Tag: 8. Februar 2024

Each Friday, host Felicity Harley and Body + Soul’s digital editor Ashleigh Austin chat through three stories that made them spit-out – or guzzle – their green juices. Or wine. This week, they chat about ‘millenopause’ (see story here); the animal movement workout (see TikTok here or study here); drinking sugar-free cordial as your water intake (see story here). 

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On the big screen, we’re used to seeing movie characters stumble upon an unfortunate health discovery in one of two dramatic ways. Either a lump is mysteriously felt in the middle of a shower, or their weekly grocery shop is interrupted by a sudden fainting spell. 

And while these two examples reflect a series of events many cancer patients endure, not every serious illness is discovered like that. Cancer, an umbrella diagnosis comprised of thousands of combinations of stages and types, can often be found in a patient who may not necessarily be displaying ‘tell-tale’ symptoms. 

Without evoking paranoia with every cough, rash or ache your body may develop, it’s important to constantly check in with how your body looks, feels and functions. As some symptoms of serious illness are hard to detect or distinguish on our own, keeping up to date with your regular GP visits and screening requirements throughout the years is also a must.

From unsightly rashes to seemingly normal aches and pains, here are ten physical indications of cancer that might surprise you.

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#1. Neverending itching

Lymphomas, such as Hodgkin’s and non-Hodgkin lymphoma, are types of cancer that affect the lymph system. How does this cause itchiness? Well, according to experts, the body releases chemicals known as cytokines as a response to lymphoma, which can irritate the skin and cause incessant itching. Dr Craig Moskowitz, physician in chief for oncology at Miami’s Sylvester Comprehensive Cancer Center, urges people not to overlook a severe and persistent itch, “If nobody can really figure out why you’re having generalised itching, you really need to pursue a possible diagnosis of an underlying malignancy,” he tells Health. 

#2. Pearly pimples

Being the most common type of cancer, it’s no surprise that skin cancer can manifest in several ways. According to dermatologist Dr Marc Glashofer, one of the main types– basal cell carcinoma– can often appear as a pearly, translucent pimple. They also have been diagnosed after examining sores, scaly patches, and cyst-like bumps. According to the expert, skin concerns persisting beyond six to eight weeks should be examined by a specialist. 

#3. A droopy eyelid

Strangely enough, a droopy upper eyelid can indicate the presence of a Pancoast tumour, a type of lung cancer that spreads from the upper part of the lung. Unlike most cancers of this region, developing a bad cough is not a common symptom associated with Pancoast tumour, instead manifesting as severe shoulder pain, a droopy eyelid and the loss of sweating on one side of the face. 

#4. Eczema-like rashes

If a red, scaly patch of skin develops on a patch of skin that is often exposed to the sun and persists beyond eight weeks, don’t jump to the concussion that it’s eczema, Dr Glashofer says. Rashes of this type can sometimes be a symptom of squamous cell carcinoma. Fortunately, when caught early enough, Squamous cell carcinoma is almost always curable.

#5. An earache

An earache is usually a sign of infection, but what about one that persists despite any rhyme or reason? It may be a symptom known as ‘referred otalgia’, and can be triggered by oral cancer. As Dr Bruce Davidson from Georgetown University Medical Center in Washington explains, “An early cancer on the back of the tongue or tonsil might have pretty subtle symptoms.”

#6. Irregular vaginal bleeding

Irregular vaginal bleeding is almost always an indication of some kind of hormonal imbalance or ongoing physical issue. While it often can be caused by uterine fibroids or polyps, some cases of unusual bleeding can be linked to endometrial cancer, a common type of uterine cancer. Dr Stephen Rubin, MD, chief of gynaecologic oncology at Fox Chase Cancer Center in Philadelphia, urges anyone who experiences abnormal bleeding (especially after menopause) to seek medical evaluation. 

#7. That lump-in-the-throat feeling

Noticing that feeling of having a lump in your throat, but the finale of Marlie and Me isn’t playing in the background? Often accompanied by acid reflux, this feeling can be an indication of a present tumour. Dr Davidson says he’s seen a rise of base-of-tongue and tonsil tumours due to human papillomavirus infections, often acquired through oral sex. 

#8. Pain after drinking alcohol

While most people are familiar with a pounding headache the morning after heavy drinking, experiencing pain from just a few sips of alcohol can sometimes indicate the presence of Hodgkin lymphoma. Initially impacting the body’s white blood cells, Hodgkin lymphoma can start almost anywhere in the body, often appearing in the lymph nodes in the chest, neck, or under the arms. “Usually, these patients can have some swollen lymph nodes in the neck or the chest,“ Dr Moskowitz says, explaining alcohol consumption appears to induce pain in these lumps.

#9. Losing your voice

Unless you’ve spent the weekend at a music festival, or are recovering from a terrible cold, persistent hoarseness of the voice could be an indication of laryngeal cancer. Attacking to voice box, this cancer can also cause throat and ear pain, or a lump in the throat. 

#10. Nipple discharge

While breastfeeding women are more than familiar with irritating and often uncontrollable milk discharge, experiencing the phenomenon outside of pregnancy (i.e. not breastmilk) can indicate a grave issue. Discharge that is sudden, yellowish or bloody, or occurs in one breast only can sometimes be a symptom of Paget’s disease, a rare form of breast cancer. 

As always, if any symptom or physical ailment is concerning you, seek medical advice from your doctor– not Google.

Billshock hurts. Like when you walk into the doctor expecting to pay $200, but walk out with a bill for more than double. It’s an unpleasant experience that can leave you feeling uneasy about the financial side of your healthcare. 

Australians spent a total of $241.3bn on health goods and services in 2021-22 (the most recent data) according to the Australian Institute for Health and Welfare. That’s $9365 per person, per year – and that figure is going up. 

It’s a lot of money, and it’s a lot of money to shell out when you’re not prepared for it. 

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How does it happen?

Let me share my story. I’m in the process of diagnosing and managing a slightly obscure disorder called temporomandibular joint disorder (TMJ). In short, it causes jaw and facial tension, leading to migraines and other horrible things. So far I’ve seen multiple GPs, dentists and now a few specialists. The latest of which was unable to help me. 

The initial consult was around $200, with about $100 taken care of by Medicare. When I booked the receptionist mentioned that anything additional would cost extra. Of course. 

But when I went to pay, the bill was more than $400. The doctor hadn’t mentioned any extra charges. Shocked, I said, “Sorry, the quote was for a little over $200.” 

The receptionist looked at me like I was silly and calmly explained a camera I had jammed up my nose cost another $200. Ouch on a few levels. 

Before you start in the comment section, yes, I know, these costs are necessary, it’s your health, and you need to care for yourself. 

But what are the guidelines on letting patients know about these costs, and when – because sometimes, sadly, dinner on the table has to take precedence. 

What do the rules say?

The Australian Health Practitioner Regulation Agency (AHPRA), a body that deals with best practices for medicos in the country has strong guidelines on informed consent and financial dealings. The most relevant of these are:

• Ensure that your patients are informed about your fees and charges in a timely manner to enable them to make an informed decision about whether they want to proceed with consultations and treatment.
• When referring a patient for investigation, treatment or a procedure, advising the patient that there may be additional costs, which patients may wish to clarify before proceeding. 

The Australian Medical Association (AMA), another peak industry body, has a guide on ‘informed financial consent’, but similar to AHPRA, it puts it on the patient to clarify costs. 

“The AMA is strongly committed to fee and billing transparency and publishes extensive information to support fully informed financial consent between doctors and their patients,” President Professor Steve Robson said.

“The AMA supports and actively encourages full transparency of doctors’ fees and for doctors and patients to discuss fees as early as is practical.”

It does also note there are a range of circumstances where a doctor might find it difficult to provide full informed financial consent i.e. if someone needs emergency care.

The Royal Australian College of General Practitioners said it’s a complex issue for GPs, who won’t know what issue a patient will present with, or what treatments are required until after the examination. 

“A GP can’t know what all the costs involved in an illness will be ahead of time, and in a complex medical investigation, a GP might have to explore several potential issues before a diagnosis. It’s vital to continuously communicate with patients on these kinds of issues,” President Dr Nicole Higgins said.

“Our guidance for GPs and practice staff and position statement emphasises the importance of being transparent about any out-of-pocket costs. 

“Sometimes those may be down to an external service, such as pathology, but with the cost of materials growing faster than Medicare patient rebates, some practices may have to pass those costs onto the patient to keep their doors open.

“The important thing is that GPs and practice staff are comfortable having conversations with patients to prevent bill shock.” 

What can you do if you are in financial strife?

I contacted my specialist, just out of curiosity to find out what their process was after my appointment. They dodged the question and claimed everything was done according to standard. And they’re technically not wrong. 

The onus, according to the AHPRA and AMA, is on the patient to ask. It seems difficult, especially mid-consult, but don’t let that put you off; you’re within your rights to engage the doctor on costs.

Victorian Health Complaints Commissioner, Adjunct Professor Bernice Redley encourages discussion early on in the consultation period and cost transparency.

“It is expected that health consumers are fully informed about any fees or charges and provide consent when making decisions about their health care,” she said.

“Generally, information about fees or charges is provided up-front, and options discussed early in the consultation or at the time when a fee becomes apparent.”

She also said there are options for recourse if you’re unable to pay, or if you believe the complaint should be escalated.

“Patients are encouraged to discuss their concerns, including costs, with their health provider in the first instance,” she said. 

“If their concerns are not addressed to their satisfaction, they can raise a complaint with their provider or the health service. Information about how to make a complaint should be easily accessible at the service or on their website.

“If the patient’s concerns email unresolved, they can escalate their concern to the Health Complaints Commissioner. If the complaint relates to an individual registered health practitioner, they can make a notification to the AHPRA.” 

How can you avoid bill shock?

To avoid bill shock the AMA encourages you to ask the following questions:

• What are your fees?
• Are there any fees for other doctors?
• Will I have any out-of-pocket expenses?
• Is your fee an estimate only?
• Can I have an estimate of your fees in writing?
• If the costs change, when will you let me know?
• Should I contact my health fund?

As for me, – well I’m just going to have to wear the costs, no matter how badly the situation has gotten up my nose –  but next time at least I’ll be better informed.