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Health of Men
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No link 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 Therapy

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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