A recurring problem
I have just been diagnosed with skin cancer on my forehead. It is going be removed in a couple of weeks. The dermatologist has said that I will be "cured" after the operation. Can one ever be truly cured of cancer? Isn't there always a risk that it will come back, either at the original place or somewhere else in the body?
From your description, your skin cancer is probably a basal cell carcinoma – sometimes called a BCC or rodent ulcer. It is the most common type of skin cancer, and also the least serious. BCCs are unusual cancers because they do not spread to other parts of the body. But they do tend to get bigger, and can begin to invade underlying tissues if left untreated. Normally they can be completely cured, leaving only a small scar. The two other types of skin cancer – squamous cell carcinomas and malignant melanomas – are more serious. Both can spread to other organs, and both can be fatal. If your cancer is a BCC, you should be cured of it, but no one can guarantee that you won't develop another one in the future.
Why are NHS prescriptions not free for people with asthma and other chronic diseases? A friend with diabetes gets all of her prescriptions for free. I have asthma and must pay for mine.
Many years ago, the NHS decided that it would provide free prescriptions for patients who were suffering from "deficiency diseases" – ones caused by the human body's inability to produce natural hormones. People with diabetes are not able to produce enough insulin, whereas asthma is not caused by a specific hormone deficiency. Yet if you had both diabetes and asthma, your asthma prescriptions would be free. The rules are hopelessly out of date, but no one seems keen to update them. Why, for example, isn't hormone replacement therapy free? It is a classic example of a condition caused by the body's inability to produce natural hormones. Your best bet is a pre-payment certificate, which is like a season ticket for prescriptions. If you buy more than four prescription items in three months or 14 items in 12 months, this will save you money. A three-month pass costs £26.85, a 12-month pass £98.70. You can pay for the 12-month pass by direct debit spread out over 10 months. You can order online at www.ppa.org.uk/ppa/ppc_intro.htm.
Please send questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax: 020-7005 2182; email: firstname.lastname@example.org. Dr Kavalier is unable to respond personally to questions
A few more tips for preventing cystitis:
RH from Hants: Always empty your bladder before and after sex.
JP: Avoid all bath products and perfumed soap (I have found that these products can give me thrush, too); always wear cotton underwear (no G-strings); and only use tampons for sporting activities.