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found between prostate cancer and vasectomy
Good news for the millions of men worldwide who've had vasectomies:
a new study disputes a link between this birth-control operation and
prostate cancer. Two 1990 studies that connected prostate cancer and
vasectomies caused men to question the procedure, even though no medical
explanation for the connection could be found. Other research has both
confirmed and denied the association in the past 10 years.
But the new study, published in the June 19, 2002, Journal of the
American Medical Association, should ease men's minds. It involved
over 2,000 men of European descent living in New Zealand, the country
with the highest rate of vasectomies.
Researchers asked 953 men with prostate cancer and 1,260 who were cancer
free about their medical histories — including whether they had
had a vasectomy. It turned out that slightly fewer men with prostate
cancer had undergone the surgery, which supports claims that going under
the knife doesn't cause cancer. The same held true for the 38% of men
studied who had had the procedure more than 25 years ago, which suggests
that there are no long-term effects.
One reason why the link may have been found in earlier studies is that
men who have vasectomies generally see their urologists more often, which
may lead to more tumors being found in these men as compared to others,
the researchers said. The study also found no link between prostate cancer
and history of sexually transmitted disease, smoking, drinking alcohol,
and number of children.
Prostate cancer will be diagnosed in 198,000 Americans this year, and
it will take 31,500 lives. Although prostate cancer lags behind heart
attacks, strokes, and lung cancer as the leading cause of death in American
men, it's the disease many men fear most.
August 2002 Update
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Comparing the Side Effects of Prostatectomy vs. Radiation
Prostate cancer is the most commonly diagnosed non-skin cancer among
men in the United States. When caught early, it is also among the most
treatable. Two of the more aggressive and common methods
of treatment for early stage prostate cancer are radiation therapy and
surgery (radical prostatectomy) to remove the prostate gland. Although
both options have favorable outcomes, physicians have not reached a consensus
on which therapy is more effective. This means that men who are treated
with either surgery or radiation can usually expect to live for many
more years. The caveat is that they often have to live with the side
effects of their treatment. Deciding on a treatment option, then, becomes
a question of which side effects are more likely with each therapy, and
also which side effects are more tolerable to a particular patient.
A recent analysis of data from the Prostate Cancer Outcomes Study helps
to clarify this issue by comparing the side effects of the two therapies
in men between the ages of 55 and 74, two years after treatment. The
results showed that men in both treatment groups experienced significant
decreases in sexual function. Of the men in the surgery group, 80% became
impotent, compared to 62% of the men in the radiation group. Age and
status of sexual function prior to treatment affected these outcomes.
Twelve percent of the men who underwent surgery experienced dripping
or leaking urine, compared to only 2% of the men who had radiation therapy.
Few men in either group were bothered by bowel problems. Of the men who
were affected, however, radiation patients experienced more diarrhea,
bowel urgency, and painful hemorrhoids (33%, 30%, and 19%, respectively)
compared to surgery patients (22%, 16%, and 10%).
Overall, this study showed that men who opt for surgery can expect to
have more urinary and sexual problems, while men who choose radiation
are more likely to suffer from bowel disturbances. A man's age and initial
health are also important factors in the development and duration of
long-term side effects from either treatment. Physicians and their patients
should use this information, as well as a discussion of the patient's
priorities, preferences, and concerns, to help decide which treatment
method is appropriate.
March 2001 Update
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Symptomless Genital Herpes Infections
Recent research tested a potential vaccine against genital herpes only
to find it ineffective. But study investigators did learn something very
important about this infection. During the course of the trial, 63% of
study volunteers who developed antibodies to the virus (indicating exposure)
never developed symptoms. Women were about equally likely to develop
symptoms or not.
Perhaps the most important message here is that while a newly acquired
genital herpes infection may cause no symptoms, new symptoms of genital
herpes may in fact result from an old infection. If you or your sexual
partner develop symptoms of genital herpes, it is very possible that
this is ancient history coming to light in the context of a new relationship.
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