DR MAX PEMBERTON: Full body MOTs claim to spot early signs of cancer but here's why I'd wouldn't advise one
The effect of social media on our lives has been profound. There's no doubt it can provide people with a sense of connection and community.
But it can also be a force for ill, spreading misinformation and fear, and allowing the darker sides of human nature to fester and grow.
This is especially true when it comes to health. Yes, sites like Facebook, Reddit and Instagram can educate people – but they can also allow people to perpetuate whacky ideas and daft remedies.
For doctors, it can be hugely frustrating. All too often the people at the heart of the online health debate aren't medically qualified, appear to have only a vague grasp of science, yet feel emboldened to speak with authority on highly complex matters they simply don't understand.
A similar scourge relates to the online promotion of so-called health tourism, or 'diagnosis tourism', where people travel abroad for tests and procedures, including in-depth screening for various conditions.
Screening tests abroad are often fraught with risk and are much more likely to end up causing completely unnecessary stress
One social media post watched a staggering 12million times last week, for example, advertised a Turkish clinic's £600 '30-test full body MOT', which claimed to spot heart, eye and even gynaecological conditions. Yet these screening tests are often fraught with risk.
Presented as a sensible thing for any health-conscious person to consider, they're much more likely to end up causing completely unnecessary stress. For a start, the financial cost may well not end at £600 because often one test will lead to another needing to be ordered and so on.
But there's a potentially high physical and psychological cost too. Let me be clear – I'm not talking about tests that are done to investigate actual symptoms. That's something else entirely.
No, the issues arise when scans and tests are done in the hope of 'catching' something lurking unseen and unfelt within. That's when you can actually cause more problems than you ever had to begin with.
The truth is, every time you screen someone for a condition, you're performing a delicate balancing act. On the one hand you may find something real and significant, but on the other you can end up putting someone through needless and even harmful treatment.
No test is entirely accurate, meaning there is always a risk it produces a 'false positive', which then triggers a range of other, usually more invasive tests, for example.
Every time you screen someone for a condition, you're performing a delicate balancing act
Blanket screening in otherwise fit and healthy people also regularly picks up incidental things that don't actually pose a risk to their health, but must then be investigated with similarly riskier tests or even operations.
These chance findings are sometimes termed 'incidentalomas' – benign growths, anatomical variations and so on – and you'd be surprised how many of us have them. About 20 per cent of MRI scans of the brain or spine, for example, find an incidental anatomical anomaly, the vast majority (over 95 per cent) of which are totally benign and clinically irrelevant.
A few years ago, I had an X-ray on my ankle and, purely incidentally, they found a strange lump in my foot. I needed a further scan to identify what it was, and lo and behold, it was discovered I have an extra bone in my foot! It was just a weird quirk of nature, which has never caused me any problems, and I'd never have known about unless I'd had the scan.
Because it had been found, however, I assumed it should be removed. Yet when I saw a surgeon, he very astutely ran through all the consequences of such an operation, explaining I wouldn't be able to weight bear at all for many months and would likely have to use a wheelchair.
My legs would become deconditioned, he said, so I'd have to have extensive physiotherapy afterwards. The op itself required a general anaesthetic, which should never be taken lightly, and risked permanently affecting my gait and balance.
There was even a possibility of nerve damage which could result in a dropped-foot. Far safer to forget all about it – or enjoy the fact I was a quirk of nature and had more bone in my body than most other people. Yet imagine if the surgeon had been unscrupulous.
Or if the anomaly hadn't been found somewhere easy to examine and assess, like my foot, but on an internal organ. I'd almost certainly have had to have a biopsy or operation to see what it was. It's the same with these screening packages. They run the risk of creating unnecessary anxiety, stress and worry.
They create expense that people might be unable to comfortably afford, and run the risk of exposing the person to more tests, procedures and operations, all of which have risks attached to them. Again let me be clear – I'm not talking about NHS screening for conditions like breast or bowel cancer, which are tightly focused and rigorously tested for efficacy.
No, my issue is with the kind of scatter-gun screening tests that are roundly considered unethical in this country but, in the wild west of social media, are increasingly pushed and promoted by overseas clinics. Always ask yourself when you see these glossy adverts: what are the downsides?
A new GP has been suspended after 'speeding up' videos of consultations she had to submit as part of her training because they ran over the 12-minute time limit. Some were 45 minutes. I suspect I'm not alone in reading this and thinking, what lucky patients!
Beware of selling your soles online, Lily
Amid all the election coverage last week, you might have missed one of the more bizarre stories to have featured in this paper. Singer Lily Allen, 39, has joined OnlyFans – a website generally used for sex work and sexual or explicit images – to sell pictures and videos of her feet.
Now, part of me thinks, good for you, what's the harm? If people are into this fetish and are willing to pay money for these pictures, who am I do judge? But there is a bigger issue here.
Singer Lily Allen, 39, has joined OnlyFans – a website generally used for sex work and sexual or explicit images – to sell pictures and videos of her feet
I've had an alarming number of young patients who have confessed to setting up OnlyFans accounts in an attempt to earn money. It's seen as a quick and easy way to manage student debt and off-set rising rents.
But they have rarely stopped to consider the longer term implications. These images will be out there forever, after all, shared on websites and via social media.
With summer apparently just around the corner, a story went viral last week about antidepressants affecting our ability to regulate body temperature. There is some truth in this. About 10 per cent of those taking SSRIs – the most common antidepressants – experience excessive sweating in the heat.
And sertraline, paroxetine and venlafaxine are known to make some people intolerant to the sun and more at risk of sunburn. A number of other medications, not just antidepressants, have the same effects – although they are often not talked about by doctors and patients are rarely warned
Dr Max Prescribes: Time with friends
Long-term loneliness can increase risk of a stroke by up to 56 per cent, a Harvard study suggests. The middle-aged are most at risk. I'm often struck by how much of my working day is focused on social problems rather than the strictly medical.
So many of our difficulties in life come down to a struggle to find someone to connect with and the best medicine I could ever prescribe would be a friend.
Long-term loneliness can increase risk of a stroke by up to 56 per cent, a Harvard study suggests
