Statins

No answers I'm afraid but my own circumstances. I was taking both statins and Omeprazole (for acid reflux) well before my cancer diagnosis and still am; never been made aware of any increased risk of stroke so maybe that's something I need to ask about. If I can ever get an appointment with my GP, 3/4 week waiting time currently. He's a brilliant GP who gave me a fast track referral for my cancer even though I didn't fit the "guidelines" but he's about as difficult to get an audience with as the Queen nowadays. Not his fault obviously, massive population increase in our town so huge amount of new patients with no funding for the surgeries to cope.

Makes me extremely angry but I won't get political, 6/7 years ago I could call in the morning and get an appt for that day. Not any more.  

10 days for my GP but if it’s urgent you can call at 8.30 ( on the dot and even then there is a queue) and you’ll get an appt that day. 
Generally stuff for reflux increases the blood level of statins. Similar with fluconazole. Strange as doctor gave me all three on same script and pharmacist said nothing either. 
I’ll have to check it out with them when I go for bloods. 
RT to neck increases your stroke risk by 12% ish because it damages the carotid arteries. It’s a well known side effect that none of our oncologists bother telling us. 

Hi, 

Is the Lanzaprazole, Lansoprazole, that protects stomach? I take that and also atorvastatin.

Should l be concerned considering l'm about to go on the RT journey?

Val

Your team will know what you’re taking. 
I take lanzaprazole occasionally for a week at a time. Today I picked up my first prescription of Atorvastatin and it’s plainly in the warnings and precautions. There is no interaction with Radiotherapy. What radiotherapy does is damage the carotid arteries so you have to keep an eye on your BP and cholesterol after treatment. 

Beesuit at our practise you can get an appointment with a "healthcare professional" on the same day if you wait for 30/45 minutes on hold but not a GP, it's insane. We also had an email from the practise manager recently telling us that we were no longer assigned our regular GP and had to go into a "pool" to see whoever was a available unless we had "complex medical issues". The practise manager offered three "drop in" sessions to discuss this with him, two of which had already passed by the time we got the email.

It was decided by them that my wife didn't qualify for "complex medical issues" despite the fact that a Personal Independence Tribunal a few days earlier had overturned the DWP decision to slash her benefit in 2018 (they now owe us £5,500-ish in backdated payments).

I emailed him and have had no response so his last "drop in" is next Monday where I shall assert my view in a very strong manner. NHS at its best is a wonderful thing, probably saved my life more than once, but it needs attention.

You’re right. The NHS can’t be everything to everybody any more without a serious overhaul. Aging population, improving medical innovation allowing a multitude of expensive options for treatment and increasing expectations. Where do you start? 
On top of it all Consultants’ pensions are being hit so badly that even small amounts of over time incur huge income tax. I know they are well paid, and they should be, but you can’t expect a doctor to have to pay HMRC to work. It’s crazy! 
ok rant over..... I’ll stop now. 

Afternoon Beesuit! A good question. I leant about the increased risk of stroke after radiotherapy to neck from this site (Thanks Linda). I read about it, discussed with GP and eventually got an appointment will a stroke consultant. He was well aware of the increased risk (8-12% depending on who you read/believe). He informed me that there is no “level 1”(the best sort of science) evidence of anything known to reduce the stroke risk for H&N radio patients. However, he felt that the evidence was ‘good enough’ that in my position he would take a statin for life. My choice - there are some small risks. What a helpful conversation, why can’t the Oncologists warn us briefly of the risk, give us some simple info and send us off to GP to decide whether we want to reduce our risk by moderating our lifestyle (fewer fattty foods - boo, more exercise, monitor blood pressure etc) or considering taking a statin for life. I’ve done both/all. Simple. Can’t understand why this piece of info is kept from us......

Back to your question - the Stroke Physician simply said that when I needed to take fluconazole - yes I  still get thrush 2 1/4 yrs on - then I should stop the statin for the duration of the fluconazole, usually 14 days. Easy. Only started statin in Autumn and not needed fluconazole yet. Don’t know about lansoprazole risks. Some statins have less interaction with fluconazole-like drugs than others, could be same for lansoprazole? 

So, without worrying anyone,  there is a small increase risk of having a stroke after neck radio, and we can mitigate against this risk in several ways, but taking a statin is one of them. But be aware of interactions with others drugs - a Pharmacist should really know this though!

Hilary

Hi Hilary

Great reply as usual. 
I actually phoned the doctors this morning and they got back to me just five minutes after I read your reply. 
Yes, stop the statin while on Fluconazole but Lanzaprazole is ok. 
The nurse was surprised the pharmacist didn’t mention it

Thank heavens for this community. 
You get a more sensible answer at times than from your own team. 

Did you ever get round to that book/ booklet you were going to write with all this info we don’t get? 

I'm probably at quite a high risk of stroke as my dad had one at a very early age and has suffered several since.  Plus I've had the rt.  However, I've decided to go down the route of regular tests for now rather than to start taking statins.  My mum had a very bad reaction to them and my brother in law a life threatening reaction so I'm wary.   If things change in the future however I will consider taking statins.

Hi Beesuit. Impressive from your GP practice getting back to you so promptly. Shame the Pharmacist didn’t pick it up at the start - can’t win ‘em all!

Regarding the info booklet - I sent a draft one covering several of the commonest problems post-treatment (from what I’ve learnt here and those my CNS felt were the most frequently asked about), andasked if we could adapt it and produce for patients -radio silence. No interest from myTeam - clearly they think they do a great job (they don’t). I find the Macmillan info on Late and long term effects detailed, but v hard to locate on the site and rather reserved. It tells you what to do if you have a side-effect but isn’t useful for being aware of what’s to come when treatment is over the effects start to roll in!

My team has an incredibly reactive stance - if you have an issue you can ask about it, they’ll acknowledge it and maybe offer support or therapy. But what if patients don’t know to ask? How is it fair that Only those who ask get help - a 2-tier system sucks. They should be proactive - making patients aware of common problems so treatment is prompt. Classic example is Lymphoedema. When you raise it they send you for assessment and treatment. If you don’t mention it, nothing. Result- later treatment for the condition than is desirable. I could go on.

So sadly I have so far failed to make progress, but I haven’t given up. I’d like to see a comprehensive leaflet/online info on Dry Mouth - written by patients. I have learnt so much from this site and some things myself - all of which should be common knowledge for the Clinicians. As it isn’t, numerous patients are not aware of all the possible things they can do to alleviate dry mouth. Etcetc. If anyone has any bright ideas, do let me know.

Hilary