“Let us recognize that there can be no health without mental health.” Those were the profound words of UN Secretary General Ban Ki-moon on October 10, a day earmarked since 1992 as World Mental Health Day. In his message, he also emphasized that mental health is paramount to a person’s “well-being, family relationships and an individual’s ability to contribute to society.” But on a grave note, he reminded us that because resources are not only “insufficient, inequitably distributed and inefficiently used,” a large majority of people with mental disorders receive no care at all. “Scaling-up services should be a priority,” he said.
The World Health Organization’s Mental Health Gap Action Program is designed to do just that. Launched this month, the program highlights the huge treatment gap for a number of mental, neurological and substance use disorders and identifies strategies for “scaling up” mental health care using cost-effective interventions in resource-constrained settings. Strategies include assessing an individual countries needs and resources, developing sound mental health policy and legislation, and increasing human and financial resources. The program calls on all partners, including governments, donors and mental care stakeholders to join together for advocacy and action to make this program successful.
Unfortunately, mental disorders generally ranks low on the public agenda, with most countries allocating less than 2 percent of their health budget to mental health care, according to WHO. Not only are mental health resources scarce worldwide, they are distributed inequitably among different regions. Data indicates that in developing countries, 36 percent of all mental health professionals work in mental hospitals located mostly in urban areas, far from the reach of rural population. “We need to reinforce partnerships, accelerate efforts, scale up interventions, increase investments towards providing services to those who do not have any, and the political will to see all this through,” said Dr. Shigeru Omi, WHO Regional Director for the Western Pacific. Community and economic development can also be used to restore and enhance mental health, the doctor said.
With proper care and medication, 450 million people worldwide could benefit from treatment for diseases such as depression, schizophrenia, and epilepsy and begin to lead healthy lives—even in areas where resources are scarce. For example, poor countries could provide basic treatment for schizophrenia, bipolar disorder, depression and alcohol abuse by spending a mere 20 cents for every person in the country each year. And for $5 a year per person, the nine of ten people suffering from epilepsy across Africa who go untreated could have access to anticonvulsant drugs.
“Governments across the world need to see mental health as a vital component of primary health care. We need to change policy and practice,” said WHO Director-General Margaret Chan. “Only then can we get the essential mental health services to the tens of millions in need.”
Showing posts with label men health. Show all posts
Showing posts with label men health. Show all posts
Wednesday, November 5, 2008
Common Cause of Male Infertility Successfully Treated Without Surgery
According to new research, many men who suffer from infertility due to a problem with varicoceles can now be effectively treated with a minimally invasive procedure called retrograde venous embolization.
Varicoceles are abnormally enlarged veins in the scrotum. The condition can cause testicles to shrink and soften. As many as 16 percent of men have this type of varicose vein, which is a common cause of low sperm count. In fact, about 40 percent of men who are infertile have varicoceles, with the traditional treatment being surgery. Why the condition can cause fertility problems in men remains unknown.
Retrograde venous embolization (RVE) is a procedure done with a tiny catheter that works by blocking excessive blood flow into the veins and allowing them to shrink back to their normal size. During the procedure, a radiologist inserts a small catheter through a small incision in the groin and uses an imaging tool to guide it to the affected right or left-sided varicocele. There is a minimal recovery time and according to researchers, most patients can return to work the next day.
Dr. Sebastian Flacke from the University of Bonn Medical School in Germany led the study of infertile men aged 18-50 with at least one varicocele. All of the men had healthy partners who were trying to become pregnant. There was a total of 228 varicoceles in the 223 men who underwent the RVE procedure. Of them, 226 varicoceles were successfully treated while clinical and ultrasound testing revealed that the varicocele was totally resolved in 92.4 percent of patients (206 participants). The procedure significantly improved both sperm count and their ability to move spontaneously and actively (motility), yet the averages were still abnormally low according to the World Health Organization guidelines.
Of all the potential pre-treatment predictors of pregnancy such as varicocele severity, hormone levels, ultrasound findings, and other semen parameters, the researchers found that the only significant predictor was sperm movement.In follow-up data on pregnancy in partners for 173 of the men, 45 couples or 26 percent, reported a pregnancy with five of them assisted by intrauterine insemination.
The study findings indicate that RVE does improve semen quality, resulting in pregnancy about one-third of the time, which prompted the authors to conclude that fertility benefits seen with this procedure are "similar to those reported after surgical repair," and refer to the treatment as a "useful adjunct to in vitro fertilization therapy."
The authors acknowledged several limitations of the study which included the absence of a control group, the lack of further assessment and grading of female infertility in women without proven infertility, and the relatively short observation period for treatment success. The study and its findings appear in the August issue of Radiology.
Varicoceles are abnormally enlarged veins in the scrotum. The condition can cause testicles to shrink and soften. As many as 16 percent of men have this type of varicose vein, which is a common cause of low sperm count. In fact, about 40 percent of men who are infertile have varicoceles, with the traditional treatment being surgery. Why the condition can cause fertility problems in men remains unknown.
Retrograde venous embolization (RVE) is a procedure done with a tiny catheter that works by blocking excessive blood flow into the veins and allowing them to shrink back to their normal size. During the procedure, a radiologist inserts a small catheter through a small incision in the groin and uses an imaging tool to guide it to the affected right or left-sided varicocele. There is a minimal recovery time and according to researchers, most patients can return to work the next day.
Dr. Sebastian Flacke from the University of Bonn Medical School in Germany led the study of infertile men aged 18-50 with at least one varicocele. All of the men had healthy partners who were trying to become pregnant. There was a total of 228 varicoceles in the 223 men who underwent the RVE procedure. Of them, 226 varicoceles were successfully treated while clinical and ultrasound testing revealed that the varicocele was totally resolved in 92.4 percent of patients (206 participants). The procedure significantly improved both sperm count and their ability to move spontaneously and actively (motility), yet the averages were still abnormally low according to the World Health Organization guidelines.
Of all the potential pre-treatment predictors of pregnancy such as varicocele severity, hormone levels, ultrasound findings, and other semen parameters, the researchers found that the only significant predictor was sperm movement.In follow-up data on pregnancy in partners for 173 of the men, 45 couples or 26 percent, reported a pregnancy with five of them assisted by intrauterine insemination.
The study findings indicate that RVE does improve semen quality, resulting in pregnancy about one-third of the time, which prompted the authors to conclude that fertility benefits seen with this procedure are "similar to those reported after surgical repair," and refer to the treatment as a "useful adjunct to in vitro fertilization therapy."
The authors acknowledged several limitations of the study which included the absence of a control group, the lack of further assessment and grading of female infertility in women without proven infertility, and the relatively short observation period for treatment success. The study and its findings appear in the August issue of Radiology.
Hormone Therapy for Prostate Cancer: Helpful or Harmful?
If you have prostate cancer and you are an elderly man you may want to consider other options other than hormone therapy. A study has shown the one in four U.S. men with early prostate cancer will undergo hormone therapy, but it more likely to more harmful to them than helpful.
The surgery to remove the prostate, radical prostatectomy, is a little too risky for men that are in their 70s and 80s. When these men are found to have the early stages of prostate cancer, they will have three options to choose from.
The first option is they can wait to see whether this usually slow-moving cancer will become a problem. This type of observation is called conservative therapy or watchful waiting. The second option is to undergo radiation therapy and suffer its side effects. The third option is to undergo androgen-deprivation therapy: hormonal drugs such as Lupron, Eligard, Viduar, and Zoladex, or undergo surgery (orchiectomy) that will cut off the production of the male hormones.
Older men that are in the United States often opt for stand-alone hormone therapy, even thought there is really no proof that it is really helpful. One of the hormone therapy's most obvious side effects is sexual dysfunction. According to recent studies, the greater concern now with hormone therapy is linking the androgen deprivation therapies to heart disease, diabetes, bone fractures, and a reduction in muscle mass.
The most recent study on the hormone therapy strongly suggests that this type of therapy offer elderly men no benefit to justify these serious risks. Grace L. Lu- Yao Ph.D., MPH, which is from the University of Medicine & Dentistry of New Jersey, and her colleagues collected data from more than 19,000 mean that have been diagnosed with the early stages of prostate cancer at the average age of 77. Out of these men, none of them underwent surgery or radiation treatment for the early prostate cancer. Nearly 8,000 of the men, however, did decide to go with androgen deprivation therapy.
Lu-Yao said, "The reason patients want this is they want something that will improve their quality of life or their survival. But hormone therapy has a detrimental effect on quality of life. And we cannot find any survival benefit for these men in their 70s with very early-stage cancer."
So now we have to ask, why do so many men choose to undergo this unproven treatment that now seems to do more harm than it does good?
Otis Brawley, M.D. and chief medical officer for the American Cancer Society says that it is because it is just an American phenomenon. One of the problems is that when a man finds out that he has early stages of prostate cancer, both he and his physician feel it is necessary to do something. Unfortunately, the result in the end is that the number of men that should get conservative therapy end up getting some kind of intervention.
Brawley and Lu-Yao both suggest that these elderly men would have done just as well if their cancer had never been found. Brawley also notes that many of these men would have likely underwent continued prostate cancer screenings with PSA tests. The other men probably had possible prostate abnormalities that would have been detected by a urologist.
No matter how they got to their conclusions about their cancers, all of these men must have agreed to undergo prostate biopsies. Also, they may have not have been fully informed and could have come to the wrong decision, says the head of urology at New York's Mount Sinai School of Medicine, Simon Hall, MD.
"You have to have a discussion with an older man before he has a prostate biopsy. You have to ask them, 'Do you really want to open Pandora's Box?' Most patients with localized prostate cancer are not going to die from their disease in the first 10 years anyway. It is a legitimate question whether to screen patients this old, and whether urologists should biopsy older patients based on just a knee-jerk reaction."
Hall also noted that he would only treat a very few men with hormone therapy alone. A lot of the elderly men are at a very low risk and really don't need any treatment at all. It seems that the hormone therapy would make no difference so why put these men through the side effects or cost?
All of these experts have noted that the finding of the current study do not apply to the younger men who might receive androgen-deprivation therapy in combination with radiation or surgery. These such men may actually benefit from this type of hormone therapy.
The surgery to remove the prostate, radical prostatectomy, is a little too risky for men that are in their 70s and 80s. When these men are found to have the early stages of prostate cancer, they will have three options to choose from.
The first option is they can wait to see whether this usually slow-moving cancer will become a problem. This type of observation is called conservative therapy or watchful waiting. The second option is to undergo radiation therapy and suffer its side effects. The third option is to undergo androgen-deprivation therapy: hormonal drugs such as Lupron, Eligard, Viduar, and Zoladex, or undergo surgery (orchiectomy) that will cut off the production of the male hormones.
Older men that are in the United States often opt for stand-alone hormone therapy, even thought there is really no proof that it is really helpful. One of the hormone therapy's most obvious side effects is sexual dysfunction. According to recent studies, the greater concern now with hormone therapy is linking the androgen deprivation therapies to heart disease, diabetes, bone fractures, and a reduction in muscle mass.
The most recent study on the hormone therapy strongly suggests that this type of therapy offer elderly men no benefit to justify these serious risks. Grace L. Lu- Yao Ph.D., MPH, which is from the University of Medicine & Dentistry of New Jersey, and her colleagues collected data from more than 19,000 mean that have been diagnosed with the early stages of prostate cancer at the average age of 77. Out of these men, none of them underwent surgery or radiation treatment for the early prostate cancer. Nearly 8,000 of the men, however, did decide to go with androgen deprivation therapy.
Lu-Yao said, "The reason patients want this is they want something that will improve their quality of life or their survival. But hormone therapy has a detrimental effect on quality of life. And we cannot find any survival benefit for these men in their 70s with very early-stage cancer."
So now we have to ask, why do so many men choose to undergo this unproven treatment that now seems to do more harm than it does good?
Otis Brawley, M.D. and chief medical officer for the American Cancer Society says that it is because it is just an American phenomenon. One of the problems is that when a man finds out that he has early stages of prostate cancer, both he and his physician feel it is necessary to do something. Unfortunately, the result in the end is that the number of men that should get conservative therapy end up getting some kind of intervention.
Brawley and Lu-Yao both suggest that these elderly men would have done just as well if their cancer had never been found. Brawley also notes that many of these men would have likely underwent continued prostate cancer screenings with PSA tests. The other men probably had possible prostate abnormalities that would have been detected by a urologist.
No matter how they got to their conclusions about their cancers, all of these men must have agreed to undergo prostate biopsies. Also, they may have not have been fully informed and could have come to the wrong decision, says the head of urology at New York's Mount Sinai School of Medicine, Simon Hall, MD.
"You have to have a discussion with an older man before he has a prostate biopsy. You have to ask them, 'Do you really want to open Pandora's Box?' Most patients with localized prostate cancer are not going to die from their disease in the first 10 years anyway. It is a legitimate question whether to screen patients this old, and whether urologists should biopsy older patients based on just a knee-jerk reaction."
Hall also noted that he would only treat a very few men with hormone therapy alone. A lot of the elderly men are at a very low risk and really don't need any treatment at all. It seems that the hormone therapy would make no difference so why put these men through the side effects or cost?
All of these experts have noted that the finding of the current study do not apply to the younger men who might receive androgen-deprivation therapy in combination with radiation or surgery. These such men may actually benefit from this type of hormone therapy.
Task Force Advises Against Prostate Cancer Screening for Men Over 75
The U.S. Preventive Services Task Force has announced a new recommendation that men age 75 and older should not be screened for prostate cancer. In addition, younger men are advised to discuss the benefits and harms of the prostate specific antigen (PSA) test with their healthcare providers before being tested.
The Task Force recommendations are supported by findings that screening for prostate cancer offers few health benefits and can lead to considerable health problems such as erectile dysfunction, urinary incontinence, bowel dysfunction, and death for men age 75 and older, in addition to experiencing the pain and discomfort associated with prostate biopsy.
The panel found that some men with prostate cancer who receive treatment would never have developed symptoms related to cancer during their entire lifetime. Others have suffered psychological effects from false-positive test results. For men under the age of 75, the group has concluded that evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening.
Prostate cancer is the most common non-skin cancer and the second leading cause of cancer death in men in the United States. There were an estimated 218,890 men were diagnosed with the disease in 2007 within the U.S. It is also estimated that one in six men will be diagnosed with the disease within his lifetime. Older men, African-American men, and men with a family history of prostate cancer are at increased risk for developing prostate cancer.
The most common screening methods used to detect prostate cancer are PSA tests and digital rectal exams. The PSA test is the more accurate detection method of the two. However, cancers detected by a PSA test take years to affect a patient's health. It can take more than 10 years for cases to become serious enough to become terminal. Because a man who is 75years of age has an average life expectancy of approximately 10 years, he will be more likely to die from conditions such as heart disease or stroke than from prostate cancer. This would make a prostate cancer screening highly unlikely to prove beneficial for men over 75, yet currently, one-third of all men in the United States over 75 are receiving PSA testing. Additionally, men younger than 75 who suffer from chronic medical problems and have a life expectancy of less than 10 years are also unlikely to benefit from the cancer screening.
Task Force Chair Ned Calonge, M.D., M.P.H., chief medical officer for the Colorado Department of Public Health and Environment, said, "Because many prostate cancers grow slowly, early detection may not benefit a patient's health and in some cases may even cause harm." Calonge also noted, "We encourage men younger than 75 to discuss with their clinicians the potential-but uncertain-benefits and the possible harms of getting the PSA test before they decide to be screened."
The Task Force is the leading independent panel of experts in prevention and primary care and the group is the first to identify a precise age cutoff at which screenings become ineffective or detrimental. Recommendations by the task force are considered the gold standard for clinical preventive services.
There are currently clinical trials underway including the National Cancer Institute's Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial and the European Study of Screening for Prostate Cancer. The results from these trials will assist in clarifying any potential benefits of prostate cancer screening in men under age 75.
The recommendation and evidence summary can be found in the August 5 issue of the Annals of Internal Medicine.
The Task Force recommendations are supported by findings that screening for prostate cancer offers few health benefits and can lead to considerable health problems such as erectile dysfunction, urinary incontinence, bowel dysfunction, and death for men age 75 and older, in addition to experiencing the pain and discomfort associated with prostate biopsy.
The panel found that some men with prostate cancer who receive treatment would never have developed symptoms related to cancer during their entire lifetime. Others have suffered psychological effects from false-positive test results. For men under the age of 75, the group has concluded that evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening.
Prostate cancer is the most common non-skin cancer and the second leading cause of cancer death in men in the United States. There were an estimated 218,890 men were diagnosed with the disease in 2007 within the U.S. It is also estimated that one in six men will be diagnosed with the disease within his lifetime. Older men, African-American men, and men with a family history of prostate cancer are at increased risk for developing prostate cancer.
The most common screening methods used to detect prostate cancer are PSA tests and digital rectal exams. The PSA test is the more accurate detection method of the two. However, cancers detected by a PSA test take years to affect a patient's health. It can take more than 10 years for cases to become serious enough to become terminal. Because a man who is 75years of age has an average life expectancy of approximately 10 years, he will be more likely to die from conditions such as heart disease or stroke than from prostate cancer. This would make a prostate cancer screening highly unlikely to prove beneficial for men over 75, yet currently, one-third of all men in the United States over 75 are receiving PSA testing. Additionally, men younger than 75 who suffer from chronic medical problems and have a life expectancy of less than 10 years are also unlikely to benefit from the cancer screening.
Task Force Chair Ned Calonge, M.D., M.P.H., chief medical officer for the Colorado Department of Public Health and Environment, said, "Because many prostate cancers grow slowly, early detection may not benefit a patient's health and in some cases may even cause harm." Calonge also noted, "We encourage men younger than 75 to discuss with their clinicians the potential-but uncertain-benefits and the possible harms of getting the PSA test before they decide to be screened."
The Task Force is the leading independent panel of experts in prevention and primary care and the group is the first to identify a precise age cutoff at which screenings become ineffective or detrimental. Recommendations by the task force are considered the gold standard for clinical preventive services.
There are currently clinical trials underway including the National Cancer Institute's Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial and the European Study of Screening for Prostate Cancer. The results from these trials will assist in clarifying any potential benefits of prostate cancer screening in men under age 75.
The recommendation and evidence summary can be found in the August 5 issue of the Annals of Internal Medicine.
Task Force Advises Against Prostate Cancer Screening for Men Over 75
The U.S. Preventive Services Task Force has announced a new recommendation that men age 75 and older should not be screened for prostate cancer. In addition, younger men are advised to discuss the benefits and harms of the prostate specific antigen (PSA) test with their healthcare providers before being tested.
The Task Force recommendations are supported by findings that screening for prostate cancer offers few health benefits and can lead to considerable health problems such as erectile dysfunction, urinary incontinence, bowel dysfunction, and death for men age 75 and older, in addition to experiencing the pain and discomfort associated with prostate biopsy.
The panel found that some men with prostate cancer who receive treatment would never have developed symptoms related to cancer during their entire lifetime. Others have suffered psychological effects from false-positive test results. For men under the age of 75, the group has concluded that evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening.
Prostate cancer is the most common non-skin cancer and the second leading cause of cancer death in men in the United States. There were an estimated 218,890 men were diagnosed with the disease in 2007 within the U.S. It is also estimated that one in six men will be diagnosed with the disease within his lifetime. Older men, African-American men, and men with a family history of prostate cancer are at increased risk for developing prostate cancer.
The most common screening methods used to detect prostate cancer are PSA tests and digital rectal exams. The PSA test is the more accurate detection method of the two. However, cancers detected by a PSA test take years to affect a patient's health. It can take more than 10 years for cases to become serious enough to become terminal. Because a man who is 75years of age has an average life expectancy of approximately 10 years, he will be more likely to die from conditions such as heart disease or stroke than from prostate cancer. This would make a prostate cancer screening highly unlikely to prove beneficial for men over 75, yet currently, one-third of all men in the United States over 75 are receiving PSA testing. Additionally, men younger than 75 who suffer from chronic medical problems and have a life expectancy of less than 10 years are also unlikely to benefit from the cancer screening.
Task Force Chair Ned Calonge, M.D., M.P.H., chief medical officer for the Colorado Department of Public Health and Environment, said, "Because many prostate cancers grow slowly, early detection may not benefit a patient's health and in some cases may even cause harm." Calonge also noted, "We encourage men younger than 75 to discuss with their clinicians the potential-but uncertain-benefits and the possible harms of getting the PSA test before they decide to be screened."
The Task Force is the leading independent panel of experts in prevention and primary care and the group is the first to identify a precise age cutoff at which screenings become ineffective or detrimental. Recommendations by the task force are considered the gold standard for clinical preventive services.
There are currently clinical trials underway including the National Cancer Institute's Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial and the European Study of Screening for Prostate Cancer. The results from these trials will assist in clarifying any potential benefits of prostate cancer screening in men under age 75.
The recommendation and evidence summary can be found in the August 5 issue of the Annals of Internal Medicine.
The Task Force recommendations are supported by findings that screening for prostate cancer offers few health benefits and can lead to considerable health problems such as erectile dysfunction, urinary incontinence, bowel dysfunction, and death for men age 75 and older, in addition to experiencing the pain and discomfort associated with prostate biopsy.
The panel found that some men with prostate cancer who receive treatment would never have developed symptoms related to cancer during their entire lifetime. Others have suffered psychological effects from false-positive test results. For men under the age of 75, the group has concluded that evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening.
Prostate cancer is the most common non-skin cancer and the second leading cause of cancer death in men in the United States. There were an estimated 218,890 men were diagnosed with the disease in 2007 within the U.S. It is also estimated that one in six men will be diagnosed with the disease within his lifetime. Older men, African-American men, and men with a family history of prostate cancer are at increased risk for developing prostate cancer.
The most common screening methods used to detect prostate cancer are PSA tests and digital rectal exams. The PSA test is the more accurate detection method of the two. However, cancers detected by a PSA test take years to affect a patient's health. It can take more than 10 years for cases to become serious enough to become terminal. Because a man who is 75years of age has an average life expectancy of approximately 10 years, he will be more likely to die from conditions such as heart disease or stroke than from prostate cancer. This would make a prostate cancer screening highly unlikely to prove beneficial for men over 75, yet currently, one-third of all men in the United States over 75 are receiving PSA testing. Additionally, men younger than 75 who suffer from chronic medical problems and have a life expectancy of less than 10 years are also unlikely to benefit from the cancer screening.
Task Force Chair Ned Calonge, M.D., M.P.H., chief medical officer for the Colorado Department of Public Health and Environment, said, "Because many prostate cancers grow slowly, early detection may not benefit a patient's health and in some cases may even cause harm." Calonge also noted, "We encourage men younger than 75 to discuss with their clinicians the potential-but uncertain-benefits and the possible harms of getting the PSA test before they decide to be screened."
The Task Force is the leading independent panel of experts in prevention and primary care and the group is the first to identify a precise age cutoff at which screenings become ineffective or detrimental. Recommendations by the task force are considered the gold standard for clinical preventive services.
There are currently clinical trials underway including the National Cancer Institute's Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial and the European Study of Screening for Prostate Cancer. The results from these trials will assist in clarifying any potential benefits of prostate cancer screening in men under age 75.
The recommendation and evidence summary can be found in the August 5 issue of the Annals of Internal Medicine.
Calling All Men 40-49: Don't Forget That Prostate Test
According to a group of researchers, one-fifth of young men aged 40 to 49 reported having had a prostate-specific antigen (PSA) test within the last year. Although young, black, non-Hispanic men are more likely than young, white, non-Hispanic men to report having a PSA test, the screening rates in this high-risk group of black men are still considered less than optimal.
Lead author Dr. Charles Scales from Duke University in Durham, North Carolina and colleagues used the 2002 Behavioral Risk Factor Surveillance System to study prostate-cancer screening in a group of 58,511 men aged 40 years and older. The men did self-reports of a PSA test in the previous year."Our findings provide an important baseline assessment of PSA test use among young men as physicians debate whether to expand use of the PSA test in young men with risk-stratification strategies," Dr. Scales said in statement.
Only 22.5 percent of men aged 40 to 49 years reported having had a PSA test in the previous year, compared with 53.7 percent of men aged 50 years or older. Black men in there forties were found to be 2.4 times more likely to have a PSA test than white men, yet only 33.6 percent of them reportedly have the test and the group is at higher risk for prostate cancer. For young men an annual household income of $35,000 or more plus an ongoing relationship with a physician and the presence of health care coverage were associated with the PSA testing.
"Our findings for black men are discouraging," commented Judd W. Moul, M.D., a co-author who is also from Duke University in Durham, North Carolina, in a written statement. "We've been encouraging black men to get screened at age 40 or 45 for more than a decade, yet only one-third of these high-risk men reported being tested."
Blood levels of the protein PSA usually rise when a man has prostate cancer, so PSA testing is often used to screen for the disease. However, experts are in disagreement as to the use of PSA tests for cancer-risk stratification in young men in the United States. Little is known about the use of PSA testing in these men.
The U.S. Preventive Health Service Task Force has recently recommended that men discuss PSA screening for prostate cancer with their physician beginning at age 50. However, the American Cancer Society recommends screening at age 45 for African American men, or earlier if there is a strong family history. The Task Force says there is not enough evidence of benefit, compared with risk, to make such a recommendation.
The authors did acknowledge several limitations of the study including reliance on self-reporting, inability to determine whether PSA tests were performed for reasons other than cancer diagnosis, absence of information about family history, and no data on screening in men younger than 40.
In an accompanying editorial, urologist Robert Nadler, M.D., of Northwestern University in Chicago, said the Duke study adds to existing evidence that serial PSAs starting at age 40 years will allow practicing clinicians to determine which patients are at higher risk for developing prostate cancer and, specifically, allow clinicians to calculate and follow the PSA velocity initially at a time when BPH is less prevalent and PSA more predictive of cancer. This, in turn, should allow for early detection in young men, who should benefit the most.
The new study can be found in the online journal Cancer.
Lead author Dr. Charles Scales from Duke University in Durham, North Carolina and colleagues used the 2002 Behavioral Risk Factor Surveillance System to study prostate-cancer screening in a group of 58,511 men aged 40 years and older. The men did self-reports of a PSA test in the previous year."Our findings provide an important baseline assessment of PSA test use among young men as physicians debate whether to expand use of the PSA test in young men with risk-stratification strategies," Dr. Scales said in statement.
Only 22.5 percent of men aged 40 to 49 years reported having had a PSA test in the previous year, compared with 53.7 percent of men aged 50 years or older. Black men in there forties were found to be 2.4 times more likely to have a PSA test than white men, yet only 33.6 percent of them reportedly have the test and the group is at higher risk for prostate cancer. For young men an annual household income of $35,000 or more plus an ongoing relationship with a physician and the presence of health care coverage were associated with the PSA testing.
"Our findings for black men are discouraging," commented Judd W. Moul, M.D., a co-author who is also from Duke University in Durham, North Carolina, in a written statement. "We've been encouraging black men to get screened at age 40 or 45 for more than a decade, yet only one-third of these high-risk men reported being tested."
Blood levels of the protein PSA usually rise when a man has prostate cancer, so PSA testing is often used to screen for the disease. However, experts are in disagreement as to the use of PSA tests for cancer-risk stratification in young men in the United States. Little is known about the use of PSA testing in these men.
The U.S. Preventive Health Service Task Force has recently recommended that men discuss PSA screening for prostate cancer with their physician beginning at age 50. However, the American Cancer Society recommends screening at age 45 for African American men, or earlier if there is a strong family history. The Task Force says there is not enough evidence of benefit, compared with risk, to make such a recommendation.
The authors did acknowledge several limitations of the study including reliance on self-reporting, inability to determine whether PSA tests were performed for reasons other than cancer diagnosis, absence of information about family history, and no data on screening in men younger than 40.
In an accompanying editorial, urologist Robert Nadler, M.D., of Northwestern University in Chicago, said the Duke study adds to existing evidence that serial PSAs starting at age 40 years will allow practicing clinicians to determine which patients are at higher risk for developing prostate cancer and, specifically, allow clinicians to calculate and follow the PSA velocity initially at a time when BPH is less prevalent and PSA more predictive of cancer. This, in turn, should allow for early detection in young men, who should benefit the most.
The new study can be found in the online journal Cancer.
Hair Restoration Treatments: Hope or Hype?
Both men and women tend to lose hair thickness and amount as they age. Inherited or "pattern baldness" affects more men than women. Approximately 25 percent of men begin to bald by the time they are 30 years old, and about two-thirds are either bald or have a balding pattern by age 60. Women, on the other hand, generally have diffuse thinning that affects all parts of the scalp. In this situation, much of the hair remains, but the thickness of the hair shaft is smaller than normal.
There are a number of treatment options available designed to re-grow hair and to replace hair that's already been lost. Currently in the United States, there are more than 2,000 topical and oral products, about five surgical procedures and several hair restoration devices, but only a few that actually work. Out of all the topical and oral treatments available, only two are approved by the Food and Drug Administration (FDA). They are Propecia and Rogaine.
Propecia is an oral medication; its chemical name is Finasteride. It was developed nearly 40 years ago as a treatment for prostate hypertrophy (extended prostate). However, users found that the hair in their crown and bridge areas of their scalps was getting thicker, and they weren't losing hair at the same rate they once were. Propecia is known as a DHT-inhibitor, actually slowing or halting the conversion of testosterone into di-hydrotestosterone (DHT), a hormone that shrinks hair follicles as men age. Because DHT is known to be the primary cause of male-pattern baldness, stopping the conversion of DHT allows genetically susceptible hair follicles to remain intact, and in some cases increase in size. The side effects of Propecia are minimal and can include a reduced desire for sex (1% chance) and possible breast enlargement (less than .25% chance).
Rogaine is a topical treatment, the latest version being foam. Its active ingredient is Minoxidil, which was originally developed as a product to control blood pressure. But users found that they were growing hair in areas where hair didn't previously exist. Minoxidil comes in a number of strengths: the maximum non-prescription strength of five percent usually recommended for men, two percent formula recommended for women and prescription strength 12 ½ percent, which is seldom used.
Rogaine is a hair growth stimulator, meaning that when it is effectively applied to the scalp, it absorbs into the skin where it increases blood flow to the tissue and hair follicles underneath. It primarily benefits the crown and bridge area of the scalp, but some users have seen minimal benefit in the front and along the hairline. Rogaine is approved for use by men and women. It must be used twice a day, EVERY day. When used as directed, Rogaine has been reported to work in 60-70 percent of cases. Skin irritation is a side-effect and primary frustration for users.
Lasers are used with great success in a variety of medical specialties, but what about in improving hair density? The concept is simple; low-level lasers are known to increase blood flow to underlying tissue and can stimulate natural processes beneath the skin. If lasers are effective in stimulating blood flow to hair follicles and accelerating the hormonal process of hair regrowth, users should be able to realize slightly thicker hair and possibly more hair on the scalp at any given time.
In addition to the in-office laser treatment, there is a "laser comb" device that has been approved by the FDA. Reportedly, the laser comb, when brushed through the hair and over the scalp, administers phototherapy to the scalp. A six-month study reviewed by the FDA shows that men who used the comb grew an average of 19 more ‘thick' hairs per square centimeter than those who used sham devices. There are a variety of laser combs on the market, all for use three times per week. Prices range from $395 to $545, depending on the version.
Electro-magnetic stimulators claim to actually stimulate the hormones responsible for hair growth into growing new hairs in follicles that have long stopped. Small, acupuncture-type needles are injected into the areas of the scalp with thinning and loss. When the device is activated, slight electro-magnetic pulses are transmitted into the scalp. Supposedly, over time, the hormones responsible for hair growth and ultimately new hair are reactivated. While the product is receiving a lot of attention, there is virtually no clinical data to support its claims and very few medical doctors take it seriously.
Surgical hair transplantation is the fastest growing cosmetic surgery today. There are currently a few surgical procedures available: the ‘donor strip' hair transplant, ‘follicle unit extraction', and scalp reduction.
The donor strip method is the most commonly used, provides the best results and is considered the only viable surgical treatment by over 95 percent of hair restoration surgeons in the United States. The surgeon first removes a section of hair-bearing skin from the back of the head, right around the base of the skull. The removal area is sutured together, leaving a thin scar blended into the hair in the back of the head. The follicular units are extracted and placed in cool saline solution. Then, small incisions are made in the areas of thinning and loss and one-by-one the follicular units are implanted.
Follicular Unit Extraction is just that; instead of making an incision in the back of the head, each individual follicular unit is removed with a punch blade and then relocated to the areas of thinning and loss, all in one step. Unfortunately, it isn't as simple as it sounds. First of all, hair follicles do not grow straight up and down beneath the skin; they grow at angles. Not only that, but each follicle can be at a dramatically different angle than the follicle next to it. Clinical studies have shown that 25-40 percent of all follicular units being extracted are destroyed, simply cut in half. In addition, the punch blade will leave multiple scars throughout the donor area. Bottom line: follicular unit extraction procedures cost more, result in less density and compromise the donor area. This is why few surgeons employ this technique, and respected names in hair restoration caution against it.
Scalp reduction surgery involves removing an area of the scalp, eliminating part of the area affected by hair loss. The result can be a reduced bald spot and greater coverage by surrounding hair-bearing skin as it is pulled towards the spot where the skin was removed. However, there are risks associated with this procedure. Stretching is a likely possibility since the resulting scar has a great deal of tension on it. Another possibility is traction alopecia, which is the permanent hair loss caused by great stress on hair follicles. Also, reduction in scalp elasticity from a scalp reduction can compromise future hair transplant procedures.
The cost for hair transplant surgery? The average procedure is about $5,200, and depending upon the procedure, could rise to $10,000 or more.
If you are experiencing hair loss, only you can judge the procedure that is right for you. Be sure to do your homework and keep in mind the relative risks and benefits of each procedure.
There are a number of treatment options available designed to re-grow hair and to replace hair that's already been lost. Currently in the United States, there are more than 2,000 topical and oral products, about five surgical procedures and several hair restoration devices, but only a few that actually work. Out of all the topical and oral treatments available, only two are approved by the Food and Drug Administration (FDA). They are Propecia and Rogaine.
Propecia is an oral medication; its chemical name is Finasteride. It was developed nearly 40 years ago as a treatment for prostate hypertrophy (extended prostate). However, users found that the hair in their crown and bridge areas of their scalps was getting thicker, and they weren't losing hair at the same rate they once were. Propecia is known as a DHT-inhibitor, actually slowing or halting the conversion of testosterone into di-hydrotestosterone (DHT), a hormone that shrinks hair follicles as men age. Because DHT is known to be the primary cause of male-pattern baldness, stopping the conversion of DHT allows genetically susceptible hair follicles to remain intact, and in some cases increase in size. The side effects of Propecia are minimal and can include a reduced desire for sex (1% chance) and possible breast enlargement (less than .25% chance).
Rogaine is a topical treatment, the latest version being foam. Its active ingredient is Minoxidil, which was originally developed as a product to control blood pressure. But users found that they were growing hair in areas where hair didn't previously exist. Minoxidil comes in a number of strengths: the maximum non-prescription strength of five percent usually recommended for men, two percent formula recommended for women and prescription strength 12 ½ percent, which is seldom used.
Rogaine is a hair growth stimulator, meaning that when it is effectively applied to the scalp, it absorbs into the skin where it increases blood flow to the tissue and hair follicles underneath. It primarily benefits the crown and bridge area of the scalp, but some users have seen minimal benefit in the front and along the hairline. Rogaine is approved for use by men and women. It must be used twice a day, EVERY day. When used as directed, Rogaine has been reported to work in 60-70 percent of cases. Skin irritation is a side-effect and primary frustration for users.
Lasers are used with great success in a variety of medical specialties, but what about in improving hair density? The concept is simple; low-level lasers are known to increase blood flow to underlying tissue and can stimulate natural processes beneath the skin. If lasers are effective in stimulating blood flow to hair follicles and accelerating the hormonal process of hair regrowth, users should be able to realize slightly thicker hair and possibly more hair on the scalp at any given time.
In addition to the in-office laser treatment, there is a "laser comb" device that has been approved by the FDA. Reportedly, the laser comb, when brushed through the hair and over the scalp, administers phototherapy to the scalp. A six-month study reviewed by the FDA shows that men who used the comb grew an average of 19 more ‘thick' hairs per square centimeter than those who used sham devices. There are a variety of laser combs on the market, all for use three times per week. Prices range from $395 to $545, depending on the version.
Electro-magnetic stimulators claim to actually stimulate the hormones responsible for hair growth into growing new hairs in follicles that have long stopped. Small, acupuncture-type needles are injected into the areas of the scalp with thinning and loss. When the device is activated, slight electro-magnetic pulses are transmitted into the scalp. Supposedly, over time, the hormones responsible for hair growth and ultimately new hair are reactivated. While the product is receiving a lot of attention, there is virtually no clinical data to support its claims and very few medical doctors take it seriously.
Surgical hair transplantation is the fastest growing cosmetic surgery today. There are currently a few surgical procedures available: the ‘donor strip' hair transplant, ‘follicle unit extraction', and scalp reduction.
The donor strip method is the most commonly used, provides the best results and is considered the only viable surgical treatment by over 95 percent of hair restoration surgeons in the United States. The surgeon first removes a section of hair-bearing skin from the back of the head, right around the base of the skull. The removal area is sutured together, leaving a thin scar blended into the hair in the back of the head. The follicular units are extracted and placed in cool saline solution. Then, small incisions are made in the areas of thinning and loss and one-by-one the follicular units are implanted.
Follicular Unit Extraction is just that; instead of making an incision in the back of the head, each individual follicular unit is removed with a punch blade and then relocated to the areas of thinning and loss, all in one step. Unfortunately, it isn't as simple as it sounds. First of all, hair follicles do not grow straight up and down beneath the skin; they grow at angles. Not only that, but each follicle can be at a dramatically different angle than the follicle next to it. Clinical studies have shown that 25-40 percent of all follicular units being extracted are destroyed, simply cut in half. In addition, the punch blade will leave multiple scars throughout the donor area. Bottom line: follicular unit extraction procedures cost more, result in less density and compromise the donor area. This is why few surgeons employ this technique, and respected names in hair restoration caution against it.
Scalp reduction surgery involves removing an area of the scalp, eliminating part of the area affected by hair loss. The result can be a reduced bald spot and greater coverage by surrounding hair-bearing skin as it is pulled towards the spot where the skin was removed. However, there are risks associated with this procedure. Stretching is a likely possibility since the resulting scar has a great deal of tension on it. Another possibility is traction alopecia, which is the permanent hair loss caused by great stress on hair follicles. Also, reduction in scalp elasticity from a scalp reduction can compromise future hair transplant procedures.
The cost for hair transplant surgery? The average procedure is about $5,200, and depending upon the procedure, could rise to $10,000 or more.
If you are experiencing hair loss, only you can judge the procedure that is right for you. Be sure to do your homework and keep in mind the relative risks and benefits of each procedure.
High Blood Calcium Levels Put Men at Greater Risk For Fatal Prostate Cancer
Prostate cancer is the second most common form of cancer in men, with about 780,000 men being diagnosed annually. It is the sixth mostly deadly form of cancer in men, causing approximately 250,000 deaths annually, according to the American Cancer Society. For years, doctors have searched for ways to predict whether prostate cancer patients will develop a tumor of little threat, or one that will become fatal. Although blood calcium has not been found to be very predictive of whether a man will get non-lethal prostate cancer, it has been found in a recent study to be very indicative of those men who will develop fatal prostate cancer tumors.
According to the new study published by U.S. researchers, the findings suggest that the use of a simple blood test can assist in identifying men who are at elevated risk for the development of potentially fatal prostate tumors. Once identified, these men can be treated with readily available drugs that decrease calcium levels in the bloodstream including Fontus Pharmaceuticals Incorporated's Rocaltrol, also called calcitriol; Genzyme Corporation's Hectorol (doxercalciferol); Abbott Laboratories' Zemplar (paricalcitol); and Amgen Incorporated's Sensipar (cinacalcet).
The researchers followed 2,814 men in who participated in the National Health and Nutrition Examination Survey (NHANES) and the NHANES Epidemiologic Follow-up Study. The men gave blood samples that revealed calcium levels that showed a direct link between the levels and the risk of fatal prostate cancer.
The research group found that men in the top one-third of high blood calcium levels were 2.68 times more likely to develop fatal prostate cancer in their lifetime when compared to men in the group who were in the bottom one-third. The percentage of those with the highest calcium levels and greatest risk for developing prostate cancer was found to be comparable in magnitude with the risk associated with family history.
A total of 85 cases of prostate cancer and 25 prostate cancer deaths occurred throughout the years of study follow-up (46,188 person-years). The blood samples given by participants were given, on average, about a decade before the cancer appeared.
Gary Schwartz of Wake Forest University School of Medicine, who helped lead the study, said in a telephone interview, "If serum calcium really does increase your risk for fatal prostate cancer, that's wonderfully exciting because serum calcium levels can be changed." Schwartz also added, "One way to think of it is to think of the tremendous advances in the control of cardiovascular disease that occur from understanding that things like serum cholesterol predict heart attack."
Schwartz noted that it is unclear whether actual calcium blood levels or blood levels of parathyroid hormone, which performs the function of keeping calcium levels in the body at normal levels in the bloodstream that increases the risk for prostate cancer. He explained that people who are treated for high blood calcium commonly have chronic kidney disease, which is associated with low vitamin D levels. Low vitamin D levels elevate parathyroid hormone levels.
Another researcher, Halcyon Skinner of the University of Wisconsin, said there is little relationship between calcium in the diet and blood calcium levels. Therefore, men at greater risk for prostate cancer would not benefit from eating less calcium rich food.
The findings of the study appear in the American Association for Cancer Research's journal Cancer Epidemiology, Biomarkers & Prevention.
According to the new study published by U.S. researchers, the findings suggest that the use of a simple blood test can assist in identifying men who are at elevated risk for the development of potentially fatal prostate tumors. Once identified, these men can be treated with readily available drugs that decrease calcium levels in the bloodstream including Fontus Pharmaceuticals Incorporated's Rocaltrol, also called calcitriol; Genzyme Corporation's Hectorol (doxercalciferol); Abbott Laboratories' Zemplar (paricalcitol); and Amgen Incorporated's Sensipar (cinacalcet).
The researchers followed 2,814 men in who participated in the National Health and Nutrition Examination Survey (NHANES) and the NHANES Epidemiologic Follow-up Study. The men gave blood samples that revealed calcium levels that showed a direct link between the levels and the risk of fatal prostate cancer.
The research group found that men in the top one-third of high blood calcium levels were 2.68 times more likely to develop fatal prostate cancer in their lifetime when compared to men in the group who were in the bottom one-third. The percentage of those with the highest calcium levels and greatest risk for developing prostate cancer was found to be comparable in magnitude with the risk associated with family history.
A total of 85 cases of prostate cancer and 25 prostate cancer deaths occurred throughout the years of study follow-up (46,188 person-years). The blood samples given by participants were given, on average, about a decade before the cancer appeared.
Gary Schwartz of Wake Forest University School of Medicine, who helped lead the study, said in a telephone interview, "If serum calcium really does increase your risk for fatal prostate cancer, that's wonderfully exciting because serum calcium levels can be changed." Schwartz also added, "One way to think of it is to think of the tremendous advances in the control of cardiovascular disease that occur from understanding that things like serum cholesterol predict heart attack."
Schwartz noted that it is unclear whether actual calcium blood levels or blood levels of parathyroid hormone, which performs the function of keeping calcium levels in the body at normal levels in the bloodstream that increases the risk for prostate cancer. He explained that people who are treated for high blood calcium commonly have chronic kidney disease, which is associated with low vitamin D levels. Low vitamin D levels elevate parathyroid hormone levels.
Another researcher, Halcyon Skinner of the University of Wisconsin, said there is little relationship between calcium in the diet and blood calcium levels. Therefore, men at greater risk for prostate cancer would not benefit from eating less calcium rich food.
The findings of the study appear in the American Association for Cancer Research's journal Cancer Epidemiology, Biomarkers & Prevention.
Common Pain Killers Can Mask Signs of Prostate Cancer
Common painkillers taken on a regular basis, such as ibuprofen and aspirin, appear to lower a man's PSA level, the blood biomarker used by doctors to help gauge whether a man is at a risk of getting prostate cancer.
The authors of this new study, however, caution that men should not take the painkillers in an effort to prevent prostate cancer. An author on this study Eric A Singer M.D., M.A., a urology resident at the University of Rochester Medical Center, said, "We showed that men who regularly took certain medications like aspirin and other non-steroidal anti-inflammatory drugs, or NSAIDS, had a lower serum PSA level.... But there's not enough data to say that men who took the medications were less likely to get prostate cancer. This was a limited study, and we do not know how many of those men actually got prostate cancer."
Singer and his team studind the records of approximately 1,319 men that were over the age of 40 who took part in the National Health and Nutrition Examination Survey between the years 2001 and 2002. Singer's team looked at the men's use of NSAIDs such as ibuprofen and aspirin, as well as acetaminophen, and they looked at their PSA levels. The level of a man's PSA, or prostate-specific antigen, is one of the numerous clues that doctors watch to gauge the risk a man has of getting prostate cancer.
The researchers found that men who did use NSAIDs on a regular basis had PSA levels that were about 10 percent lower than the men who did not use them. The team then made a similar observation with the pain killer acetaminophen, but the result was not statistically significant due to the lower number of men in the study that were taking that medication.
While it might be easily assumed that if you have lower PSA levels that this automatically translates to a low risk of getting prostate cancer, the authors stress that it is still too soon to draw that kind of conclusion. The corresponding author of the study Edwin van Wijngaarden, Ph.D., and the assistant professor in the Department of Community and Preventative Medicine states that while the results of this study are consistent with other research, and indicates that certain commonly used painkillers may reduce a man's risk of getting prostate cancer, the new findings are just preliminary and do not prove a link.
Singer stated that the PSA level of a man can be elevated for many reasons that are unrelated to cancer. For instance, while inflammation is a part of cancer, sometimes it may not be, and so it is possible that the lowered level of PSA reflects the reduction of inflammation without affecting a man's risk of getting prostate cancer. Also, another possibility is that a PSA level that this lowered by taking NSAIDs might artificially mask a man's risk of contracting prostate cancer. The pain medications could lower the PSA, but a man's risk might stay the exact same.
Singer says, "More than anything, these findings underscore the importance for doctors to know what medications their patients are on. For instance, there are medications commonly used to treat an enlarged prostate that can result in a decreased PSA, and most physicians know that. Doctors should also be asking about patients' use of NSAIDs such as aspirin and ibuprofen."
The data is said to show much interest, but it will take more research to determine how to interpret all the findings. In the meantime, these findings should not change men's behavior and prompt them to take these pain medications to try and prevent themselves from getting prostate cancer.
The authors of this new study, however, caution that men should not take the painkillers in an effort to prevent prostate cancer. An author on this study Eric A Singer M.D., M.A., a urology resident at the University of Rochester Medical Center, said, "We showed that men who regularly took certain medications like aspirin and other non-steroidal anti-inflammatory drugs, or NSAIDS, had a lower serum PSA level.... But there's not enough data to say that men who took the medications were less likely to get prostate cancer. This was a limited study, and we do not know how many of those men actually got prostate cancer."
Singer and his team studind the records of approximately 1,319 men that were over the age of 40 who took part in the National Health and Nutrition Examination Survey between the years 2001 and 2002. Singer's team looked at the men's use of NSAIDs such as ibuprofen and aspirin, as well as acetaminophen, and they looked at their PSA levels. The level of a man's PSA, or prostate-specific antigen, is one of the numerous clues that doctors watch to gauge the risk a man has of getting prostate cancer.
The researchers found that men who did use NSAIDs on a regular basis had PSA levels that were about 10 percent lower than the men who did not use them. The team then made a similar observation with the pain killer acetaminophen, but the result was not statistically significant due to the lower number of men in the study that were taking that medication.
While it might be easily assumed that if you have lower PSA levels that this automatically translates to a low risk of getting prostate cancer, the authors stress that it is still too soon to draw that kind of conclusion. The corresponding author of the study Edwin van Wijngaarden, Ph.D., and the assistant professor in the Department of Community and Preventative Medicine states that while the results of this study are consistent with other research, and indicates that certain commonly used painkillers may reduce a man's risk of getting prostate cancer, the new findings are just preliminary and do not prove a link.
Singer stated that the PSA level of a man can be elevated for many reasons that are unrelated to cancer. For instance, while inflammation is a part of cancer, sometimes it may not be, and so it is possible that the lowered level of PSA reflects the reduction of inflammation without affecting a man's risk of getting prostate cancer. Also, another possibility is that a PSA level that this lowered by taking NSAIDs might artificially mask a man's risk of contracting prostate cancer. The pain medications could lower the PSA, but a man's risk might stay the exact same.
Singer says, "More than anything, these findings underscore the importance for doctors to know what medications their patients are on. For instance, there are medications commonly used to treat an enlarged prostate that can result in a decreased PSA, and most physicians know that. Doctors should also be asking about patients' use of NSAIDs such as aspirin and ibuprofen."
The data is said to show much interest, but it will take more research to determine how to interpret all the findings. In the meantime, these findings should not change men's behavior and prompt them to take these pain medications to try and prevent themselves from getting prostate cancer.
HIV Takes Heaviest Toll on African Americans, Especially Young Gay Males
There are 33 million people infected with the human immunodeficiency virus (HIV) worldwide with 25 million lives having been claimed by it. There is still no cure and no vaccine available for the prevention of HIV although there are drugs that can help control the infection.
The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). The AIDS virus is transmitted in bodily fluids such as blood, semen and breast milk with sexual contact being the most common method of transmission. The use of contaminated needles and blood transfusions can also cause infection.
Recently, the U.S. Centers for Disease Control and Prevention (CDC) reported that 56,300 people in the U.S. become infected with HIV annually, which far surpasses previous estimates of about 40,000. The CDC has now found that HIV has the heaviest impact on men who have sex with men (MSM). This group of men includes gays, bisexuals and men who have an occasional sexual encounter with other men.
In a new report from the CDC the authors write, “The male-to-male sexual contact transmission category represented 72 percent of new infections among males, including 81 percent of new infections among whites, 63 percent among blacks, and 72 percent among Hispanics.” The report explains that more than half of the new infections in 2006 were among gay and bisexual men, with 46 percent among whites, 35 percent among blacks and 19 percent in Hispanics. However, among the overall U.S. population, more blacks are affected at more than 45 percent.
Kevin Fenton, MD, PhD, director of the CDC's division of HIV/AIDS, said at a news conference, “The number of new HIV infections among young black men who have sex with men is alarming.” Similarly, Richard Wolitski, PhD, acting director of the CDC's division of HIV/AIDS Prevention said that the astonishingly heavy impact of HIV on African-American women is no less alarming.
The CDC now sees the need to intensify prevention efforts targeting the black community as the report read, “The alarming number of new infections among young black MSM underscores the need to ensure that each new generation has the knowledge and skills to prevent HIV infection beginning early in their lives.” Additionally, the CDC wrote, “African-Americans make up 12 percent of the total U.S. population, yet represented 45 percent of new HIV infections in the United States in 2006.”
Other findings listed in the report include that 27 percent of new infections are among girls and women with high-risk sexual contact with men, which causes 80 percent of new infections. The authors also noted, “Among females, 61 percent of infections were in blacks, 23 percent were in whites, and 16 percent were in Hispanics.”
The bottom line of the facts are that young black men, ages 13 to 29, who have sex with men get HIV more often than any other age or racial group and African-American men are six times more likely to get HIV than are white men. In addition, African-American women are 15 times more likely to get HIV than white women.
The new CDC report was published in the Sept. 12 issue of Morbidity and Mortality Weekly Report.
The last stage of HIV infection is AIDS (acquired immunodeficiency syndrome). The AIDS virus is transmitted in bodily fluids such as blood, semen and breast milk with sexual contact being the most common method of transmission. The use of contaminated needles and blood transfusions can also cause infection.
Recently, the U.S. Centers for Disease Control and Prevention (CDC) reported that 56,300 people in the U.S. become infected with HIV annually, which far surpasses previous estimates of about 40,000. The CDC has now found that HIV has the heaviest impact on men who have sex with men (MSM). This group of men includes gays, bisexuals and men who have an occasional sexual encounter with other men.
In a new report from the CDC the authors write, “The male-to-male sexual contact transmission category represented 72 percent of new infections among males, including 81 percent of new infections among whites, 63 percent among blacks, and 72 percent among Hispanics.” The report explains that more than half of the new infections in 2006 were among gay and bisexual men, with 46 percent among whites, 35 percent among blacks and 19 percent in Hispanics. However, among the overall U.S. population, more blacks are affected at more than 45 percent.
Kevin Fenton, MD, PhD, director of the CDC's division of HIV/AIDS, said at a news conference, “The number of new HIV infections among young black men who have sex with men is alarming.” Similarly, Richard Wolitski, PhD, acting director of the CDC's division of HIV/AIDS Prevention said that the astonishingly heavy impact of HIV on African-American women is no less alarming.
The CDC now sees the need to intensify prevention efforts targeting the black community as the report read, “The alarming number of new infections among young black MSM underscores the need to ensure that each new generation has the knowledge and skills to prevent HIV infection beginning early in their lives.” Additionally, the CDC wrote, “African-Americans make up 12 percent of the total U.S. population, yet represented 45 percent of new HIV infections in the United States in 2006.”
Other findings listed in the report include that 27 percent of new infections are among girls and women with high-risk sexual contact with men, which causes 80 percent of new infections. The authors also noted, “Among females, 61 percent of infections were in blacks, 23 percent were in whites, and 16 percent were in Hispanics.”
The bottom line of the facts are that young black men, ages 13 to 29, who have sex with men get HIV more often than any other age or racial group and African-American men are six times more likely to get HIV than are white men. In addition, African-American women are 15 times more likely to get HIV than white women.
The new CDC report was published in the Sept. 12 issue of Morbidity and Mortality Weekly Report.
Limiting Iced Tea May Limit Kidney Stones in Men
Lipton lovers, beware! With gallons guzzled throughout the year and a guaranteed summer heat-beater, iced tea is the go-to refreshing soda substitute for many. With over 80 percent of the tea drank in the United States each year being iced tea, its popularity is growing with new tea infusions and more bottles being produced to keep up with demand. However, men need to beware, as new evidence suggests that iced tea can make them at higher risk for kidney stones. Lemonade, anyone?
The demographic being targeted for this new study are men over the age of 40 who hold a higher risk for kidney stones. Kidney stones are little crystals developed in the kidneys that travel through the urinary tract into the bladder causing extreme pain. Side effects of a kidney stone can include nausea and vomiting as well as added kidney pressure depending on the size and length of time it stays within the body blocking the flow of urine. Kidney stones affect about 10 percent of the population and while women aren’t immune, men are four times more at risk of developing them.
A recent news release by Loyola University Chicago Stritch School of Medicine’s urology department delved into the occurrence of Oxalate, a main chemical ingredient in the formation of stones within the kidneys, is also highly concentrated within iced tea. An instructor at Loyola, John Milner said, “For many people, iced tea is potentially one of the worst things they can drink and for people who have a tendency to form kidney stones, it's definitely one of the worst things you can drink." Experts contend that water is the best substance to drink to stave off dehydration, but if you’re looking for a little flavor, add a slice of lemons or simply make lemonade to jumpstart your taste buds. Milner continues his observations and explains why lemonade is a healthier alternative to iced tea, "Lemons are very high in citrates, which inhibit the growth of kidney stones," said Milner, "Lemonade, not the powdered variety that uses artificial flavoring, actually slows the development of kidney stones for those who are prone to the development of kidney stones."
Kidney stones have a higher concentration during summer months when heat and humidity are at their highest. Because dehydration is common when it’s hot out, the kidneys don’t have enough fluids to cleanse out of the body and the kidneys start slowing down causing deficiencies and a buildup of chemicals within the kidneys due to dehydration can form painful stones.
If you want to avoid kidney stones just follow these six steps to a healthier you. Keep hydrated with fluids to decrease saturation in your urine, the best fluids to drink are water and lemonade. Iced Tea and sodas are to be avoided because of their mineral (like Oxalate) content. High protein foods like spinach, nuts and rhubarb and high protein diets also contribute to stone formation, as well as an over-consumption (daily dose of over 1,000 milligrams) of vitamin C. High risk adults for kidney stones shouldn’t use large quantities of antacids. If you already have a stone or are prone to kidney stones, taking vitamin B and magnesium should help reverse the formation of new stones and lessen the pain of passing stones through your system.
Some men have likened the pain of kidney stones to child birth—and I’m sure there are women who would refute that claim—however I haven’t had the pleasure of having either a kidney stone or a child so I can’t weigh in. Even though my risk is significantly lower than the average middle-aged man, you can bet I will be refilling my water bottle and adding a lemon wedge from time to time just in case.
The demographic being targeted for this new study are men over the age of 40 who hold a higher risk for kidney stones. Kidney stones are little crystals developed in the kidneys that travel through the urinary tract into the bladder causing extreme pain. Side effects of a kidney stone can include nausea and vomiting as well as added kidney pressure depending on the size and length of time it stays within the body blocking the flow of urine. Kidney stones affect about 10 percent of the population and while women aren’t immune, men are four times more at risk of developing them.
A recent news release by Loyola University Chicago Stritch School of Medicine’s urology department delved into the occurrence of Oxalate, a main chemical ingredient in the formation of stones within the kidneys, is also highly concentrated within iced tea. An instructor at Loyola, John Milner said, “For many people, iced tea is potentially one of the worst things they can drink and for people who have a tendency to form kidney stones, it's definitely one of the worst things you can drink." Experts contend that water is the best substance to drink to stave off dehydration, but if you’re looking for a little flavor, add a slice of lemons or simply make lemonade to jumpstart your taste buds. Milner continues his observations and explains why lemonade is a healthier alternative to iced tea, "Lemons are very high in citrates, which inhibit the growth of kidney stones," said Milner, "Lemonade, not the powdered variety that uses artificial flavoring, actually slows the development of kidney stones for those who are prone to the development of kidney stones."
Kidney stones have a higher concentration during summer months when heat and humidity are at their highest. Because dehydration is common when it’s hot out, the kidneys don’t have enough fluids to cleanse out of the body and the kidneys start slowing down causing deficiencies and a buildup of chemicals within the kidneys due to dehydration can form painful stones.
If you want to avoid kidney stones just follow these six steps to a healthier you. Keep hydrated with fluids to decrease saturation in your urine, the best fluids to drink are water and lemonade. Iced Tea and sodas are to be avoided because of their mineral (like Oxalate) content. High protein foods like spinach, nuts and rhubarb and high protein diets also contribute to stone formation, as well as an over-consumption (daily dose of over 1,000 milligrams) of vitamin C. High risk adults for kidney stones shouldn’t use large quantities of antacids. If you already have a stone or are prone to kidney stones, taking vitamin B and magnesium should help reverse the formation of new stones and lessen the pain of passing stones through your system.
Some men have likened the pain of kidney stones to child birth—and I’m sure there are women who would refute that claim—however I haven’t had the pleasure of having either a kidney stone or a child so I can’t weigh in. Even though my risk is significantly lower than the average middle-aged man, you can bet I will be refilling my water bottle and adding a lemon wedge from time to time just in case.
Mixed Results on Prostate Medications Harmful Affect on Bones
Millions of men suffer each year from an enlarged prostate gland. There are multiple medications available on the market today for treatment, but what price do men pay for their use? What effects do these medications have on the health of their bones?
Some researchers have estimated that more than 8 million men in the United States between the ages of 50-79 will have to deal with an enlarged prostate gland by the year 2010. Prescription medication is the primary course of treatment. The medications that treat an enlarged prostate, or benign prostatic hyperplasia (BPH), come in two different groups: alpha blockers and 5-alpha reductase inhibitors. The medications are used to treat BPH in part by blocking testosterone from converting to dihydrotestosterone.
Steven J. Jacobsen, MD, of Kaiser Permanente Southern California, led researchers in finding out if there is any connection between the 5-alpha reductase inhibitors—such as Avodart and Proscar—and the occurrence of hip fractures. The researchers stated that other studies conducted “suggest that dihydrotestosterone might have a role in bone metabolism, but no clear evidence exists to support this theory.”
The researchers gathered information on 7,076 men that were ages 45 and older, from the year 1997 to 2006, all of which did have hip fractures. They then compared these men with another group of 7,076 similar men that did not have hip fractures.
A similar percentage of men from each of these groups had benign prostatic hyperplasia. The researchers found out that:Approximately 109 men with hip fractures had taken a 5-alpha reductase inhibitorApproximately 141 men without hip fractures had taken the same 5-alpa reductase inhibitor
The researchers concluded that the 5-alpha reductase inhibitors were not liked to an increased risk of hip fracture; instead, they may actually decrease the risk of a hip fracture.
Interestingly, the research team also found that there was a modest increase in the risk for a hip fracture in the men who took alpha-blockers (such as Cardura, Flomax, Hytrin, and Uroxatral). There was more use of alpha-blockers (32%) in the men that had hip fractures vs. the men that did not have hip fractures (30%). Since this was not the primary focus of the study, the researchers write that this information warrants further investigation.
The researchers also noted that they only studied older men and that more research need to be conducted on the long term risks of these medications in younger men.
This study appears in the October 8 issue of The Journal of the American Medical Association.
Some researchers have estimated that more than 8 million men in the United States between the ages of 50-79 will have to deal with an enlarged prostate gland by the year 2010. Prescription medication is the primary course of treatment. The medications that treat an enlarged prostate, or benign prostatic hyperplasia (BPH), come in two different groups: alpha blockers and 5-alpha reductase inhibitors. The medications are used to treat BPH in part by blocking testosterone from converting to dihydrotestosterone.
Steven J. Jacobsen, MD, of Kaiser Permanente Southern California, led researchers in finding out if there is any connection between the 5-alpha reductase inhibitors—such as Avodart and Proscar—and the occurrence of hip fractures. The researchers stated that other studies conducted “suggest that dihydrotestosterone might have a role in bone metabolism, but no clear evidence exists to support this theory.”
The researchers gathered information on 7,076 men that were ages 45 and older, from the year 1997 to 2006, all of which did have hip fractures. They then compared these men with another group of 7,076 similar men that did not have hip fractures.
A similar percentage of men from each of these groups had benign prostatic hyperplasia. The researchers found out that:Approximately 109 men with hip fractures had taken a 5-alpha reductase inhibitorApproximately 141 men without hip fractures had taken the same 5-alpa reductase inhibitor
The researchers concluded that the 5-alpha reductase inhibitors were not liked to an increased risk of hip fracture; instead, they may actually decrease the risk of a hip fracture.
Interestingly, the research team also found that there was a modest increase in the risk for a hip fracture in the men who took alpha-blockers (such as Cardura, Flomax, Hytrin, and Uroxatral). There was more use of alpha-blockers (32%) in the men that had hip fractures vs. the men that did not have hip fractures (30%). Since this was not the primary focus of the study, the researchers write that this information warrants further investigation.
The researchers also noted that they only studied older men and that more research need to be conducted on the long term risks of these medications in younger men.
This study appears in the October 8 issue of The Journal of the American Medical Association.
Stem Cells Used for Prostate Regeneration
Stem cells can generate into many types of cells in the body. In a recent study Genentech scientists in San Francisco say they have grown entire prostates in mice using only a single adult stem cell. The success of the study was made possible by identification of a genetic signature which distinguished stem cells from other cells. The information has not been confirmed in humans, but understanding normal cells should help with the understanding of how prostate cancer develops.
Some scientists consider that stem cells in normal tissues produce cancer. Study co-author Leisa Johnson, a senior scientist with Genentech said that has not been proven. Stem cells have several surface markers, but they are also on other cells, making identification difficult. The study authors found a new marker, CD117, combined with previously known prostate stem cell cancer markers. This allowed identification of a single, normal prostate stem cell. That cell was able to generate a functional prostate and was capable of renewing itself. This holds the promise of treatments and even cures for many diseases.
Johnson explained that it is important to define a normal cell compartment that can generate a tissue. Once that knowledge is available it would be able to identify the compartment that goes awry if cancer initiates. What is resistant, what is regenerating a tumor, is the same cell responsible for generation of normal tissue?
According to Paul Sanberg, professor of neurosurgery and director of the University of South Florida Center of Excellence for Aging and Brain Repair in Tampa “It’s another step showing that stem cells can be a root case of cancer, so it gives targets for treatment.”
Wei-Qiang Gao, Ph.D. also of Genentech said that same kind of cells carrying the same CD117 marker can be found in humans. According to Gao and colleagues two different research teams recently reported growing mouse mammary glands from a single stem cell. The finds add to this “hallmark advancement in the stem-cell research field.” Researchers grew their transplant cells in gel in the lab, and when the gels were placed inside the kidneys of immune-deficient mice, they grew into functional prostrate tissue.
There were 97 single cell transplants, and 14 developed functioning prostates. This may seem like a low percentage of success, but since it is the first attempt it is an extremely significant process.
Stem cells have had scientists extremely interested in recent years because of the potential to grow specific cells to replace damage or diseased tissue. The interest has also generated a lot of public controversy because the biggest focus has been on embryonic cells. Embryonic cells are “pluripotent” and can become any tissue in the body. There are “unipotent” adult stem cells which are already programmed to divide into specific cells. These were the cells used in this research. Isolating “unipotent” cells and getting them to regenerate into the desired tissue has been a major hurdle. Future medical research will show whether tailor made transplants can be grown from a patient’s own cells by using the findings of this study.
The prostate is a small gland located just below the bladder that helps make seminal fluid and expel semen. Prostate cancer is one of the most prominent cancers in developed countries. Even if non-cancerous prostates cause many medical problems for the aging male population.
Some scientists consider that stem cells in normal tissues produce cancer. Study co-author Leisa Johnson, a senior scientist with Genentech said that has not been proven. Stem cells have several surface markers, but they are also on other cells, making identification difficult. The study authors found a new marker, CD117, combined with previously known prostate stem cell cancer markers. This allowed identification of a single, normal prostate stem cell. That cell was able to generate a functional prostate and was capable of renewing itself. This holds the promise of treatments and even cures for many diseases.
Johnson explained that it is important to define a normal cell compartment that can generate a tissue. Once that knowledge is available it would be able to identify the compartment that goes awry if cancer initiates. What is resistant, what is regenerating a tumor, is the same cell responsible for generation of normal tissue?
According to Paul Sanberg, professor of neurosurgery and director of the University of South Florida Center of Excellence for Aging and Brain Repair in Tampa “It’s another step showing that stem cells can be a root case of cancer, so it gives targets for treatment.”
Wei-Qiang Gao, Ph.D. also of Genentech said that same kind of cells carrying the same CD117 marker can be found in humans. According to Gao and colleagues two different research teams recently reported growing mouse mammary glands from a single stem cell. The finds add to this “hallmark advancement in the stem-cell research field.” Researchers grew their transplant cells in gel in the lab, and when the gels were placed inside the kidneys of immune-deficient mice, they grew into functional prostrate tissue.
There were 97 single cell transplants, and 14 developed functioning prostates. This may seem like a low percentage of success, but since it is the first attempt it is an extremely significant process.
Stem cells have had scientists extremely interested in recent years because of the potential to grow specific cells to replace damage or diseased tissue. The interest has also generated a lot of public controversy because the biggest focus has been on embryonic cells. Embryonic cells are “pluripotent” and can become any tissue in the body. There are “unipotent” adult stem cells which are already programmed to divide into specific cells. These were the cells used in this research. Isolating “unipotent” cells and getting them to regenerate into the desired tissue has been a major hurdle. Future medical research will show whether tailor made transplants can be grown from a patient’s own cells by using the findings of this study.
The prostate is a small gland located just below the bladder that helps make seminal fluid and expel semen. Prostate cancer is one of the most prominent cancers in developed countries. Even if non-cancerous prostates cause many medical problems for the aging male population.
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