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BPH drugs linked to small risk of falls

In the Journals

Alpha blockers, a type of medication that many men take for urinary difficulties caused by an overgrown prostate, are associated with a dangerous but very small risk of falling, according to a recent study in BMJ. This should reassure men who have heard that the drugs could cause dizziness from a sudden drop in blood pressure.

The Canadian study identified more than 147,000 men in Ontario prescribed one of three drugs: alfuzosin (Uroxatral), silodosin (Rapaflo), and tamsulosin (Flomax). Most of the men (84%) took Flomax, although all three drugs work the same way.

Vasectomy and prostate cancer


Image: iStock

Ask the Doctor

Q. I had a vasectomy many years ago, at age 45. I recently read that this increases my risk of prostate cancer. Should I be concerned?

A. Despite the reports you've heard about the connection between vasectomy and prostate cancer, the evidence is weak for a cause-and-effect relationship. Right now, this hypothetical risk should not cause you undue concern.

Not satisfied with your sex life?


Image: Thinkstock

Erectile dysfunction is common, but it's not always the problem. A doctor can help you get to the bottom of it.

Erectile dysfunction (ED) is difficulty either getting or maintaining an erection firm and lasting enough for a satisfying sexual encounter. The most common cause is inadequate blood supply to the spongy tissues in the penis that provide rigidity. That's a straightforward "plumbing problem" that can usually be treated with medication. But there are other possible causes, too.

Active surveillance is safe for low-risk prostate cancers

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.

Active surveillance is safe for low-risk prostate cancers

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.

Ask the doctor: Medical x-rays and risk of cancer

Image: Thinkstock

Q. I am currently receiving annual chest CT scans to check for hidden lung cancer (I used to be a heavy smoker). Should I be concerned about the cumulative effects of radiation exposure?

A. Radiation from medical scans can cause cancer, but the level of exposure considered potentially dangerous appears to be many times greater than the average CT scan. In addition, cancer from medical scans takes decades to develop, which makes it less of a concern for men being screened for lung cancer, which is currently only recommended for current or former smokers ages 55 and older. Radiation from CT scans is a bigger concern for children and young adults, who have more time to develop cancer after exposure to medical x-rays.

Following low-risk prostate cancers before starting treatment becoming more common

Treatment decisions are complicated for men with low-risk prostate cancer that grows slowly. These cancers may never become deadly during a man’s expected lifespan. And there is no conclusive evidence showing that treatment in these cases extends survival. So cancer specialists have been leaning toward monitoring low-risk prostate cancer carefully and starting treatment only when it begins to spread. This approach was once used only in academic cancer centers, but new research suggests that this strategy is becoming more common in urology practices throughout the United States and other countries as well.

Following low-risk prostate cancers before starting treatment becoming more common

Treatment decisions are complicated for men with low-risk prostate cancer that grows slowly. These cancers may never become deadly during a man’s expected lifespan. And there is no conclusive evidence showing that treatment in these cases extends survival. So cancer specialists have been leaning toward monitoring low-risk prostate cancer carefully and starting treatment only when it begins to spread. This approach was once used only in academic cancer centers, but new research suggests that this strategy is becoming more common in urology practices throughout the United States and other countries as well.

Survival of the fittest: Men at 100 are healthier than women

Fewer men than women live to 100, but the men who do tend to be healthier, according to a study in the Journal of the American Geriatrics Society. Researchers sorted through primary care health records of over 11,000 men and women in the United Kingdom who reached age 100 between 1990 and 2013. They hoped this would provide a more representative look at the health of the oldest people in the population than earlier studies have offered.

As expected, more women than men became centenarians during this period: about 9,000 versus 2,100. However, under the current concept of "successful aging," quality of life is more highly valued than simply the number of life years racked up. So the researchers took a close look at the records for evidence of so-called geriatric syndromes—health problems that are common in older people. These include falls, hip and spine fractures, dementia, and hearing or vision loss.

Heart-healthy diet boosts survival in men with low-risk prostate cancer

Can a healthy diet help men with low-risk prostate cancer live longer? The authors of a new study say “yes.” A long-running Physicians’ Health Study, suggests that a diet that is good for the heart, brain, and other parts of the body may also help keep low-risk prostate cancer at bay. On the flip side, a diet rich in red meat and high-fat dairy foods appears to be hazardous for men with this kind of cancer. It isn’t clear why a diet that protects against heart disease would also protect against death from prostate cancer. Dr. Chavarro speculates that it’s because high-fat foods are easily broken down and absorbed by the digestive system, and so they might provide quick energy sources for growing tumors. Nevertheless, the results suggest that by eating healthily, men with prostate cancer can take a proactive step towards living a long life.

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