once their results come back, building partnerships with other healthcare providers within the community increases the likelihood, and streamlines the process of, referrals and creates better joined-up care for customers.