As this comment box is too small to provide an adequate response from Dr Hopcroft to the comments posted here, could anybody who requires further explanation on any of the points raised in the article email body&soul@thetimes.co.uk and I shall reply with a response from the doctor.

Harriet Addison, Body & Soul, The Times, London,

A GP writes again... A bacterium that has happily survived five days antibiotic treatment is hardly likely to die off on the sixth or seventh. The growth of antibiotic resistance relates to doctors' overprescription of them (often at a patients' insistence) not the length of the courses.

Martyn Lobley, Bexley, UK

Whilst breast self-examination has been shown to be ineffective, it’s important that all women are ‘breast aware’. This just means regularly checking your breasts to know what’s normal and see your GP if you spot any unusual changes. Early detection means treatment is more likely to be successful.

Breakthrough Breast Cancer, London, UK

I am not convinced with the statement that self examination of breast and testis is futile, coz from what I have heard most people go to their GP, only when they have found a lump. In most of the cases it might not be significant, but in a small percent it could mean that they have picked up a cancer before spread. same applies for testis. Moreover its a harmless test, and i dont buy the claim that it causes significant anxiety.

George, oxford, uk

does cracking your knuckles cause arthritis?

dustin, moreno valley, usa

I studied microbiology at university. You must always complete a course of antibioticsto prevent increased drug resistance. You should also start with a double dose for the same reason. Yes, we're building drug resistance through the things we do. No surprise we have MRSA!

Peter, Warwick, UK

Regular breast self-examination has been shown to be ineffective in increasing the overall detection of breast cancer but definitely increases patient anxiety. Recommending an exam that harms a patient and does not benefit them is unethical. Breast "awareness" has been the cry for many years now.

Dan, Kent , UK

An NHS GP with 20 years experience writes... Check the BMJ - early June 2006 if memory serves. Research showing that taking antibiotics until you feel better and then stopping is perfectly OK.

Dr Martyn Lobley, Bexley, UK

Tom Brown from Oxford makes a valid and very important point. Save our life-saving antibiotics and finish your course. You will do everybody a favour.

As for self examination, I beg to differ. A few years back I noticed a change in one of my testicles during a shower. It turned out to be a cancer. My advice is simple. Testicles shoul feel smooth under the skin. If it is not smooth or you notice a change, go and visit your friendly GP. It saved my life.

John, London, UK

How can we just trust our doctors when even the few who have left comments here seem to disagree so much?

Sandra, London,

What a load of rubbish most of these so-called myths were. Actually examining your breasts or testicles is important as lumps can be detected this way. It is not possible to tell from touch alone whether the lump is cancerous or not, but it lets you know a lump is there to be checked out. Finishing a course of antibiotics is very important for ensuring that you do not end up resistant to the antibiotic. People who do not finish their course of antibiotics may still get their infection cleared up, but next time they get an infection from this bacterium they will be immune to the treatment. This is why we are seeing a spread of antibiotic resitant diseases, which can be fatal. Antibiotics should not be taken with alcohol, it is not dangerous but alcohol interferes with the absorption of the antibiotic. I work with a lot of British GPs and it worries me how inaccurate their information is, I see a lot of them giving out false information to patients. This GP is just another example.

Dr Lewis, Europe,

it's irresponsible to encourage people to not take a full course of antibiotics. it's to ensure that all bacteria are killed off in order to avoid any drug resistant bacteria surviving and passing on their resistance to other bacteria. 1 of the reasons for "superbugs" like mrsa is poor compliance

graham, manchester,

If you don't like doctor's views - please stay away - it makes all our lives less stressful. (speaking as a GP).

James, London,

Perhaps the respectable medical doctor has never heard of the disulfuram reaction, from which I almost died some years ago, because I had not been informed of the side-effects of mixing alkohol and 3rd generation cephalosporins - any medical book of pharmacology gives detailed information about it.

Yannis, Tokyo,

it's irresponsible to tell people not to finish their course of antibiotics. it's not to cure the sickness, it's to prevent drug resistant bacteria.

beau, denver,

" In fact, sex equates only to climbing two flights of stairs." ye, maybe if you're over 65, or on your back with your wife doing all the work. Hehe, your sex life must be a joke

Alex, London,

I completely concur with Thalia - it is only when I've had contact with so called quallifed medical practitioners that my life has been seriously threatened. (twice from what should have been simple outpatient precedures) and more or less every time I have sought advice for a condition that has been misdiagnosed and for which medication has caused me severe damage, (steroids, barbituates etc.) I have no intention of ever visiting a GP again...I'll die of what ever it is the good Lord has destined for me.

Nora, London, UK

Debbie
Do yourself and your subjects a favour and read the trial data on statins and reduction of vascular events at various cholesterol levels. Rigorous science and placebo-controlled double blinded trials are more valid than rhetoric. Used appropriately statins are remarkably effective and well tolerated. A series of google based anecdotes is not enough evidence to disparage these agents.

Sean Latouf, Cardiologist, Townsville, Australia

As a doctor myself, I have never read such a load of bologne. You can neither believe the myths, nor the a sensationlist GP turned journalist. For the truth, turn to the scientific journals- but ONLY after a course on 'how to read a scientific paper'. Or, trust your doctors, who do this regulary.

Michelle, London, UK

As far as the information on antibiotics and alcohol, this is completely incorrect. Many other antibiotics should not be taken and just to name a few of these include 3rd generation cephalosporins, and the effects u get from this is the disulfuram reaction which is the same as metro or liver induct

joe dombroski ms3, bradenton, fl

#1 medical myth... that MDs can distinguish between unsubstantiated opinion and fact.

facts are supported by research -- the type that is done rigorously and systematically, peer-reviewed by the scientific/medical community and cited in such an article to support controversial opinions.

Sara, pasadena, CA

> "Any related myths? That you should always finish your course of antibiotics. It usually makes little difference."

i think a few commentators have already objected to this. it's a totally selfish and irresponsible assertion. while it might make little difference to the individual patient, it's certainly been indicated in increasing antibiotic resistance.

sarah j, london,

Fantastic article. Glad you wrote it. Glad I read it.

I shall, of course, pass this on to my homeopath, my witch doctor, and my barber to get their opinions.

Why are all homeopaths called Debbie?

clarke ching, Linlithgow Bridge, west lothian

My hypertension was diagnosed after I went to the doctor with severe recurring headaches. And despite doctors keeping saying that high blood pressure doesn't cause headaches, I find in myself a pretty strong *correlation*.

High blood pressure may not by itself cause headaches, but they could both have a common cause... like stress?

Rachel, Bristol,

R.e. that sex equates to climbing two flights of stairs-I'm a fairly fit mid 30's bloke and don't get put of breath climbing two stairs. During/after sex I'm breathing heavily (no not because of that) and my heart is thumping due to the energy that I've exerted, and it's not from excitement so I'm guessing the sex described here is fairly pedestrian.
As for the 'myth' that inspecting your testicles for signs of lumps you should ask my best friend about that. He was taking a look, found a lump, went to the doctor and was diagnosed with testicular cancer, had it removed and is now all clear. I can't help but wonder that using these 2 examples alone, what other sweeping inaccuracies are contained within this article?

Tim, Redditch, UK

What do you call a doctor who graduated last in his class....Dr. Apparently the old joke has some basis. Andrea, Queensbury N.Y.

andrea, queensbury, new york

There is so much mis-information from EXPERTS ...this MD is presumably speaking " from his experience"...

ACTUALLY what we lack in the UK are Generalist Consultants. If you go to your GP and are for example short of breath - you are sent to a consultant who will be either a Heart, Respiratory, Neurological, etc specialist and who will not have an over view. THis means we have to go to umpteen Consultants which wastes a great deal of time both for the NHS and the patients.

MY story: Following a car accident = fatigue ++ and short of breath - sent to Heart Consultant = NOT your Heart. ( zilch suggestions) Sent to Respiratory Consultant = NOT your Lungs..Sent to M.E. Consultant = NOT M.E..........and so here I am with Fatigue and of course looking into Alternative remedies with some success.

Acupuncture hekps with energy
Deep Remedial neck massage to relieve rigid muscles in neck (following car accident)
Homeopathy - various with benefits

Trish Niblock, Edinburgh,

Heh - "Any related myths? That sex is a form of exercise. In fact, it equates only to climbing two flights of stairs."

Oh dear, I do feel sorry for the good Doctor's partner if that's all the effort he puts into it!

Dan, London,

Antibiotic course completion is far more important in slowing the spread of resistant bacteria. Tell patients to finish their course and they tend not to save the drug for 'next time they feel like that' when more likely than not they have a virus and are just promoting the development of resistant bacteria. Unless of course papers sell more copies when patients are infected with MRSA?

James Herzig, Leicester,

If diet has little effect on cholesterol what abt all the studies showing Japanese etc have less heart disease becasue they eat less meat etc?

julia, london,

Cholesterol.
Im a Naturopath and have successfully helped people lower their cholesterol with diet alone. The difference between success and failure in this is patient compliance. Everyone thinks their diet is 'good' but when I really look at it on paper it's appalling. Dietary changes and especially taken with 'natural' supplements reduce cholesterol significantly.
As for 'Statin' drugs, they are dangerous long term and allows people to think they can carry on eating badly as they have a 'pill' to correct it. just google 'statin drugs and side-effects' and it should be enough to put you off. Its ok short term if someones high cholesterol is putting their life in danger and need a quick solution while using diet and natural supplementation to regulate it when at normal levels, then come off the medication. Seriously, I don't know many who go on meds for life threatening cholesterol level, Dr's prescribe it like sweets & everyones on it for mildly raised cholesterol. Sickening

Debbie, Plymouth, UK

Ten years ago I had regular very bad headaches and found out by chance that my blood pressure was 270 / 170. Medication quickly brought it under control and the headaches ceased. I was obviously a prime candidiate for a stroke. Moral - if you suffer bad headaches have your blood pressure checked, it may save your life.

Mike, Bahrain,

The advice about alcohol and antibiotics is misleading and dangerous: Certain third generation cephalosporins may be subject to hydrolysis by ethanol. Moreover, an infection is frequently associated with a fever, which increases the body's loss of free water. Alcohol intake causes a diuresis which will compound the loss of free water and make the person that much sicker. Mild anaemia is common, but in a man it would be grounds for a colonoscopy.
I have been a primary care physician in the US for 12 years and if all teaching breast self examination does for women is increase their involvement with their own medical care, then it is still worth the time

David Chorley, Tulsa, Oklahoma USA

I have been a full time GP for more than 20 years. I wholeheartedly endorse Dr Hopcroft's opinions

Dr Peter Francis Rice, Birmingham,

In some of his points, Dr Hopcroft has interpreted a lack of evidence for an intervention / test as meaning that the intervention / test is of no value.

This often results from the research quoted not being powerful or sensitive enough, or being poorly performed.

Common sense should prevail. It is obvious that palpating for lumps in breast tissue or testicles can detect early lumps that would have otherwise presented later, as the comments clearly illustrate. The fact that a study has not found a correlation between self examination and outcome does not make self examination invalid.

Lack of evidence does not mean lack of effect.

David, Auckland, New Zealand

The writer appears to have confused half truths with myths. Perfectly sensible advice like advising patients to finish a course of antibiotics and to refrain from drinking while taking them does not become invalid by revealing the greater complexity behind, and therefore exceptions to, these rules of thumb. As an educator of medical students i would be dissappointed to have them publish such an ill-informed article

Michael Duncan, Glasgow,

As a Doctor I saw brain tumour with headache alone...
Now explain them they didn't need a scan

Thierry Vidal, London,

This is not a helpful article and should be removed.
Many cancers are found early by self examination.

Annie Mortensen, Helsingborg,

frankly I'm amazed at how many of you seem to know better than the DOCTOR who wrote this article

Ben, manchester, uk

I was quite intrigued by this article. I agree that there many myths in medicine that have been wrongly taught from generation to generation, and usually are derived from pre-existent household remedies/myths.

However, i think there are a few flaws in this article. I agree with most people comment that self-examination for breasts has helped in diagnosis of breast cancer. Even if one in a million is diagnosed in this way, it is a beneficial, potentially life-saving and cost-effective.

Secondly, I agree that not all tiredness is caused by anaemia, however, anaemia does cause tiredness and if found, one should have further investigations, unless in very obvious cases of young women with heavy periods. So if found to be anaemic, one should have further investigations!
Antibiotics and alcohol - well, I am afraid that this is incorrect!!
Acute alcohol ingestion reduces efficacy of drugs while chronic ingestion increases drug levels - more side effects!

No more words allowed to fit!

Stephan, Beckenham, Kent

I know that the writer is a doctor but a doctor of what? It surely cannot be medicine, can it?

I know a few people who have been diagnosed with breast cancer because they have found lumps in their breasts or under their arms.

My mum had a cholestrol level of 10 (very high) and within 8 months had got it down to 7 (still not low enough but acceptable) by completely overhauling her diet and without any medication.

The writer says that 'High blood pressure has no symptoms' - that is until you fall down dead of a heart attack or a stroke of course! The symptom may not be the cause but that does not mean that the symptom sohuld be ignored (which is how the article reads).

If this is how doctors of medicine (if indeed the writer is one!) find their way around the human body then it really is no surprise that people are turning to alternative medicine and a more holistic approach. This doctor seems to think that the body, the symptoms and the risk factor are all individual traits

kim, london,

This article itself contains a myth - that metronidazole and alcohol causes a di-sulfiram like reaction. This is taught in medical school and not questioned. The reality is that a very minor number of people will suffer from the reaction and in the great majority of people there will be no ill effects.

Jane, Newcastle,

Michelle, Lyon: "Was this written by someone with actual medical knowledge?"

I think the "Dr Keith Hopcroft GP" probably gives it away a bit.

Ben, London,

While examining my left breast one evening, I found a lump. Ane yes, it turned out to be cancer. And it hadn't been caught by a mammogram done six months before -- not because it was too small but because of a doctor's error.
That was 15 years ago. I'm fine now. But I wouldn't skip the self-exams. You can worry perfectly well without examining -- so why not examine?

Barbara Elizabeth, New York, USA

Yes Kris is this is the nightmare scenario...so many resistant bugs, so little time. And John Dean in Perth, the idea behind the flu and the pneumonia vaccine is not that you won't catch it, but that if you do after the jab you won't wind up in hospital. Makes it an illness you get over at home instead of one where you stay a few days in hospital. Your doctor was still wrong to blanketly say 'I won't treat you for this' but the idea behind vaccines is protecting the herd, not every individual. I hate the flu jab and always will but if i prevent the transmission of the virus to someone older or frailer then its worth it.

Sarah, London,

Was this written by someone with actual medical knowledge? Many of the things he says are myths are things that my doctor has told me - finish the course of antibiotics, headaches can be caused by high blood pressure, don't be excessive in self examination but do it once a month, etc. Could it be that doctors don't know everything??

Michelle, Lyon, France

I completely disagree that testicular self examination is a waste of time. As a Urology surgeon I see testicular cancer devastate young men's lives as they have not been aware of the importanve of examining for lumps and then seeking help. The comments by Dr Hopcroft are dangerous!

Mark Lynch, London,

The antibiotic advice is totally wrong.

If he means it makes little difference to the resolution of symptoms then yes it it sof limited help. If he means you souldn't bother to finish the course he is very wrong.

Did the doctor actually write this advice himself?

Damian, Coventry, England

Self examination does help some women discover growths which are cancerous. Surely that's a good enough reason for all women to do it?

Besides, screening starts so late in this country. My mother and grandmother both had breast cancer before 50. My mum discovered she had it at her first mammogram. Perhaps if she had been self-examining, it might have been caught even sooner than that.

louise orton, London,

Where did these myth rebuttals come from? Im quite willing to believe them -but only when I know their provenence .
I rarely visit the doctor and dont pay heed to the latest health scares published seemingly daily but I did examine my own breast to find a very aggressive cancer growing alarmingly fast. 2 years before I would have been called for a mammogram Im glad I didnt wait for the experts.

betty, hayes , uk

My grandmother's headaches were due to high blood pressure- she had a stroke; her two daughters, -one of whom was my mother,- suffered excruciating headaches for a long while before both died of brain tumours. I take headaches seriously as a sign of there being something wrong, whether stress,tiredness or some foods even,(don't drink so no hangover cause!) and without being a hypochondriac,but do think when the above symptoms happen it is often already in the later stages of brain tumours.Strangely ,both daughters had initial tumour in the speech area which is inoperable being in the brain stem.

madmar, Bournemouth, U.K.

Any related myths? That you should always finish your course of antibiotics. It usually makes little difference

This is a ridiculous and frankly dangerous claim for a doctor to be making. Patients should always finish a course, even if outwardly they feel fine as residual resistant bacteria could remain. Idiots who refuse to take sound advice and don't finish their courses are amongst those responsible for the rise in antibiotic resistance, a threat to society that will only get worse.
Worried about MRSA? It's reistant to almost all known antibiotics, so do your bit and FINISH ALL COURSES OF ANTIBIOTICS.

Tom Brown, oxford,

Good to know.

Anybody ever considered reflexology where your body's own healing mechanisms are activated and do the work.
It seems the Prince of Wales Foundation thinks it's great and effective.

johan harlaar, Johannesburg, South Africa

If we need to ensure that we complete a course of antibiotics to prevent the devlopment of drug resistant bacteria - aren't we sleepwalking into a nightmare scenario of widespread pathogen resistance by using antibacterial cleaners around our houses, shops and restaurants?

Kris, London, England

my breast self-exam discovered cancer that had not been revealed by a mammogram 6 months before. after surgery, chemotherapy and radiation, i am now free of cancer. i would not have been without my self-exam since i would not otherwise be due for a mammogram for another year or so. how big would that tumor have been by then?

anna, sacramento, california, u.s.a.

I am 79 years of age and the last time I caught the flu was some 10 years ago when my GP strongly advised me to have the injection and swore he would not treat me if refused it and caught the flu. I did catch the flu and he still did not treat me because high incidence of flu among those of his patients who took his advice.
I now visit another doctor who recognises my right to refuse fli innoculations. I have not had influenza since my refusal to be innoculated for the past 9 years

John DEAN, Perth, Western Australia, Australia

Actually, it is important that you finish your course of antibiotics. You may feel better half way through but stopping the antibiotic early only increases the amount of antimicrobial resistance. You should always take whatever your doctor prescribes for the full length of time recommended.

Sarah Mooney, London,

Fabulous! Stay away from doctors and you won't get ill!
Actually, there's something in that.
There was a doctors strike in France years ago and the mortality rate dropped overnight.
The French have one of the best healthcare systems in the world.
Imagine how many lives would be saved by an English doctor's strike!

Thalia, London,