Inside Health

The Terminally Ill Adults End of Life Bill is working its way through Parliament. If it became law in England and Wales it would be one of those moments in history that profoundly changes society. There are similar discussions taking place in Scotland, the Isle of Man and Jersey too. To be clear about what we’re doing on Inside Health. We’re not going to debate the rights or wrongs of assisted dying. Or go through the politics of the Bill. Instead, over the next few episodes we’re going to explore some of the issues that will come up if assisted dying goes ahead. We’re going to start with eligibility and who could get an assisted death under the proposed rules? To discuss we're joined by: Katherine Sleeman - Professor of Palliative Care at King's College London David Nicholl - Consultant Neurologist at University Hospital Birmingham Mark Taubert - Consultant Palliative Medicine at NHS Wales Erica Borgstrom - Professor of Medical Anthropology at The Open University Also in the programme we have exclusive research on the differences between men and women’s immune systems and why that affects the risks of infection and even autoimmune disease. James speaks Professor Lucy Wedderburn from the Great Ormond Street Institute of Child Health and Director of the Centre for Adolescent Rheumatology at University College London, and Associate Professor Dr Lizzy Rosser also from the Centre for Adolescent Rheumatology at University College London. Presenter: James Gallagher Producers: Hannah Robins & Tom Bonnett

John is registered blind, and relies on his hearing to get around in his everyday life. But as he has got older, he’s started to notice his hearing deteriorate. He wants to know – is there anything available in between the initial solution of wax removal, and the final destination of hearing aids? He emailed Inside Health to ask James Gallagher to investigate. James speaks to Nish Mehta, an Ear, Nose and Throat surgeon at Royal National ENT Hospital, to find out how we hear, and learn about the different causes of hearing loss. He then visits UCL Ear Institute to undergo a hearing test with audiologist Dr Hannah Cooper, and see the potential future of hearing tests with Professor Maria Chait, an auditory cognitive neuroscientist. But hearing in day to day life is not as simple as in a science laboratory. James meets Kevin Munro, Professor of Audiology at the University of Manchester, in a noisy café to discuss hearing aid technologies and learn about their latest advancements. Presenter: James Gallagher Producer: Hannah Fisher Editor: Holly Squire and Colin Paterson

Five years on from the first Covid lockdown in the UK, we consider how the pandemic changed medicine. We're joined by Dr Emma Wall, academic consultant in Infectious Diseases at University College London Hospital who also runs a long covid clinic, Professor Katrina Pollock, Associate Professor in Vaccinology at the Oxford Vaccine Group and Jon Otter Director for Infection Prevention and Control at Guy’s Hospital London. Presenter: James Gallagher Producer: Hannah Robins

Fitness trackers at the ready! Join James Gallagher at Cardiff Science Festival as he runs through the ways wearable tech is making an impact on health and how it might shape the future of medicines and care. With him are Dr Sanne Lugthart, Haematology consultant at the University Hospital of Bristol and Weston NHS Foundation Trust. She's pioneering using wearables and an app to track pain in people who suffer from sickle cell disease. Also on the panel is Professor Kathryn Peall who is Personal Chair, Division of Psychological Medicine and Clinical Neurosciences at Cardiff University. Kathryn tells James all about working with data from the UK Biobank to test if wearables could predict Parkinson's disease. She's also developing 80s-style headbands that could help take hospital grade sleep monitoring to the comfort of the bedroom. And, running experiments with the audience and on his skydiving assistant Danni, James is also joined by Damian Bailey, Professor of Physiology and Biochemistry from the University of South Wales. Presenter: James Gallagher Producers: Tom Bonnett and Hannah Robins Production Co-ordinator: Ishmael Soriano Editor: Colin Paterson

When we hit our teens it's often a time when everything starts to change. We meet new friends through work or studies, we start going out more at night and we're often in new situations independent from our parents. For people with severe allergies it can be a risky time because they have all this change in their life, on top of what Priya Matharu calls the 'full time job' of managing your condition. Presenter James Gallagher talks to Priya about her experience of having severe allergies from a young age and how she has coped with reactions that mean just touching her face after chopping a carrot has put her in hospital. For Priya, when she reached adolescence and moved out of her family it was a scary time and she had to grow up quickly to take responsibility for her allergies. In a recent debate in the House of Lords it was discussed that moving young people out of the paediatric allergy services they have grown up with the support of and into adult services, just as everything else in their life is changing too can be really difficult for patients, and potentially dangerous. Dr Claudia Gore from Imperial College Healthcare NHS Trust shared her experience of working in a children's allergy clinic in London for that debate and she joins James along with Dr Paul Turner from Imperial College London to discuss how this transition from children's to adult services could be made safer and smoother for patients. Also in the programme, James is joined again by Dr Vanessa Apea, Consultant in Genito-Urinary and HIV medicine at Barts Health NHS Trust to answer more of your questions on genital herpes, UTIs and urinary incontinence. Presenter; James Gallagher Producer: Tom Bonnett Assistant Producer: Anna Charalambou Editor: Colin Paterson

Has James been buying shoes that are bad his feet? He meets podiatrist Dao Tunprasert to find out how healthy his shoes are. Also, returning to our theme of health conditions you find embarrassing, we get the lowdown on genital herpes from Dr Vanessa Apea. She's consultant physician in Genito-urinary and HIV medicine at Barts Health NHS Trust and an Honorary Senior Lecturer at Queen Mary University of London and answers some of your questions. Presenter: James Gallagher Producer: Tom Bonnett Assistant Producer: Siobhan Maguire

You sent in your questions on dementia and now we're tackling them. Professor Tara Spires-Jones, Director of the Centre for Discovery Brain Sciences at the University of Edinburgh, joins James Gallagher to go through the insidehealth@bbc.co.uk mailbag. James also visits mushroom grower the Bristol Fungarium which has teamed up with the University of the West of England to examine a mushroom called lion's mane. Lion's mane has a lot of hype about it online as well as a long history in traditional medicine and neuroscientist Dr Tim Craig and his team are taking it into their to lab to investigate whether it might harbour properties that could benefit people with dementia. Thanks to everyone who sent in questions after listening to our episode 'What next for Alzheimer's treatment' which is available on BBC Sounds: https://www.bbc.co.uk/programmes/m0024ng7 Presenter: James Gallagher Producer: Tom Bonnett Editor: Holly Squire

James Gallagher discusses the risk from H5N1 bird flu in the UK as a poultry worker in the West Midlands is infected and looks to the US where the disease is spreading in cattle. He's joined by virologist Dr Ed Hutchinson from the University of Glasgow to discuss how the virus is evolving, whether we are edging closer to bird flu becoming a pandemic and how it's being handled in the US as President Trump's government takes office. Also, you've been sending in your questions on embarrassing health problems and lots of you have asked about the problem of leaking urine, known as urinary incontinence. James puts your questions to Dr Vanessa Apea, a consultant physician in Genito-urinary and HIV medicine at Barts Health NHS Trust and an Honorary Senior Lecturer at Queen Mary University of London. Presenter: James Gallagher Producer: Tom Bonnett

Pasteurising milk makes it safer, but are there any benefits to drinking it “raw”? James heads to a dairy farm to investigate the evidence and see if anything is lost in pasteurising milk. Guests: Professor Marion Nestle, food policy expert, New York University Dr Ellen Evans, food safety expert at Cardiff Metropolitan University Jonny Crickmore, Fen Farm Dairy and chairman of the Raw Milk Producers Association Professor Markus Ege, researcher, University of Munich Presenter: James Gallagher Producer: Tom Bonnett

From kombucha to cold water swims, sleep to supplements, so many things are claimed to help enhance your immune system. We investigate the evidence, and ask if it's possible to avoid catching a virus this winter (and still leave the house). Plus, James braves 3.9 degree water to see for himself if cold water swimming has any affect on our immune systems. Guests: Margaret McCartney - Resident GP and expert in evidence-based medicine John Tregoning - Professor in Vaccine Immunology at Imperial College London Eleanor Riley - Professor of Immunology and Infectious Disease at University of Edinburgh Presenter: James Gallagher Producer: Hannah Robins Content Editor: Holly Squire The programme was produced in partnership with the Open University.

It has been a cold start to the year and for many that means the heating's on, windows are shut and we're drying clothes inside the house. For many people, mould becomes a major concern in winter and the health problems mould can cause have been under more scrutiny since the death of two-year-old Awaab Ishak who died in 2020 from long-term exposure to mould at his home in Rochdale. At Imperial College London a study called WellHome is underway to monitor levels of mould and other indoor pollutants in homes across the west of the capital. Presenter James Gallagher meets Mum of four Roxanne who had monitoring equipment installed in her house to collect data that could lead to guidance on housing quality and inform how healthcare professionals look for and treat conditions affected by mould. Joining James at Roxanne's is WellHome's Dr Athena Trachalaki, a Respiratory Registrar with Imperial College NHS trust. With her, to go through all the pollutants that pose a risk to our health indoors is WellHome lead and Professor of Community Health and Policy at Imperial College, Frank Kelly. Dr Jonathan Grigg, Professor of Paediatric Respiratory and Environmental Medicine at Queen Mary University, London, tells James it could be the end of the line for the gas cooker, and Professor Alastair Lewis who is Professor of Atmospheric Chemistry at the University of York takes a virtual tour of James's home to discuss all the ways James could be cleaning up the air he breathes. Presenter: James Gallagher Producer: Tom Bonnett Editor: Holly Squire

In the UK, around a third of British children have tooth decay. Just among the under-fives, it's a quarter - a figure that rises significantly in the most deprived areas. Tooth decay can cause speech development issues, embarrassment for children and in 2023, 15 million school days were missed due to tooth pain or treatment. There’s a financial cost too – in 2023 in England alone tooth extractions under a general anaesthetic cost the NHS £41 million. And it's totally preventable. So, how can we stop teeth rotting in the first place? One way initiative announced by the new Labour government is to expand supervised toothbrushing sessions to more children. We find out how these work with Oral Health Team Lead Helen Bullingham who supports nurseries and schools in East Sussex to deliver these programmes. But what about the evidence to support this intervention? Zoe Marshman, Professor of Dental Public Health at University of Sheffield, explains her findings and dental hygienist and researcher at King's College London Dr Claire McCarthy describes what parents should be doing, in an ideal world, at home. And finally, what role does sugar play and how can we get consumption down? Dr Nina Rogers from the Population Health Innovation Lab at the London School of Hygiene & Tropical Medicine explains her findings into the impact of the Sugar Drinks Industry Levy introduced in 2018. Presenter: James Gallagher Producers: Hannah Robins Content Editor: Holly Squire Inside Health is a BBC Wales & West production for Radio 4, produced in partnership with The Open University.

Olympic cyclist Sir Chris Hoy is calling for more prostate cancer testing after he was diagnosed with terminal cancer. Prostate cancer can often present without symptoms, and for people like Sir Chris, this can mean it isn't diagnosed until it has spread and become incurable. Unlike breast, bowel, or cervical cancer, there is currently no national screening programme that routinely invites men for prostate cancer testing. Instead, men over 50 can request what's known as a PSA blood test from their GP, but it's not automatically offered. Sir Chris wants that to change and is calling for the test to be made more easily available for men under 50, especially those with a family history of prostate cancer. But, expanding prostate screening is a divisive issue. While it could help detect cancer earlier in some cases, there are potential drawbacks. Inside Health's James Gallagher talks with Professor Frank Chinegwundoh, Consultant Urological Surgeon at Barts Health NHS Trust, Professor Hashim Ahmed, Chair of Urology at Imperial College London and Inside Health's resident GP Dr Margaret McCartney about the evidence for and against prostate cancer screening - and whether Sir Chris's campaign could and should change the guidance. This programme was produced in partnership with The Open University. Presenter: James Gallagher Producer: Tom Bonnett Editor: Holly Squire

The first drugs to slow Alzheimer's progression have been making headlines around the world. For researchers in the field, the arrival of these two therapies called Lecanemab and Donanemab is testament to decades of advancements in the field of Alzheimer's research because for the first time they go further than modifying the symptoms and have been shown in trials to slow down cognitive decline. For patients and families these treatments offer hope that the amount of quality time they'll have together could be lengthened. Around the world regulatory bodies are weighing up their effectiveness, safety and cost. In the UK by the Medicines and Healthcare products Regulatory Agency (MHRA) has approved Lecanemab and Donanemab for use but the National Institute for Health and Care Excellence (NICE) rejected them for use in the NHS on the basis the benefit to patients did not outweight the cost, although they could still be available privately. Presenter James Gallagher examines the decision with Professor of Public Health Carol Brayne from the University of Cambridge and neuroscientist Professor Tara Spires-Jones from the University of Edinburgh. Then, looking forward, he meets scientists searching for future treatments including Dr Emma Mead, chief scientist at the Alzheimer's UK Drug Discovery Institute at the University of Oxford, Dr Ashvini Keshavan, co-lead of University College London's ADAPT blood biomarker trial, Selina Wray, Professor of Molecular Neuroscience and Alzheimer's Research UK Senior Research Fellow at University College London, and UK Dementia Research Institute Emerging Leader Dr Claire Durrant. This programme was produced in partnership with The Open University. Presenter: James Gallagher Producer: Tom Bonnett Editor: Holly Squire

Have you ever thought about how you breathe? For many of us, the 20,000+ breaths we take each day go underneath our conscious awareness. But every now and then, a short-lived spout or a chronic case of breathlessness can remind us just how vital good breathing is for our health. But can we all breathe “better”? Some wellness trends suggest so... James Gallagher gets to grips with mouth-taping: the practice of taping the mouth shut during the night to promote exclusive ‘nasal breathing’. Many claim it has improved their sleep, their athletic performance and even given them a more chiselled jaw. Ken O’Halloran, professor of physiology at University College Cork, explains what research has been done looking into this trend and warns about when taping might do more harm than good. James also visits The Coliseum in Covent Garden to hear how an operatic training programme has improved the quality of life for people living with Long-COVID. ENO Breathe, designed by The English National Opera and Imperial College Healthcare NHS Trust, has seen 4000 people learn to breathe like a classical singer to help them handle breathlessness. Creative director, Suzi Zumpe, and respiratory registrar, Keir Philip, talk through the programme and its impacts. Finally, could taking consciousness control of our breathing for a short time each day improve our health? Guy Fincham, researcher at the University of Sussex, dives into his PhD research on breathwork, including his initial studies looking at who might benefit from these practices. Presenter: James Gallagher Producer: Julia Ravey Content Editor: Holly Squire Studio Engineer: Giles Aspen Production Coordinator: Ismael Soriano This programme was produced in partnership with The Open University.

There are so many campaigns now to stop stigma and embarrassment - from Davina McCall talking about the menopause to Idris Elba campaigning for black men to get their prostate checked. And when we asked for your stories of how embarrassment impacts your health, our inbox was flooded with stories of incontinence, IBS, genital problems, skin issues, fertility troubles, fatty lumps and more - along with the huge and varied ways these issues are affecting your lives. So, how does embarrassment affect how we behave regarding our health, how can doctors and our health service adapt to alleviate it, and do awareness campaigns really help? To discuss James Gallagher is joined by: Dr Margaret McCartney, GP Dr Vanessa Apea, consultant in sexual health at Barts Health NHS Trust and Medical Director at Preventx Professor Ruth Parry, communications expert who studies clinician-patient interactions about sensitive issues. Plus, James gets some top tips to help alleviate embarrassment when talking to your doctor. Presenter: James Gallagher Producer: Hannah Robins Content Editor: Holly Squire Production Coordinator: Ismael Soriano This programme was produced in partnership with The Open University.

If you have a rare genetic disorder, new technology that allows your genetic code to be analysed means you could have a diagnosis within weeks. Before, people with rare diseases would often go their entire lives without a diagnosis. It's a revolutionary advancement but does it change how patients are treated or help improve their wellbeing? Presenter James Gallagher meets Lisa whose daughter Jaydi was born with a rare genetic disease that affects her growth, speech, eyesight and a number of other conditions. We hear the story of Lisa and Jaydi's journey to diagnosis through Exeter University's Deciphering Developmental Disorders (DDD) study, and how it changed the course of Jaydi's life. Her clinician, Consulatant Clinical Geneticist Dr Emma Kivuva, tells James how the diagnosis impacted on the care they offered and Dr Caroline Wright, Genetics & Genomics Theme Lead on the DDD study explains how they are measuring the effect of diagnosis on patient treatment and wellbeing. This programme was produced in partnership with The Open University. Presenter: James Gallagher Producer: Tom Bonnett Editor: Holly Squire

Trials of a cancer 'vaccine' have begun and presenter James meets Steve, one of the first patients to trial the new treatment, Steve remembers his shock at being diagnosed with colorectal cancer in his 40s and tells the story of how he became involved in this pioneering research into tackling cancer. The vaccine is based on the same mRNA technology as the Pfizer-BioNTech COVID-19 vaccine and James heads to the University of Cambridge to find out how the early work into cancer vaccines became the foundation for the rapid rollout of the covid vaccine. In the lab, molecular biologist Dr Anne Willis and immunologist Dr James Thaventhiran explain how the vaccine is personalised to target the unique make-up of an individual patients' cancer cells, and how if the trials are successful they could open the door to mRNA treatments being used to treat a wide range of diseases. Also, Imperial College London cyber security researcher Dr Saira Ghafur joins James in the studio to explain why healthcare is a growing target for cyber attackers and how we can prepare for the next one because, as Saira says, it really is a case of "when" not "if". Presented by James Gallagher Produced by Tom Bonnett with Hannah Robins Assistant Producer: Katie Tomsett Editor: Holly Squire

Mpox is spreading and it’s been classified a public health emergency by the World Health Organization. Presenter James Gallagher meets Professor Trudie Lang from the University of Oxford who has been working in the areas affected to discuss what it means for people in the countries it’s already reached and whether its spread can be stopped. James also puts your questions on statins to Professor Naveed Sattar, and we hear the story of Simon who works in the outdoors as a landscape manager. He was having bouts of severe illness and was struggling to understand what was behind it. The answer? He’d had successive bites from ticks and was having symptoms of an allergic reaction when he was eating meat. He had alpha gal syndrome, commonly known as a meat allergy. We hear how it’s caused debilitating changes to his life. We also hear from Consultant Immunologist Dr Rachael O’Brian who has been documenting the first case of alpha gal syndrome her team have been diagnosing at Frimley Park Hospital in Surrey. Presenter: James Gallagher Producer: Tom Bonnett Assistant Producer: Katie Tomsett Editor: Holly Squire

Richard was 10 when he started smoking, and by the age of 35, he had given up on giving up smoking. But thanks to vaping he quit, almost by accident, in just a few months. However, vaping has been in the spotlight recently, with the rise of disposable vapes and awareness of more young people starting to vape. So, is vaping a useful tool to help people get off of cigarettes, or is it a gateway for young people into smoking? We hear from young people about their experiences and thoughts on vaping. In the studio, Dr Sarah Jackson, Principal Research Fellow at UCL Alcohol and Tobacco Research Group, and Hazel Cheeseman, Deputy Chief Executive of ‘Action on Smoking and Health’, are with James to discuss. Plus, podiatrist Dr Ivan Bristow is on hand to advise why James and listener Linda have had a hard time getting rid of their verrucas for years. We find out exactly what the warts are and what options are available to help our body tackle them. Presenter: James Gallagher Producer: Hannah Fisher Assistant producer: Katie Tomsett Editor: Holly Squire