Prostate Cancer Archive

A study in the December 2015 issue of The Lancet Oncology found that a new test, called STHLM3, is more helpful at detecting aggressive cancer than traditional tests for prostate-specific antigen (PSA).

The STHLM3 test is a blood test that analyzes a combination of six protein markers, more than 200 genetic markers, and various clinical data, such as age, family history, and previous prostate biopsies.

Here is one more way men and women are different: research published online Oct. 20, 2015 in Radiology found that male and female hearts do not age the same way.

For the study, researchers reviewed MRI heart scans performed on almost 3,000 older adults, ages 54 to 94, without existing heart disease. (Scans were given 10 years apart.) The scans showed that in both sexes, the main heart chamber—the left ventricle, which fills with and then forces out blood—gets smaller with time. As a result, less blood enters the heart, and less gets pumped out to the rest of the body.

Ask the doctor

Q: I have always had difficulty sleeping. Since I have taken to heart the advice for good sleep habits, I think I'm sleeping better, but I'm not sure. I'm in bed about 8.5 hours, but am often restless and get up to go to the bathroom a couple of times during the night. Is there a way to compute how much sleep I'm actually getting?

A: Adequate sleep is an important part of health. While the exact amount needed to maximize health and wellness is not totally clear, many experts recommend around seven to nine hours per night. Adequate sleep is associated with memory, improved mood, better weight control, improved diabetes control, greater resistance to colds, and fewer accidents.

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A research letter published online Jan. 21, 2016, in JAMA Oncology suggests that many older adults are getting unnecessary cancer screenings. Researchers looked at questionnaire answers from about 150,000 seniors (ages 65 or older) across the country, and found that about half had received prostate-specific antigen (PSA) testing or mammography in the past year. But a third of those screened did not have a 10-year life expectancy, a major guideline for screening. Unnecessary screening rates varied by state—for example, 11% in Colorado and about 20% in Georgia. "Undergoing a screening test may actually cause more harm than good, especially with older patients or those with significant medical conditions," says Dr. Marc Garnick, an oncologist at Beth Israel Deaconess Medical Center and editor in chief of Harvard's Annual Report on Prostate Diseases. So talk to your doctor about the guidelines. Both the American Cancer Society (ACS) and the U.S. Preventive Services Task Force (USPSTF) recommend routine mammograms every two years for women ages 55 to 74. The ACS does not recommend mammograms in this age group if a woman has a life expectancy of less than 10 years.

For all men, the USPSTF recommends against routine PSA testing. The ACS suggests that men 50 or older (at average risk for prostate cancer) make the decision about screening with their doctor, but only if they have a life expectancy of at least 10 years, and only if they have been advised about the uncertainties, risks, and potential benefits of prostate cancer screening.

They're convenient and affordable, but they don't replace a relationship with a primary care physician.

Walk into a drugstore, supermarket, or "big box" store these days, and you'll find more than prescriptions, food, and household goods. Many now feature health clinics. They're part of the big trend of making health care more convenient. "Twenty years ago you had to go to an emergency department if you got sick and needed immediate care. Now we have an explosion of options, such as retail health clinics," says Dr. Ateev Mehrotra, a researcher on the topic and an associate professor of health care policy at Harvard Medical School.

The clinics

Retail health clinics began showing up about 15 years ago. Today, there are about 2,000 clinics across the United States, mostly in large retail chain settings. A typical clinic is open from 7 a.m. to 7 p.m., seven days a week, and is staffed by a nurse practitioner or a physician assistant. Clinics offer all kinds of health services—everything from treating minor illness like a cold, pinkeye, or a urinary tract infection to providing physicals, health screenings, lab work, smoking cessation help, and vaccinations.

They're cute, cuddly, and loving, but dogs and cats aren't always appropriate for older adults.

There's a reason dogs are dubbed man's best friend. Dogs—and cats, too—make wonderful companions and provide many emotional and physical benefits. "I'm a believer in the beneficial effects of having a pet, and I'm impressed with the ability of dogs in particular to form bonds with human beings. I think the science is starting to support their special ability to do that," says psychiatrist Dr. Greg Fricchione, director of the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine. However, there are a number of considerations to mull over before adding a pet to your household.

Benefits

The most obvious benefits of pet ownership are love and companionship. "We do best medically and emotionally when we feel securely attached to another, because we're mammals and that's the way we've evolved," says Dr. Fricchione. He points out that we feel especially secure with dogs and cats because of the unconditional love they provide. "No matter what you do or say, your dog or cat accepts you and is attached to you," says Dr. Fricchione. Taking care of a dog or a cat can provide a sense of purpose and a feeling of validation when you wake up or come home and there's someone who's happy to see you.

Ask the doctor

Q: I am 68 years old, and recently my PSA level (which was normal before) increased to 5.2 nanograms per milliliter (ng/ml). My doctor repeated the test one month later, and it was normal again at 3.3 ng/ml. Should I still be concerned?

A: One of the reasons that routine PSA testing is so controversial is the inability of the test to distinguish men with prostate cancer from those without it. A common cutoff is 4 ng/ml, but this is hardly a black-and-white answer. In fact, 30% of men with a PSA result between 4 and 10 have cancer. (The remaining 70% have benign causes, like an enlarged prostate.) In men with a "normal" PSA in the 2-to-4 range, 20% have cancer. So the risk is still present.

Fostering strong social connections does not come easy for many men, but it is one of the best means to a longer and healthier life.

Social connections are as important to your health as proper diet and exercise. Research has linked social bonding to longer lives, lower incidence of depression and anxiety, and reduced risk of disease.

"Our brains and bodies function best when we are part of a community and maintain close, personal connections," says Dr. William S. Pollack, assistant clinical professor in the Department of Psychiatry at Harvard Medical School.

The annual check-up is important for older men. Here is how to make the most out of your visit.

Men have a long reputation for avoiding check-ups, and that resistance tends not to soften when they are older.

"Many older men put off exams because they fear finding out something is wrong," says Dr. Suzanne Salamon, a geriatrician with Harvard-affiliated Beth Israel Deaconess Medical Center. "Also, many of today's baby boomers don't think they will have medical problems associated with age, so it can difficult for the 'younger older men,' like those in their 60s and early 70s, to see their doctor."

Declining muscle mass is part of aging, but that does not mean you are helpless to stop it.

The saying goes there are two certainties in life: death and taxes. But men should also add loss of muscle mass to the list.

Age-related muscle loss, called sarcopenia, is a natural part of aging. After age 30, you begin to lose as much as 3% to 5% per decade. Most men will lose about 30% of their muscle mass during their lifetimes.