Sunday, 2 September 2012

Enlarged prostate problems? Best to bone up first even before seeing your specialist

Take a look at Even for the medical profession gone are the days when every doctor would advise men over a certain age to have regular socalled PSA screening to test for cancer of the prostate. A lot of money was wasted on that test. 'PSA levels can change for many reasons other than cancer. Two common causes of high PSA levels are enlargement of the prostate (benign prostatic hypertrophy (BPH)) and infection in the prostate (prostatitis). It can also be raised for 24 hours after ejaculation and several days after catheterization.' 

If you have an uncomfortable 'pressing' feeling in the perineum area between the legs and above that area 'on the inside' so-to-speak, maybe like you are 'sitting on a ball', that may turn out to be caused by an enlarged prostate. Leave off bicycling while you have it checked out professionally!

Absent any immediate life-threatening diagnosis from the experts, check out alternative treatments. If you just have a (benign) enlarged prostate, you may find that a few drops of Saw Palmetto tincture taken daily for a few months will remove the discomfort totally with little or no risk of side effects. There are also other homeopathic and herbal remedies which can often help your body to cure the problem: see your homeopath or herbalist. But remember that your own dietary e.g. excess alcohol, and other habits (bicycling?!), could be the cause of an enlarged prostate, and so you will have to be prepared to do detective work in that area as well.

And when should you contemplate surgery? Well, the article extracted below is a reminder why surgery to remove an enlarged prostate is now thought to be probably normally not the way to go unless your specialist comes up with very convincing reasons for it - which you should check and doublecheck yourself.

"If you were diagnosed with an enlarged prostate about 10 years ago, then you may be one of many unlucky men. Especially if your blood tests revealed a higher than normal PSA. You would've probably gone under the knife straight away, because surgery, followed by radiation or chemo (or both!), was the common course of treatment back then. 

Fortunately, there were a few good doctors back then (and more thankfully now) prepared to hold off on treatment and monitor your condition instead. In light of recent PSA research, hopefully more doctors will discontinue yearly PSA monitoring altogether. 

All men should be so lucky. But far too many are not. 

Changing the standard of care 

A recent New England Journal of Medicine study enrolled more than 730 men with localized prostate cancer — meaning their cancer had not spread beyond the prostate. Their average age was about 66 years. 

In half of the men, surgeons removed their prostates. Men in the other half were "observed." They weren't treated. Doctors screened their PSA levels. 

After 10 years, there was very little difference in death rates between the two groups. The difference was so small that it landed within the possible margin of error. 

Meanwhile, more than 20 percent in the surgery group suffered complications from their surgery, including one death. 

Let's make this as simple as possible. Most men with localized prostate cancer should not be treated. And this is especially true for men in their 70s and beyond. 

Men? Doctors? Are you getting all this? It could hardly be more important! Let's not wait years for the standard of care to change… nobody should take an aggressive course of action if it is not absolutely necessary. 

"Radical Prostatectomy versus Observation for Localized Prostate Cancer" New England Journal of Medicine, Vol. 367, No. 3, 7/19/12, 

"Prostate cancer surgery fails to cut deaths in study" Gene Emery, Reuters Health, 7/18/12,"

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