Our nurses answer your frequently asked questions about cancer

Every year, our Cancer Awareness Roadshow sets off around the country to talk to people about cancer whilst they are out and about. They chat to people in the street, in community venues and even at big events like Pride. 

At the same time, our Cancer Awareness in the Workplace team are visiting busy workplaces to support employees to reduce their risk of cancer and take positive action for their health.  

Our Cancer Awareness nurses chat to people about how small changes to their day-to-day routine can reduce their cancer risk, encourage them to listen to their body and give them the confidence to talk to the GP if they notice something that’s unusual or not going away. 

Our experienced nurses help thousands of people every year and so far, we’ve reached over 750,000 people. But if you haven’t been able to make it to one of our stops, our nurses have answered some of the frequently asked questions they hear on the roadshow and at Cancer Awareness in the Workplace sessions. 

1) How does age affect the risk of cancer?  

As we age our risk of developing cancer increases.  

Often changes in our DNA are fixed by our body, but sometimes damage builds up, and this causes cells to multiply and grow unusually, leading to cancer. As we get older, there is more time for damage to build up and so more chance of cancer developing. 

Damage also happens over time due to things outside the body such as UV rays from the sun and drinking alcohol. 

The risk of most cancer types starts increasing from the age of 50, and half of all cancers are in people over the age of 70. 

2) Cancer is in us all – so are we all going to get cancer? 

Not everyone will get cancer – 1 in 2 of us will get cancer in our lifetime.  

To understand why not everyone will get cancer, it’s important to know what cancer is and how it develops. 

Our bodies are made up of more than a hundred million million cells (100,000,000,000,000). Our cells are constantly dividing, dying and being replaced. This normally happens in a controlled way to make sure we have the right number of each type of cell in our body.  

But sometimes things can go wrong, leading to a change in one cell or a small group of cells. This is called a mutation.  

Due to these changes, the cell may not understand it’s instructions and begin to divide and multiply uncontrollably which in turn can lead to cancer. There needs to be about 6 different mutations before a normal cell becomes a cancer cell.  

Some mutations happen by random chance, and others are caused by factors from outside the body like chemicals in tobacco smoke or UV radiation from the sun. More rarely, cancer is linked to an inherited faulty gene, which we’ll cover in the next question.   

3) Is family history a risk factor for cancer?  

Some people have an increased risk of certain cancer types because they have inherited a faulty gene. But only a small percent of cancers – 5 to 10% – are related to a family history of cancer.  

Because cancer is common, most families will have at least one person who has or has had cancer. But having a couple of relatives diagnosed with cancer doesn’t mean there is a cancer gene fault running in the family. 

If you think that you may have a strong family history of cancer and have any questions or concerns, talk to your GP. Try to have as much information about your relatives’ cancer diagnoses as possible. 

Healthcare professionals will look at several factors when working out if there is a faulty gene in a family. This includes the type of cancer, which relatives and how many relatives have been diagnosed, and what age they were diagnosed at.  

4) What should I do if I am struggling to get an appointment with my GP? 

Stick with it! We know how disheartening and frustrating it can be when you have tried to get an appointment with the GP but haven’t been able to.  

But if something’s unusual for you, not going away, or if you think you might have cancer, it’s important to keep trying. Cancers found at an early stage are more likely to be treated successfully. 

There are a few ways you can get an appointment at a GP, like phoning or filling in an e-consultation online, and some GP’s still have walk in clinics. This varies from surgery to surgery.  

If you have tried one method of getting in contact but haven’t been able to get through, try one of the other methods your GP surgery has to offer.  

If you have managed to get in contact with your GP and have been told there are no appointments for a few weeks, or to call back in the morning, then there are a few things you can do: 

• You can take the appointment that they offer you for now, this doesn’t mean you have to stop trying to get an earlier appointment.  
• Ask to be put on a cancellation list if they have one. Double check that your GP surgery has your correct contact details in case a cancellation becomes available.  

Write down any symptoms you have, roughly how long you’ve had them for and if anything makes it better or worse. This means that when you speak to your doctor, you can explain your symptoms clearly and ensure everything has been mentioned.  

And finally, as we mentioned earlier, tell your GP practice if you are worried about cancer or have a family history of cancer.  

5) Do I have to tell GP receptionists about my heath? 

We understand it might feel uncomfortable telling your GP receptionist what’s wrong, but they have been trained to ask you certain questions, and anything you tell them will be treated as confidential. 

Giving the receptionist an idea about any symptoms you are experiencing means you’ll get the most appropriate care for you as quickly as possible. Depending on your symptoms, they might be able to get you an earlier appointment or suggest someone who can talk to you sooner than your GP. This could be a practice nurse or a pharmacist. 

Sharing even a small amount of information can be helpful and could mean you speak to someone who can help sooner. 

The receptionist is also there to help with anything else you might want to know or are unsure about before your appointment. This includes information about how any remote appointments are going to work, or any concerns or questions about tests you may need to have.  

Video and telephone consultations are new to lots of people – so ask the receptionist if you’d like more information or support. 

6) Do people with darker skin tones need to wear sunscreen?

Yes, everyone should think about how to protect their skin and stay safe in the sun.  

Too much ultraviolet (UV) radiation from the sun can damage DNA in your skin cells, which can build up over time and cause skin cancer.  

People with darker skin tones can still burn in the sun. Sunburn is skin damage and your body’s response to try to repair it. It is a clear sign that the DNA in your skin cells has been damaged by too much UV radiation. Sunburn can feel different for people with darker skin. It may be irritated, itchy or tender.  

Although people with naturally darker skin generally have a lower risk, anyone can get skin cancer. 

Sunscreen is just part of the picture when it comes to staying safe in the sun, the best ways you can protect yourself are by spending some time indoors or in the shade, and covering up with clothing. So when the sun is strong don’t forget to find shade, cover up and use sunscreen for the parts that can’t be covered up.  

7) If I wear sunscreen, will I get enough Vitamin D? 

Our skin makes vitamin D in sunlight, but the amount of time you need in the sun depends on your skin tone and the time of year. 

Between April and the end of September, most people in the UK can make enough vitamin D by spending short periods of time in the sun without protection. There is no need to sunbathe to get enough vitamin D. Short breaks in the sun (minutes, not hours) without sun protection should be enough. 

People with darker skin tones maybe more at risk of a vitamin D deficiency as they need to spend longer in the sun to produce enough of it. In the UK, the NHS recommends  people at risk of vitamin D deficiency take a 10 microgram (400 I.U.) supplement throughout the year. 

The government recommends that everyone takes a vitamin D supplement between October and the end of March, when the sun’s rays are weaker. 

 

Others more at risk of vitamin D deficiency include:  

• People who spend most of their time inside 
• People who cover most of their skin  
• People who are pregnant or breastfeeding  
• People over the age of 65 and babies or children under 4 years old.  

If you are concerned that you aren’t getting enough vitamin D, please speak to your healthcare provider. 

8) I have a cancer diagnosis but I’m not on any treatment. Is this normal?  

There are over 200 types of cancer. Cancers are also diagnosed at different stages and grow at different rates. Some cancers require chemotherapy, radiotherapy or immunotherapy and some require surgery. Some cancers may need more than one form of treatment.   

Some cancers do not require treatment straight away, and occasionally not at all, and are just monitored by your healthcare professional to look for changes. This all depends on how the cancer is affecting your body and how aggressive the cancer is.  

To understand why you are not on any treatment, its best to speak to your specialist nurse or doctor to understand how they came to that decision. 

9) Do I have to pay for prescription for nicotine replacement if I want to stop smoking? 

Depending on where you live in the UK, some nicotine replacement therapies (NRT) are free through the NHS. Your local pharmacy will be able to advise you on different forms of NRT and whether you would need to pay for them.  

Most local stop smoking services can also provide free one-to-one support and stop smoking tools, including NRT. You’re around 3 times more likely to stop smoking for good with their help. To find your local stop smoking services, you can ask your local pharmacy of GP surgery.  

You could also speak to your GP about stopping smoking and get a prescription to help you stop.  Stopping smoking is the best thing you can do for health, so whatever your reasons for stopping, keep going. You can do it! 

10) Is cervical screening for me if I’ve never been sexually active, or never had penetrative sex? 

Yes. Anyone with a cervix between the ages of 25-64 can go for cervical screening.   

HPV is passed on through close skin to skin contact, usually during sexual activity. You don’t need to have penetrative sex to be infected with HPV, it can be passed on through any form of sexual contact. This includes vaginal, anal or oral sex, sharing sex toys and any close skin-to skin contact through sexual activity. 

11) Is cervical screening for me if I’ve not been sexually active recently or have only had one partner? 

Yes. HPV can stay in the body a long time so even if you have not been sexually active recently or have only had one sexual partner, you could still benefit from screening. 

Our common questions about HPV article has more information on how HPV can lie undetected in our body and become active later. 

12) Does cervical screening hurt?

Cervical screening only takes a few minutes but it can be uncomfortable. The speculum (the tool used to open up the walls of the vagina so the nurse can see inside) doesn’t usually hurt, but everyone is different. 

Let the nurse know if you are worried about screening being painful for you, you can ask them to use a different sized speculum or to help you find a more comfortable position.  

You could also ask for a female or male nurse, bring someone with you for support, or wear a long dress, skirt or top to help you feel more covered and make the process more comfortable for you.  

If you feel too uncomfortable during the test, you can ask your nurse to stop and either find a better position and try again or make an appointment for another time. It’s your choice. 

If you are worried about getting your cervical screening you can also speak to your health care provider for reassurance or more information. 

Sophie Marshall is a cancer awareness nurse at Cancer Research UK