Hi, I'm Ms. Lowe and I'm the RSHE teacher for today.

Today's lesson is all about intimate healthcare and because of some of the themes and the topics that we're gonna go through together today, it's important that you complete your learning with the company of an adult.

So here's a look at our outcome for today's lesson.

And by the end, you are gonna be able to explain the importance of health checks and self-examination and how to conduct one.

Every RSHE lesson should begin with a set of ground rules.

This ensures that every conversation had in RSHE is respectful and we're all able to learn effectively.

So Laura is reminding us that in RSHE, we should listen to others.

It's okay to disagree with each other but we should listen properly before making assumptions or deciding how to respond.

And when disagreeing, we challenge the statement and not the person.

Andeep is reminding us to respect privacy.

We can discuss examples but we don't use names or descriptions that can identify anyone including ourselves.

Izzy is reminding us to choose a level of participation that suits us.

Everyone has the right to choose not to answer a question or to join in a discussion, but we never put anyone on the spot.

And finally, Jacob is reminding us that in RSHE, there is no judgement.

We can explore beliefs and misunderstandings about a topic without the fear of being judged.

So here are our key words for today's lesson.

Our first key word is breast self-examination.

This is an inspection of the appearance and feel of the breast tissue to check for abnormalities.

Testicular self-examination.

This is an inspection of the appearance and feel of the testicles to check for abnormalities.

And finally, smear test.

This is a test to check for abnormal cells in the cervix, which is the neck of the uterus.

So here's an overview of what we're gonna be learning about together today.

And we're gonna begin by asking the question, how can I check if my body is healthy? So Dr.

Elsie here is telling us that as we get older, we're at higher risk of developing different health conditions.

And the best way that we can prevent this is to know our bodies and to check regularly for any changes that might occur.

Nurse Daniel tells us that although breast, testicular, and cervical cancer are extremely rare in young people, it is important to know about the signs and what to do if you notice any changes at all.

So most lumps found in breasts are not cancer.

These are often benign, which means non-cancerous and are caused by normal changes to your hormones.

For females, this is sometimes linked to the menstrual cycle or it could be cysts or infections in the glands of your breast.

Dr.

Elsie tells us that self-awareness is really important.

Knowing what's normal for your body through regular breast self-examination can help you to notice any changes early.

Breast cancer is extremely rare in young people, but any changes that you notice should be followed up.

Nurse Daniel is telling us that breast cancer is most common in people over 50.

Both male and female bodies have breast tissue and can develop breast cancer.

Although breast cancer in men is rare, it is also important for men to check themselves.

Dr.

Elsie here is telling us that although it might feel embarrassing to see the doctor, we are not embarrassed.

This is our job and it is important that you come to us as early as possible.

So when someone is conducting a self-breast examination, the signs that they need to look out for include a change in nipple position or the nipple is pulled in, a rash, or dry, red or scaly skin on or around the nipple, a swelling or lump in the armpit, breast, or collarbone, and fluid or discharge from either nipple in a female who isn't pregnant or breastfeeding.

And other signs to look out for is a change in the outline or silhouette of the breast, a lump or thickening of skin on the breast, and swelling or changes in size or shape without explanation.

For example, pregnancy or menstruation.

So normally these changes are nothing to worry about, but if you do notice any of these signs, it's really important to be checked out by a doctor.

You can request a female doctor if you'd feel more comfortable with that when you make your appointment.

So if you speak to the doctor, you can always request that you are seen by a female doctor if that would make you more comfortable.

Now let's pause here and let's check our understanding.

Which of these changes should you see a doctor about? Is it a change in breast outline, a swelling or lump in the armpit, or a change in nipple direction? So pause the video here and have a think about your answer.

Well done if you said all three.

As Dr.

Elsie told us before, these changes are usually nothing but it is really important that if you do notice any changes to the breast, that you have this checked out by a doctor.

Breast pain is not normally a sign of breast cancer, but if this persists, if it carries on for a long time, then you should seek advice from your doctor.

The best way to check your breasts is to perform regular breast self examinations to notice any differences or changes to your breasts.

Knowing how to do this can help you to detect any issues early on.

Let's have a look now at the five steps of carrying out a breast self-examination.

Number one, you stand in front of the mirror and lift your arms up to examine your armpits for lumps or swelling.

Number two, move your hand slowly up and down over each breast to check for lumps under the skin.

And three, move your hand in a circular motion around each breast noticing any changes in the breast tissue.

Number four, squeeze each nipple to see if there is any crusting or discharge around it.

And number five, repeat these actions while lying flat on a bed as this allows the breast tissue to spread more evenly, which allows you to check more thoroughly.

Now we're gonna pause here and we're gonna check our understanding.

When you carry out a breast self-examination, you should, and I want you to read through those three options, tell me which are the correct ones and then we'll go through the right answer together.

Really well done if you said C.

When you carry out a breast self-examination, you should check the breasts lying down and standing up.

Now, testicular cancer is cancer that is found in the testicles.

So here on the left we can see a diagram.

So we can see there we have the penis and then the testicles and around the testicles is what we call the scrotum.

So the testicles are the two small oval-shaped organs that hang below the penis and they are found inside the scrotum, which is a pouch of skin.

The testicles are there to make sperm and testosterone.

Nurse Daniel here is telling us that although it's normal for testicles to be slightly different in size or for one to hang a bit lower than the other, regular testicular self-examination is important to detect any issues early on.

Remember that you should examine your testicles at least once a month.

So when you carry out a testicular self-examination, you should perform the examination in the shower 'cause warm water helps to relax the skin.

And you should use soap as this can help to reduce any friction caused by the self-examination.

You should check one testicle at a time.

Feel the spermatic chords that travel up either side of the testicle and you can see a little diagram of that there on the left.

You should look for any lumps or hard bumps on both testicles and gently roll each testicle between the finger and thumb to check for any lumps or unusual masses.

Check for any changes in size or shape or for any swelling and pay attention to any areas that feel painful to touch or when you sit down.

Let's pause here and we'll check our understanding about what we've just learned.

True or false? You should carry out testicular self-examination on your testicles every month.

I want you to pause the video here and tell me, is that true or false? Really well done if you said true.

Yes.

Testicular self-examination should be done at least once a month.

Now we're gonna have a look at how someone can check for cervical cancer.

So cervical cancer is a type of cancer that develops in the cervix, which is the lower part of the uterus as you can see there on the diagram to the left.

It is often caused by repeated infection with human papillomavirus or HPV, which causes abnormal cells to grow uncontrollably and form a tumour.

Dr.

Elsie here is telling us that early stage cervical cancer often has no noticeable symptoms. The most effective way to be checked is to have regular smear tests, which are done with either a nurse or a doctor.

To maintain good intimate health, you should see the doctor if you experience any of the following physical symptoms, unusual vaginal bleeding, changes in vaginal discharge, or pelvic pain.

Now what I want you to do is I want for you to rewrite this sentence to correct the misconception.

Cancer is just something that affects older people.

Testicular cancer and cervical cancer are less prevalent in younger people.

So you're gonna pause the video here and rewrite that sentence.

So when you rewrote your sentence, you should have said that cancer is not just something that affects older people.

Testicular cancer and cervical cancer are more prevalent in younger people.

Now we're gonna put our learning into practise.

So what I want you to do is to complete the missing steps for each of the processes for breast self-examination and testicular self-examination.

What you'll need to do is either draw the missing diagram or write in the missing instructions.

So here we have number one, I'm gonna pause the video here.

We are gonna pause the video here, and you are going to complete these instructions for breast self-examination.

And then in a moment we'll have a look at testicular self-examination.

Great work there.

Now let's have a look at testicular self-examination.

You are gonna do the exact same thing here.

Pause the video and either draw or write in the missing steps.

Great work, let's have a look at what you should have said in your answer.

So your completed guide should look like this.

For breast self-examination, you should have said that, number one, you stand in front of the mirror and lift your arms up to examine your armpits for lumps and swelling.

Number two, move your hand slowly up and down over each breast to check for lumps.

Number three, move your hand in a circular motion around each breast.

Number four, squeeze each nipple to see if there is any crusting or discharge.

And number five, repeat these actions while lying flat in bed.

Number two, let's have a look at what you should have said for your testicular self-examination.

So number one is perform the examination in the shower.

You use soap and check one testicle at a time.

While checking the testicles, you should check the spermatic cords.

You should check for any lumps or bumps and roll the testicle between the finger and thumb.

You should check for any changes in size or shape and take notice of any pain or discomfort.

Big well done if you mentioned any of those things in your completed guides.

We're moving on now to the second part of our lesson where we're asking the question, what happens if I do find something abnormal? So Dr.

Elsie here is telling us that if you notice any changes to your body, it's important to remember that most changes are harmless, but getting it checked out by a doctor is the best way to feel reassured.

If you do notice any changes, you should note down what you've noticed and include details about whether it was pain, change in size, a swelling or a lump, and when it was found.

You should avoid excess pressing or touching as this can cause additional swelling and make the diagnosis harder later.

And you should tell a trusted adult and schedule a doctor's appointment.

Dr.

Elsie says it's normal to feel worried if you ever find a change or a lump on your body.

Remember that most abnormalities are not cancer, but it is important to get them checked.

And regular self-examination can help with an early diagnosis, which can make treatment more successful or reduce the amount of treatment that someone might need.

So what to expect when you visit the doctor? So if somebody was to notice an abnormality on their body, this is what they would expect when they visit the doctor.

When you go to the doctor, they will also perform an examination of either your breasts or testicles.

If you are under 18, you will need to have an adult in the room with you.

If you are over 18, you can request a companion to be present if you wish.

And you can also request whether or not this examination is performed by a male or female doctor.

Dr.

Elsie says if we have concerns about a lump or change in the breast, we will arrange for you to have a mammogram.

And this is when you have a special kind of x-ray of the breast to detect any early signs of breast cancer often before any symptoms occur.

A mammogram takes a closeup image of your breast to check for any abnormalities, lumps, or masses.

And females between the ages of 50 to 71 will be invited for a mammogram every three years.

If we have concerns about a lump or a change in the testicles or scrotum, we will arrange for blood check tests or an ultrasound.

They do this by collecting a blood sample.

A needle is used to take a small amount of blood from a vein in your arm.

It's not painful, but you may feel a small scratch as the needle is inserted and it only takes a minute or two to collect this sample.

Now, if a doctor sends somebody for an ultrasound, they will be invited to lie on a bed.

The nurse or doctor will ask you to put a small amount of gel on your testicles.

They will then move a probe over your scrotum to get an internal image of the testicles.

This process is not painful at all, and it usually takes less than 10 to 15 minutes.

Let's pause here and let's check our understanding.

Regular breast and testicular self examinations can, I want you to pause the video, read through those three options, and then tell me the correct answer.

Well done if you said B and C.

Regular breast and testicular self examinations can reduce the amount of treatment needed and help with early diagnosis.

Now to check for cervical cancer, you'll be offered something called a smear test.

A smear test is offered to all females every three years from the age of 25, and then every 5 years from the age of 50 to 65, a nurse or gently inserts a small tool, which is called a speculum into the vagina in order to see the cervix.

They then use a small brush to collect a few cells and this test only takes a few minutes.

As you can see on the right hand side there, there's a diagram of the speculum and of the small brush that's used to collect the cell sample.

Dr.

Elsie says that feeling nervous about a smear test is normal, but you have to try not to let be nervous make you avoid letters or miss appointments.

These are really important and lifesaving tests.

Remember, you can ask questions, bring someone in for support, or ask for a female nurse or doctor if you prefer.

A smear test is a quick process and it's not painful, just a little uncomfortable, and you can stop anytime if needed.

The nurse or doctor will explain everything as they go, and they are trained to make you feel safe and respected during the smear test.

Holly here says that she was sent a letter for her first smear test appointment when she turned 25.

She was nervous at first so she called the nurse and the nurse talked her through what to expect.

Holly took her mum with her for support and she waited outside.

It was a little uncomfortable but it didn't hurt at all.

And having peace of mind after getting the results was really reassuring.

Holly won't need another checkup now for another three years unless she notices any signs in between.

We're gonna pause the video here and we're gonna check our understanding.

So true or false? You can request a male or female nurse or doctor when you go for an examination.

I want you to pause the video here and have a think about your answer.

Well done if you said true.

Yes, you can request a female or male nurse or doctor for any of these intimate health examinations.

And now we're gonna put our learning into practise.

So what I want for you to do is to explain what happens when someone goes for an examination at the doctors if they're worried about the signs of breast cancer, and in that, I want you to include what a mammogram is, testicular cancer including what an ultrasound is, and cervical cancer including what a smear test is.

And I want you to add information about whether or not you can request a male or female doctor and whether or not you can have someone with you.

So you can pause the video here and explain those three examinations and then we'll go through the right answers together.

Great work, so your explanations should look like this.

If you notice changes to your breasts or testicles, the doctor will also carry out a physical examination.

If they want to investigate further for signs of breast cancer, they will arrange for you to have a mammogram.

This is a special kind of x-ray of the breast to detect any early signs of breast cancer.

Follow up with testicular cancer may include a blood test or an ultrasound.

An ultrasound creates an internal image of the testicles to see if there are any concerns.

Smear tests, check for abnormal cells that might indicate cervical cancer.

A speculum is inserted into the vagina in order to collect sample cells and these are then analysed.

For all appointments, you can request a male or female doctor or nurse.

If you are under 18, you must have a trusted adult accompany you.

But if you're over 18, you can also bring someone with you if you wish.

Now let's end here by having a look at a summary of what we've learned together today.

So as we get older, we need to carry out breast and testicular self examinations to check for signs that might indicate cancer.

Regular self examinations are important as most cancers are more treatable for earlier they're detected.

Most abnormalities aren't cancer, but it's important to get them checked anyway.

Smear tests are offered every three years to females over the age of 25 and then every 5 years from the ages of 50 to 65.

Now, if any of the topics that we've covered today concern you in any way, there are some places that you can go to to access support.

First, we have NHS Live Well, which provides advice about healthy living, exercise, quitting smoking, and drinking less alcohol.

And then the NHS website, which includes advice about health and prevention, including how to access services.

And I'd like to end today's lesson by saying a big well done for all of your fantastic work.

It's been a pleasure to work with you today, and I look forward to seeing you in another RSHE lesson soon.