Are you in shape for surgery? Your doctor will want to check you out thoroughly beforehand. Surgery may be delayed if you’ve recently had other prostate surgery for BPH (see below), and it’s generally scheduled for six to eight weeks after a needle biopsy of the prostate. These delays give the body a chance to recover from the earlier procedures. Also, imagine a surgeon’s difficulty in trying to operate on inflamed, irritated tissue, where a needle has penetrated the rectal wall six times, and it hasn’t yet healed properly! A few weeks’ wait, though it may seem agonizing to a man who’s anxious to have the cancer removed as soon as possible, can be critical in helping the surgeon preserve the delicate neurovascular bundles and avoid injury to the patient’s rectum during the procedure.

Before surgery, when you give the doctor your medical history, be sure to say so if you’ve had any unusual problems with bleeding in the past (from dental work, for example). Also, aspirin can cause excessive bleeding; if you are taking aspirin regularly, make sure you stop at least ten days before the operation. Another point to discuss with your doctor: Many men who undergo radical prostatectomy need a blood transfusion during the procedure. The best blood for you to get, obviously, is your own; if your hospital allows this, it’s a good idea to donate several units of your blood ahead of time. This is another good reason for the six-to-eight-week delay; it gives you plenty of time to make up your own blood bank. The night before surgery, you’ll be given an enema and perhaps some laxatives, as well. Or, if you’re scheduled to be admitted the day of your surgery, you may be asked to give yourself an enema or take laxatives the night before. You’ll probably be told not to eat anything the night before surgery, as well.

This is how some men find out they have prostate cancer—when the prostate tissue removed in a TUR procedure or open prostatectomy is evaluated by a pathologist. It’s more difficult for surgeons to perform a radical prostatectomy after an open prostatectomy, but that doesn’t mean it can’t be done. It often is, and with greater success. You may be told to wait, however, about twelve weeks after a TUR procedure, until the inflammation from this operation has gone down.

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Posted by admin on March 30th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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First, educate yourself. Learn everything important there is to know about your own cancer—your clinical stage, PSA level and Gleason score. Explore all your options—we’ve done our best to cover them all in this chapter, and specific forms of treatment are covered in greater detail in the next chapters. Get a second opinion, and a third if you need it, and talk to patients. If you can’t get some names from your doctor, call a prostate cancer support group (see “Where to Get Help,” at the back of this book) or another organization that specializes in prostate cancer. Be your own advocate, and take heart—there is much you can do to make sure you get the best treatment possible.

Say a man has a palpable tumor involving one entire lobe of the prostate (stage T2b, or Bi disease), a Gleason score of 7, and a PSA between 10 and 20. The likelihood that his tumor is confined to the prostate is 19 percent; the probability that his cancer has penetrated beyond the prostate wall is 81 percent. He has a 33 percent chance of having cancer in the seminal vesicles, and a 24 percent chance of lymph node involvement. What should this man do? Here, age plays a major role. Say this man is in his early fifties. Even though cure is not certain, it’s clear that if he does nothing he will probably die of his disease. Because the side effects of surgery are much milder in men this age, surgery is certainly a reasonable option, and it does offer the possibility of cure.

On the other hand, say he’s in his seventies. The question here is whether a man who may not live long enough to die of prostate cancer should be put through an operation with an uncertain likelihood of cure. Surgery has more side effects on people in their seventies. So, for this man, radiation therapy is a better, more reasonable option.

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Posted by admin on March 30th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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Some men who opt for watchful waiting take solace in the fact that their cancer cells are well-differentiated. But unfortunately, just because you have well-differentiated cancer cells today does not mean they’ll stay that way forever. There are two concepts here; one is genetic drift. As a cancer progresses—as its cells double again and again—the DNA becomes less stable. The cancer develops new mutations; it becomes more aggressive. As the tumor progresses, well-differentiated cells deteriorate into poorly differentiated cells. The other concept is heterogeneity, or clonal selection. By the time a prostate cancer is large enough to be diagnosed clinically, its cell population is mixed—a diverse group of cells, all jockeying for position in one location. In this varied group are both well and poorly differentiated cells, cells driven by hormones and cells untouched by hormones. And although an initial biopsy may find well-differentiated cancer cells, almost certainly some poorly differentiated ones have mingled in there as well. With time and further growth, these poorly differentiated cells grow at a faster rate than do their more sedate, better-differentiated counterparts. Eventually, they will outpace the stately progression of the well-differentiated cells and dominate the tumor. So a well-differentiated cancer, one that’s localized to the prostate, may be only a temporary condition. And unfortunately, we can’t tell which well-differentiated cancers are going to stay that way.

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Posted by admin on March 30th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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Watchful waiting is certainly not a new approach. It’s been a mainstay of prostate cancer treatment for years; and today, one third of men with prostate cancer are treated with watchful waiting.

Some doctors who argue for watchful waiting refer to studies that suggest the mortality rate for men who don’t get treatment is low—about the same as for men who don’t have prostate cancer.

But results can be seriously misleading. One prominent Swedish study, for example, citing a “high ten-year survival rate in patients with early, untreated prostatic cancer” has been widely criticized because it’s based on a group of older men, average age 72, with small, slow-growing tumors. (Only 4 percent of these men had aggressive, poorly differentiated tumors—unlike the 10 percent to 20 percent of men with localized cancer in this country who undergo therapy. So basically, this was not a typical group—many of these patients would have been followed with watchful waiting in the United States, as well.)

After ten years, 13 percent of these men had died from the cancer. And the disease had progressed in another so percent of the men. Most of these men eventually did need treatment (castration or hormonal therapy) to treat urinary obstruction, bleeding or pain.

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Posted by admin on March 30th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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Most men experience temporary urgency and stress incontinence after the catheter is removed—in fact, it would be remarkable if they didn’t. Think about it: The urethra has been stretched and possibly irritated for three weeks by the catheter; it’s probably going to take hours to days for it to recover from this insult.

Urinary control generally returns in three phases . Phase One—you’re dry when lying down at night. Phase Two—you’re dry when walking around. And Phase Three—you’re dry when you stand up after sitting. Persistent stress incontinence (leaking urine when you stand up or exercise) is rare, and total incontinence is even more rare.

There’s also something you can do to control stress incontinence—special exercises, called Kegel exercises, that strengthen the external sphincter. To help speed up your recovery, practice starting and stopping your urinary stream every time you go to the bathroom. The best way to do this is when standing to urinate: Try to shut off your urinary stream by contracting the muscles in your buttocks tightly. (There are other methods of performing these exercises, but by doing them this way you can be sure you’re exercising the right muscles.) Only perform these exercises when you urinate—don’t do them at other times, because you will tire out the sphincter muscle.

Until your urinary control returns completely, wear a pad, such as a Serenity pad, or disposable diaper, such as Depends. You can get these at the pharmacy or grocery store. Some men prefer using a special kind of padded underwear called Confidens Brief; your doctor should have good suggestions and perhaps even some samples for you to try. Whatever you do, do not wear an incontinence device with an attached bag, a condom catheter or clamp! If you use these devices, you won’t develop the muscle control you need to be continent. Also, until your urinary control has returned, avoid drinking excessive amounts of fluids, and limit alcohol and caffeine—both can make the problem worse. Again, remember: You will get through this.

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Posted by admin on March 30th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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It’s best to tell the person yourself rather than having a friend do it or having the person hear it through the grapevine. If the person hears it from someone else, he or she is going to feel even worse. The person may feel like you’ve made a fool of him or her, or that you didn’t even care enough to bother being honest. The person may feel even more hurt or angrier if he or she has to hear the bad news from someone else.

It’s usually very difficult for us to be honest and to tell someone that our feelings have changed. Even though it’s perfectly normal and natural for a person’s feelings to change, we may none the less, feel guilty about it. We may feel that we’re some terrible, disloyal, bad sort of person. Sometimes we may feel so guilty, so disloyal and so afraid of the other person’s angry, hurt feelings that we may pick a fight so we’ll have an ‘excuse’ for splitting up. Rather than honestly admitting the real reason we want to end the relationship, we may try to shift the ‘blame’ to the other person. We may try to pretend that it’s the other person’s fault, that it’s something he or she has done or that it’s something about him or her as a person that’s causing the split. But, if you think about it, is it really right or really fair to shift the ‘blame’?

Our advice is be honest, but be kind. You might say something like ‘I really want to be your friend, but I don’t want to be tied down to just one person’ or ‘You’re really terrific and I really care about you, but I just feel I’m too young to settle down and date only one person.’

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Posted by admin on March 27th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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Many, if not most, boys and girls engage in some form of sex play during childhood. Psychologists and sex experts agree that this is a perfectly normal and natural part of growing up and learning about sex. It doesn’t mean that there’s anything ‘wrong’ or ‘nasty’ about you if you’ve done these things.

However, bullying someone else or being bullied into doing something sexual by another child can be harmful. If you are bullied into doing something sexual by another child – or, for that matter, by anyone – it’s important that you talk this problem over with your parent or another grown-up you trust.

If it’s natural and normal, why do parents make you stop if they catch you playing doctor?

When parents discover their children playing doctor or other sex games, they usually make the children stop. Some parents even become angry or upset with their children if they find them playing sex games.

There may be any number of reasons why parents make children stop and/or get upset. For instance, some parents have religious values that lead them to feel that sex play in children is morally wrong or sinful. Some parents were caught doing the same thing when they were children and their parents stopped them or became angry with them. So they react in the same way their parents did. Moreover, some parents don’t realize that sex play is natural and normal, so they become upset by what they think is unnatural or abnormal behaviour.

Even parents who don’t have religious objections and who realize sex play is a natural part of growing up usually put a stop to it when they find children engaging in sex play. Part of the job of being a parent is to teach your children what kind of behaviour is considered proper, polite and socially acceptable. For instance, if someone didn’t tell them not to, many little children wouldn’t think twice about taking off their clothes and walking down the street naked. In our society it’s not considered proper or socially acceptable for people to go out in public nude, so parents usually teach their children to keep their clothes on. The same is true of sex play. In our society it is not considered proper or socially acceptable for children to take off their clothes and look at other people’s sex organs or to play doctor. So even though they don’t necessarily think playing sex games is sinful or nasty, parents usually stop this kind of thing because it isn’t considered socially acceptable or proper behaviour.

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Posted by admin on March 27th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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Anyone, of any age, who thinks he or she may have an STD should go straight to a special clinic for free advice, testing and treatment. It is not necessary to be referred by your GP. The names and addresses of special clinics can be found on posters and notices displayed in doctors’ surgeries, health centres, post offices, and Citizens’ Advice Bureaux. The special clinics are sometimes called the Departments of Genito-urinary Medicine, STD clinics or Special Treatment Centres. You can also call a Brook Advisory Centre for advice on how to get treatment.

Testing and treatment is entirely confidential. You don’t need your parents’ permission. The people at the clinic will not inform your parents (or anyone else for that matter) that you have been tested and/or treated for an STD. The people who work at the special clinics are used to dealing with young people who have STDs. You needn’t feel embarrassed or ashamed to go to a clinic.

Even if you don’t have symptoms, but think you may have had contact with an infected person, it’s important that you be tested. Even if your symptoms have disappeared, the germs may still be in your body causing damage, and you can still pass the infection to others. So it’s important to be tested even if your symptoms have subsided.

You should go to a clinic immediately so you can be tested and treated as soon as possible. If you do have an STD, it’s important that you notify all your recent sexual partners so they, too, can be tested and treated.

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Posted by admin on March 27th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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If pregnancy occurs, there are three choices: continuing the pregnancy and keeping the baby; continuing the pregnancy but giving up the child for adoption; and abortion. If you are not certain which is the best choice for you, your GP or the doctor at the place where you got your pregnancy test can refer you to a counsellor who will help you decide. Regardless of what decision you make, you have the right to sympathetic counselling and to complete information about each of the choices available. Even if you feel certain about your decision, you may find it helpful to discuss your decision with a counsellor.

Is it legal for a teenager to have an abortion?

Yes, but young women under the age of 16 need the permission of a parent or guardian in order to obtain an abortion. In addition, women of all ages must have two doctors agree that the woman or any children she already has will suffer physical or emotional harm if she continues the pregnancy or that the baby is likely to be born handicapped or that continuing the pregnancy would endanger the woman’s life.

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Posted by admin on March 27th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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Sterilization involves a surgical operation, which is called vasectomy in men. Vasectomy is a minor operation that can be done in a doctor’s surgery under a local anaesthetic, but is also often carried out in a clinic or hospital under a general anaesthetic. The vas deferens are cut, sealed or otherwise blocked so that sperm can no longer travel from the testicles to the penis. Female sterilization is a more involved operation, done under a general anaesthetic, and usually requires at least a short stay in hospital. The Fallopian tubes are cut, sealed or otherwise blocked so that ova can no longer travel through them and therefore can’t be fertilized by sperm.

Sterilization is a permanent method, so it is only for people who are sure they won’t want children in the future. After the operation, a man still ejaculates, but there are no sperm in his semen. After sterilization men still produce sperm in their testicles and women still produce ripe ova, but the sperm and ova are reabsorbed by the body. Only one member of a couple-either the man or woman (not both) – need have the operation in order to protect against pregnancy.

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Posted by admin on March 27th, 2009 :: Filed under Men's Health-Erectile Dysfunction

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