PSA Screening in Older Men Often Unnecessary-When Is Testing Not Warranted?

By Charles Bankhead, Staff Writer, MedPage Today Published: March 30, 2011 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Almost a third of older men with limited life expectancy continue to have unnecessary PSA tests. Screening rates increased steadily after age 54, peaked among men ages 70 to 74 and then declined thereafter. However, 30.7% of men with a high probability of dying from prostate cancer within five years continued to be screened, Michael W. Drazer, BS, of the University of Chicago, and colleagues reported online in the Journal of Clinical Oncology. Moreover, a fourth of men ages 85 and older underwent PSA screening, the same proportion as men ages 50 to 54, Drazer and co-authors noted in their analysis of National Health Interview Survey (NHIS) data from 2000 to 2005.   “Excessive screening for prostate cancer in elderly men who have limited life expectancies in the U.S. results in unnecessary anxiety, diagnoses, overtreatment, treatment-related morbidity, and healthcare expenditures without meaningful clinical benefit,” the investigators concluded. I suggest that the merits and limitations of PSA should be discussed with patients considering prostate cancer screening, particularly in older men and in those with short estimated life expectancies. Deciding when to stop PSA testing constitutes a major part of the screening controversy. The American Urological Association and the American Cancer Society recommend screening for men who have an estimated life expectancy of at least 10 years, the authors noted. So what advice do I have for men over age 70?  If you are active, exercise regularly, have normal blood pressure and no other significant co-morbid conditions like diabetes, heart disease, or other cancers, then you should consider a PSA test every year or every other year.  However, if you have high blood pressure, heart disease or diabetes and your life expectancy is less than 10 years, then you will probably die WITH prostate cancer and not from prostate cancer.  In the latter situation, it is not necessary to have annual PSA testing.

“Take Two and Call Me in the Morning” – Aspirin’s Role In Cancer Prevention

One of mankind’s oldest remedies, aspirin, which has references dating it’s use to at least the 4th century BC, has received another endorsement: cancer prevention.

A recent study published in the highly respected British journal, The Lancet, indicates that low dose aspirin may play a role in the prevention of a variety of cancers. These include cancers of the esophagus, stomach, colon, pancreas, intestine, lung, and prostate.

Now this new study shows that daily aspirin regimens of 5 years or more substantially reduce the risk of colorectal cancer. Researches found that this regimen reduced mortality from various cancers by 10 to 60%, depending upon the type of cancer.

These findings occurred in a study of over 25,000 persons, which was initially undertaken to assess the protective effects of aspirin on heart and vascular disease. Researchers were quick to point out that the public should consult with their physician before embarking on an aspirin regimen, but do concede that the small risk of gastrointestinal (GI) bleeding is likely outweighed by the benefits in terms of cardiovascular disease prevention and now possible cancer prevention.

The study followed patients for up to 20 years. Those followed for this length of time showed a reduction in cancer related death of 10% for prostate cancer, 30% for lung cancer, 40% for colorectal cancer and 60% for esophageal cancer.

Again, doctors have cautioned patients not to be overly optimistic about this report, as some feel the claims made by this study are quite dramatic and require further analysis and investigation. Patients with a history of ulcers or other GI disorders such as ulcerative colitis, Crohn’s Disease, gastric or duodenal ulcers, as well bleeding disorders are strongly advised to seek medical guidance regarding any planned use of aspirin regimens.

Diet and prostate cancer-what do you need to know?

If you have prostate cancer or if you want to prevent prostate cancer, you will want to read this article about what is known about diet and supplements and the relationship to prostate cancer.

Everyone with prostate cancer who goes on the Internet receives information about green tea preventing prostate cancer, that pomegranate juice can be consumed to lower the prostate-specific antigen (PSA) and advice on consuming broccoli and cauliflower.  So what is a man to do?

Numerous studies have been conducted that have looked at vitamin E, selenium, vitamin C and combinations of these 3 supplements. There has been no conclusive study that any of these supplements or vitamins reduce the risk of prostate cancer or prevented the recurrence of prostate cancer.

However there are compelling data supporting the therapeutic potential of a high vegetable diet for prostate cancer. Red meat and fat tend to be associated with increased risk of prostate cancer while broccoli, cauliflower and radishes and tomato products tend to be associated with decreasing the risk of prostate cancer.

So here are my recommendations: 1) avoid supplements for cancer prevention, 2) maintain a diet rich in vegetables and whole grains, 3) limit red meat and refined or processed carbohydrates, and 4) be physically active at least 30 minutes a day.  So go to your grocery store and visit the vegetable counter and pass up the bakery area!  Your prostate gland will thank you!

Cranberry Juice Does Not Prevent Urinary Tract Infections-Another Medical Myth Bites The Dust

According to a report in Clinical Infection Diseases (2011;52:23-30), a placebo beverage fared better than cranberry juice in protecting against repeat urinary tract infections (UTIs) in 319 female college students presenting with acute UTI. The women were assigned to drink either eight ounces of cranberry juice or a placebo juice twice a day for six months or until another UTI developed. Although the investigators expected to see a 30% recurrence rate in the placebo group, the actual overall recurrence rate was 17%, with the cranberry-juice group experiencing a slightly higher recurrence rate than the those girls taking the placebo drink. according to a report in Clinical Infection Diseases (2011;52:23-30).

 

An Apple A Day Does More Thank Keep the Doctor Away-It Just Might Make You Live Longer…Especially If You Are a Fruit Fly!*

Scientists are reporting the first evidence that consumption of a healthful antioxidant substance in apples extends the average lifespan of test animals, and does so by 10 percent. The new results, obtained with fruit flies – stand-ins for humans in hundreds of research projects each year – bolster similar findings on apple antioxidants in other animal tests. The study appears in ACS’s Journal of Agricultural and Food Chemistry.

Zhen-Yu Chen and colleagues note that damaging substances generated in the body, termed free radicals, cause undesirable changes believed to be involved in the aging process and some diseases. Substances known as antioxidants can combat this damage. Fruits and vegetables in the diet, especially brightly colored foods like tomatoes, broccoli, blueberries, and apples are excellent sources of antioxidants. A previous study with other test animals hinted that an apple antioxidant could extend average lifespan. In the current report, the researchers studied whether different apple antioxidants, known as polyphenols, could do the same thing in fruit flies.  (This is particularly good news for fruit flies. If I were a fruit fly I would want to live longer too.)

The researchers found that apple polyphenols not only prolonged the average lifespan of fruit flies but helped preserve their ability to walk, climb and move about. In addition, apple polyphenols reversed the levels of various biochemical substances found in older fruit flies and used as markers for age-related deterioration and approaching death. Chen and colleagues note that the results support those from other studies, including one in which women who often ate apples had a 13-22 percent decrease in the risk of heart disease, and polish the apple’s popular culture image as a healthy food.

*J Agric Food Chem. 2011 Mar 9;59(5):2097-106. Epub 2011 Feb 14.
Apple Polyphenols Extend the Mean Lifespan of Drosophila melanogaster.

Testosterone Safety In Men With Prostate Cancer-May Be Safer Than You Think

Debate continues about whether it is safe to provide androgens to men who have been treated for prostate cancer or with known cancer on active surveillance. Dr. Abe Morgentaler from Harvard  administered testosterone therapy to 13 testosterone deficient men with untreated prostate cancer . Followup evaluation found that  testosterone replacement therapy in patients with prostate cancer did not produce a detectable increase in disease progression in the short term or midterm with regard totheir prostate cancer . This study should prompt further investigation of androgen replacement therapy in men who either have been treated for prostate cancer or are under active surveillance or watchful waiting and have opted not to have their prostate cancer treated.

How Safe Are Expired Drugs?-The Truth Will Set Your Medications Free

By Richard Altschuler:

Does the expiration date on a bottle of a medication mean anything? If a bottle of Tylenol, for example, says something like “Do not use after June 1998,” and it is August 2002, should you take the Tylenol? Should you discard it? Can you get hurt if you take it? Will it simply have lost its potency and do you no good?

 In other words, are drug manufacturers being honest with us when they put an expiration date on their medications, or is the practice of dating just another drug industry scam, to get us to buy new medications when the old ones that purportedly have “expired” are still perfectly good?
  These are the pressing questions I investigated after my mother-in-law recently said to me, “It doesn’t mean anything,” when I pointed out that the Tylenol she was about to take had “expired” 4 years and a few months ago. I was a bit mocking in my pronouncement — feeling superior that I had noticed the chemical corpse in her cabinet — but she was equally adamant in her reply, and is generally very sage about medical issues.

 So I gave her a glass of water with the purportedly “dead” drug, of which she took 2 capsules for a pain in the upper back. About a half hour later she reported the pain seemed to have eased up a bit. I said “You could be having a placebo effect,” not wanting to simply concede she was right about the drug, and also not actually knowing what I was talking about. I was just happy to hear that her pain had eased.

First, the expiration date, required by law in the United States, beginning in 1979, specifies only the date the manufacturer guarantees the full potency and safety of the drug — it does not mean how long the drug is actually “good” or safe to use.

Second, medical authorities uniformly say it is safe to take drugs past their expiration date — no matter how “expired” the drugs purportedly are. Except for possibly the rarest of exceptions, you won’t get hurt and you certainly won’t get killed.

Studies show that expired drugs may lose some of their potency over time, from as little as 5% or less to 50% or more (though usually much less than the latter). Even 10 years after the “expiration date,” most drugs have a good deal of their original potency. So wisdom dictates that if your life does depend on an expired drug, and you must have 100% or so of its original strength, you should probably toss it and get a refill, ” If your life does not depend on an expired drug — such as that for headache, hay fever, or menstrual cramps — take it and see what happens.

 

In light of these results, a former director of the testing program, Francis Flaherty, said he concluded that expiration dates put on by manufacturers typically have no bearing on whether a drug is usable for longer. Mr. Flaherty noted that a drug maker is required to prove only that a drug is still good on whatever expiration date the company chooses to set. The expiration date doesn’t mean, or even suggest, that the drug will stop being effective after that, nor that it will become harmful. “Manufacturers put expiration dates on for marketing, rather than scientific, reasons,” said Mr. Flaherty, a pharmacist at the FDA until his retirement in 1999. “It’s not profitable for them to have products on a shelf for 10 years. They want turnover.”

The FDA cautioned there isn’t enough evidence from the program, which is weighted toward drugs used during combat, to conclude most drugs in consumers’ medicine cabinets are potent beyond the expiration date. Joel Davis, however, a former FDA expiration-date compliance chief, said that with a handful of exceptions — notably nitroglycerin, insulin, and some liquid antibiotics — most drugs are probably as durable as those the agency has tested for the military. “Most drugs degrade very slowly,” he said. “In all likelihood, you can take a product you have at home and keep it for many years. ”

 

Bald On Top May Be Related To Prostate Cancer Below

wwltv.com

Posted on March 18, 2011 at 5:40 PM

 

Meg Farris / Eyewitness News

There is an important question that men who are losing their hair need to ask themselves: How old were you when it started?

The answer to that question could mean early detection of a serious illness.

Male pattern baldness is a common genetic trait that many men inherit. But a recent study finds that early hair loss may be a signal of another serious condition that has genetic ties.

“Early male pattern baldness is associated with a malfunction of the testosterone, which is the male hormone. And it’s interesting, it’s that same male hormone that is associated with prostate cancer,” said Dr. Neil Baum, a urologist at Touro.

In a French study, doctors found that if a man in his early 20s has a pronounced widow’s peak from his hair receding, he should be vigilant about screening for prostate cancer.

“It means that younger men, who are having male pattern baldness in their 20s, probably need to start getting tested for prostate cancer with a blood test called a PSA blood test earlier than normal men who don’t start (balding) until age 50,” explained Dr. Baum.

Dr. Baum also says there is another way to be proactive. He says men should talk to their doctors about getting on prescription drugs such as Avodart or Finasteride, which is called Propecia. These drugs block the enzyme that converts testosterone in the body to DHT (a hormone called Dihydrotestosterone), and too much DHT shortens the life of the hair follicle which causes male pattern baldness.

But there could be another benefit of taking one of these drugs.

“It is also that drug that can be very protective against developing prostate cancer, so there is a double reason why men should consider taking Finasteride,” said Dr. Baum.

It is important to note that other previous studies did not find a similar link of male pattern baldness in men in their early 20s and later early onset of prostate cancer, so more studies are needed for this link to be conclusive. And the study did not find a higher link between baldness in men starting in their 30s and 40s with prostate cancer. But remember there is another sign that you may be at higher risk.

“If your father had prostate cancer, brother, uncle or cousin, you have a slightly increased risk of prostate cancer,” Dr. Baum explained.

Male pattern baldness also happens in women and can be inherited from either your mother’s or father’s side of the family.

 

Spider Venom May Be Used To Treat Erectile Dysfunction-Never Be Afraid of Spiders Again

Scientists Say: Let’s Cure Erecile Dysfunction With Spider Venom!

Spiders and penises are two things most people want to keep far, far apart. Until now. New research suggests that the venom of one aggressive arachnid could be used in future treatments for erectile dysfunction (that is, if it doesn’t kill you first).

Say hello to the  Brazilian wandering spider (Phoneutria nigriventer), also known as the armed spider, or as the banana spider. With an over four-inch leg span, this South and Central American native normally creeps around banana plantations, although some have wound up in American supermarkets and Canadian grocery stores. Flaccid fellows beware: On top of severe pain, a single bite from this eight-legged foe can cause you to lose control of your muscles—and if it’s not treated, the bite can screw up your ability to breathe so much so that you slowly die of oxygen deprivation.With a sip of the anti-venom, though, you’d recover in a week. And truth be told, only 10 people out of 7,000 are known to have actually died from a bite. Survivors tell of experiencing painful erections that last for more than four hours—a medical ailment known as priapism.

It’s this last side effect that interests Kenia Nunes, a physiologist at the Medical College of Georgia, who thinks this venom can be used to treat sexual dysfunction in both men and women. As outlined in her Journal of Sexual Medicine study, she first had to isolate the toxin to blame. “The venom of the P. nigriventer spider is a very rich mixture of several molecules,” Nunes told MSNBC. Feeding the active ingredient—a peptide called PnTx2-6—to a bunch of erection-challenged rats (with high blood pressure to boot), she discovered that it did indeed perk up these poor flaccid fellows.

Aside from achieving side-effect-free erections, the rat’s new-found potency is much different from drugs such as Viagra: Nunes discovered that the banana spider’s toxin follows different pathways to create erections, which has a major advantage.

Now she wants to see if this toxin can also help female sexual dysfunction. And if everything goes to plan, in the coming years, this spider toxin could wind up on drug store shelves and bedroom across the nation, causing shortness of breath of a very different kind.

 

Is oral sex worse than tobacco?! … Say it ain’t so!

Caroline May – The Daily Caller – Tue Feb 22, 11:54 am ET

Oral sex — not tobacco — could now be the leading cause of throat cancer among people under 50!

American scientists now say that oral cancer caused by the human papilloma virus (HPV) has become more prevalent in the U.S. than oral cancer caused by tobacco.  Scientists have found a 225 percent increase in the number of oral cancer cases in the U.S. during the last three decades.  The single greatest risk factor is the number of partners on whom the person has performed oral sex. Studies have shown that people who have performed oral sex on more than six partners have an eight times greater risk of developing head or neck cancer than their perhaps less promiscuous peers.

In the last two decades, incidents of oral cancer in the U.S. from HPV have doubled.

 

HPV has gotten attention in recent years for causing cervical cancer in women.  Some states now mandate recommend Gardasil as preventative vaccines. With this troubling data, however, researchers are advising boys and men to get vaccinated as well.

in mass vaccinations, there is no fail safe.

 

Teenagers really have no idea that oral sex is related to any outcome like STIs (sexually transmitted infections), HPV, chlamydia etc.

 

Bottom Line: Cigarettes are bad and cause more than oral cancer.  Oral sex may be a vehicle for transmitting a STD and one of the best preventions is to get the vaccination, Gardasil.