Medical Tests & Procedures Archive

Articles

Radiation after prostate cancer surgery may not be necessary

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.

Why do my legs swell at the end of the day?

On call

Q. I would occasionally get some swelling in my legs. But now I notice it by late afternoon every day. I otherwise feel fine. Should I be worried?

A. It sounds like you have edema, swelling in your legs due to fluid in the soft tissues beneath your skin. This usually occurs when pressure from the fluid inside your veins is high, which forces water out of the blood vessels and into the surrounding tissues.

Unlocking the mystery of chronic pelvic pain syndrome

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.

Slightly leaky heart valves

A small amount of leakage (regurgitation) from the mitral or tricuspid valve is normal. People with either condition do not need to modify their activity levels, but they should stay alert to symptoms that suggest the problem is worsening.

Our evolving understanding of the problem with plaque

New imaging techniques that use light or sound waves to create images of the inside of coronary arteries have helped researchers better understand the fat-laden plaque that builds up inside artery walls (atherosclerosis). Most heart attacks happen when small, inflamed areas of fatty plaque rupture suddenly, causing a clot that blocks blood flow. This may explain why treating large, obstructive plaques with stents or bypass surgery does not seem to prevent heart attacks or help people live longer.

The best way to beat colon cancer

When do you need to get screened, and how often?

One of the deadliest cancers can be prevented or detected at a curable stage if you follow recommended screening guidelines.

Colon cancer is the second most common cause of cancer deaths in the United States, according to the American Cancer Society (ACS). The good news is that the death rate has steadily dropped over the past several decades among older adults. (However, among people under 55, death rates from colon cancer have grown slowly, but steadily, since 2008.)

Blood test could find Alzheimer’s disease before symptoms appear

In the journals

Researchers are close to finding early cancer with a blood test. They may soon do the same with Alzheimer's disease. A new blood test called p-tau217 has shown great promise in diagnosing people with the disease, according to findings published online July 28, 2020, by JAMA.

The test looks for a specific type of tau protein in the blood. In people with Alzheimer's, tau protein in the brain forms tangles. Accumulation of tau protein tangles along with beta-amyloid deposits is thought to play a key role in how the disease develops.

Stress-induced brain activity linked to chest pain from heart disease

Research we're watching

Doctors have long known that mental or psychological stress can lead to angina (chest pain or discomfort caused by inadequate blood to the heart). Now, new research reveals a direct correlation between angina and stress-related activity in the brain's frontal lobe. The study included 148 people with coronary artery disease with an average age of 62. All underwent brain and heart imaging tests done in conjunction with mental stress testing, which involved mental arithmetic and public speaking. Imaging tests were also done under "control" conditions, which featured simple counting and recalling a neutral event. Researchers monitored the participants for angina during the tests; they also assessed angina rates again after two years.

Activity in the inferior frontal lobe area of the brain during mental stress was linked to the severity of self-reported angina, both during the brain imaging and at the two-year follow-up. A better understanding of how the brain reacts to stress may be an important consideration for doctors who treat angina, according to the study's lead author. The study was published online Aug. 10, 2020, by the journal Circulation: Cardiovascular Imaging.

Smokers may have higher risk of brain aneurysm

Research we're watching

Need another reason to quit smoking? A study published in the September 2020 issue of the Journal of Neurology, Neurosurgery and Psychiatry found that women ages 30 to 60 who smoked had four times the risk of having a brain aneurysm (a weakened artery in the brain that bulges and could burst) compared with nonsmokers.

Researchers looked at nearly 550 women who had a brain scan performed, most often because of persistent headaches. The scans showed that 113 of them had one or more brain aneurysms. These individuals were then matched with 113 people who did not have brain aneurysms. In comparing the two groups, the researchers found not only that smoking drove up the risk of finding a brain aneurysm, but also that women who both smoked and had high blood pressure had seven times the risk compared to nonsmokers with normal blood pressure. If future research shows that smokers also have a significantly higher risk of brain aneurysm rupture, women smokers ages 30 to 60 might be candidates for aneurysm screening.

Beyond "bad" cholesterol: A closer look at your blood lipids

For assessing heart disease risk, a standard cholesterol test doesn't always tell the whole story. Some people with "normal" LDL cholesterol levels might benefit from a test that measures apolipoprotein B (apoB). This test, which measures the number of LDL particles as well as other particles that can contribute to clogged arteries, may be a better indicator of heart disease risk than just an LDL cholesterol value.

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