Contraception and birth control Archive

Falls rank among the top causes of death and injuries among the elderly, and the risk increases significantly in older people being treated for cancer. Now, investigators are reporting that a newer class of drugs for advanced prostate cancer is associated with a significant increase in fall risk. Called androgen receptor inhibitors, or ARIs, these […]

The pandemic may be making life harder for those in abusive relationships, but help is available.

A woman experiencing abuse at the hands of an intimate partner often feels isolated and alone. But the truth is, she has a lot of company. As many as one in three women in the United States has experienced intimate partner violence (IPV), which is violence involving a current or former spouse, partner, significant other, boyfriend or girlfriend, says Eve M. Valera, an associate professor in psychiatry at Harvard Medical School. This number includes women from all different ages and backgrounds.

Those who experience IPV may be left with lingering health effects, including mental health disorders such as anxiety, depression, or post-traumatic stress disorder. IPV is also linked to a number of physical symptoms and conditions, according to the federal Office on Women's Health, such as digestive problems, migraine headaches, arthritis, asthma, chronic pain, sexual problems, and heart problems. Another area of growing concern for many researchers is the potential for cognitive changes caused by traumatic brain injuries linked to abuse, says Valera.

Research we're watching

Can your current or past menstrual cycle offer clues about your longevity? A study published Oct. 3, 2020, in The BMJ linked irregular or long menstrual cycles (defined as 40 days or more) throughout adolescence and adulthood to a higher risk of early death (before age 70), compared with that seen in women who had normal or short menstrual cycles. The study authors, who used data from nearly 80,000 women who participated in the Nurses' Health Study II, found that the association was stronger for deaths from heart and blood vessel disease and in women who smoked.

Women in the study were, on average, 38 years old and had no history of cardiovascular disease, cancer, or diabetes when the study began. Researchers asked them to recall the regularity and length of their menstrual cycles at various times in their life. The researchers followed the women for 24 years, noting deaths from various causes over time. The association of early death with irregular or long menstrual cycles persisted even after they corrected for other factors, such as lifestyle and family history.

New calculators can estimate the chance your cancer might — or might not — become more aggressive.

Active surveillance is a popular option for men with low-risk prostate cancer, defined as a tumor that is confined to the prostate gland and unlikely to grow or spread. It involves monitoring prostate-specific antigen (PSA) levels in the blood for changes and having regular digital rectal exams to look for abnormal areas on your prostate.

During active surveillance, you have a PSA test and a digital rectal exam every six months and prostate biopsies approximately every other year. If your PSA level rises, your doctor will likely recommend a prostate MRI or an immediate prostate biopsy to see if the cancer has become more aggressive. If so, you and your doctor can decide whether to continue with active surveillance and have another biopsy six months or a year later, or move ahead to treatment, such as radiation, hormonal therapy, or surgery.

In the journals

Many men with prostate cancer who have a radical prostatectomy (prostate removal) receive radiation therapy afterward to wipe out any residual cancer cells. Alternatively, men can choose to delay radiotherapy and be monitored for evidence of prostate cancer activity, such as a rising blood level of prostate-specific antigen (PSA). If PSA testing or an imaging test like an MRI shows cancer, these men can then consider radiation therapy.

According to the findings of an analysis published online Sept. 28, 2020, by The Lancet, there is no clear benefit of immediate radiation over monitoring with later radiation therapy as necessary. Since some men will never need radiotherapy, this means that by forgoing immediate treatment, they can avoid potential side effects like incontinence and bowel problems.

Imagine trying to find a single match from a book of matches in a large room. Not an easy task, right? But if the lights were dimmed and the match was lit, then its location would be immediately apparent. This is the basic idea behind PSMA imaging, a newly approved method for detecting prostate cancer […]

In the journals

Men with intermediate-risk prostate cancer may benefit from undergoing androgen-deprivation therapy (ADT) depending on how far the cancer has progressed, says a study published online Sept. 9, 2020, by JAMA Network Open. The results could help men better weigh risk versus reward when choosing their prostate cancer treatment options.

The study looked at men with intermediate-risk prostate cancer. This is the mid-range of prostate cancer in terms of aggressiveness between low-risk (which often doesn't need treatment) and high-risk cancer. There are two categories of intermediate-risk cancer: favorable intermediate-risk (FIR) and the more advanced unfavorable intermediate-risk (UIR).

Research we're watching

Treatment for women with a type of early breast cancer called ductal carcinoma in situ (DCIS) might not be doing enough to prevent deaths from the disease, says a study published online Sept. 16, 2020, by JAMA Network Open. The study sought to determine whether women diagnosed with DCIS had a higher risk of dying from breast cancer than women who did not have the disease. They looked at 144,524 women who were diagnosed with DCIS from 1994 and 2014 and then treated for the condition. Researchers compared them against women without DCIS from the general population. They found that the women with DCIS had three times the risk of dying of breast cancer in the follow-up period, which ran until December 2016, than women without DCIS. Study authors suggest ways that might identify which women with DCIS need more aggressive therapy to prevent breast cancer death.

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News briefs

Need a little inspiration? The next time you take a walk outside, note things that spark a sense of wonder or awe. That's what some older adults tried for a small study published online Sept. 21, 2020, by the journal Emotion. Of the 50 people who took part, half went for weekly 15-minute walks outdoors (alone) for eight weeks, and snapped "selfies" along the way. The other half took the same walks and selfies, but visited a new place each time. They were asked, especially, to note things that inspired a sense of awe — like tree colors or leaves underfoot softened by rain. Participants also answered surveys about the emotions they felt on walk and non-walk days. After analyzing responses and photos, scientists found that people who people took the "awe walks" reported less distress and increasing awe, joy, compassion, and gratitude, compared with people on the regular walks. Awe walkers also smiled more and made themselves smaller in their photos, focusing more on landscapes — a sign of a greater appreciation of the world around them. Try it yourself: On your next walk, imagine you're seeing things for the first time. What will inspire you? Perhaps a path lined with trees, the shore of a lake, or an up-close look at skyscrapers. Jot down your observations, and see if you feel a sense of wonder and joy. Happy trails!

Image: © Igor Alecsander/Getty Images

The condition is an all-too-real problem for men, and one of the more difficult to treat.

After age 50, men often have periods of discomfort "down there." It could be a cramping, aching, or throbbing pain in and around your pelvis and genitals. You also may have issues in the bedroom and bathroom. While the problems are real, the cause is often difficult to pinpoint.

It's called chronic pelvic pain syndrome (CPPS) — also known as chronic prostatitis — and it's one of the most puzzling and difficult-to-manage conditions for older men.