It seems that not a week goes by without some form of ‘Named Day’ celebration taking place. Two weeks ago, we of course noted International Women’s Day on the 8th March. Last Friday, on the 15th, we celebrated World Sleep Day, which followed naturally enough from National Dream Day on Monday 11th and coincided with True Confessions Day. So perhaps now is a good time for a true confession. It was not expert planning which led the launch of my new sleep clinic at Wessex Private GP to follow World Sleep Day so closely; however, it is a nice coincidence.

Sleep is important. We can see this if we consider its cost. Sleep renders us largely unconscious, a state in which we spend about a third of our lives. If it wasn’t critically important, why would we make this sacrifice? Think of all the things we could achieve with another 30 years, think how much easier it would have been for our ancestors to escape that hungry lion if they could be alert more of the time. But, more importantly, on an individual level, we know the importance of sleep when we consider the cost of a bad night. For more and more people, a bad night’s sleep is becoming a maddeningly frequent reality.

In 2022, YouGov carried out a survey of over 2,500 adults in the UK; they found that 89% of people felt their lives would be improved by having more sleep, with 49% thinking that they do not get enough sleep each night, and 12% having difficulty falling asleep every single night.

But when does bad sleep become a ‘medical’ problem? And when should we treat it? Well, perhaps we should start by asking what ‘medicine’ is for? In my simple opinion, medicine is there to increase our time on this planet, whilst also making that time better (more productive, more enjoyable, more meaningful, however you want to define it). In these terms, ‘bad sleep’ might become a medical problem as soon as it starts impacting your life, as soon as it starts making it worse. Nevertheless, stricter definitions can be useful when we start thinking about treatment, so this is how a doctor would define ‘medically’ bad sleep, also known as chronic insomnia.

Difficulty falling asleep, staying asleep, or waking early, occurring three or more nights a week, ongoing for at least three months, and affecting you during the day, which is not caused by a lack of opportunity to sleep.

If we use this strict definition, then it’s estimated that up to 10% of adults in Western countries suffer. On one level, these numbers are horrifying. However, for someone suffering from insomnia, perhaps they are a little comforting. Not being able to sleep can make you feel powerless, can rob you of control over a basic, physiological need, a need that other people seem to be able to meet easily. But the numbers above challenge this. You are not alone. You are not alone, and more importantly, you are not powerless.

Recently, there has been an explosion of information in the mainstream media about sleep and how to improve it, and a lot of it is actually very good quality. Popular medic, Dr Michael Mosely, was so interested in the topic he wrote a book, produced a podcast, and presented a Horizon Documentary (featuring some of my colleagues from the University of Oxford).

There is clearly a growing recognition of the burden of poor sleep. What needs to happen now, is for the NHS to catch up. The gold-standard treatment for chronic insomnia is a form of talking therapy called Cognitive Behavioural Therapy for Insomnia (aka CBTi). It is recommended internationally, including in the UK, and yet access to it on the NHS is patchy at best.

This is where I come in. I am a GP with a special interest in sleep and insomnia. I am trained in assessing sleep disorders and delivering CBTi. I have a passion for it, and if you need it, I hope to be able to share that passion with you, and improve your sleep. If you are interested, please take a look at our Sleep Clinic page and book your first appointment.

All the best and sleep well,

Dr Jonathan Tham

Dr Jonathan Tham

According to research, the UK may finally be in a position to roll out a prostate cancer screening program. The potential benefits of widespread screening are substantial, including a 20% reduction in prostate cancer deaths. However, past attempts at national rollout were hampered by concerns that the drawbacks outweighed the benefits.

The primary obstacle to implementing a screening program has been the lack of accuracy of the PSA (Prostate Specific Antigen) blood test, which is currently the first diagnostic step. The test alone cannot provide a definitive diagnosis of prostate cancer, requiring additional testing such as a biopsy to confirm the presence of the disease.

The rollout of safe screening for early detection is pivotal to helping improve diagnosis rates and boosting survival rates. Here, we look at the current testing methods for prostate cancer.

Safer screening for prostate cancer

The screening process for prostate cancer currently involves undergoing a PSA test, followed by other tests.

Until recently, a biopsy would be organised next, without an MRI. As the PSA test isn’t overly accurate, this meant men were sometimes sent for unnecessary biopsies.

Biopsies are known for their risk of infection, and they can also be painful for patients. Conversely, some men may also be diagnosed with the disease and given aggressive treatments, even though their type of prostate cancer is not likely to cause them harm during their lifetime.

Now, new MRI scans, called multiparametric MRI scans (mpMRI) and safer biopsies (transperineal guided biopsies) can give men a more accurate and less harmful diagnosis of prostate cancer.

The advantage of an MRI scan before a biopsy

If a prostate cancer screening is advised, this begins with a simple PSA blood test carried out here at the Wessex Private GP. If your test shows the PSA is a higher level than expected, then you may be referred for Whole-Body MRI scanning.

MRI scanning provides a detailed image of your entire body and can detect the presence of tumours and other abnormalities. If the scan shows any abnormalities, then you may need a biopsy.

The main benefits of having an MRI scan before a biopsy are:

  • it provides an accurate indication of the presence of prostate cancer
  • if nothing shows – a biopsy will be avoided along with possible side effects
  • if you do need a biopsy, it will inform the specific areas to target
  • if nothing shows – you will avoid unnecessary treatment with possible side effects

Our prostate cancer screening service

If you are concerned about symptoms of prostate cancer, or your risk of getting the disease, it is important to discuss it with your GP. During your appointment at the Wessex Private GP, Dr Charlie Middle will discuss your medical history and your risk of prostate cancer. He can then carry out a physical prostate exam and a urine test if necessary. You can then discuss the suitability of a PSA test.

If you are concerned about your prostate cancer risk, book an appointment with Dr Charlie Middle at the Wessex Private GP today.

Looking to get healthier but don’t know where to start? The answer could be in your DNA.

Our unique genetic makeup holds valuable information about the optimal nutrition that our body responds well to. Thanks to advancements in science, it is now feasible to develop a customised diet, nutrition, and lifestyle plan based entirely on your DNA.

Here, we look at how a health and wellness assessment could be the answer to improving your health and wellbeing.

What is a Health and Wellness Assessment?

A Health and Wellbeing Assessment is designed primarily as an educational tool. However, it can help you take the guesswork out of your diet and exercise routines.

This easy-to-use test requires you to take a saliva sample. The sample is then sent off to a lab to be assessed. Once analysed, the results will reveal what dietary and exercise choices work best for you, providing the key to unlocking an optimal healthy and active lifestyle to suit you.

The Health and Wellbeing Assessment is an at-home kit that will be delivered to your doorstep, allowing you to complete the test in the convenience of your own home.

How can a Health and Wellness Assessment help you get healthier?

A Health and Wellness Assessment provides a detailed analysis based on your individual DNA. It unlocks a wealth of information regarding your body’s specific needs and the various factors that can affect your overall health and wellbeing.

It will reveal the most important micro and macro-nutrients that your body needs. By understanding your unique nutritional requirements, you can make more informed decisions about your diet. You will also see how your body responds to physical activity, giving you a greater understanding of which sports and activities will benefit you most.

The assessment can also identify any potential health risks you may face such as high cholesterol, high blood sugar, weak bones, and more. This information can help you take proactive steps to manage your health and reduce your risk of developing these conditions.

You will even get to know how fast you are likely to age due to your risk of oxidative stress. Armed with this information, you can take steps to slow down the aging process and live a healthier, more vibrant life.

Receive your own personalised guide

Once you have completed the Health and Wellness Assessment, you will receive a comprehensive 80+ page guidebook. This guide delves into every crucial aspect of your diet and lifestyle, tailored to your specific genetic profile. It can help you make informed decisions about your overall health and wellbeing. You can find a sample Health and Wellness Assessment report by clicking here.

This easy-to-follow guide will help set you on your way to optimal health. Get your own personalised plan by booking a Health and Wellness Assessment through the Wessex Private GP today.

According to a study carried out by the NHS, 1 in 4 people in England will experience some form of mental illness each year. From mixed anxiety and depression to Post-Traumatic Stress Disorder (PTSD), millions of people suffer from a variety of mental health conditions that can be difficult to treat.

Genes testing for mental health was introduced back in 2011 in the United States. In 2022, the testing came to the UK and is now offered by selected clinics, including here at the Wessex Private General Practice. Known as Pharmacogenetics testing, it helps to create personalised mental health treatments based upon each patient’s DNA.

Read on to discover more about Pharmacogenetics testing and its benefits in the treatment of mental health issues.

What is Pharmacogenetics Testing in mental health?

Pharmacogenetics testing aims to identify how genetics will impact a patient’s medication response. It can reveal how a person’s body metabolises and responds to various medications. This enables doctors to provide personalised treatments based upon each patient’s specific requirements.

The testing itself typically involves collecting a sample of your DNA. This could be a blood or a saliva sample. It is then analysed in a laboratory. The results will be used to influence treatment decisions. For example, choosing the most appropriate medication and dosage required based on your genetic profile.

Dr Charlie Middle provides various Pharmacogenetics tests, each provided by Myogenes, a renowned UK-based diagnostic company.

The benefits of Myogenes Pharmacogenetic testing

Myogenes Pharmacogenetic testing has significant benefits when treating patients with mental health disorders. The test will help to identify which medications are most likely to be effective. But also, it can also help to reduce the patient’s risk of experiencing side effects from the treatments they receive.

It could be that you have genetic variations which make you more likely to experience side effects from certain medications. Or, you may have specific genetic variations that make some medications less effective.

While medications can be an effective way of treating mental health conditions, they are known to cause a variety of nasty side effects. This can make them both unpleasant for patients to use, as well as potentially dangerous. With Pharmacogenetic testing, patients are less likely to experience negative side effects from the treatments they receive.

If patients do need to take medications that the test has revealed could pose a greater risk of side effects, they can also be provided with regular checks and scans. Importantly, this would help to detect and address any problems early on.

To learn more about genes testing for personalised mental health treatment, book an appointment with Dr Charlie Middle today.

Next month is National Ovarian Cancer Awareness Month, putting the spotlight on a disease that affects around 7,500 women every year. Family health history and genetics play a big part in a woman’s risk of getting ovarian or breast cancer.

If more than one relative has had ovarian or breast cancer, before the age of 50, you are at much higher risk of developing ovarian cancer. But, how do you know for certain if you’ve inherited a faulty gene? How accurate are genetic tests for hereditary cancer? And, if you know that you have inherited a faulty gene, what next?

Your risk of developing ovarian cancer

A family history of ovarian or breast cancer can be challenging to deal with. Women have a 2% chance of developing ovarian cancer in their lifetime, but inheriting the BRCA1/2 gene mutation increases the risk of getting ovarian cancer to 65%.

But most women that are identified as high risk based on family health history, do not have the BRCA gene mutation. So, there are other factors that can increase your risk of developing ovarian cancer.

The main factors that contribute to a higher risk of ovarian cancer include:

  • Family: close family members on either side have had ovarian cancer.
  • Age: 84% of cases are diagnosed in women over the age of 50.
  • Genetic mutation: a BRCA1/2 gene mutation, or one associated with Lynch syndrome.
  • Menstrual history: a longer menstrual history e.g., starting your periods earlier or reaching menopause later.
  • Endometriosis: women who have endometriosis are at increased risk

Testing for hereditary cancer

There are several different types of ovarian cancer depending on the type of cell and tissue the cancer starts in. The only way to be certain is by having a genetic test. This will highlight specific gene mutations with a high level of accuracy. At the Wessex Private GP, we offer genetic testing with Myogenes state-of-the-art testing, that gives 99.99% accuracy and checks across 61 genes associated with hereditary cancers. Knowing that you have a gene mutation will enable you and your physician to be proactive with your health – including having regular blood screening checks or preventative medication that is specific to you.

New research has shown that early monitoring of women with the BRCA gene is essential for early detection of ovarian cancer. If screening begins early, there is a higher chance of catching cancer in the early stages and treating it effectively.

Of course, genetic testing will not find causes for all inherited breast and ovarian cancers. Keeping a healthy weight, having a balanced diet, exercising regularly, not smoking and making healthy lifestyle choices will all help to lower your risk.

If you have any concerns about ovarian cancer, or if you would like to be referred for a hereditary cancer test, the Wessex Private GP can help. Get in touch to make an appointment with Dr Charlie Middle and to find out more.

There is no ‘one size fits all’ for medications. For some patients, certain drugs can do wonders to treat conditions, whereas for others those drugs might not be so effective.

Pharmacogenomics is the study of prescribing medications that are tailor-made to an individual’s genetic make-up – enabling patients to benefit from effective treatments.

The Royal College of Physicians together with the British Pharmacological Society is putting in a plan to help make pharmacogenomics testing more widely available for patients. This will lead to better results and treat a wider range of medical problems.

At Wessex GP, we offer pharmacogenomics testing to patients who request it.

What is Pharmacogenomics?

Pharmacogenomics is the study of how genes affect a person’s response to drugs. As the name suggests, it is a combination of pharmacology and genomics. It has been around for decades – but recently we have seen a rise in precision (personalised) prescribing due to the advances in genetics and a better understanding of the human body.

Researchers are still learning about how our genes affect how we respond to certain treatments, with new approaches undergoing clinical trials. One big positive of the testing is that it only needs to be done once, because your genes hardly change throughout your lifetime.

Despite the growing awareness and recognition of the potential benefits, tests aren’t widely available. Currently, for NHS patients, it is being used for treating some cancers. In the future, it will be used to develop tailored drugs to treat a wide range of health problems, including Alzheimer disease, cancer, cardiovascular disease and asthma.

Who benefits most from Pharmacogenomics testing?

Patients with comorbid (co-existing) conditions would benefit as additional diagnosis could complicate treatments – especially as they are often prescribed multiple medications for different symptoms.

Patients that have previously experienced side effects from medications, or are concerned about developing side effects would also benefit from testing. Additionally, if you are going to be taking a drug that has varying results, a pharmacogenomics test will be useful.

The main benefits for patients are:

  • Avoiding treatments that will not work for you
  • Fewer side effects from treatments and a safer experience
  • Only prescribing what you need – resulting in less appointments

One study on the effectiveness of psycho pharmacogenetic testing and major depressive disorder found that it led to individuals being almost twice as likely to achieve remission.

Availability now

Pharmacogenomics testing is available privately for patients at Wessex GP. Blood testing is carried out by The Doctor’s Laboratory TDL and arranged through our service.

The results will be available within 48 hours, but sometimes sooner, and will be emailed to you. A doctor will email you or ring you to discuss the results.

If you wish to be referred or to discuss this further please make an appointment with Dr Middle at Wessex Private GP.

A new groundbreaking blood test that detects over 70 types of cancers in their early stages, could be rolled out as a standard screening in as little as five years time.

Now, the NHS is carrying out its biggest ever trial of its kind – so the blood tests can be ready to roll out to patients across the UK. With cancer causing one in four deaths in the UK, never has there been a stronger spotlight on early cancer detection testing.

MCED Multi Cancer Early Detection Blood test

In England, around half of cancers are currently diagnosed at an early stage. The importance of early detection cannot be understated. If cancer can be caught before metastasis (before it spreads to other organs), there is a significantly higher chance of survival. The government is aiming to increase early stage diagnosis to three quarters by 2028.

Recent advances in genetics have led to the development of a number of multi-cancer detection blood tests, these are progressing through clinical trials and are now coming onto the market.

One of these tests, the Trucheck test, offers the highest levels of accuracy, and if cancer is detected, it can show the tissue or organ of origin. Extensive clinical trials have demonstrated Trucheck’s effectiveness.

The Cancer Screening Trust (CST) that developed the Trucheck test, is a not-for-profit company and the largest independent provider of multi-cancer screening tests in the UK.

Trucheck Tests – detects cancer with accuracy

The Trucheck blood test has full UK clinical approvals and it screens for over 80% of cancers by incidence, with 96.8% accuracy.

Research showed that the new ‘liquid biopsy’ Trucheck tests from the CST were superior over other cancer blood tests, detecting nine in 10 cases of cancer. Also, the technology used can detect cancer earlier than before, and with the highest level of accuracy. This will allow life-saving treatments to begin before symptoms even develop – resulting in millions of lives saved!

Now, CST is in discussion with the NHS over its current trials that involve 140,000 patients (Galleri test), but using the CST Trucheck technology as it has proved an even higher accuracy.

Availability now

Trucheck is now available privately to individuals and companies at a cost of £1250, and includes all pre and post-test consultations, a referral from our in-house doctor, a full written report with the results and advice on the best way forward in the event of a positive reading.

The test takes less than a minute to complete, following a detailed consultation. This unique test detects and characterises circulating tumour cells ( CTC’s) via a lab checking process of a few days. If cancer cells are detected, the patient will be able to access treatment without delay.

If you wish to be referred or to discuss this further please make an appointment with Dr Middle at Wessex Private GP.

Seasonal Affective Disorder (SAD) or ‘Seasonal Depression’, is a mood disorder that affects around 2 million people in the UK. It can affect anyone, but is most common among young adults and women and it occurs during periods of lower sunlight levels.

Everyone is affected differently by the condition, but is characterised by low energy levels, poor appetite and a low mood that can impact on everyday life.

The cause of this recurring disorder is still unknown. However, there are a number of treatments that will successfully manage the condition. Read on to learn more about alleviating the symptoms of SAD.

Causes of SAD

Although the causes of Seasonal Affective Disorder are not fully understood, some researchers believe that lower levels of sunlight interfere with melatonin and serotonin production.

Serotonin is the brain chemical that helps regulate mood and melatonin is the hormone that maintains the normal sleep-wake cycle that repeats every 24 hours. This imbalance of chemicals impacts your circadian rhythms, or your natural body clock – that cannot adjust to seasonal changes. The result is a major depressive episode.

With less sunlight in the winter, SAD sufferers will produce less vitamin D which hinders serotonin activity. Some studies also suggest that higher temperatures can be linked to summer pattern SAD – but more research is needed.

Symptoms of SAD

There are a wide range of symptoms that may be seen in Seasonal Affective Disorder. These vary between individuals but may include:

  • Feeling depressed nearly everyday
  • Low energy levels
  • Feelings of hopelessness
  • Withdrawal from social activities
  • Difficulty concentrating
  • Oversleeping
  • Overeating

People can experience milder symptoms, and may experience a less intense form of the condition, known as subsyndromal SAD (S-SAD).

Treating SAD

One of the best ways to combat seasonal depression is getting outside for a walk. Exposing yourself to bright, natural daylight can be highly effective – especially in the morning hours when our cortisol levels are at their highest.

By maintaining a healthy diet, containing plenty of rich nutrients, vitamins and minerals and taking regular exercise will help elevate your mood. Also, try and get into a good nighttime routine – go to bed and rise at the same time, and avoid staying up too late.

There are a range of treatments for managing the symptoms of SAD include relaxation techniques such as meditation, CBT (cognitive behavioural therapy) as well as medications. Sometimes low dose antidepressants like sertraline, fluoxetine or citalopram can help lift the mental gloom, and help us survive the winter months.

For people with milder symptoms, bright light therapy or phototherapy can be helpful. Bright artificial lamps (‘SAD lamps’ or ‘light boxes’) can be used for set periods of time, simulating the sunlight. Alternatively, sunrise alarm clocks, which gradually light up your bedroom as you wake up, may also be useful.

The most important thing if you are struggling with seasonal depression, is to speak to your doctor. At Wessex Private GP, we will support you and we can discuss personalised, tailored treatments to help you manage your symptoms.

Get in touch today with our friendly team to book a consultation with Dr Charles Middle.

Most of us are now familiar with the renaming of the penultimate month of the year, ‘Movember’. Men around the world grow a moustache in support of the annual event to raise funds for different charities that focus on men’s health issues. These include prostate cancer, testicular cancer, mental health and suicide prevention.

Prostate Cancer UK is the main beneficiary of the campaign. The most common cancer in men, prostate cancer affects 52,000 men in the UK every year, and one in eight men has a diagnosis in their lifetime.

The early signs of prostate cancer can be difficult to spot. But if you know your risk, you can start having regular checks to catch it early and start treatment that will give you a greater chance of survival.

Your risk of Prostate Cancer

Prostate cancer often causes no symptoms at all. It can grow so slowly that it does not impede on a man’s quality of life – and might never need treatment. But sometimes it is quick growing, and is likely to spread to other parts of the body. So, it is important to know your risk factors. The following can put you at higher risk:

  • Aged over 50
  • Your race and ethnicity
  • Having close male family members that have had prostate cancer

Certain lifestyle factors can also make you more susceptible. These include diet, obesity, and smoking.

Symptoms of Prostate Cancer

If the cancer grows close to the tube that you urinate through (your urethra) and presses it, then you might experience changes in the way you urinate. However, this is often caused by an enlarged prostate, which is a much more common men’s health issue.

Other symptoms might include:

  • Difficulty urinating
  • A weak flow when urinating
  • Feeling that you haven’t emptied your bladder
  • Urinating more frequently or more urgently
  • Loss in weight
  • Blood in urine or semen
  • Erectile dysfunction
  • Back pain, hip pain or pelvic pain

Not sure? Book a Male Health Check

The only way to get a confirmed diagnosis is by visiting your doctor. If you are at higher risk, a regular health check will give you peace of mind, especially if you already have a niggling concern. Furthermore, catching it early will open up more treatment options.

At Wessex Private GP, your health check will be carried out by a doctor that specialises in men’s health and will include a comprehensive range of tests – a full MOT if you like. It can include screening for prostate cancer as well as colon cancer, another cancer which is also difficult to detect in the early stages.

You can choose tests for your cholesterol, liver, kidneys, glucose levels, a full blood count-checking for anaemia, calcium, prostate-specific antigen (PSA) and any other tumour markers. We will also screen your cardiovascular performance.

Choosing a male health check will help you to catch prostate cancer early, but also rule out many other common male health concerns. To arrange your male medical, book online with Wessex Private GP.

Dr Charles Middle is now available for Private Appointments at the Poundbury Clinic on Mondays and Thursdays, and Virtual Appointments on Saturday mornings.

It is possible to contact WPGP and make appointments at other times by request:

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