May 26, 2011

Prostate Cancer Angst -- Who Needs Testing?

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May 26, 2011
Bottom Line's Daily Health News
In This Issue...
  • The Surprising Truth About Why Most Women Can't Lose Weight!
  • Prostate Cancer Angst -- Who Needs Testing?
  • New Treatment Reverses 82% of Deadly Cancers... Without Chemotherapy, Radiation or Surgery
  • Is it Safe to Have Pets in Your Bed?
  • Secret to Reversing Arthritis Pain

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Prostate Cancer Angst -- Who Needs Testing?

A conversation with a male friend inspired me to conduct a review of the latest information on prostate cancer screenings -- because men still are getting conflicting information. This time around, yet another study is raising questions on the usefulness of the popular PSA test... and, as my friend said to me in frustration, what else is there for a guy who’s worried about getting prostate cancer to do? His angst is understandable -- his 52-year-old brother has been undergoing rigorous treatment for prostate cancer that was identified by a high PSA reading in a recent exam. This is not a guy who wants to hear that the test is unreliable so he shouldn’t bother getting it.

I took my friend’s question to Sheldon Marks, MD, associate professor of surgery at the University of Arizona College of Medicine and author of the book Prostate & Cancer: A Family Guide to Diagnosis, Treatment, and Survival. I asked Dr. Marks to explain what men need to know -- here’s his guidance...

Facts First

Prostate cancer is nothing to be trifled with. According to the most recent data, about 32,000 men die of it each year in the US alone. The average age men die at is 80, and 32,000 deaths is quite large enough in my view. It’s understandable, then, why men want any test that can give them an edge.

"PSA" stands for prostate-specific antigen, a protein made by the cells of the prostate gland. PSA tests measure the level of PSA in the blood -- a level of no higher than 2.5 nanograms per milliliter of blood is now considered "normal." A higher level can be a warning sign of cancer, most especially if the level is rising rapidly (known as "velocity").

The rap against having regular PSA tests is that numerous studies have demonstrated that the results aren’t all that reliable because there are many false-positives. For instance, inflammation anywhere in the pelvis can cause an elevation in PSA, as can such everyday activities as riding a bicycle and indeed any "rectal/anal trauma" (though, Dr. Marks told me, hemorrhoids don’t cause this problem). A high reading from causes other than prostate cancer can, and often does, lead to unnecessary biopsies. Not only does this create a lot of anxiety that may turn out to be unfounded, but the biopsies also have some risks (such as bleeding and infection), though typically not severe.

Back-and-Forth Findings

So now let’s take a look at the back-and-forth research findings. PSA tests became standard for men over age 50 starting in the 1990s, but a 2004 study cast doubt on the old benchmark of 4.0, showing that biopsies often detected cancer in men with a lower level of 2.5. Dr. Marks told me that most experts continue to believe that tens of thousands of lives are saved every year by PSA testing -- yet a 2009 study published in The New England Journal of Medicine showed that no fewer men were dying from prostate cancer with regular PSA screenings than without them. Then last year, a major study published in BMJ (formerly British Medical Journal) concluded that PSA levels are highly accurate predictors of prostate cancer risk in men at age 60... and now, to add further complication, a study published in the February 24, 2011, issue of the Journal of the National Cancer Institute has said that a rapid increase in PSA levels, which had been thought to be an indicator of cancer, really isn’t a reliable indicator.

What’s a Man to Do?

Be aware of your risk level. Men who are African-American and men with a family history (prostate cancer in a father, grandfather, uncle or brother) should consider themselves at high risk and should begin PSA testing at age 40 and then at the intervals their doctors recommend. Dr. Marks tests his low-risk patients at ages 45, 48 and 50, and then annually.

Calling himself a "firm believer in the power of the PSA as a useful tool," Dr. Marks told me that it’s important to understand that while an elevated PSA does not necessarily mean cancer, it does usually mean something is not right and that further urologic evaluation is appropriate. "Cancer is just one possibility—it could be enlarged prostate, a prostate infection or bladder infection," he said, noting that the problem with the PSA test is that not all doctors understand its proper use and how to appropriately interpret the number.

Dr. Marks told me that over his career he has seen significant progress in reducing the number of young men who die from prostate cancer. "It’s directly attributable to PSA testing and early detection and treatment," he said, adding that "just last week I saw a patient diagnosed 15 years ago with a very aggressive killer prostate cancer, and he looked great and was still happy, and alive! To me, the fact that some men have anxiety or stress with a biopsy is far outweighed by the dramatic benefits of saving such men’s lives. There is nothing more sad than to see a man die too young from a preventable or treatable cancer."

Source(s):

Sheldon Marks, MD, clinical associate professor of surgery, University of Arizona, clinical lecturer, department of radiation oncology, University of Arizona College of Medicine, Tucson. He is author of Prostate & Cancer: A Family Guide to Diagnosis, Treatment, and Survival, Fourth edition (DaCapo).


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Is it Safe to Have Pets in Your Bed?

My mother often warned me that "if you lie down with dogs, you get up with fleas." Of course, she was speaking metaphorically about boyfriends, but Bruno Chomel, DVM, PHD, professor in the department of population health and reproduction at the UC Davis School of Veterinary Medicine, has a more literal reading of that phrase. His recent research has shown that sleeping with pets puts you and your pet at risk for zoonoses, diseases transmitted between animal and human. "Pets in the bedroom are fine, but it’s better if they stay out of your bed," Dr. Chomel told me.

In truth, it is rare that pet owners get sick from their cats or dogs, but it can and does happen. Illnesses you can acquire this way include...

Tickborne diseases (Lyme, Babesiosis, Ehrlichiosis). Your pet may be harboring diseased ticks in its coat. When you are in close proximity, there is a danger of the ticks crawling onto you and infecting you as well. The risk is heightened if the pet is in your bed because you are spending long hours close together... plus the ticks can get into the bedding and then onto you even when the pet is not there. Tickborne disease symptoms to watch for include aches, fever, rashes and fatigue. You are at risk for infection even if your pet is asymptomatic.

Methicillin-Resistant Staphylococcus Aureus (MRSA). A dangerous bacterial infection that is resistant to most antibiotics, MRSA can be transmitted when the bacterium enters the body through a cut or sore. Pets can carry the infection on their skin or in their nostrils even when they don’t have symptoms of illness, and it can be transmitted to humans by skin-to-skin contact or face-licking and to pets by close contact with humans. If you or your pet has painful, swollen sores that have pus or other drainage, seek medical help immediately. MRSA moves very fast and, if not caught early, can be lethal.

Cat Scratch Disease (also known as cat scratch fever) is carried by 15% to 30% of cats -- and is more likely to be carried by kittens than adult felines. This infection is caused by the Bartonella henselae bacterium, which is mainly transmitted by cat scratches. Within 10 days of exposure, you will experience a raised lump at the site of injury, followed by swollen lymph nodes, headaches and fatigue. This is typically not a serious disease. In fact, it often needs no treatment, though some cases are severe enough to be treated with antibiotics. If your symptoms do not clear up within two to three weeks, or are continuing to worsen, check with your doctor.

Bacterial Meningitis affects the brain and spinal cord, causing high fever, headache and stiff neck. Some forms are contagious through exchange of respiratory or throat secretions -- yet another reason not to let your pet lick your face. Bacterial meningitis is easy to treat with antibiotics if caught early. With no treatment, it can be deadly.

Bubonic Plague. Most associate this disease with the "Black Death" that ravaged 14th-century Europe. Today it is very rare, but it hasn’t been eliminated in the US. Transmitted by infected fleas, bubonic plague is not just an historical issue -- there were small outbreaks in the US in 1974 and 1983 and two cases in 2010. Studies have shown that the occurrences were probably caused by cats or dogs sleeping in the owners’ beds. Symptoms include chills, high fever and muscle pain. Untreated, there is a 50% to 70% chance of death. Treated early with antibiotics, the risk for death falls to 10% to 15%. "This is an extremely rare event, but pet owners should be aware of the possibility," said Dr. Chomel.

Infants, toddlers, the elderly, pregnant women and people who are immunocompromised should never sleep with a pet. The immune systems in these people are not as strong as those in healthy, younger adults, so there is a heightened risk of contracting infections. And the following precautions apply to everyone...

Do not kiss your pet, and do not let it lick you. (Keep a box of baby wipes or sanitizing gel by your bed to immediately wipe off saliva if you can’t bear that rule.)

Take your pet to a veterinarian for regular checkups.

Make sure your pet is up-to-date on all its shots.

Give your pet monthly heartworm and regular flea and tick preventives.

Cover any weeping or oozing abrasions (yours and the pet’s).

Keep your cat indoors.

Shampoo your dog monthly.

Also: Never sleep with exotic pets or wild animals. Not only can their behavior be dangerously unpredictable, they may easily be carrying bacteria, viruses or fungi that can infect you. Snakes, lizards and turtles, for example, can transmit salmonella.

Important: "If you have any unexplained symptoms, or if your pet has been diagnosed with a transmittable disease, see your health-care professional immediately," warns Dr. Chomel.

Source(s):

Bruno Chomel, DVM, PHD, professor, population health and reproduction, UC Davis School of Veterinary Medicine, Davis, California.

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Be well,


Carole Jackson
Bottom Line's Daily Health News


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1 comment:

  1. I was diagnosed with hypothyroidism last December. I started taking desiccated thyroid up to now. It helped me stop gaining weight and hair thinning too. I was surprised of its dramatic improvement.

    ReplyDelete