What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.

The term “man flu” takes a humorous poke at men with minor respiratory infections, such as colds, who supposedly exaggerate their symptoms.

According to the stereotype, a man lies on the sofa with a box of tissues. Meanwhile his female partner, also with a snotty nose, carries on working from home, doing the chores and looking after him.

But is man flu real? Is there a valid biological reason behind men’s symptoms or are men just malingering? And how does man flu differ from flu?

What are the similarities?

Man flu could refer to a number of respiratory infections – a cold, flu, even a mild case of COVID. So it’s difficult to compare man flu with flu.

But for simplicity, let’s say man flu is actually a cold. If that’s the case, man flu and flu have some similar features.

Both are caused by viruses (but different ones). Both are improved with rest, fluids, and if needed painkillers, throat lozenges or decongestants to manage symptoms.

Both can share similar symptoms. Typically, more severe symptoms such as fever, body aches, violent shivering and headaches are more common in flu (but sometimes occur in colds). Meanwhile sore throats, runny noses, congestion and sneezing are more common in colds. A cough is common in both.

What are the differences?

Flu is a more serious and sometimes fatal respiratory infection caused by the influenza virus. Colds are caused by various viruses such as rhinoviruses, adenoviruses, and common cold coronaviruses, and are rarely serious.
Colds tend to start gradually while flu tends to start abruptly.

Flu can be detected with laboratory or at-home tests. Man flu is not an official diagnosis.

Severe flu symptoms may be prevented with a vaccine, while cold symptoms cannot.

Serious flu infections may also be prevented or treated with antiviral drugs such as Tamiflu. There are no antivirals for colds.

OK, but is man flu real?

Again, let’s assume man flu is a cold. Do men really have worse colds than women? The picture is complicated.

One study, with the title “Man flu is not a thing”, did in fact show there were differences in men’s and women’s symptoms.

This study looked at symptoms of acute rhinosinusitis. That’s inflammation of the nasal passages and sinuses, which would explain a runny or stuffy nose, a sinus headache or face pain.

When researchers assessed participants at the start of the study, men and women had similar symptoms. But by days five and eight of the study, women had fewer or less-severe symptoms. In other words, women had recovered faster.

But when participants rated their own symptoms, we saw a somewhat different picture. Women rated their symptoms worse than how the researchers rated them at the start, but said they recovered more quickly.

All this suggests men were not exaggerating their symptoms and did indeed recover more slowly. It also suggests women feel their symptoms more strongly at the start.

Why is this happening?

It’s not straightforward to tease out what’s going on biologically.

There are differences in immune responses between men and women that provide a plausible reason for worse symptoms in men.

For instance, women generally produce antibodies more efficiently, so they respond more effectively to vaccination. Other aspects of women’s immune system also appear to work more strongly.

So why do women tend to have stronger immune responses overall? That’s probably partly because women have two X chromosomes while men have one. X chromosomes carry important immune function genes. This gives women the benefit of immune-related genes from two different chromosomes.

Oestrogen (the female sex hormone) also seems to strengthen the immune response, and as levels vary throughout the lifespan, so does the strength of women’s immune systems.

Men are certainly more likely to die from some infectious diseases, such as COVID. But the picture is less clear with other infections such as the flu, where the incidence and mortality between men and women varies widely between countries and particular flu subtypes and outbreaks.

Infection rates and outcomes in men and women can also depend on the way a virus is transmitted, the person’s age, and social and behavioural factors.

For instance, women seem to be more likely to practice protective behaviours such as washing their hands, wearing masks or avoiding crowded indoor spaces. Women are also more likely to seek medical care when ill.

So men aren’t faking it?

Some evidence suggests men are not over-reporting symptoms, and may take longer to clear an infection. So they may experience man flu more harshly than women with a cold.

So cut the men in your life some slack. If they are sick, gender stereotyping is unhelpful, and may discourage men from seeking medical advice.

Thea van de Mortel, Professor, Nursing, School of Nursing and Midwifery, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Catherine, Princess of Wales, is undergoing treatment for cancer. In a video thanking followers for their messages of support after her major abdominal surgery, the Princess of Wales explained, “tests after the operation found cancer had been present.”

“My medical team therefore advised that I should undergo a course of preventative chemotherapy and I am now in the early stages of that treatment,” she said in the two-minute video.

No further details have been released about the Princess of Wales’ treatment.

But many have been asking what preventive chemotherapy is and how effective it can be. Here’s what we know about this type of treatment.

It’s not the same as preventing cancer

To prevent cancer developing, lifestyle changes such as diet, exercise and sun protection are recommended.

Tamoxifen, a hormone therapy drug can be used to reduce the risk of cancer for some patients at high risk of breast cancer.

Aspirin can also be used for those at high risk of bowel and other cancers.

How can chemotherapy be used as preventive therapy?

In terms of treating cancer, prevention refers to giving chemotherapy after the cancer has been removed, to prevent the cancer from returning.

If a cancer is localised (limited to a certain part of the body) with no evidence on scans of it spreading to distant sites, local treatments such as surgery or radiotherapy can remove all of the cancer.

If, however, cancer is first detected after it has spread to distant parts of the body at diagnosis, clinicians use treatments such as chemotherapy (anti-cancer drugs), hormones or immunotherapy, which circulate around the body .

The other use for chemotherapy is to add it before or after surgery or radiotherapy, to prevent the primary cancer coming back. The surgery may have cured the cancer. However, in some cases, undetectable microscopic cells may have spread into the bloodstream to distant sites. This will result in the cancer returning, months or years later.

With some cancers, treatment with chemotherapy, given before or after the local surgery or radiotherapy, can kill those cells and prevent the cancer coming back.

If we can’t see these cells, how do we know that giving additional chemotherapy to prevent recurrence is effective? We’ve learnt this from clinical trials. Researchers have compared patients who had surgery only with those whose surgery was followed by additional (or often called adjuvant) chemotherapy. The additional therapy resulted in patients not relapsing and surviving longer.

How effective is preventive therapy?

The effectiveness of preventive therapy depends on the type of cancer and the type of chemotherapy.

Let’s consider the common example of bowel cancer, which is at high risk of returning after surgery because of its size or spread to local lymph glands. The first chemotherapy tested improved survival by 15%. With more intense chemotherapy, the chance of surviving six years is approaching 80%.

Preventive chemotherapy is usually given for three to six months.

How does chemotherapy work?

Many of the chemotherapy drugs stop cancer cells dividing by disrupting the DNA (genetic material) in the centre of the cells. To improve efficacy, drugs which work at different sites in the cell are given in combinations.

Chemotherapy is not selective for cancer cells. It kills any dividing cells.

But cancers consist of a higher proportion of dividing cells than the normal body cells. A greater proportion of the cancer is killed with each course of chemotherapy.

Normal cells can recover between courses, which are usually given three to four weeks apart.

What are the side effects?

The side effects of chemotherapy are usually reversible and are seen in parts of the body where there is normally a high turnover of cells.

The production of blood cells, for example, is temporarily disrupted. When your white blood cell count is low, there is an increased risk of infection.

Cell death in the lining of the gut leads to mouth ulcers, nausea and vomiting and bowel disturbance.

Certain drugs sometimes given during chemotherapy can attack other organs, such as causing numbness in the hands and feet.

There are also generalised symptoms such as fatigue.

Given that preventive chemotherapy given after surgery starts when there is no evidence of any cancer remaining after local surgery, patients can usually resume normal activities within weeks of completing the courses of chemotherapy.

Ian Olver, Adjunct Professsor, School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide

This article is republished from The Conversation under a Creative Commons license. Read the original article.