Men's Health Archive

Articles

Choosing the right ED drug

Men have a higher risk of having erectile dysfunction (ED) as they age and many can benefit from taking an ED drug. There are currently four choices in the US, and men usually adopt a trial-and-error approach to find the drug and dosage that works for them. The choice also can be dictated by how fast they want the drug to work and how long the effect will last.

American Heart Association issues statement on cardiovascular side effects from hormonal therapy for prostate cancer

The American Heart Association issued a statement addressing cardiovascular risks from hormonal therapy for prostate cancer, emphasizing the need to identify men with pre-existing cardiac risk factors or a family history of cardiovascular diseases who should be monitored closely during treatment.

Is male menopause real?

In general, men don't really go through "menopause" because testosterone levels slowly decline over many decades. Symptoms such as low energy and decreased sex drive can sometimes be related to low testosterone levels that may improve with replacement therapy.

Should I continue PSA screening for prostate cancer?

On call

Q. I am 74 years old and unsure whether I want to continue with PSA screening for prostate cancer. Before deciding, I wanted to better understand my options since I probably would not want surgery or radiation therapy if I do have prostate cancer. What is your approach?

A. No matter what your age, men should ask themselves these types of questions before having a blood test for PSA (prostate-specific antigen) to look for hidden prostate cancer.

New ways to test for prostate cancer

Recent advances can help men with a worrisome PSA result avoid immediate biopsy.

Prostate-specific antigen (PSA) blood testing receives high marks as an effective way to monitor disease activity in men diagnosed with prostate cancer. Yet, as a screening tool for prostate cancer, PSA testing is problematic.

PSA naturally tends to increase as men get older, but levels that get too high may suggest prostate cancer. A PSA level of less than 4 nanograms per milliliter (ng/mL) is often reassuring, unless there has been a sudden jump from a much lower number. Many doctors consider a total PSA level higher than 10 ng/mL as the threshold for getting a biopsy to check for cancer.

Focusing on your future

Make your remaining years the best possible with these strategies.

There's a saying: "The trouble is, you think you have the time." People may understand their lives are limited, but they often don't internalize how much time they actually have left. This mindset can delay goal setting and long-term preparation, which increases the chances of later problems — for instance, with finances, housing, or health.

"People don't like to talk about their mortality because they don't want to see themselves as 'old,'" says Joan Gillis, a geriatric clinical social worker and senior clinical team manager with Harvard-affiliated McLean Hospital. "But embracing this reality can help people grasp a sense of urgency, so they get the most from their remaining years."

Can gout be prevented?

Gout, a debilitating form of arthritis, is on the rise compared with rates in prior decades. Obesity is probably a significant factor in this increase. Now, a new study suggests that three-quarters of gout cases in men might be completely avoidable by following certain protective health habits.

Predicting low-risk prostate cancer

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.

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.

Hormone therapy and radiation may help with certain 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).

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