Even the most successful people sometimes wonder if they could achieve more in the day.  If only they could focus better.

Our unconscious mind can hold a seemingly unlimited amount of information.  Our conscious minds, however, are limited by the ‘magic number 7’ – once we have around 7 items (plus or minus 2), adding anything else in will tend to make another piece of information drop out of our awareness.

You can test this by trying to recall the following number sequences, using your conscious mind, rather than any memory hooks or techniques you may know.  Note your conscious mind’s capacity.

 3      8      0      1
 8      5      1      4      9
 4      6      3      8      1      2
 2      9      5      1      7      3      4
 6      1      8      2      5      9      0      7
 5      8      6      1      9      4      3      7      2
 3      0      8      2      5      7      4      9      1      6

What can tend to happen is that, while working on one thing, something else pops into the mind to distract us.  We can explain this as the result of being too busy – just too much to think about, or procrastination perhaps.  Sometime this happens because we don’t particularly want to do the task, sometimes it may be our mind’s way of livening things up and trying to give us something more interesting to concentrate on.

Some people swear by focusing on the outcome of anything they decide to do and only doing one thing at a time until it’s finished.  That’s not realistic in today’s world of instant communications and umpteen ways to be distracted.

An alternative is to have in mind the source rather than the outcome.  As with Key Performance Indicators (KPIs), often we focus on the outcome – e.g. a company’s KPIs might be its sales, share price, or profit before tax.  But focusing on what is at the source of a desired outcome can be more powerful in affecting a desired result.  For example, sales can be affected by the number of clients a business has, their average spend each time they buy and the number of times they buy in a year.  Getting to the source of what impacts on those factors can be more effective than just looking to increase sales.  What affects a client’s decision to return to the company, what affects the price elasticity and how are the ‘touches’ that a company has with its clients managed?

Change your awareness towards the source of whatever outcome it is that you’re interested in and you’ll find yourself focusing on what’s most important.  That’ll give you a better return for your time and energy.

One physiological change that can increase the ability to focus is, counter-intuitively, to use your peripheral vision.  Visually, instead of focusing in on one thing, let your awareness roll out so that you are aware of everything that is on the periphery of your visual field.  Rather like looking at those Magic Eye pictures, where you have to relax in order to look through the design and see the picture within.

You’ll find that as you use your peripheral vision, you’ll relax a little, your breathing will slow and quieten slightly and you’ll be able to think more quickly.  This is just your system moving out of sympathetic nervous system arousal (fight or flight mode) into parasympathetic system.  In this more relaxed state you’ll be able to see things more clearly, engage your memory to retrieve relevant information and you’ll feel as if you’re focusing better.
So, how to incorporate these ideas into your daily life? 

Keep your Action List down to 7 items maximum.  You may have tasks scheduled elsewhere, but keep your eye on just the 7 most important ones at a time.  Otherwise you’ll find yourself doing the small tasks just to get them ticked off your list.  This gives short-term relief only.  Better to focus on up to 7 key tasks.

Focus on the source of what will create the outcome that you want, the behaviour and actions that will be most effective in the circumstances.  And use peripheral vision to get into the kind of relaxed yet focused state that will enable you to choose those appropriate actions.

Like with the tightrope walker, the kind of focus that achieves results is a relaxed experience.  So begin to focus with ease.

Sara Longmuir, Business and Executive Coach, SLongmuir@shirlawscoaching.com 07941 015 866

The Facts

Back pain is a common condition in the UK and is the largest cause of work-related absence. 4 out of 5 of us get back pain at some time in our lifetime and the commonest age group is between 35 and 55 years. It can be very uncomfortable but most people recover spontaneously in 4-6 weeks. However the recurrence rate is high and can increase and become more of a problem year after year if preventative steps are not taken. It is difficult to accurately diagnose back pain as the spine is made up of many structures each of which can contribute to pain and frequently two similar types of pain can have very different diagnoses. For this reason back pain is often called ‘non specific’ back pain. It is essential to remember that the spine and indeed the whole body is made up of moving parts and you either ‘move it or lose it’ therefore rest is never a good idea except for short periods.

The Structure

The back is a complicated structure built around the bones of the spinal column. There are 24 vertebrae locking in to each with 7 in the cervical spine (neck), and 12 thoracic vertebrae which also attach to the ribs and 5 lumbar vertebrae which form the lower back. The skull balances on the neck and the pelvis articulates with the 5th lumbar vertebra. Interspinous discs and facet joints connect the vertebrae and are the moving parts and the discs also act as shock absorbers. Ligaments together with the spinal muscles give the back its strength. The deep muscles are smaller connecting one vertebra to the next and have the role of stabilising, and the superficial muscles are longer and stretch over several segments create movement.

The Nerves

The spinal nerve roots come off at each vertebral level and connect the brain to the rest of the body, through the spinal cord. Each nerve root will carry both sensory fibres which transmit both deep and light touch as well as pain; and motor fibres which connect with muscles to create movement.

Some of the more common causes of back pain.

Sprains

Overreaching or twisting can cause a sprain or strain of a ligament or muscle. The result can be muscle spasm which can last several days or even weeks and prolong what is really a simple problem. This may result in muscle weakness and the best remedy is gentle but frequent movement for short periods of time to reduce the spasm, maintain good blood supply and movement patterns. The loss of normal movement patterns can become a bad habit which is hard to remedy once it becomes established.

Bulging, herniated or prolapsed disc

The discs consist of thick bands of fibrous tissue surrounding a soft jelly like material called the nucleus pulposis. A good analogy is a thick car tyre with a soft centre. While acting as a shock absorber the ‘jelly’ shifts from side to side and a minor bulge should not cause a problem. However overloading the spine can cause the disc to herniate or prolapse putting pressure on the nerve roots.

Sciatica

Sciatica is pain travelling down the back of the leg to the foot and is caused by pressure on the 5th lumbar nerve root.

Spondylosis, wear and tear or degenerative joint disease.

In the normal aging process the discs in the spine become thinner and the spaces between the vertebrae become narrower. Spurs of bone, known as osteophytes, may form at the edges of the vertebrae and the facet joints.  These can pinch the nerve roots and may cause pain. The important thing to remember with degenerative joints is that good posture and muscle support is vital to remain pain free.

Spinal stenosis

Occasionally back pain can be associated with pain in the legs which comes on with walking. This is called spinal stenosis.  It is caused by narrowing of the spinal canal by osteophytes. This causes compression of the spinal cord or nerves. Typically, the pain is only felt after a few minutes’ walking and usually settles after a few minutes’ rest when the person can walk again for a while.  This type of problem may need surgery to open up the spaces for the nerves.

Rarer causes of back pain

Osteoporosis which can cause micro-fracturing of bone; the joint inflammatory diseases such as rheumatoid arthritis; fractures; spondylolisthesis which is the slippage of one vertebra on another and can be either degenerative or genetic; infections and tumors are the more rare causes of back pain.

Investigations

In order to make a more accurate diagnosis an Xray, MRI scan or CT scan may be necessary.

Treatment

Physiotherapists recommend a proactive approach to back pain. In general prolonged rest is not helpful for back problems. Anti-inflammatory medication and pain killers may be prescribed by the GP and will help to reduce pain so that normal movement may be maintained. Maintaining strength in both deep and superficial back and abdominal muscles and keeping mobile is essential for both the short and long term recovery. Weight management and posture are important to reduce stresses on the spine. Pilates based exercises, a gym programme or just walking more frequently and using the stairs rather than a lift will be helpful in getting back to normal and maintaining good function. Physiotherapy treatments such as joint manipulation and mobilisation, soft tissue release and joint stabilization can expedite recovery.

Special Offer

ESPH works with Asquith clients to offer preferential rates to members. Please quote Asquith 2009 to receive a 25% discount on your first appointment if you book before February 28th 2009. For more details visit www.esph.co.uk or call directly on 020 7907 1900.

By ESPH
www.esphysicalhealth.com / www.esph.co.uk

Yesterday you fled for your life from an enraged mammoth. Later you stalked a boar through a forest but then had to fight your main rival for the carcass. Another day at the office, 12008 BCE.

For most of our species’ history the ‘flight-or-fight response’ allowed us to react instantly to events by giving us sudden boosts of energy or aggression so we could flee - or fight.

• Breathing becomes fast and shallow. Oxygen is fuel for your muscles to run faster, hit harder.
• The heart pumps three times faster (to carry the oxygen to those muscles). Tiny blood vessels at the surface of the skin close down so the body can sustain a wound and not bleed to death.
• Digestion stops, sexual function stops, even the immune system is temporarily turned off.
• It’s not about thinking clearly – the body doesn’t need to think, it wants to take action.

These days we don’t face predators or prey or (usually) tribal rivals. Instead we face job pressures, deadlines, public transport, meetings, traffic jams, domestic issues. Yet our bodies can react in the same way.

Your mouth can dry; you may feel trapped and want to escape, or get a sudden burst of aggression (which you try to keep under control); your hands might feel clammy; you may sweat; your heart can pump faster and blood pressure could soar.

Every time stress triggers the fight-or-flight response you are experiencing a false alarm. Short-term it may boost performance. When it becomes prolonged and excessive it can take its toll.

Too many false alarms lead to disorders like heart disease, high blood pressure, immune system disorders, panic attacks, fatigue, migraine headaches, IBS, insomnia, TMJ (temporomandibular joint) syndrome, skin conditions and sexual dysfunction.

What can you do?

With fast shallow breathing your brain constantly searches for an explanation of why your body is in a heightened state of alertness.

1. To interrupt the stress cycle, simply be quiet for a short time and do some gentle abdominal breathing.

• Sit with both feet on the floor. Relax your jaw. Inhale slowly through the nose. Expand your abdomen (let it inflate like a balloon).
• As you exhale, let your belly drop back towards your spine. Contract your abdominal muscles as you finish exhaling to expel all the air.
• Make the breath silent so that it’s gentle and relaxed.
• It can be helpful to place one hand lightly on your abdomen to direct the breath. Breathing like this for just 1 minute will help to relax you.
  With relaxed abdominal breathing you’ll be able to focus on what’s really important.

1. Discharge the energy.

• Exercise is good. Any activity that will help release muscular tension will also tend to lead naturally to abdominal breathing.
• A brisk walk around the block can also help by getting you away from the stressor, even temporarily. When you return, you may benefit from a different perspective on the issue.

When you understand the stress cycle you can do things differently, feel differently and get different – better – results. Whatever mammoth lies ahead.

Sara Longmuir, Business and Executive Coach,
SLongmuir@shirlawscoaching.com 07941 015 866

Recent reports suggest that preventive screening for prostate cancer in the United States might have seen fatalities from the disease decrease at as much as four times the rate of the United Kingdom. Across America some 60% of men over 50 are tested for signs of the cancer each year, as opposed to a mere 10% in Great Britain. As with all cancers, early detection is crucial to an improved survival rate, not to mention minimising the amount of time patients have to spend enduring painful and debilitating treatments. As many as 30,000 men are diagnosed with prostate cancer each year in the UK, of these a third will die from the disease: a statistic which Preventicum, West London’s state-of-the-art full body health check clinic, is keen to see dramatically reduced by encouraging men to undergo health screening in good time to detect any early warning signs.

A Preventicum Ultimate Check-Up augments the standard blood and urine tests with in-depth screening for major health conditions and their all-important risk factors: for clients over 50 years old, this includes the prostate-specific antigen (PSA) test, which checks for the presence of substances in the blood which can indicate prostate cancer. Results from this blood test, which is currently unavailable to patients on the NHS, are further reinforced by ultrasound scans as well as a digital rectal examination carried out by an experienced doctor. The combination of these three checks ensures that Preventicum’s medical team can fine-tune its diagnosis and ensure that results are as accurate as possible. Results are also available immediately, ensuring that any referrals that may need to be made can be actioned as swiftly as possible.

Dr Garry Savin, Medical Director at Preventicum says “As with so many cancers, the key to beating the disease lies in early detection through efficient screening. All too often there is a reluctance from men to undergo preventive screening for prostate cancer, as if the condition is somehow embarrassing or a sign of impending old age. We have gone to great lengths to ensure that our screening for prostate cancer is as accurate and unobtrusive as possible, ensuring that visitors to the clinic can leave with peace of mind that they have been thoroughly examined.”

Preventicum and Asquith work together to provide preferential rates to readers of this newsletter. By quoting Asquith 2008 at the time of booking, you can receive a 15% discount on your Ultimate Check-Up until 31st December 2008. The Preventicum team is available Monday to Friday 9.00 – 5.30 to answer all your queries. Please contact them on 020 7605 6900 or visit the Preventicum website www.preventicum.co.uk

Don’t read this - it could change your whole outlook and way of communicating.

Don’t even think about it.

Then don’t do things differently

Negative suggestions

Negative suggestions are powerful.  Derren Brown on TV recently demonstrated children’s natural curiosity when he left them alone with a box saying “Don’t open the box”.  Phrased like that it was impossible for them not to.

Our brains can’t process negatives (and yes, I know that’s a negative).  For example, towards the end of a snooker game, a player just had to pot one ball to win a whole tournament.  As he was walking around the table deciding how best to take the shot, his opponent whispered “Don’t miss”.  Whenever I tell that story there’s an intake of breath from the listener.  They don’t need to be told the outcome. 

If you hear yourself using unhelpful negative suggestions to other people, when delegating, when speaking to children, even your own self-talk, convert it to something more positive.  Instead of: “This is difficult and time-consuming” notice the response when you say “It’s not easy or quick, it’ll be satisfying when you complete it though”.

Problem solving with a question

If you ever want to solve a problem, before you go to sleep set your unconscious mind a question.  Phrase it positively e.g. “What’s the best way to solve XYZ?”.  Imagine what it will feel like when you wake up in the morning with the solution in mind.  You’re likely to wake in the morning with an answer.

The effect of stress on your memory

Ever had the experience of seeing someone familiar across a room at a party and forgetting their name.  The more you wrack your brains the more the name eludes you.  But as soon as you leave the party, the name pops back into your mind. 

Our unconscious minds are affected by our stress levels.  The more you try to remember, the more stress you are putting on yourself and the less your mind will want to recall it.  As soon as you relax, the memory comes flooding back.

Apply that to driving tests, job interviews and presentations.  Of course, there’s a balance to be made between a healthy state of focus and relaxation to achieve optimum results.

Focus on what you want (not on what you don’t want)

Successful people naturally seem to focus their minds on what they want to achieve (not what they don’t want to achieve).  That’s more likely to see big success rather than just scraping by, avoiding failure.

An element of realism is healthy.  But visualising your goal will set your mind working to help you to make that a reality.  E.g. people who feel nervous before giving a presentation focus on their nerves and make themselves feel worse.  Instead, imagine finishing the presentation and smiling to a standing ovation.  Your body language and choice of words will make it more likely that you’ll achieve something like it.

It’s your choice

If you don’t notice your language and the power of your communication, nothing will change.  But when you do communicate positively to yourself and others, with your outcome in mind, your ability to influence your results will increase.  Thanks to the power of your unconscious mind.

Sara Longmuir, Business and Executive Coach, SLongmuir@shirlawscoaching.com 07941 015 866 

How to see off one of Britain’s Biggest Killers 

It may lack glamour, but it still packs a killer punch: bowel cancer is the second biggest cancer killer in the UK, claiming some fifty lives every day. Of the 35,500 people estimated to develop the disease each year, half will die: a sad testament to the fact that not enough people are seeking diagnosis or treatment early enough when the disease is in its, eminently curable, early stages. Preventicum, West London’s state-of-the-art full body MOT clinic, makes a point of highlighting the importance of screening for any polyps that might go on to manifest themselves malignantly in the body ensuring that all visitors to the clinic leave with peace of mind safe in the knowledge that any potential nasties will have been detected.

A Preventicum full-body check-up augments the standard blood and urine tests with in-depth screening for major health conditions and their all-important risk factors: including a radiation-free MRI colonoscopy to look for bowel cancer and its primary precursor of polyps. Particularly prevalent in those of middle-age (1 in 10 people of 60 will develop them), polyps manifest themselves in the colon and, if left undetected and untreated, can spread and become malignant. The good news is that if these potentially cancerous polyps are detected early enough they can be removed painlessly.

Preventicum’s MRI colonoscopy only takes 15 minutes and is less invasive and less uncomfortable than conventional colonoscopy methods.  The procedure is also radiation-free, unlike CT colonoscopy, which exposes the client to a more than significant dose of unnecessary radiation.  Results are also available immediately from Preventicum’s full-time radiologist, so referrals can be made there and then for polyps to be quickly and painlessly removed.

Whilst medical experts are still looking to ascertain precisely what causes bowel cancer, certain triggers have been identified which can aggravate symptoms and encourage the manifestation of the disease: namely a lack of fresh fruit and vegetables in the diet coupled with a higher than normal fat content and a tendency towards obesity.

Dr Garry Savin, Medical Director at Preventicum says “Bowel cancer is one of the nation’s biggest killers, but it lacks the profile of other diseases which feature more prominently in the media and are higher on the public’s agenda. The tragedy of the disease’s high death toll is that, when detected early enough, 90% of bowel cancer cases can be successfully treated. With many of the disease triggers lying latent, the need for preventative check-ups is paramount to ensure that any diagnosis can take place before the disease has a chance to progress. The minimally-invasive, radiation-free screening that we offer at Preventicum is perfect to detect any polyps, comfortably providing patients with peace of mind.”

Preventicum UK
www.preventicum.co.uk
020 7605 6900

As an executive coach, I’ve found that the more successful my clients become, the more they want to review certain aspects of their lives:

• Why do I choose to do what I do? 
• What do I get out of my work?
• What might I want to put back to leave as a legacy in the world?

When you reach a certain level of seniority, other questions arise: 

• Am I doing what I’m passionate about?
• What am I passionate about?!
• Do the people I work with have the same purpose and passion as I do?

These kind of questions have traditionally been raised with friends over a bottle of wine in the wee small hours.  You get fired up but in the cold light of day nothing seems to change.  The purpose and passion with which you may have started your career retreats once again.
Time for a review.

You may have a commercial vision for what you want in terms of:

• Salary
• Profits
• Return on investment (ROI)
• Return on equity (ROE) etc.  

Outside of money, why are you and your business ‘in business’?

Getting in touch with your values – what’s important to you – can be a way to get to the root of your ‘purpose’.  Think back to times when life was at its most fulfilling – what was important to you about those experiences, what values were you honouring? 

Think about times or people that drive you crazy – it may be because some of your values were being trampled on.  What might they be?

Identify which three values are most important to you.  For example, you may value independence, competition, freedom, excitement, peace, fun, success. 

Knowing your values then makes it easier to identify your purpose or intent - why you and your business are in business, apart from money.

The intent of an individual or a business is usually expressed as the contribution made to society in a broader sense.  Intent also sets the tone for an organisation’s culture.  Intent is outward looking and ‘giving’ in nature.

Businesses can also usefully review their values and intent.  Clarity across the business can motivate staff, lead to greater staff retention and attract the right people in the first place.

Think again about those possible values, other examples are: challenge, achievement, security, risk-taking, beauty, kindness, learning. 

Imagine if your colleagues or business partners were aligned on their intent and the reasons for being in business.

Once you have your intent you’ll find it easier to make decisions about strategy, and the ways you can express yourself to the world. 

Our legacy, or what we leave in the world, can reflect how we have touched other people.  What will yours be?

Sara Longmuir, Executive and Business Coach, SLongmuir@shirlawscoaching.com 07941 015 866 

Stress

We now live in the so-called information age which has introduced rapidly evolving new technology and more competition.  These have brought about very rapid changes in the workplace and increased expectations of those who work there.  Sending messages is instant, putting on more pressure to deal with an ever burgeoning level of information, which leaves us little time for reflection before we are obliged to move swiftly on to the next task.  In addition to this, we are often required to work against a background of corporate mergers, short-term contracts, downsizing and a threat of redundancy – which could increase the incidence of stress.  Sustained levels of stress over a prolonged period may well promote illness both physical and mental, and in severe instances, premature death or even suicide.  Too much stress and endless wear-and-tear drives us into exhaustion. 

Burnout

Burnout is a condition which develops when an individual works too hard for too long in a high pressure environment.  The victim of burnout is exhausted on all levels, physical, emotional and attitudinal.  As a result work suffers, as can their family relationships.  In its most severe form the individual simply cannot go on and can have a full blown mental breakdown.  Those most likely to develop burnout are very productive people on the whole.  They often feel indispensable, work long hours and have high energy levels.  These people often multi-task and can be found doing three things at once.  Unfortunately they do not know when to stop.  They have very high expectations of themselves and others, but are poor delegators.  Often they are perfectionists and set themselves unrealistic targets, both in their work and play.  They tend to be very competitive and live life in the fast lane, working at full throttle most of the time.  Over conscientious perfectionists with type A personalities, those with so-called ‘hurry sickness’ are the most vulnerable.  Unfortunately they are used to being in control and are the least likely to ask for help when things begin to spiral out of control.  The signs and symptoms of burnout include:  emotional exhaustion with sleep problems, tiredness, irritability, depression, mood swings.

Low productivity accompanied by feelings of low achievement, high absenteeism and a high sickness rate.

Accident proneness

Multiple physical symptoms including headache, backache, indigestion, shortness of breath, frequent coughs and colds.  Using the accompanying questionnaire, it is possible to help to identify those individuals whose coping mechanisms are at full stretch and therefore at risk of stress related issues and burnout. 

Most people would score between 0 and 2 on this test and this would indicate that one is coping.  A score of 3 to 5 means that one is generally operating slightly outside of the comfort zone.  A score of 6 to 9 would indicate that coping mechanisms are under significant stress and remedial action should be taken as soon as possible to avoid the problem worsening.  A score of 10 to 12 indicates significant concern and could indicate that the person is suffering from significant stress, anxiety and depression, and should take avoiding action or seek professional help.

(This is an arbitrary risk system and should be used in conjunction with a clinical mental state examination to be more accurate.)

We’ve all seen how personal presence works: think Bill Clinton, Nelson Mandela or even Tony Blair. But charisma is not only about someone’s physical presence. Other qualities mark out those who have charisma.
How can you build these qualities and become more charismatic? Here are 7 ways:

• Energy attracts. Energy is generated when we’re passionate about something beyond ourselves. We’ve all noticed how some speakers, friends, family members entrance an audience when they talk from the heart. Genuine enthusiasm will make you more attractive to others.
• Improve awareness of others’ feelings (emotional intelligence or empathy). Take a minute or two imagining a situation from the other person’s perspective to give you insight. When you communicate, the other person will feel more understood. They will warm to you, want to listen to you and are more likely to agree with you.
• What you say has to be important. Remember that people listen out for ‘WII FM’ – What’s In It For Me. For charismatic communication, use words that generate images, feelings and emotions rather than intellectual arguments. Your aim is to engage and move first – details can come later.
• Work on your voice. A voice can better communicate a more memorable message when it’s strong, clear, deep and resonant. This is something that men and women can improve upon with brief, specialist coaching. It really does make a difference.
• Physical presence is connected to voice tone. When your posture is upright yet relaxed it will also contribute to a mellifluous voice that people want to listen to. Working out regularly may exercise your muscles, but how often have you seen people hunched over an exercise bike or on the treadmill with shoulders high and neck tensed? Stand upright, shoulders relaxed, breathing from the abdomen. Walk tall to be noticed.
• Charismatic people are interesting. That’s because they are more interested in others than they are in themselves. Think about it: It’s rare to be on the receiving end of someone who can really listen. It’s one of the benefits you get from working with an executive coach. Active listening means putting all of your attention in the other person without thinking of what you want to say next, or waiting to leap in with what’s important to you. It enables a deeper response and connection with the other person. Cultivate your listening skills.
• Inner confidence is charismatic. This kind of self-belief is based on a boldness at engaging with the world and a sense of humour. Charismatic people smile a lot, which feeds into how relaxed they are, what they focus on and the energy they project.

There is no charisma gene. We are not born with charisma. It’s something that can be learned and cultivated and is most powerful when it comes from the heart.

Sara Longmuir, Executive Coach, www.coachingtalent.com

What does the pancreas do?

The pancreas is a large gland sitting in the upper abdomen which has two important roles in the body.  The first is to produce the pancreatic digestive juices which help us to break down the food we eat.

The second is to produce insulin and other hormones concerned with digestion.  Insulin is very important in the body as it enables us to absorb sugar and thus helps to keep the level of sugar at a stable level.  

What happens if my pancreas stops producing insulin?

The sugar in our blood stream is partly controlled by insulin and generally the more sugar in the blood the more insulin is produced by the pancreas to absorb this.  If the cells producing insulin fail, then the level of sugar in the blood rises as we cannot absorb sugar properly without insulin and this is called “type I diabetes”. 

What can go wrong with the pancreas?

The pancreas can become inflamed and this is called pancreatitis, a potentially life threatening condition.  The pancreas can also be a site for cancers to develop.  Pancreatic gland failure can also result in diabetes and malabsorption syndromes since normally food breakdown and digestion is reliant upon pancreatic enzymes.

Pancreatitis

There are several causes of inflammation of the pancreas (pancreatitis) but the two commonest are gallstones and excessive alcohol consumption and these account for 80% of cases.  The former can occur when a gallstone causes a block in bile drainage which can cause pancreatic enzymes to activate whilst still in the gland and this can classically be triggered by a large meal.  In alcohol induced pancreatitis, symptoms usually begin 6-12 hours after an episode of binge drinking. Typically, pancreatitis presents as a severe pain in the upper abdomen associated with nausea and vomiting and can be very serious with a mortality rate of 10-15%.  This can rise to 70% in patients with infected severe pancreatitis.  It is thus important to recognise this condition early. 

Pancreatic Cancer

Pancreatic cancer is uncommon under the age of 40 but it is the tenth most common cancer in the UK.  (Not counting non-melanoma skin cancer.)

There are several associated risk factors including smoking.  Up to a third of all pancreatic cancers are linked to smoking including cigarettes, cigars and chewing tobacco.  Diet may also play a role and a diet high in fat, sugar or red or processed meats seems to increase risk.  Chronic pancreatitis is a known risk factor as is being overweight.  Sometimes pancreatic cancers can run within a family but this is in a minority of cases.  The breast cancer gene faults BRCA1 and BRCA2 if present can also increase the risk.

Exposure to some industrial chemicals called “chlorinated hydrocarbon solvents” have also been linked to an increased risk.  Some studies suggest that other chemicals such as pesticides, nickel, chromium and iron may also increase risk.  Symptoms of pancreatic cancer are usually weight loss, abdominal pains and sometimes jaundice.

As with many other types of cancer, the outcome depends on how advanced the cancer is when it is diagnosed.  Generally speaking, the earlier it is detected the better the prognosis, however it is a difficult cancer to treat and doctors hope that there will be advances in treatment in the not too distant future.

Dr Garry Savin MBBS DRCOG MRCGP
Medical Director
Preventicum UK
www.preventicum.co.uk