Archive for February, 2014

Good News For the Bedroom-Sex Is Heart Healthy

February 28, 2014

Certainly there are some men who worry that having sexual intercourse may cause a heart attack. Or men who have had a heart attack are at risk for another attack if they have sexual intercourse. Well, there’s good news for men. A recent study from England shows men who indulge in regular lovemaking are up to 45 per cent less likely to develop life-threatening heart conditions than men who have sex once a month or less.

The study, of over 1,000 men, shows sex appears to have a protective effect on the male heart but did not examine whether women benefit too.

Now the American researchers who carried out the investigation are calling for doctors to screen men for sexual activity when assessing their risk of heart disease.

Every year, around 270,000 people in Britain suffer a heart attack, and coronary disease remains Britain’s biggest killer.

Although sex has long been regarded as good for physical and mental health, there has been little scientific evidence to show the full benefits that frequent intercourse can have on major illnesses such as heart disease.

In the latest study, scientists at the New England Research Institute in Massachusetts, tracked the sexual activity of men aged between 40 and 70 who were taking part in a long-term project called the Massachusetts Male Ageing Study, which began back in 1987.
At regular points over a 16-year period, each man was questioned on how often they had sex and then checked for signs of heart disease.
Researchers took into account other risk factors, such as their age, weight, blood pressure and cholesterol levels.

The results, published in the American Journal of Cardiology, showed men who made love at least twice a week were much less likely to have heart disease than those whose sexual encounters were limited to once a month or less.

In a report on their findings, researchers said the benefits of sex could be due to both the physical and emotional effects on the body.
Men with the desire for frequent sexual activity and who are able to engage in it are likely to be healthier.

But sex in some forms has a physical activity component that might directly serve to protect cardiovascular health.

Also, men who have frequent sex might be more likely to be in a supportive intimate relationship and this might improve health through stress reduction and social support.

And there’s a benefit for the women in your life as well: Regular sex can even boost a woman’s sense of smell by triggering the release of a hormone called prolactin, according to scientists at Calgary University in Canada. This may be a mechanism to help mums bond with their new babies.

Bottom Line: No one disagrees that sex is good and sex might just be good for your health as well. So men, if you are looking for a reason to have regular sex, tell your partner to do it for your health and her health as well. It’s a twofer!

http://www.telegraph.co.uk/health/healthnews/6950548/Having-sex-twice-a-week-reduces-chance-of-heart-attack-by-half.html

Sex and the Prostate Cancer Patient

February 28, 2014

Q. I can’t get erections after prostate cancer treatment. Does that mean I will never have sex again?
A. The quality of your erections may not be the same after treatment for prostate cancer, but that doesn’t mean that you can’t enjoy penetrative sex. There are many options to help the firmness: medication, vacuum erection pumps, injections and implants. It is also important to realize that sex can be about more than penetration. Learning different techniques to pleasure your partner may be just as enjoyable. Improving upon your oral sex techniques, or mutual masturbation may bring pleasure equal to vaginal intercourse. A sex therapist can help you learn with these techniques.

Q. Since my treatment for prostate cancer, I have lost my interest in sex. Will that return?
A. Some of the hormone treatments, Lupron, Zolodex, Firmagon, used to fight prostate cancer can interrupt one’s desire for sex by decreasing the testosterone levels in the man’s blood stream. If you have a partner, it is important to discuss this side effect. You may find it helpful to have scheduled sexual activity to encourage closeness and intimacy. Sometimes, interest in sex builds when people engage in more foreplay. Also, touching by handholding and kissing can be also be pleasurable to both the man and the woman.

Q: Will my sexual function ever return to what it once was?
Many men grieve the function they had in their youth, forgetting that even without cancer, their level of function would likely change as they age. In either case, if you are going through proper rehabilitation starting immediately after treatment, you will have a greater chance of regaining most of your sexual function. Depending on the long-term treatment plan you and your doctor choose, you may find you need assistance through medications, vacuum erection devices, injections, and the surgical implantation of a penile prosthesis.

This Q and A was inspired and modified from an article by Melissa Donahue, LCSW from the New Jersey Center for Sexual Wellness http://www.njsexualwellness.com

Impotence: The Body’s Thermometer

February 28, 2014

When you have a fever, the elevated temperature provides you with a sign that there’s something wrong with your body. Usually it is a viral infection and the illness passes spontaneously or, if the fever persists, you go seek the assistance of your physician. Impotence or erectile dysfunction can also serve as a thermometer of illness occurring somewhere else in your body.

Erectile dysfunction is a common condition affecting nearly 30 million American men. Since the introduction of Viagra in 1998, hundreds of thousands of men have sought treatment and nearly 6 million prescriptions have been written for this drug that helps men engage in intimacy with their partners.

There are still millions of men who continue to suffer in silence. More importantly, there are millions of men whose suffer from erectile dysfunction which may serve as a thermometer of other life-threatening diseases such as heart disease, stroke, hypertension, high cholesterol, diabetes, depression, and cancer of the prostate gland.

In order for an erection to occur, there must be an integrated and coordinated function of the nerves, hormones and blood vessels that supply the penis. The diameter of the blood vessels that supply the penis are 1-2 mm (less than 1\10 of an inch) in diameter. The blood vessels to the coronary arteries that supply the muscles on the heart are 5-6 mm (approximately 1\5 of an inch). Therefore, any disease process like arteriosclerosis or hardening of the arteries is more likely to cause symptoms at the level of the penis before symptoms occur in the heart. That is why men who have difficulty obtaining and maintaining an erection should see their doctors, as the erectile dysfunction may be an indicator of more serious heart disease.

Erectile dysfunction is more common in men with high blood pressure, high cholesterol levels and obesity. For example, men with 42-inch waists are nearly twice as likely to have impotence as men with 32-inch waists. Another risk factor is alcohol consumption. But not all alcohol is going to negatively impact a man’s potency. As a matter of fact, 1-2 drinks per day have a protective affect against heart disease and erectile dysfunction. On the other hand those who drink more than 1-2 drinks per day are more likely to the experience a decrease in their potency.

High cholesterol levels are also predictive of erectile dysfunction. In men with total cholesterol levels >200 mg, or high density lipoproteins (HDL), or good cholesterol, <40 mg, they are more likely to have erectile dysfunction. The reason is that cholesterol-like plaques are deposited on the lining of the blood vessels and reduces the lumen or size of the blood vessels and consequently decreases the blood supply to the organ or tissue supplied by that blood vessel.

Erectile dysfunction is also common in many men with diabetes. Nearly 50 percent of men with adult-onset diabetes mellitus will experience erectile dysfunction. Also erectile dysfunction may be the first manifestation of diabetes. In a significant number of men the onset of impotence may be the first presenting symptom of diabetes, a condition that can be controlled with diet and medication.

Here are 10 actions steps that you can use to prevent impotence:

1. Recognize the normal signs of aging. Remember, it may take longer to obtain an erection at age 60 than at age 20. More genital stimulation and foreplay are required as a man ages.

2. Beware of medications that can cause impotence. There are literally hundreds of medications associated with the side effects of impotence. These common medications include tranquilizers, medication for high blood pressure and ulcers.

3. Avoid tobacco. Tobacco it is a performance-zapper because its effect on blood vessels can decrease blood flow to the penis.

4. Drink alcohol in moderation. 1-2 drinks per day may relax you and even protect your heart. More than 2 drinks per day may impact your sexual performance.

5. Timing can be everything. Sexual performance is influenced by body rhythms. Hormonal levels can vary at different times of the day. It is important to find that time of day or evening that is best-both mentally and physically-for you and your partner.

6. Accept occasional failure. One episode of impotence-even if it last for weeks-does not mean that a man is permanently impotent. Stress and fatigue, and anticipation of failure, can paralyze your sex life. Accept occasional impotence as something that happens to every man at different times in his life.

7. See your physician at least once a year. If you are more than 50 years of age, the cause of your erectile dysfunction is usually physical and not due to psychological or emotional reasons. You need to be sure there are not more serious, life-threatening conditions lurking behind the sexual problem.

8. Balanced nutrition is important for sexual function. The American Heart Association states that a low-fat, a low-cholesterol diet prevents heart disease and arteriosclerosis which also affects a man's erection.

9. Excess stress. Excessive, long-term stress is "counter erotic" and affects both a man and his partner’s capability to have a happy sexual relationship.

10. Get help. Persistent, chronic impotence needs medical attention before it interferes with relationships. Not treating erectile dysfunction may result in more severe illnesses including heart disease, stroke and diabetes.

Bottom line: If you or your loved one is suffering from erectile dysfunction, see your physician because help is available and no one needs to "suffer the tragedy of the bedroom." If you want to keep it up, get a checkup!

Dr. Neil Baum is a urologist and can be reached at 504 891 8454 or visit his Web site at http://www.neilbaum.com

Birds Do It; Bees Do It; and so Do Senior Citizens

February 17, 2014

With aging of the baby boomers, with their focus on health and wellness, and with increasing life expectancy for both men and women, it is natural and normal for our seniors to be sexually active. Many people want and need to be close to others as they grow older. This includes the desire to continue an active, satisfying sex life. But, with aging, there may be changes that can cause problems. This blog will discuss the normal changes that occur with aging and what can be done to add intimacy for both men and women.
Normal Changes With Aging
Normal aging brings physical changes in both men and women. These changes sometimes affect the ability to have and enjoy sex. A woman may notice changes in her vagina. As a woman ages, her vagina can shorten and narrow. Her vaginal walls can become thinner and also a little stiffer. Most women will have less vaginal lubrication. These changes could affect sexual function and/or pleasure. The solution to the vaginal dryness is easily resolved with the use of water soluble lubricant such as KY Jelly.
As men get older, impotence (also called erectile dysfunction–ED) becomes more common. ED is the loss of ability to have and keep an erection for sexual intercourse. ED may cause a man to take longer to have an erection. His erection may not be as firm or as large as it used to be. The loss of erection after orgasm may happen more quickly, or it may take longer before another erection is possible. ED is not a problem if it happens every now and then, but if it occurs often, a doctor can usually provide an effective solution.
What Causes Sexual Problems?
Some illnesses, disabilities, medi­cines, and surgeries can affect your ability to have and enjoy sex. Problems in your relationship can also affect your ability to enjoy sex.
Arthritis. Joint pain due to arthritis can make sexual contact uncomfortable. Exercise, drugs, and possibly joint replacement surgery may relieve this pain. Rest, warm baths, and changing the position or timing of sexual activity can be helpful.
Chronic pain. Any constant pain can interfere with intimacy between older people. Chronic pain does not have to be part of growing older and can often be treated. But, some pain medicines can interfere with sexual function. You should always talk with your doctor if you have unwanted side effects from any medication.
Dementia. Some people with dementia show increased interest in sex and physical closeness, but they may not be able to judge what is appropriate sexual behavior. Those with severe dementia may not recognize their spouse but still seek sexual contact. This can be a confusing problem for the spouse. A doctor, nurse, or social worker with training in dementia care may be helpful.
Diabetes. This is one of the illnesses that can cause ED in some men. In most cases, medical treatment can help. Less is known about how diabetes affects sexuality in older women. Women with diabetes are more likely to have vaginal yeast infections, which can cause itching and irritation and make sex uncomfort­able or undesirable. Yeast infections can be treated.
Heart disease. Narrowing and hardening of the arteries can change blood vessels so that blood does not flow freely. As a result, men and women may have problems with orgasms, and men may have trouble with erections. People who have had a heart attack, or their partners, may be afraid that having sex will cause another attack. Even though sexual activity is generally safe, always follow your doctor’s advice. If your heart problems get worse and you have chest pain or shortness of breath even while resting, talk to your doctor. He or she may want to change your treatment plan.
Incontinence. Loss of bladder control or leaking of urine is more common as we grow older, especially in women. Extra pressure on the belly during sex can cause loss of urine, which may result in some people avoiding sex. This can be helped by a change in positions. The good news is that incontinence can usually be treated.
Stroke. The ability to have sex is sometimes affected by a stroke. A change in positions or medical devices may help people with ongoing weakness or paralysis to have sex. Some people with paralysis from the waist down are still able to experience orgasm and pleasure.
Depression. Lack of interest in activities you used to enjoy, such as intimacy and sexual activity, can be a symptom of depression. It’s sometimes hard to know if you’re depressed. Talk with your doctor. Depression can be treated.
Surgery. Many of us worry about having any kind of surgery—it may be even more troubling when the breasts or genital area are involved. Most people do return to the kind of sex life they enjoyed before surgery.
Hysterectomy is surgery to remove a woman’s uterus. Often, when an older woman has a hysterectomy, the ovaries are also removed. The surgery can leave both women and men worried about their sex lives. If you’re afraid that a hysterectomy will change your sex life, talk with your gynecologist or surgeon.
Mastectomy is surgery to remove all or part of a woman’s breast. This surgery may cause some women to lose their sexual interest or their sense of being desired or feeling feminine. In addition to talking with your doctor, sometimes it is useful to talk with other women who have had this surgery. Programs like the American Cancer Society’s (ACS) “Reach to Recovery” can be helpful for both women and men. If you want your breast rebuilt (reconstruction), talk to your cancer doctor or surgeon.
Prostatectomy is surgery that removes all or part of a man’s prostate because of cancer or an enlarged prostate. It may cause urinary incontinence or ED. If removal of the prostate gland is needed, talk to your doctor before surgery about your concerns.
Medications. There are many drugs can cause sexual problems. These include some blood pressure medicines, antihistamines, antidepressants, tranquilizers, appetite suppressants, drugs for mental problems, and ulcer drugs. Some can lead to ED or make it hard for men to ejaculate. Some drugs can reduce a woman’s sexual desire or cause vaginal dryness or difficulty with arousal and orgasm. If the cause of a man or woman’s sexual problem is related to a medication, the doctor can usually reduce the dosage of the medication, change the medication that doesn’t have the side effect of sexual problems, or may even allow the patient to discontinue the medication for a short period of time, i.e., drug holiday, to allow the man or woman to enjoy intimacy without completely discontinuing the medication.
Alcohol. Too much alcohol can cause erection problems in men and delay orgasm in women.
Safe Sex Is For Seniors Too
Age does not protect you from sexually transmitted diseases. Older people who are sexually active may be at risk for diseases such as syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, genital warts, and trichomoniasis.
Almost anyone who is sexually active is also at risk of being infected with HIV, the virus that causes AIDS. The number of older people with HIV/AIDS is growing. You are at risk for HIV/AIDS if you or your partner has more than one sexual partner or if you are having unprotected sex. To protect yourself, always use a condom during sex. For women with vaginal dryness, lubricated condoms or a water-based lubricating jelly with condoms may be more comfortable. A man needs to have a full erection before putting on a condom.
Talk with your doctor about ways to protect yourself from all sexually transmitted diseases. Go for regular checkups and testing. Talk with your partner. You are never too old to be at risk.
What Can A Couple Do?
There are things you can do on your own for an active sexual life. Make your partner a high priority. Take time to enjoy each other and to understand the changes you both are facing. Try different positions and new times, like having sex in the morning when you both may be well-rested. Don’t hurry—you or your partner may need to spend more time touching to become fully aroused. Masturbation is a sexual activity that many older people, with and without a partner, find satisfying.
Don’t be afraid to talk with your doctor if you have a problem that affects your sex life. He or she may be able to suggest a treatment. For example, the most common sexual difficulty of older women is painful intercourse caused by vaginal dryness. Your doctor or a pharmacist can suggest over-the-counter vaginal lubricants or moisturizers to use. Water-based lubricants are helpful when needed to make sex more comfortable. Moisturizers are used on a regular basis, every 2 or 3 days. Or, your doctor might suggest a form of vaginal estrogen.
If ED is the problem, it can often be managed and perhaps even reversed. There are pills, Viagra, Levitra, Cialis, and now Stendra, that can help. They should not be used by men taking medicines containing nitrates, such as nitroglycerin. The pills do have possible side effects. Other available treatments include vacuum devices, self-injection of a drug, or penile implants.
Physical problems can change your sex life as you get older. But, you and your partner may discover you have a new closeness. Talk to your partner about your needs. You may find that affection—hugging, kissing, touching, and spending time together—can make a good beginning.
Bottom Line: Sex is good at 20-30, better at 30-40, and can be best of all after age 60. Intimacy is just as important as we age as when we were younger. Help is available; don’t be afraid to ask your doctor.

Got an Elevated PSA Level and the Prostate Biopsy Negative? Managing the Dilemma

February 15, 2014

Approximately 700,000 American men receive a negative prostate biopsy result; however approximately 25%3 of these results are false-negative and that is the man has prostate cancer but the biopsy was not able to discover or confirm the disease. Under the current standard of care, prostate biopsy procedures sample less than 1% of a man’s prostate. This approach leaves men at risk of occult cancer, leading to a high rate of repeat biopsies. ConfirmMDx for Prostate Cancer addresses the unmet medical need for a clinically effective diagnostic test to address this dilemma.

ConfirmMDx for Prostate Cancer is a test to help distinguish patients who have a true-negative biopsy from those who may have occult cancer. The test helps your doctor to rule-out prostate cancer and to make it possible to perform repeat biopsies.

The test is conducted on the biopsy material that was obtained at the time of your ultrasound and prostate biopsy. No additional invasive tests are required. This test is also covered by most insurance companies including Medicare.

ConfirmMDx is a sophisticated test that detects subtle changes in the DNA level in cells adjacent to cancer cells. This halo around a cancer lesion can be present despite having a normal appearance under the microscope.\

Bottom Line: If you have an elevated PSA level and you have had a negative prostate biopsy, then consider this additional test which may help rule out cancer or confirm early prostate cancer when it is treatable and can be cured.

Breast Cancer – to Screen Or Not To Screen

February 15, 2014

When the medical world agreed that mammography and breast self exams were a good thing, the whole discussion turned upside down with a recent publication in the British Medical Journal, that suggest that mammography is no longer necessary. This article will discuss that report and provide advice for women so that they may make the best decision regarding their screening for breast cancer.

What is mammography?
A mammogram is an x-ray picture of the breast. It can be used to check for breast cancer in women who have no signs or symptoms of the disease. It can also be used if you have a lump or other sign of breast cancer.

In the past screening mammography is the type of mammogram that checks a woman when she has no symptoms. It was thought that screening mammography would reduce the number of deaths from breast cancer among women ages 40 to 70. But it can also have drawbacks. Mammograms can sometimes find something that looks abnormal but isn’t cancer. This leads to further testing and can cause a woman significant anxiety. Sometimes mammograms can miss cancer when it is there. It also exposes the woman to radiation. The National Cancer Institute recommends that women age 40 or older have screening mammograms every 1 to 2 years.

How is a mammogram performed?
In a screening mammogram, each breast is X-rayed in two different positions: from top to bottom and from side to side. When a mammogram image is viewed, breast tissue appears white and opaque and fatty tissue appears darker and translucent.

How does it differ from breast self-examination?
A breast self exam is a check-up a woman does at home to look for changes or problems in the breast tissue. Many women feel that doing this is important to their health.
However, experts do not agree about the benefits of breast self exams in finding breast cancer or saving lives. Most organizations and doctors believe that breast self-exams have little value, based on findings from several large studies. However, this is far better than no examination or no mammography at all.

Talk to your health care provider about whether breast self exams are right for you.
The best time to do a self-breast exam is about 3 – 5 days after your period starts. Your breasts are not as tender or lumpy at this time in your monthly cycle.

If you have gone through menopause, do your exam on the same day every month.

What did the recent report say about mammography?
One of the largest and most meticulous studies of mammography ever done, involving 90,000 Canadian women age 40-59 and lasting a quarter-century, has added powerful new doubts about the value of the screening test for women of any age.

It found that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not. And the screening had harms: One in five cancers found with mammography and treated was not a threat to the woman’s health and did not need treatment such as chemotherapy, surgery or radiation.

The study, published in February 2014 in The British Medical Journal, is one of the few rigorous evaluations of mammograms conducted in the modern era of more effective breast cancer treatments. It randomly assigned half of the women to have regular mammograms and breast exams by trained nurses or to have breast exams alone.

The death rate from breast cancer was the same in both groups, but 1 in 424 women who had mammograms received unnecessary cancer treatment, including surgery, chemotherapy and radiation.

The findings of this study will not lead to any immediate change in guidelines for mammography, and many experts will dispute the idea that mammograms are on balance useless, or even harmful.

So what is a woman to do?
The American Cancer Society recommends yearly screening mammograms starting at age 40. However, the U.S. Preventive Services Task Force (USPSTF) does not recommend screening for women in their 40s. For women between the ages of 50 and 74, USPSTF experts say women should have mammograms every two years and do not recommend screening at all after age 74. The American Cancer Society and the American College of Obstetricians and Gynecologists suggest that woman consider screening mammograms beginning at age 40.

It is noted that women whose tumors are discovered through mammography are smaller and present at earlier stages and are more likely to undergo breast conservation therapy, i.e., lumpectomy and women who have their cancer identified through breast self examinations tend to have more advanced cancer and have mastectomies or the entire breast removed.

When you need a mammogram is a personal decision between you and your doctor. If you’re over 40, talk to you doctor about when you should begin mammogram screening.
Bottom Line: Breast cancer remains the most common cancer in women and early detection is important for improving outcomes and saving breast tissue, i.e., having a lumpectomy instead of a mastectomy. I encourage each woman to have a discussion with their doctor about when to begin screening for breast cancer and whether or not to screen with mammography.

Stendra-Viagra’s New Cousin For the Treatment of Erectile Dysfunciton

February 14, 2014

For the past decade Viagra, Levitra, and Cialis have been the mainstay of oral medications for the treatment of erectile dysfunction or impotence. There’s a new drug on the block, Stendra, whose main claim to fame will be the faster onset of action compared to the three previous drugs.

In published studies in the medical literature, Stendra has an onset of action as early as 15 minutes. The drug can be taken with food or fluids but a high fat meal reduces the rate of absorption and delays the onset of action. Duration of Stendra is the same as Viagra and Levitra at 4-6 hours. Viagra and Levitra report onset at 30 minutes to 1 hour. Cialis is about the same or a little longer, but duration of Cialis is 24-36 hours.
The response or efficacy appears to be similar as the other oral medications, i.e., Cialis, Viagra and Levitra.

The same safety precautions exist: 1) Contraindicated with the use of any nitrates such as nitroglycerin as the use of Stendra with nitroglycerin may drop the blood supply to the hear and risk a serious heart problem; 2) Caution in combination with certain prostate drugs such as Flomax or Rapaflo; 3) Seek help for erection lasting more than 4 hours although I have never seen a man with an erection lasting more than 1-2 hours with the use of any oral medication for the treatment of erectile dysfunction.

The side effects include headaches, facial flushing, nasal congestion, and back pain.

Bottom Line: If a man is looking for a faster onset of action of oral medication for the treatment of erectile dysfunction, then Stendra may be his Holy Grail!

Bladder Cancer-Shedding “Blue” Light On Detection and Treatment

February 14, 2014

Blood mixed with any bodily fluids, such as sputum and stool is worthy of medical attention. However, blood in the urine is particularly ominous and requires prompt medical attention.
Bladder cancer is the ninth most common cancer worldwide, with more than 380,000 new cases each year and more than 150,000 deaths per year. It is more common in elderly and affects approximately four times the number of men than women. The US National Cancer Institute estimates that there will be 72,570 new cases of bladder cancer in the US in 2013 and 15,210 deaths.

If detected at an early stage, this cancer can be successfully treated and has a good prognosis. Nearly half of bladder cancer patients will experience cancer recurrence. A new technique, blue-light cystoscopy, is an improved option for the diagnosis and the treatment in order to reduce the recurrence of bladder cancer.

Bladder cancer occurs when cells in the bladder start to grow out of control, typically on the inner layers of the bladder. Some may spread into the deeper layers of the bladder, eventually penetrating the walls of the bladder, making it much harder to treat.

The most common initial sign of bladder cancer is hematuria or blood in the urine. A look into the bladder with a lighted tube or cystoscopy is recommended in all patients with symptoms suggestive of bladder cancer. This test is done in the doctor’s office and requires a local anesthetic to reduce the paint and discomfort of the procedure. There are two forms of bladder cancer: non-muscle invasive and muscle invasive bladder cancer.

Non-muscle invasive bladder cancer accounts for about 75% of all newly diagnosed bladder cancer cases. Most of these cases show a high probability of recurrence and 10-20 % will progress to muscle invasive bladder cancer. The treatment will consist of using a cystoscope to remove the affected bladder areas followed by post–operative treatment options such as early instillation of chemotherapy or instillation of BCG which stimulates an immune response to prevent recurrence of the cancer.

Cysview is a new modality for detecting bladder cancer. Cysview is a chemical agent used to detect early bladder cancer. This agent is instilled into the bladder prior to cystoscopy and will stain or highlight bladder cancer when using a blue light inside the bladder much more effectively than using the standard white light of the conventional cystoscope. As a result the blue light cystoscopy using Cysview exposes cancer earlier when it is confined to the lining of the bladder and is easily treatable by removing the tumor using the cystoscope. Also the blue light treatment leads to improved tumor removal, since every tumor detected can be removed at the time of diagnosis and not requiring any additional procedures.

Bottom Line: Cancer of the bladder is a common urologic condition. The hallmark symptom is blood in the urine, either microscopic or visible to the eye. A new diagnostic option is the use of blue light Cysview that helps with the diagnosis and treatment of bladder cancer. For more information see your urologist.

What Culprits Send Cupid Out of the Bedroom?

February 14, 2014

Today is Valentine’s Day, the day that couples think about love and intimacy. However, there are relationships where love and affection have left the bedroom. There are many culprits that can affect intimacy between a man and a woman.

Medications

There are literally hundreds of medications that can impact a man or a woman’s sex life. Medications that are prescribed for stroke and heart issues can have devastating effects on sexual functioning. In addition, researchers have found that a family of antidepressants known as selective serotonin-reuptake inhibitors (SSRI) can take the wind right out of your sexual sails. These drugs include Prozac, Zoloft and Paxil.

Doctors can often reduce the dosage of these offending drugs or can change to another drug that can accomplish the same result without the sexual side effects.

Chronic Pain

People of both sexes can develop pain disorders as they get older, and that can have a big effect on sexuality. Arthritis and chronic back pain are just two examples. Those who suffer from chronic pain are advised to find the time of day when pain is at a minimum to engage in sexual intimacy. Also, those who suffer from chronic pain may need to take a pain pill before attempting to have sex. There are positions such as side by side that actually put the least amount of stress on your joints and your back and may make it possible to have successful intimacy.

Sex does not always equal intercourse. There are many successful relationships that do not have penis-vaginal intercourse. However, these people are able to engage in intimacy by sensual touching, massage and mutual masturbation.

Make Time for Rest and Play

The National Sleep Foundation recommends getting seven to eight hours of shut-eye a night. But with the stress of work, kids, bills and, oh yeah, your marriage, who can think about fitting in time to have sex, much less sleep? Still, you have to do your best to get a healthy amount of sleep.

Cupid likes to be included on regular dates. Plan some sex dates around times that you know you feel more energetic. You plan other things in your life and you don’t complain about it. You can do the same with sex.

Menopause and Testosterone Deficiency

Menopause and the accompanying decrease in sex drive and the appearance of vaginal dryness can wreak havoc on your sex life. Menopause results from a decrease in estrogens. The solution is as simple as applying a vaginal cream or a lubricant such as K-Y jelly or estrogens, which can be administered by a pill, a patch, topical gels, or a vaginal ring.

If you aren’t in the mood, you may be suffering from testosterone deficiency. This applies to women as well as men. Women also make low doses of testosterone and if the hormone is deficient, women may not be in the mood for sexual intimacy. The application of a topical gel or the insertion of a small pellet under the skin may quickly solve the problem of a lack of sex drive.

Bottom Line: Valentine’s Day is just one day a year. However, Cupid can be your best friend the other 364 days of the year. Try a few of these ideas to bring Cupid back into your bedroom. It’s the best threesome in the world!

This article appeared in the February 2014 issue of Health & Fitness Magazine

X-Rays, CT SCans, Dental X-Rays May Be Killing You

February 3, 2014

Americans are receiving more testing and imaging that makes use of ionizing radiation than ever before. The healthcare profession knows that excessive radiation can be a contributing factor to many forms of cancer such as leukemia (blood cancer) breast cancer, and thyroid cancer just name a few.

Ionizing radiation is high-frequency radiation that has enough energy to remove an electron from (ionize) an atom or molecule. Ionizing radiation has enough energy to damage the DNA or the genetic makeup inside cells, which in turn may lead to cancer.

Ionizing radiation is a proven human carcinogen (cancer causing agent). The evidence for this comes from many different sources, including studies of atomic bomb survivors in Japan, people exposed during the Chernobyl nuclear accident, people treated with high doses of radiation for cancer and other conditions, and people exposed to high levels of radiation at work, such as uranium miners.

Even though great strides have been made in cancer prevention and treatment, cancer rates remain high and may soon surpass heart disease as the leading cause of death in the United States. One of the important culprits may come from your doctor who is prescribing excessive imaging studies that make use of ionizing radiation. The use of medical imaging with high-dose radiation — CT scans in particular — has soared in the last 20 years. Our resulting exposure to medical radiation has increased more than six fold between the 1980s and 2006. The radiation dose of CT scans (a series of X-ray images from multiple angles) is 100 to 1,000 times higher than conventional X-rays such as a chest X-ray.

The risks have been demonstrated directly in two large clinical studies in Britain and Australia. In the British study, children exposed to multiple CT scans were found to be three times more likely to develop leukemia and brain cancer. In a 2011 report sponsored by Susan G. Komen, concluded that radiation from medical imaging, and hormone therapy, the use of which has substantially declined in the last decade, were the leading environmental causes of breast cancer, and advised that women reduce their exposure to unnecessary CT scans.

One in 10 Americans undergo a CT scan every year, and many of them get more than one CT scan every year. While it is difficult to know how many cancers will result from medical imaging, a 2009 study from the National Cancer Institute estimates that CT scans conducted in 2007 will cause a projected 29,000 excess cancer cases and 14,500 excess deaths over the lifetime of those exposed. Given the many scans performed over the last several years, a reasonable estimate of excess lifetime cancers would be in the hundreds of thousands. Unless we change our current practices or overusing CT scans, 3 percent to 5 percent of all future cancers may result from exposure to medical imaging.

We know that these tests are overused. But even when they are appropriately used, they are not always done in the safest ways possible. The rule is that doses for medical imaging should be as low as reasonably achievable. But there are no specific guidelines for the imaging centers to use to identify what optimum low doses are, and thus there is considerable variation within and between institutions. The dose at one hospital can be as much as 50 times stronger than at another.

A recent study at one New York hospital found that nearly a third of its patients undergoing multiple cardiac imaging tests were getting a cumulative effective dose equivalent to 5,000 chest X-rays. And last year, a survey of nuclear cardiologists found that only 7 percent of stress tests were done using a “stress first” protocol (examining an image of the heart after exercise before deciding whether it was necessary to take one of it at rest), which can decrease radiation exposure by up to 75 percent.

But we still have a long way to go. Fortunately, we can reduce the rate of medical imaging by simply avoiding unnecessary scans and minimizing the radiation from appropriate ones. For example, emergency room physicians routinely order multiple CT scans even before examining a patient. For example a patient with possible diagnosis of a kidney stone can often be diagnosed with a history, a physical exam, a urine test, and very simple x-ray called a KUB which has minimal radiation exposure compared to a spiral CT scan that is so frequently ordered.

Better monitoring and guidelines would also help. The Food and Drug Administration oversees the approval of scanners, but does not have regulatory oversight for how they are used. We need clear standards, published by professional radiology societies or organizations like the Joint Commission or the F.D.A. In order to be accredited for CT scans, hospitals and imaging clinics should be required to track the doses they use and ensure that they are truly as low as possible by comparing them to published guidelines.

Patients have a part to play as well. Consumers can go to the website, http://www.choosingwisely.org, to learn about the most commonly overused tests. Before agreeing to a CT scan, they should ask: Will it lead to a better treatment and outcome? Would they get that therapy without the test? Are there alternatives that don’t involve radiation, like ultrasound or MRI? Even when we go to the dentist to have our teeth cleaned, we need to question the dentist about the routine use of dental x-rays and if you do get dental x-rays, it is important to wear a neck shield that protects your thyroid gland.

Bottom Line: We are probably receiving more radiation through medical tests and is important to question your doctor about the necessity of using so many imaging tests that increase our exposure to ionizing radiation.

A version of this op-ed appears in print in the New York Times on January 31, 2014.