Most people with polyps won’t be aware of them as they produce no symptoms and are often discovered by accident.
However, some larger polyps can cause:
a small amount of rectal bleeding (blood in your stool)
mucus to be produced when you open your bowels
diarrhoea or constipation
abdominal pain
Bowel polyps are caused by an abnormal production of cells. The lining of the bowel constantly renews itself, and a faulty gene can cause the cells in the bowel lining to grow more quickly.
There may be a family tendency towards developing bowel polyps or bowel cancer.
There are several methods for treating polyps, but the most common procedure involves snaring the polyp during a colonoscopy. Snaring is like cutting the polyp off with cheese wire and is painless.
Both of the above methods involve passing a flexible instrument called a colonoscope through your bottom and up into your bowel. The colonoscope has a wire with an electric current to either cauterise (burn off) or snare the polyp.
In rare cases, polyps may need to be treated by surgically removing part of the bowel. This is usually only done when the polyp has some cell changes or is particularly large.
After the polyp or polyps have been removed, they are sent to specialists in a laboratory, who will inform your consultant if:
the polyp has been completely removed
there is any risk of it regrowing
there is any cancerous change in the polyp
If there is a cancerous change in the polyp, you may need further treatment (depending on the degree and extent of change). Your specialist will be able to advise you on this.
an overdose of illegal drugs, tranquillisers, poisons or other chemical agents
an abnormally low body temperature (hypothermia)
severe under-activity of the thyroid gland
Once these factors have been ruled out, tests are carried out to confirm brain death. The diagnosis of brain death has to be made by two senior doctors. Neither of them can be involved with the hospital’s transplant team.
The doctors will explain the tests to you and they’ll keep you informed about your loved one’s condition at all times.
Tests
The doctors will run a series of tests. Both doctors have to agree on the results for a diagnosis of brain death to be confirmed. The tests are carried out twice to minimise any chance of error.
The tests used to determine whether brain stem death has occurred are outlined below:
A torch is shone into both eyes to see if they react to the light.
The cornea (transparent outer layer of the eye), which is usually very sensitive, is stroked with a tissue or piece of cotton wool to see if the eye reacts.
Pressure is applied to the forehead and the nose is pinched to see if there’s any movement in response.
Ice-cold water is inserted into each ear, which would usually cause the eyes to move.
A thin, plastic tube is placed down the trachea (windpipe) to see if it provokes gagging or coughing.
The person is disconnected from the ventilator for a short period of time to see if they make any attempt to breathe on their own.
Brain death will be diagnosed if a person fails to respond to all of these tests.
Occasionally, a person’s limbs or torso (the upper part of the body) may move, even after brain stem death has been diagnosed.
These spinal reflex movements are generated by the spinal cord and don’t involve the brain at all. Therefore, they won’t affect the diagnosis of brain death.
There are a number of criteria for diagnosing brain stem death.
For a diagnosis of brain stem death to be made:
a person must be unconscious and fail to respond to outside stimulation
a person’s heartbeat and breathing can only be maintained using a ventilator
there must be clear evidence that serious brain damage has occurred and it can’t be cured
Ruling out other conditions
Before testing for brain stem death, doctors must carry out a series of checks to ensure that the symptoms aren’t being caused by other factors, like:
an overdose of illegal drugs, tranquillisers, poisons or other chemical agents
an abnormally low body temperature (hypothermia)
severe under-activity of the thyroid gland
Once these factors have been ruled out, tests are carried out to confirm brain death. The diagnosis of brain death has to be made by two senior doctors. Neither of them can be involved with the hospital’s transplant team.
The doctors will explain the tests to you and they’ll keep you informed about your loved one’s condition at all times.
Tests
The doctors will run a series of tests. Both doctors have to agree on the results for a diagnosis of brain death to be confirmed. The tests are carried out twice to minimise any chance of error.
The tests used to determine whether brain stem death has occurred are outlined below:
A torch is shone into both eyes to see if they react to the light.
The cornea (transparent outer layer of the eye), which is usually very sensitive, is stroked with a tissue or piece of cotton wool to see if the eye reacts.
Pressure is applied to the forehead and the nose is pinched to see if there’s any movement in response.
Ice-cold water is inserted into each ear, which would usually cause the eyes to move.
A thin, plastic tube is placed down the trachea (windpipe) to see if it provokes gagging or coughing.
The person is disconnected from the ventilator for a short period of time to see if they make any attempt to breathe on their own.
Brain death will be diagnosed if a person fails to respond to all of these tests.
Occasionally, a person’s limbs or torso (the upper part of the body) may move, even after brain stem death has been diagnosed.
These spinal reflex movements are generated by the spinal cord and don’t involve the brain at all. Therefore, they won’t affect the diagnosis of brain death.
severe, persistent headaches
seizures (fits)
persistent nausea, vomiting and drowsiness
mental or behavioural changes, such as memory problems or changes in personality
progressive weakness or paralysis on one side of the body, vision problems, or speech problems
Sometimes, you may not have any symptoms to begin with, or they may only develop very slowly over time.
If your GP is unable to identify a more likely cause of your symptoms, they may refer you to a neurologist for further assessment and tests, such as a brain scan.
Speak to your GP if you have persistent symptoms of a brain tumour. While it’s unlikely to be a tumour, it’s best to be sure by getting a proper diagnosis.
If your GP is unable to identify a more likely cause of your symptoms, they may refer you to a neurologist for further assessment and tests, such as a brain scan.
The main treatment for most brain tumours is surgery, which aims to remove as much of the abnormal tissue as possible.
It’s not always possible to remove the entire tumour, so further treatment with radiotherapy and/or chemotherapy may be necessary to kill any abnormal cells left behind.
For most benign tumours, treatment is often successful and a full recovery is possible, although there’s sometimes a small chance the tumour could come back. Regular follow-up appointments will normally be recommended to monitor this.
The outlook for malignant tumours is generally less good, although this varies depending on things such as where the tumour is in the brain, your age, and your general health. Unfortunately, a cure is often not possible and most tumours will return after treatment.
If a tumour does come back, treatment will aim to relieve your symptoms and prolong life by controlling the growth of the tumour.
Support and further information
As well as reading the separate pages on benign brain tumours and malignant brain tumours, you may find the following websites useful sources of information and support:
The Brain Tumour Charity
Brain Tumour Research
Cancer Research UK: Brain tumours
Macmillan Cancer Support: Brain tumours
Symptoms will depend on the size of the tumour, where it is and how it affects that part of the brain. Symptoms are caused by the pressure inside the head being higher than it should be. A growing tumour may push normal brain out of the way, or block the flow of fluid in the brain. Doctors call this raised intracranial pressure, and it can cause symptoms such as:
headaches (often worse in the morning)
vomiting (usually in the morning) or feeling sick
fits (seizures)
feeling very irritated or losing interest in day-to-day things
eye problems, such as abnormal eye movements, blurring or double vision feeling very tired much more quickly than usual
feeling extremely sleepy (drowsy) for no reason
Brain tumours can also cause problems with balance and walking, weakness down one side of the body, or changes in behaviour. Some of these symptoms are common even without a brain tumour, and this can cause confusion in the early stages.
Knowing what a test involves can make things a bit easier. The specialist doctor and nurse will explain things but don’t be afraid to ask questions.
Your doctor will want to hear about the problems your child has had recently, and will examine him or her properly. This will include looking into the back of your child’s eyes with an ophthalmoscope to check for swelling, which can be a sign of raised pressure in the brain. They’ll usually check other things like balance, coordination, sensation and reflexes.
CT or MRI scan
Most children will have a CT or an MRI scan, which looks in detail at the inside of the brain.
A CT scan uses X-rays. It’s quick and often is the best first-line investigation, but it does not give as detailed pictures as an MRI. It uses quite a lot of X-rays, and so it is important to make sure we do not use it on too many people if it can be avoided.
An MRI scan uses no X-rays, and gives more detailed pictures, but takes much longer. Machines are noisy, and often children cannot lie still long enough to get proper images. It is sometimes necessary to have an anaesthetic for this scan.
Ordinary X-rays are not usually helpful for brain tumours.
Blood tests
These are usually done to make sure it is safe to do an operation, and can also be used to help diagnose certain types of tumour.
Biopsy
It’s often necessary for doctors to remove a small part of the tumour (biopsy) to find out exactly what type of tumour it is. It means your child will need to go into hospital for an operation under general anaesthetic. The piece of tumour removed is then examined under a microscope by a specialist doctor called a pathologist.
A biopsy isn’t always done; it is sometimes better to remove the whole tumour in one operation. In this case, it will be a few days before the exact type of tumour is known.
Sometimes, it may be safer to do the operation in two stages. Part of the tumour might be removed in the first operation and the rest a few days later.
Because there are different types of brain tumours, treatment will not be the same for everyone. The doctors will look at the type of brain tumour, its size and where it is in the brain before deciding on the best treatment.
These are the main treatments used to treat brain tumours. Your child may have one treatment or a combination of treatments.
Surgery
Usually, a neurosurgeon will operate to remove as much of the tumour as possible. Operations can be very long. It’s not uncommon for these to be more than 6 or 8 hours.
Sometimes, the fluid in and around the brain does not flow freely, as a result of the tumour or brain swelling. In this case, it may be necessary to place a fine tube (shunt) to drain excess fluid from the brain and into the lining of the tummy area (abdomen). You cannot see the shunt outside the body. Another way of treating this is to create another drainage route for the fluid around the obstruction (called a ventriculostomy).
After the operation, your child may spend some time in an intensive care ward or high dependency unit, so the nurses and doctors can keep a very close eye on them.
Once a diagnosis is known, a plan to treat any tumour left behind can be made. For benign tumours, there may be no further treatment, but for some, radiotherapy or chemotherapy will be required.
Radiotherapy
Radiotherapy treats cancer by using high energy radiation beams. These are exactly the same as visible light, but instead of reflecting from the surface, the energy passes inside the body, where it causes damage to tumour cells.
Radiotherapy is delivered extremely carefully, using machines linked to the MRI scans of your child’s brain. The process usually takes a few minutes each time, but often needs to continue for 5 or 6 weeks.
Sometimes more specialised types of radiotherapy may be used. Your child’s oncologist will explain more about this.
Chemotherapy
Chemotherapy uses drugs to get rid of cancer cells. Chemotherapy is given into the veins, and sometimes as a liquid or tablets by mouth. Treatment is often quite prolonged, with periods of time in hospital and gaps when you will be able to return home. This part of the treatment is planned by an oncologist.
The specialist doctor and nurse will explain your child’s treatment and answer your questions so that you understand what is involved.
Other medicines your child may need to take
Your child may need to take medicines for a while to reduce or control the symptoms of the brain tumour:
Steroids
These are medicines that reduce swelling and inflammation in the brain and can help with symptoms.
Anticonvulsants
These are medicines that help prevent fits, which can be a problem before or after operations on the brain. They may only be necessary for a short period, but sometimes are needed for longer.
Side effects of treatment
Your child’s doctor and specialist nurse will explain more about what to expect. Always let them know about any side effects your child is having. Many side effects can be well controlled or made easier.
Hair loss
Both radiotherapy and chemotherapy can cause hair loss. Your child’s hair will usually grow back again after chemotherapy, although it may not after radiotherapy.
Tiredness
Tiredness is very common with both treatments and may continue for weeks after chemotherapy or radiotherapy finishes.
Feeling sick
Radiotherapy and chemotherapy may make your child feel sick. This can usually be controlled well with anti-sickness drugs, which the oncologist will prescribe for your child.
Increased risk of an infection
Chemotherapy can increase the risk of infection. It’s important to contact the oncologist or specialist nurse straight away if your child has a temperature, any signs of infection or suddenly feels unwell.
Skin changes in the treated area if your child is having radiotherapy
Radiotherapy can cause a mild form of sunburn. The skin may become red, flaky or sore if your child has fair skin and may become darker and flaky if your child has dark skin. You’ll be given advice on looking after the skin in the treated area.
Clinical trials
Trials aim to improve our understanding of the best way to treat an illness, usually by comparing the standard treatment with a new or modified version. It’s important to realise that a clinical trial is not an ‘experiment’, and your doctor will always offer you what is believed to be the best available treatment. Clinical trials are usually offered to explore ways of making new improvements to treatment, beyond what is already known.
Specialist doctors carry out many trials for brain tumours. If appropriate, your child’s medical team will talk to you about taking part in a clinical trial, and will answer any questions you have. Written information is often provided to help explain things.
Taking part in a research trial is completely voluntary, and you’ll be given plenty of time to decide if it is right for your child. You can also join a trial, and then withdraw if you change your mind at a later date.
Treatment guidelines
Sometimes, clinical trials are not available for your child’s tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Children’s Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines.
Follow-up care
After treatment is over, your child will be seen regularly by specialists. This is to check their progress and how well they’re recovering from treatment. It is also to check that they don’t have any long-term problems from treatment.
You can contact your child’s specialist doctor or nurse at any time if you have any worries about their health.
Long-term side effects
Sometimes treatments may cause possible long-term side effects that may develop later. Your child’s oncologist or specialist nurse will explain the possible risk of any long-term effects in your child’s situation. Children are monitored for any long-term problems following treatment so that they can be picked up and managed early on.
This section on brain tumours is for teenagers and young adults.
The symptoms of a brain tumour depend on the size of the tumour and where it is.
The tumour can:
cause fits
affect the messages sent by that part of the brain to other parts of the body
cause ‘raised intracranial pressure’ – there’s only a certain amount of space in the skull for the brain and as a tumour grows, there can be a rise in pressure in or around the brain
Common symptoms of ‘raised intracranial pressure’ are:
headaches, which are often worse in the morning
vomiting (usually in the morning) or feeling sick
fits (seizures)
feeling very irritated or losing interest in day-to-day things like friends, school or going out
problems with your eyes, such as blurring or seeing double
feeling more sleepy or drowsy than usual
changes in your balance and walking, or weakness down one side of the body
problems with speech
personality changes
There’s often a simple explanation for many of these symptoms. But if you have any of these or if you’re worried, it’s important to speak to your GP straight away.
This section on brain tumours is for teenagers and young adults.
The cause of most brain tumours is unknown. Research is looking into this all the time.
Young people with rare genetic conditions that run in families, such as neurofibromatosis type 1 and neurofibromatosis type 2, have an increased chance of developing a brain tumour.
Mobile phones, power lines and certain viruses have all been suggested as possible causes of brain tumours. There’s been a lot of research into these possible causes, especially mobile phones. But there has been no strong evidence for any of them.
Remember – nothing you’ve done has caused the tumour.
This section on brain tumours is for teenagers and young adults.
This section on brain tumours is for teenagers and young adults.
A team of specialists will plan your treatment. They will talk to you about the best treatment for you.
It’s normal to have a combination of treatments, so you may be seen by different doctors, such as:
a neurosurgeon, who specialises in brain operations
a neurologist, who treats brain conditions
a cancer specialist (oncologist), who treats brain tumours with radiotherapy and chemotherapy
You’ll usually see a specialist nurse who looks after people with conditions affecting the brain, or a specialist nurse for teenagers or young adults with cancer. If you have radiotherapy (X-ray treatment) you will be given this treatment by a radiographer.
There are different types of brain tumours, so treatment won’t be the same for everyone. Your doctors look at the type of brain tumour you have, its size and where it is in the brain before deciding on the best treatment for you.
The main treatments for brain tumours are:
surgery – an operation to remove all, or as much as possible, of the tumour
radiotherapy – uses high-energy x-rays to treat cancer cells
chemotherapy – uses anti-cancer drugs to destroy cancer cells
Your specialist doctor and nurse will explain your treatment and answer any questions you have. It’s important you understand what’s involved. You’ll probably need some time to talk it through with your family.
As part of your treatment for a brain tumour you’ll probably be given drugs called steroids. You may also be given some anticonvulsant drugs to prevent fits.
Steroids
Steroids help reduce the swelling that often surrounds a brain tumour. Although they don’t treat the tumour itself, they can improve symptoms and make you feel better. Steroids are often given before and after surgery, and sometimes during or after radiotherapy and chemotherapy.
It’s important to take steroids as your doctor tells you and not to suddenly stop them. If you take steroids for more than 2 weeks, it’s important to tell your doctor about them if you are unwell (for example an infection) over the next 6 months. This is because you may need an extra course of steroids.
Side effects
If you take steroids for some time, you may have some temporary side effects. These can include:
weight gain
a change in the shape of your face (making it more rounded)
indigestion
slightly more risk of getting an infection
mood changes (feeling ‘hyper’ or overactive or feeling low)
increase in the sugar level in your blood – your blood or urine may be tested to check for this
Side effects can be hard to cope with, especially with all the other stuff you have to deal with. Remember – the side effects will gradually get better when the steroids are stopped, and in the meantime there are lots of people who can support you.
Anticonvulsants
Tumours in the brain can sometimes cause fits. Anticonvulsant drugs can help prevent them. You might be prescribed these before surgery, or to take on a more long-term basis. Your doctors will tell you about any side effects of these drugs.
We also have more information about:
symptoms of brain tumours
having tests for brain tumours
the brain
If you’re looking for information about brain tumours in people of all ages, read our general brain tumours section.
Breast cancer can have a number of symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue.
Most breast lumps aren’t cancerous, but it’s always best to have them checked by your doctor. You should also speak to your GP if you notice any of the following:
a change in the size or shape of one or both breasts
discharge from either of your nipples (which may be streaked with blood)
a lump or swelling in either of your armpits
dimpling on the skin of your breasts
a rash on or around your nipple
a change in the appearance of your nipple, such as becoming sunken into your breast
Breast pain alone isn’t a symptom of breast cancer.
Learn more about the symptoms of breast cancer
After examining your breasts, your GP may refer you to a specialist breast cancer clinic for further tests. This might include a mammography (breast screening) or a biopsy.
Read more about breast screening and how breast cancer is diagnosed
The first symptom of breast cancer most women notice is a lump or an area of thickened tissue in their breast.
Most breast lumps (90%) aren’t cancerous, but it’s always best to have them checked by your doctor.
You should speak to your GP if you notice any of the following:
a lump or area of thickened tissue in either breast
a change in the size or shape of one or both breasts
discharge from either of your nipples (which may be streaked with blood)
a lump or swelling in either of your armpits
dimpling on the skin of your breasts
a rash on or around your nipple
a change in the appearance of your nipple, such as becoming sunken into your breast
Breast pain alone isn’t a symptom of breast cancer.
Read further information:
Breast Cancer Now: Signs and symptoms of breast cancer
Cancer Research UK: Breast cancer symptoms
Macmillan Cancer Support: Signs and symptoms of breast cancer
The causes of breast cancer aren’t fully understood, making it difficult to say why one woman may develop breast cancer and another may not.
However, there are risk factors that are known to affect your likelihood of developing breast cancer. Some of these you can’t do anything about, but there are some you can change.
If you’ve previously had breast cancer or early non-invasive cancer cell changes in breast ducts, you have a higher risk of developing it again, either in your other breast or in the same breast again.
If you have suspected breast cancer, either because of your symptoms or because your mammogram has shown an abnormality, you’ll be referred to a specialist breast clinic for further tests.
If a diagnosis of breast cancer is confirmed, more tests will be needed to determine the stage and grade of the cancer, and to work out the best method of treatment.
If your cancer was detected through the NHS Breast Screening Programme, you’ll have further tests in the screening centre before being referred for treatment.
Scans and X-rays
Computerised tomography (CT) scans, or chest X-ray and liver ultrasound scans, may be needed to check whether the cancer has spread to your lungs or liver. An MRI scan of the breast may be needed to clarify or to assess the extent of the condition within the breast.
If your doctor thinks that the cancer could have spread to your bones, you may need a bone scan. Before having a bone scan, a substance containing a small amount of radiation, known as an isotope, will be injected into a vein in your arm. This will be absorbed into your bone if it’s been affected by cancer. The affected areas of bone will show up as highlighted areas on the bone scan, which is carried out using a special camera.
Tests to determine specific types of treatment
You’ll also need tests that show whether the cancer will respond to specific types of treatment. The results of these tests can give your doctors a more complete picture of the type of cancer you have and how best to treat it. The types of test you could be offered are discussed below.
In some cases, breast cancer cells can be stimulated to grow by hormones that occur naturally in your body, such as oestrogen and progesterone.
If this is the case, the cancer may be treated by stopping the effects of the hormones, or by lowering the level of these hormones in your body. This is known as ‘hormone therapy’.
During a hormone receptor test, a sample of cancer cells will be taken from your breast and tested to see if they respond to either oestrogen or progesterone. If the hormone is able to attach to the cancer cells (using a hormone receptor), they’re known as ‘hormone receptor positive’.
While hormones can encourage the growth of some types of breast cancer, other types are stimulated by a protein called human epidermal growth factor receptor 2 (HER2).
These types of cancer can be diagnosed using a HER2 test, and treated with medication to block the effects of HER2. This is known as ‘biological’ or ‘targeted’ therapy.
If cancer is detected at an early stage, it can be treated before it spreads to nearby parts of the body.
Breast cancer is treated using a combination of surgery, chemotherapy and radiotherapy. Surgery is usually the first type of treatment you’ll have, followed by chemotherapy or radiotherapy or, in some cases, hormone or biological treatments.
The type of surgery and the treatment you have afterwards will depend on the type of breast cancer you have. Your doctor will discuss the best treatment plan with you.
In a small proportion of women, breast cancer is discovered after it’s spread to other parts of the body (metastasis). Secondary cancer, also called advanced or metastatic cancer, isn’t curable, so the aim of treatment is to achieve remission (symptom relief).
Read more about treating breast cancer
Surgery is usually the first type of treatment for breast cancer. The type of surgery you undergo will depend on the type of breast cancer you have.
Surgery is usually followed by chemotherapy or radiotherapy or, in some cases, hormone or biological treatments. Again, the treatment you’ll have will depend on your type of breast cancer.
Your doctor will discuss the most suitable treatment plan with you. Chemotherapy or hormone therapy will sometimes be the first treatment.
Some breast cancers are stimulated to grow by the hormones oestrogen or progesterone, which are found naturally in your body.
These types of cancer are known as hormone-receptor-positive cancers. Hormone therapy works by lowering the levels of hormones in your body or by stopping their effects.
The type of hormone therapy you’ll have will depend on the stage and grade of your cancer, which hormone it’s sensitive to, your age, whether you’ve experienced the menopause and what other type of treatment you’re having.
You’ll probably have hormone therapy after surgery and chemotherapy, but it’s sometimes given before surgery to shrink a tumour, making it easier to remove.
Hormone therapy may be used as the only treatment for breast cancer if your general health prevents you from having surgery, chemotherapy or radiotherapy.
In most cases, you’ll need to take hormone therapy for up to five years after having surgery. If your breast cancer isn’t sensitive to hormones, hormone therapy will have no effect.
Tamoxifen
Tamoxifen stops oestrogen from binding to oestrogen-receptor-positive cancer cells. It’s taken every day as a tablet or liquid. It can cause several side effects, including:
tiredness
changes to your periods
nausea and vomiting
hot flushes
aching joints
headaches
weight gain
Aromatase inhibitors
If you’ve experienced the menopause, you may be offered an aromatase inhibitor. This type of medication works by blocking aromatase, a substance that helps produce oestrogen in the body after the menopause. Before the menopause, oestrogen is made by the ovaries.
Three aromatase inhibitors may be offered. These are anastrozole, exemestane and letrozole. These are taken as a tablet once a day. Side effects include:
hot flushes and sweats
lack of interest in sex (loss of libido)
nausea and vomiting
tiredness
aching joints and bone pain
headaches
skin rashes
Ovarian ablation or suppression
In women who haven’t experienced the menopause, oestrogen is produced by the ovaries. Ovarian ablation or suppression stops the ovaries working and producing oestrogen.
Ablation can be carried out using surgery or radiotherapy. It stops the ovaries working permanently and means you’ll experience the menopause early.
Ovarian suppression involves using a medication called goserelin, which is a luteinising hormone-releasing hormone agonist (LHRHa). Your periods will stop while you’re taking it, although they should start again once your treatment is complete.
If you’re approaching the menopause (around the age of 50), your periods may not start again after you stop taking goserelin.
Goserelin is taken as an injection once a month and can cause menopausal side effects, including:
hot flushes and sweats
mood swings
trouble sleeping
Read further information about hormone therapy
Dealing with changes to your body
A diagnosis of breast cancer may change how you think about your body. All women react differently to the bodily changes that happen as a result of breast cancer treatment. Some women react positively, but others find it more difficult to cope. It’s important to give yourself time to come to terms with any changes to your body.
Read further information:
Breast Cancer Now: Coping with breast cancer emotionally
healthtalk: Body image and breast cancer
Macmillan Cancer Support: Changes to your appearance and body image
Early menopause
Although most cases of breast cancer occur in women over 50 who have experienced the menopause, some younger women have to cope with early menopause brought on by cancer treatment.
Symptoms can include hot flushes, vaginal dryness and loss of sexual desire. Talk to your healthcare team about any symptoms you have and they’ll be able to help.
Read further information:
Breast Cancer Now: Fertility and breast cancer treatment
Cancer Research UK: Breast cancer and menopausal symptoms
Macmillan: Menopausal symptoms and cancer treatment
Prosthesis
A breast prosthesis is an artificial breast, which can be worn inside your bra to replace the breast that’s been removed.
Soon after a mastectomy, you’ll be given a lightweight foam breast to wear until the area affected by surgery or radiotherapy has healed. After it’s healed, you’ll be offered a silicone prosthesis. Prostheses come in many different shapes and sizes, and you should be able to find one that suits you.
Read further information:
Breast Cancer Now: Your body after breast cancer treatment
Cancer Research UK: False breast shape (prosthesis) after breast cancer surgery
Reconstruction
If you didn’t have immediate breast reconstruction (carried out at the time of a mastectomy), you can have reconstruction later. This is called a delayed reconstruction.
There are 2 main methods of breast reconstruction – reconstruction using your own tissue and reconstruction using an implant. The type that’s most suitable for you will depend on many factors, including the treatment you’ve had, any ongoing treatment and the size of your breasts. Talk to your healthcare team about which reconstruction is suitable for you.
Read further information about breast reconstruction
If you have an increased risk of developing breast cancer, treatment is available to reduce your risk.
Your level of risk is determined by factors such as your age, your family’s medical history and the results of genetic tests.
You will usually be referred to a specialist genetics service if it’s thought you have an increased risk of breast cancer. Healthcare professionals working at these services should discuss treatment options with you.
The 2 main treatments are surgery to remove the breasts (mastectomy) or medication.
Mastectomy
A mastectomy is surgery to remove the breasts. It can be used to treat breast cancer and reduce the chances of developing the condition in the small number of women from high-risk families.
By removing as much breast tissue as possible, a mastectomy can reduce your risk of breast cancer by up to 90%.
However, like all operations, there’s a risk of complications, and having your breasts removed can have a significant effect on your body image and sexual relationships.
If you want to, you can usually choose to have breast reconstruction either during the mastectomy operation, or at a later date. During breast reconstruction surgery, your original breast shape is recreated using either breast implants or tissue from elsewhere in your body.
An alternative is to use breast prostheses. These are artificial breasts that can be worn inside your bra.
Read more about your body and your breasts after treatment
Medication
In 2013, the National Institute for Health and Care Excellence (NICE) announced that 2 medications, called tamoxifen and raloxifene, would be available on the NHS for women who have an increased risk of developing breast cancer.
Either tamoxifen or raloxifene can be used in women who’ve been through the menopause, but only tamoxifen should be used in women who haven’t.
These medications may not be suitable if in the past you’ve had blood clots or womb cancer, or if you have an increased risk of developing these problems in the future.
Women who’ve already had a mastectomy to remove both breasts won’t be offered these medications, because their risk of developing breast cancer is very small.
A course of treatment with tamoxifen or raloxifene will usually involve taking a tablet every day for 5 years.
Raloxifene can cause side effects including flu-like symptoms, hot flushes and leg cramps. Side effects of tamoxifen can include hot flushes and sweats, changes to your periods, and nausea and vomiting.
Your chances of giving birth to a child with birth defects increase while you’re taking tamoxifen, so you’ll be advised to stop taking it at least 2 months before trying for a baby. The medication can also increase your risk of blood clots, so you should stop taking it 6 weeks before having any planned surgery.
Tamoxifen and raloxifene aren’t currently licensed for the purpose of reducing the risk of breast cancer in women with an increased risk of developing the condition. However, they can still be used if you understand the benefits and risks, and your doctor believes the treatment will be helpful.
Read further information:
Breast Cancer Now: Breast cancer causes
Cancer Research UK: Diet and cancer
As the causes of breast cancer aren’t fully understood, it’s not possible to know if it can be prevented altogether.
If you’re at increased risk of developing the condition, some treatments are available to reduce the risk.
Studies have looked at the link between breast cancer and diet and, although there are no definite conclusions, there are benefits for women who maintain a healthy weight, exercise regularly and who have a low intake of saturated fat and alcohol.
It’s been suggested that regular exercise can reduce your risk of breast cancer by as much as a third. If you’ve been through the menopause, it’s particularly important that you’re not overweight or obese. This is because being overweight or obese causes more oestrogen to be produced, which can increase the risk of breast cancer.
Read more about preventing breast cancer
As the causes of breast cancer aren’t fully understood, it’s not known if it can be prevented altogether.
Some treatments are available to reduce the risk in women who have a higher risk of developing the condition than the general population.
Although it’s rare, your treatment for breast cancer may cause new problems, such as:
pain and stiffness in your arms and shoulders may occur after surgery, and the skin in these areas may be tight
lymphoedema (a build-up of excess lymph fluid which causes swelling) – this may occur if surgery or radiotherapy damages the lymphatic drainage system in the armpit
Talk to your healthcare team if you experience these or any other long-term effects of treatment.
Read further information:
Breast Cancer Now: Life after treatment
Breast Cancer Now: Lymphoedema
Cancer Research UK: Follow up after breast cancer treatment
The main symptom of breast cancer in men is a hard lump in one of your breasts. The lump is almost always painless.
The lump is usually located underneath the nipple and areola (the circle of dark-coloured skin surrounding the nipple).
However, the vast majority of breast lumps are caused by a condition called gynaecomastia. This is a common non-cancerous condition where male breast tissue becomes enlarged.
Less common symptoms of male breast cancer include:
the nipple beginning to turn in on itself (nipple retraction)
the nipple becoming hard and inflamed, and looking sore (nipple ulceration)
fluid leaking from the nipple (nipple discharge)
Additional symptoms usually only develop if the cancer spreads from the breast to other parts of the body, such as the bones, liver or lungs. This is known as metastatic breast cancer.
Symptoms of metastatic breast cancer include:
bone pain
swelling of the lymph nodes (glands), usually in or around the armpit
shortness of breath
feeling unusually tired all the time
feeling sick (nausea)
itchy skin with yellowing of the skin and whites of the eyes (jaundice)
The cause of male breast cancer is unclear, but factors known to increase your chances of developing the condition include:
age – most cases affect men over the age of 60
having a family history of breast cancer (male or female)
obesity – a body mass index (BMI) of 30 or more
Read more about causes of breast cancer in men
It’s not clear exactly what causes breast cancer in men, although a number of things can increase your risk of developing the condition.
If you have symptoms of breast cancer, such as a hard, painless lump in one of your breasts, your GP will carefully examine you.
During the examination, they’ll also look for other possible signs of male breast cancer, such as swollen lymph nodes (glands).
It’s likely your GP will refer you for further tests if there’s a possibility you may have breast cancer.
Being told you have breast cancer can cause a wide range of emotions, such as shock, fear, confusion and, in some cases, embarrassment.
Most people assume breast cancer only affects women, so it can be difficult to come to terms with the diagnosis.
Feelings of isolation and being alone are common in men with breast cancer. This may be because there’s little in the way of advice and support for men with breast cancer, particularly when compared with the support available for women with the condition.
Sometimes men who find themselves in this situation can become depressed. You may be depressed if you’ve felt very down and no longer interested in doing activities you used to enjoy during the past month.
If you think you may be depressed, visit your GP. There is a range of effective treatments, such as medication and counselling, that can help relieve feelings of depression.
You may also find it useful to talk to other men affected by the condition. Breast Cancer Now is a breast cancer charity that provides an online forum for anyone diagnosed with breast cancer. Cancer Research UK also provides Cancer Chat, an online forum for anyone affected by cancer.
You should always talk to your GP if you notice a lump in your breast or you have problems affecting your nipples, such as discharge.
While these symptoms are unlikely to be caused by breast cancer, they should be investigated further.
In most cases, surgery is used to remove the cancer, along with a section of the breast. This may be followed by a long-term course of hormone-blocking therapy using medication, usually a drug called tamoxifen.
Tamoxifen helps block the effects of hormones known to stimulate the growth of cancerous cells in breast tissue. It should help prevent the cancer returning.
In some cases, radiotherapy or chemotherapy may be used for the same purpose.
Read more about treating breast cancer in men
You should always visit your GP if you notice a lump in your breast or you have problems affecting your nipples, such as retraction, ulceration or discharge.
These problems are unlikely to be of the result of breast cancer, but they should be investigated further.
Treatment for breast cancer in men largely depends on how far the cancer has spread.
Most hospitals use multidisciplinary teams (MDTs) to treat men with breast cancer. These are teams of specialists who work together to make decisions about the best way to proceed with your treatment.
Deciding which treatment is best for you can often be confusing. Your cancer team will recommend what they think is the ideal treatment option, but the final decision will be yours.
Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions you’d like to ask the specialist. For example, you could ask about the advantages and disadvantages of particular treatments.
Your recommended treatment plan depends on how far the cancer has spread. If the cancer hasn’t spread significantly beyond your breast, a complete cure may be possible.
In these cases, surgery to remove the affected breast is usually recommended. This is often followed by radiotherapy, hormone therapy, or chemotherapy to help prevent the cancer returning.
If the cancer has spread beyond your breast into other parts of your body, such as your lungs, a complete cure won’t be possible. However, hormone therapy and chemotherapy can be used to relieve symptoms and slow down the spread of the cancer.
More information about these treatments can be found below.
The most common symptom of bronchiectasis is a persistent cough that brings up a large amount of phlegm on a daily basis.
The phlegm can be clear, pale yellow or yellow-greenish in colour. Other people may only occasionally cough up small amounts of phlegm, or none at all.
Other symptoms may include:
shortness of breath
wheezing
coughing up blood or blood-stained phlegm
chest pain
joint pain
clubbing of the fingertips – the tissue beneath the nail thickens and the fingertips become rounded and bulbous
Bronchiectasis can develop if the tissue and muscles that surround the bronchi are damaged or destroyed.
There are many reasons why this may happen. The three most common causes in the UK are:
a lung infection during childhood, such as pneumonia or whooping cough, that damages the bronchi
underlying problems with the immune system (the body’s defence against infection) that make the bronchi more vulnerable to damage from an infection
allergic bronchopulmonary aspergillosis (ABPA) – an allergy to a certain type of fungi that can cause the bronchi to become inflamed if spores from the fungi are inhaled
However, in many cases of bronchiectasis, no obvious cause for the condition can be found (known as idiopathic bronchiectasis).
Read more about the causes of bronchiectasis.
Bronchiectasis is caused by the airways of the lungs becoming damaged and widened. This can be due to an infection or another condition. Sometimes, the cause is not known.
Your lungs are continually exposed to germs, so your body has sophisticated defence mechanisms designed to keep the lungs free of infection.
If a foreign substance (such as bacteria or a virus) gets past these defences, your immune system will attempt to stop the spread of any infection by sending white blood cells to the location of the infection. These cells release chemicals to fight the infection, which can cause the surrounding tissue to become inflamed.
For most people, this inflammation will pass without causing any further problems. However, bronchiectasis can occur if the inflammation permanently destroys the elastic-like tissue and muscles surrounding the bronchi (airways), causing them to widen.
The abnormal bronchi then become filled with excess mucus, which can trigger persistent coughing and make the lungs more vulnerable to infection. If the lungs do become infected again, this can result in further inflammation and further widening of the bronchi.
As this cycle is repeated, the damage to the lungs gets progressively worse. How quickly bronchiectasis progresses can vary significantly. For some people, the condition will get worse quickly, but for many the progression is slow.
In around half of all cases of bronchiectasis, no obvious cause can be found.
Some of the more common triggers that have been identified are described below.
Childhood infections
Around a third of cases of bronchiectasis in adults are associated with a severe lung infection in childhood, such as:
severe pneumonia
whooping cough
tuberculosis (TB)
measles
However, as there are now vaccinations available for these infections, it is expected that childhood infections will become a less common cause of bronchiectasis in the future.
Immunodeficiency
Around 1 in 12 cases of bronchiectasis occur because a person has a weakened immune system, which makes their lungs more vulnerable to tissue damage. The medical term for having a weakened immune system is immunodeficiency.
Some people are born with an immunodeficiency because of problems with the genes they inherit from their parents. It’s also possible to acquire an immunodeficiency after an infection such as HIV.
Allergic bronchopulmonary aspergillosis (ABPA)
Around 1 in 14 people with bronchiectasis develop the condition as a complication of an allergic condition known as allergic bronchopulmonary aspergillosis (ABPA).
People with ABPA have an allergy to a type of fungi known as aspergillus, which is found in a wide range of different environments across the world.
If a person with ABPA breathes in fungal spores, it can trigger an allergic reaction and persistent inflammation, which in turn can progress to bronchiectasis.
Aspiration
Aspiration is the medical term for stomach contents accidentally passing into your lungs, rather than down into your gastrointestinal tract. This is responsible for around 1 in 25 cases of bronchiectasis.
The lungs are very sensitive to the presence of foreign objects, such as small samples of food or even stomach acids, so this can trigger inflammation leading to bronchiectasis.
Cystic fibrosis
Cystic fibrosis is a relatively common genetic disorder, where the lungs become clogged up with mucus. The mucus then provides an ideal environment for a bacterial infection to take place, leading to the symptoms of bronchiectasis.
It is estimated that cystic fibrosis is responsible for around 1 in 33 cases of bronchiectasis.
Cilia abnormalities
Cilia are the tiny, hair-like structures that line the airways in the lungs. They are designed to protect the airways and help move away any excess mucus. Bronchiectasis can develop if there is a problem with the cilia that means they are unable to effectively clear mucus from the airways.
Conditions that can cause problems with the cilia include:
Young’s disease – a rare condition only affecting males that is thought to be caused by exposure to mercury in childhood
primary ciliary dyskinesia – a rare condition caused by inheriting faulty genes
It’s estimated that about 1 in every 33 cases of bronchiectasis are caused by Young’s disease and 1 or 2 in every 100 cases are caused by primary ciliary dyskinesia.
However, as the regulations regarding the use of mercury are now much stricter than they were in the past, it is expected that Young’s syndrome will become a much less common cause of bronchiectasis in the future.
Connective tissue diseases
Certain conditions that cause inflammation in other areas of the body are sometimes associated with bronchiectasis, including:
rheumatoid arthritis
Sjögren’s syndrome
Crohn’s disease
ulcerative colitis
These conditions are usually thought to be caused by a problem with the immune system, where it mistakenly attacks healthy tissue.
You should see your GP for advice if you develop a persistent cough, so they can look for a possible cause.
Your GP will ask you about your symptoms, such as how often you cough, whether you bring up any phlegm (sputum) and whether you smoke.
They may also listen to your lungs with a stethoscope as you breathe in and out. The lungs of people with bronchiectasis often make a distinctive crackling noise as a person breaths in and out.
You’ll also probably have a chest X-ray to rule out other, more serious, causes of your symptoms, such as lung cancer.
If your GP thinks you may have a lung infection, they may take a sample of your phlegm, so it can be checked for bacteria.
You should see your GP if you develop a persistent cough. While this may not be caused by bronchiectasis, it requires further investigation.
If your GP suspects you may have bronchiectasis, they’ll refer you to a specialist in treating lung conditions (a respiratory consultant) for further tests.
Read more about diagnosing bronchiectasis.
The damage caused to the lungs by bronchiectasis is permanent, but treatment can help relieve your symptoms and stop the damage getting worse.
The main treatments include:
exercises and special devices to help you clear mucus out of your lungs
medication to help improve airflow within the lungs
antibiotics to treat any lung infections that develop
Surgery is usually only considered for bronchiectasis in rare cases where other treatments haven’t been effective, the damage to your bronchi is confined to a small area and you’re in good general health.
Read more about the treatment of bronchiectasis.
If you haven’t previously been diagnosed with bronchiectasis and you develop a persistent cough, visit your GP for advice.
While persistent coughing may not necessarily be the result of bronchiectasis, it requires further investigation.
If you’ve been previously diagnosed with bronchiectasis and you begin to experience symptoms that suggest you have a lung infection, contact your GP. You’ll usually need treatment with antibiotics.
Some people with bronchiectasis are given a stock of antibiotics as a precaution, in case they suddenly develop a lung infection.
Some people with bronchiectasis develop a severe lung infection that may need to be treated in hospital.
Signs and symptoms of serious lung infection include:
a bluish tinge to the skin and lips (cyanosis)
confusion
a high temperature of 38C (100.4F) or above
rapid breathing (more than 25 breaths a minute)
severe chest pain that makes it too painful to cough and clear your lungs
If you experience any of the above, phone the healthcare professional in charge of your care immediately. This may be your GP, a doctor who specialises in lung conditions (pulmonologist) or a specialist nurse.
If this isn’t possible, then phone the NHS 24 111 service or your local out-of-hours service.
The damage to the lungs associated with bronchiectasis is permanent, but treatment can help prevent the condition getting worse.
In most cases, treatment involves a combination of medication, exercises you can learn and devices to help clear your airways. Surgery for bronchiectasis is rare.
There are a number of things you can do to help relieve the symptoms of bronchiectasis and stop the condition getting worse, including:
stopping smoking (if you smoke)
having the flu vaccine every year
making sure you have had the pneumococcal vaccine to protect against pneumonia
exercising regularly
keeping yourself well hydrated
eating a balanced diet
Complications of bronchiectasis are rare, but they can be serious. One of the most serious complications is coughing up large amounts of blood, caused by one of the blood vessels in the lungs splitting. This problem can be life-threatening and may require emergency surgery to treat it.
Read more about the complications of bronchiectasis.
In some cases, people with bronchiectasis can develop serious complications that require emergency treatment.
The main symptom of bronchitis is a hacking cough. It is likely that your cough will bring up thick yellow-grey mucus (phlegm), although this does not always happen.
Other symptoms of bronchitis are similar to those of other infections, such as the common cold or sinusitis, and may include:
sore throat
headache
runny or blocked nose
aches and pains
tiredness
If you have bronchitis, your cough may last for several weeks after other symptoms have gone. You may also find that the continual coughing makes your chest and stomach muscles sore.
Some people may experience shortness of breath or wheezing, due to inflamed airways. However, this is more common with long-term (chronic) bronchitis.
If you have bronchitis:
get plenty of rest
drink lots of fluids – this helps prevent dehydration and thins the mucus in your lungs, making it easier to cough up
treat headaches, fever, and aches and pains with paracetamol or ibuprofen – although ibuprofen is not recommended if you have asthma
There is little evidence that cough medicines work – read more about treating coughs. The Medicines and Healthcare Products Regulatory Agency (MHRA) has recommended that over-the-counter cough medicines should not be given to children under the age of six.
As an alternative to an over-the-counter cough medicine, try making your own mixture of honey and lemon, which can help soothe a sore throat and ease your cough.
The bronchi are the main airways in your lungs, which branch off on either side of your windpipe (trachea). They lead to smaller and smaller airways inside your lungs, known as bronchioles.
The walls of the bronchi produce mucus to trap dust and other particles that could otherwise cause irritation.
Most cases of acute bronchitis develop when an infection causes the bronchi to become irritated and inflamed, which causes them to produce more mucus than usual. Your body tries to shift this extra mucus through coughing.
Smoking is the most common cause of chronic bronchitis. Over time, tobacco smoke can cause permanent damage to the bronchi, causing them to become inflamed.
Read more about the causes of bronchitis.
The bronchitis infection can be caused by either a virus or bacteria, although viral bronchitis is much more common.
In most cases, bronchitis is caused by the same viruses that cause the common cold or flu. The virus is contained in the millions of tiny droplets that come out of the nose and mouth when someone coughs or sneezes.
These droplets typically spread about 1m (3ft). They hang suspended in the air for a while, then land on surfaces where the virus can survive for up to 24 hours. Anyone who touches these surfaces can spread the virus further by touching something else.
Everyday items at home and in public places, such as door handles and keyboards, may have traces of the virus on them. People usually become infected by picking up the virus on their hands from contaminated objects, and then placing their hands near their nose or mouth. It is also possible to breathe in the virus if it is suspended in airborne droplets.
Most cases of bronchitis can be treated easily at home with rest, non-steroidal anti-inflammatory drugs (NSAIDs) and plenty of fluids.
You only need to see your GP if your symptoms are severe or unusual – for example, if:
your cough is severe or lasts longer than three weeks
you have a constant fever (a temperature of 38°C – 100.4°F – or above) for more than three days
you cough up mucus streaked with blood
you have an underlying heart or lung condition, such as asthma or heart failure
Your GP may need to rule out other lung infections, such as pneumonia, which has symptoms similar to those of bronchitis. If your GP thinks you may have pneumonia, you will probably need a chest X-ray, and a sample of mucus may be taken for testing.
If your GP thinks you might have an undiagnosed underlying condition, they may also suggest a pulmonary function test. You will be asked to take a deep breath and blow into a device called a spirometer, which measures the volume of air in your lungs. Decreased lung capacity can indicate an underlying health problem.
In most cases, bronchitis will clear up by itself within a few weeks without the need for treatment. This type of bronchitis is known as “acute bronchitis”. While you are waiting for it to pass, you should drink lots of fluid and get plenty of rest.
In some cases, the symptoms of bronchitis can last much longer. If symptoms last for at least three months, it is known as “chronic bronchitis”. There is no cure for chronic bronchitis, but there are several medications to help relieve symptoms. It is also important to avoid smoking and smoky environments, as this can make your symptoms worse.
Read more about treating bronchitis.
See your GP as soon as possible if:
your cough is very severe or lasts longer than three weeks
you have a constant fever (a temperature of 38°C – 100.4°F – or above) for more than three days – this may be a sign of flu or a more serious condition, such as pneumonia
you cough up mucus streaked with blood
you develop rapid breathing (more than 30 breaths a minute) or chest pains
you become drowsy or confused
you have had repeated bouts of bronchitis
You should also contact your GP if you have an underlying heart or lung condition, such as:
asthma
heart failure – weakness in the heart that leads to fluid in your lungs
emphysema – damage to the small airways in your lungs
Most cases of bronchitis do not require treatment from a GP, and the symptoms can be easily managed at home.
There is no cure for chronic bronchitis, but healthy living will help. In particular, you should stop smoking, if you smoke.
Pneumonia is the most common complication of bronchitis. It happens when the infection spreads further into the lungs, causing air sacs inside the lungs to fill up with fluid. 1 in 20 cases of bronchitis leads to pneumonia.
People at an increased risk of developing pneumonia include:
elderly people
people who smoke
people with other health conditions, such as heart, liver or kidney disease
people with a weakened immune system
Mild pneumonia can usually be treated with antibiotics at home. More severe cases may require admission to hospital.
Read more about the treatment of pneumonia.
The main symptoms of bulimia are:
bingeing – overeating in a particular pattern
purging – trying to reduce the effect of binging by attempting to get calories out of your body
focus on food – thinking about food all the time, even when you don’t want to
problems with self-esteem
focussing on body image when it comes to food and weight
When making a diagnosis, your GP will probably ask questions about your eating habits. For example, they could ask:
how you feel about your weight
if you’re concerned about it
if you make yourself vomit regularly
if you binge-eat
It’s important to answer these questions honestly. Your GP isn’t trying to judge you or ‘catch you out’. They just need to accurately assess how serious your symptoms are.
Weight and BMI
Your GP may check your weight and calculate your body mass index (BMI).
Blood tests and other tests
Your GP might check your pulse and blood pressure.
Sometimes an (electrocardiogram (ECG) may be needed to check how well your heart is working.
Your GP may do blood tests to check the level of:
fluids in your body
chemicals or minerals, like potassium in your blood
Blood tests look for the complications of bulimia. Even if they come back as ‘normal’, your GP may still refer you to a specialist if you’re experiencing bulimia symptoms.
Before your treatment begins, you’ll probably have an overall assessment of your health. Your GP or another healthcare professional will do this.
The assessment will help your healthcare professional plan for your treatment and care. For example, they may assess:
your overall health and any medical needs
your social situation, like how much support you have from family and friends
your mood
any risks that affect you, like whether you’re at risk of harming yourself
whether there are any physical risks as a result of bulimia that need urgent treatment
Guided self-help
For many people, guided self-help can be an effective treatment for bulimia. Guided self-help is where you work through information and activities on your own. You’ll have regular support sessions with a professional (usually a psychologist).
Activities can include:
worksheets
a food diary
meal plan
writing about difficult thoughts and feelings
Eating disorder service
If guided self help is unsuccessful, your GP can refer you for treatment to an eating disorder service. An eating disorder service will usually offer a structured programme of psychological treatment.
Psychological treatment
The main type of psychological treatment for bulimia is cognitive behavioural therapy (CBT). CBT starts with the idea that thoughts, feelings, and behaviour are linked and affect one another. CBT helps to change the harmful behaviour while working on changing how you think about food, eating, and weight.
One alternative to CBT is interpersonal therapy (IPT). IPT explores the way you interact with other people. It also looks at the relationships you have, with the goal of improving them.
Learn more about talking therapies
Medication
Antidepressants like selective serotonin reuptake inhibitors (SSRIs) may be used to treat bulimia. They can reduce the urges to binge and vomit.
The medication will usually take several weeks before it starts to work. You’ll usually start on a low dose. The dose will gradually increase as your body adjusts to the medicine.
Very few drugs are recommended for children and young people below the age of 18. It’s best not to take SSRIs if you have epilepsy or a family history of heart, liver or kidney disease.
Relapse
Recovery from bulimia can take a long time. It’s common for bulimia symptoms to return after treatment. This is often called a relapse, and is more likely during times of stress. If relapse happens, the approach to getting treatment is the same. The first step is going to your GP.
There are physical complications associated with bulimia.
These can include:
dental problems – regular vomiting can cause your stomach acid to damage the enamel on your teeth, which can lead to tooth decay
repeated vomiting can cause bad breath and a sore throat
due to a lack of nutrients, your skin and hair can become dry and your fingernails can become brittle
your saliva glands can become swollen from frequent vomiting, which makes your face appear rounder
frequent use of laxatives can damage your bowel muscles, causing permanent constipation (finding it difficult to poo)
an increased risk of heart problems
Frequent vomiting or laxative use can cause:
tiredness
weakness
abnormal heart rhythms
kidney damage
convulsions (fits)
muscle spasms
If you have periods, bulimia can cause them to become unpredictable, or stop altogether. This does not mean bulimia makes you infertile. While it may be harder to get pregnant, you should continue to use birth control if you aren’t planning a pregnancy.
If you have diabetes, you’ll need regular health checks to help avoid problems with your eyes or other serious complications. This is particularly important if you have type 1 diabetes.