Dear doctor

Cancer in the family
Q: Everyone in my family dies of cancer - I can't think of one relative who has died of heart problems or natural old age. I keep telling my GP I want to have regular checks for cancer but he fobs me off saying my family's cancers are of lots of different, unconnected types and that they're not inherited anyway. I'm 25 and generally fit and well. Should I accept his advice?

A: It all depends on your philosophy - and nationality. There are now guidelines that spell out for GPs which symptoms are most suggestive of cancer and when to refer urgently. But the Americans aren't relying on GPs to read guidelines. The American Cancer Society now recommends that men and women with no symptoms and average risk of cancer should have a full cancer check up every three years from the age of 20, and every year from the age of 40. Where America leads, we tend to follow, albeit a couple of decades later. Meanwhile, I'd certainly ask for referral to a genetics unit, which can take a detailed history of your relatives' cancers and advise you about your own risk.

Dizzy spells

Q: My elderly mother suffers from bouts of dizziness. She's been told it's common at her age and nothing can be done, which seems rather dismissive. Any advice?

A: At least a quarter of all people over 72 have long term dizziness. Lots of factors may contribute; taking five or more drugs, low blood pressure that falls when you stand up (postural hypotension), balance problems often due to poor blood flow to the brain, heart disease, depression and anxiety and hearing loss. Many hospitals run a falls clinic to investigate dizziness and falls in which your mum could see an occupational therapist to help with aids and devices at home to prevent falls, physiotherapist to help coordination and geriatrician to check for medical problems.

I feel unbearable

Q: I feel so wretched in the week before my period, and so much better after it, that the onset of my period is the best day of the month for me - and my family. I really don't know how they put up with my Jekyll and Hyde personality. Can you help?

A: No one knows what causes premenstrual syndrome (PMS) though it's obviously a hormonal problem. It improves when you don't ovulate, so pregnancy, the contraceptive pill or the menopause can solve the problem. Keeping your diet healthy can help some symptoms. Regular exercise gives you an endorphin buzz. Evening primrose oil is good for breast tenderness and Ponstan helps headaches and heavy, painful periods. The antidepressant Prozac is now licensed for use in severe premenstrual mood disturbance. The National Association for Premenstrual Syndrome has a useful telephone helpline: 01732 760012.

Itching like mad

Q: I get patches of eczema that flare up in the hayfever season, when I'm stressed, or when I eat strawberries. The itchiness drives me mad. I've tried strong steroid creams like Betnovate for years but have been warned by my GP not to keep using it because it thins the skin. I've also noticed that it's much less effective when I use it a lot. Any other advice?

A: Prevention is key. Keep your skin moisturised with bath oil and a cream such as E45. Oral antihistamines can help itching. Accupuncture and homeopathy help some. Chinese herbal remedies are increasingly popular but you don't always know what you're swallowing.

• 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 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.

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