Breast cancer
Q I have been told that women in the UK have a one-in-12 risk of developing breast cancer. Does this really mean that out of 24 female friends and relatives, two of us are going to get breast cancer. And how can you tell who will get it?
A These sorts of figures are sent to terrify us but they need a bit of decoding. The one-in-12 figure is a woman's risk over her lifetime. If all the nation's population of women were to live to 85, one in 11 of them will have had breast cancer at some time. The risk increases as you get older, so that only one in nearly 44,000 women will have had breast cancer by the age of 20, one in 220 by the age of 40 and one in 56 by the age of 50. Many of these women will not die as a result of their breast cancer and will continue to live to a good age. That is partly why the population acquires more and more women who have had the disease. It may be that none of your circle of friends ever gets breast cancer; other women will know of several friends. You can't tell who will get breast cancer. Certain women will be at increased risk - because of a genetic predisposition, for example. One in 20 British women will die from breast cancer, but many more of us will die of heart disease, strokes and other cancers.
Unwanted pregnancies
Q I'm pregnant and I want to have an abortion - having a baby at this stage of my career would be a disaster for me, and my partner feels the same way. I don't know how to go about it and whether I should opt for the abortion pill or the alternative.
A You're not alone. One in three women in the UK apparently has at least one abortion by the age of 45. It is never a decision taken lightly, but it sounds as though you and your partner have talked through the issues and come to a decision. You will be offered counselling before the procedure and it is as well to take the opportunity to discuss fully and openly how you feel so that you don't harbour long-term regrets or guilt feelings. Abortions are legal if two doctors sign a document saying that continuing the pregnancy would be more damaging to your mental or physical health than having an abortion. This clause is the reason for nearly 90% of abortions. Other categories include risk to other children or substantial risk of having a baby with a serious handicap. Abortions are available on the NHS or privately. Recent publicity has been given to the fact that on the NHS some women have to wait several weeks for their abortion and are then denied the chance of taking the "abortion pill", mefepristone. Surgical abortions that involve sucking out the womb contents can be carried out up to 13 weeks of pregnancy and require a general anaesthetic. If you are going for an NHS abortion, urge your GP or family-planning clinic to refer you promptly and chase up the appointment if it doesn't arrive quickly. The other option is to go privately via an agency such as BPAS for a cost of around £300. The abortion pill is not widely used in this country yet and you may need to ask about it specifically so you can be fully informed about your choices.
(BPAS helpline: 08457 304030.)
Q I travel regularly to the US, and am allergic to at least three antibiotics so far: penicillin, sulfa, and trimethoprim. Does this mean that I am also allergic to ciprofloxacin - and if so, what alternatives would I have in the event of anthrax exposure?
Allergies and the anthrax antibiotic
A Penicillin, trimethoprim and ciprofloxacin are all different types of antibiotics, and just because you are unlucky enough to be allergic to the first two doesn't mean you're allergic to cipro. Sulfa-based antibiotics are rarely used and are in the same group as trimethoprim. If your allergic reactions are mild, eg an itchy rash, you can risk taking cipro if you're unlucky enough to need it. It may be wise to take a supply of antihistamines such as Piriton with you in case of mild allergic reactions. But if you suffer severe and potentially life-threatening allergic reactions, such as extreme breathlessness and collapse, you may want to be tested to find out which antibiotics you can safely take and which to avoid. Your GP can refer you to an allergy or immunology clinic for testing.
· These answers are intended to be as accurate and full as possible, but should never be used as a substitute for visiting a doctor and seeking medical help. If you have a question for Dr Robinson, email drann@dircon.co.uk or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.
