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Part Two of our Mens Health MOT & Phone In

Monday, 19 January 2009

Today Dr. Philip will be informing us of the various ailments that every man should be aware of and regularly checking for. Today we're looking at four ailments which are exclusive to men and that every man should be checking for.
Prostate Cancer

Stat: There were 2407 new cases of prostate cancer in 2005 (NCRI 2005) which means that 1 in 11 Irish men will be diagnosed with prostate cancer during their lifetime. It is the second most common cancer in men, after skin cancer. Although the number of men with this disease is large, the number expected to die is considerably smaller, since the majority diagnosed do not die of it.
Each year in Ireland however, over 500 men die from prostate cancer, usually some years after they were diagnosed. Prostate cancer generally occurs in older men; 4 out of every 5 prostate cancers are diagnosed in men over the age of 65.

What is the prostate?
The prostate is a doughnut-shaped gland of the male reproductive system that surrounds the neck of the bladder and the urethra (the tube that carries urine from the bladder to outside of the body via the penis). It produces fluid to nourish sperm and needs the hormone testosterone, produced by the testes, for normal function.

Apart from the risk of developing cancer, the prostate can cause difficulties due to enlargement. The medical term for enlargement of the prostate is BPH (Benign Prostatic Hyperplasia). Bacterial infection (prostatitis) of the prostate may also occur.

Prostate cancer is rare before the age of 50. In about two thirds of cases, prostate cancer is caused by latent or slow growing tumours and will not present clinically during the patient's lifetime.

What are the symptoms of prostate cancer?
Because of its position surrounding the neck of the bladder and the urethra, the enlarging prostate gland compresses the urethr. leading to:

. Hesitancy in initiating urination
. Reduction in the force of the uninary stream
. Post - urination dribbling
. An increase in the frequency of urinating
. Incomplete emptying of the bladder
. Nocturia (urinating at night)
. Overflow urinary incontinence
. Occasional urinary retention
. Haematuria (blood in the urine) This is a more suspicious symptom.

It is very difficult to differentiate between prostate cancer and BPH based on symptoms alone and some further tests may be required to establish a firm diagnosis.

NB: Not all men with prostate cancer are symptomatic so if in doubt get checked!

Treatment Options
There are several treatment options for prostate cancer these include .
. Radical Prostatectomy - The removal of the prostate
. Radiotherapy
. Hormone Therapy
. Watchful Waiting, in some cases an initial tumor may not be dangerous but requires constant monitoring.
Source /
Question from last week: Is a blood test on the prostate sure to detect cancer early?

. Prostate Enlargement

What causes prostate problems?
As you age, your prostate tends to grow, and like a doughnut closing its hole, this growth can pinch the urine tube, making urination difficult or painful. In fact, half of men over age 50 have symptoms related to an enlarged prostate, including the following:

. Weak urine stream
. Needing to urinate more often
. Needing to get up in the middle of the night to urinate
. Difficulty in starting urination (needing to strain in the beginning, especially in the morning)
. Not being able to empty the bladder completely
. Difficulty in stopping urination
. Dribbling after urination
Doctors refer to this prostate enlargement as benign prostatic hyperplasia, or BPH. While they know that prostate growth depends on the presence of testosterone, scientists aren't sure why the prostate enlarges as men age.
Does BPH cause prostate cancer or other problems?
BPH is not prostate cancer, nor does it make you more likely to develop cancer. However, prostate cancer can cause similar symptoms, so don't put off a trip to the doctor if you're experiencing any of them. Also, if you're having difficulty emptying your bladder, you may be at greater risk for bladder infections, since the lingering urine provides a breeding ground for bacteria.

Whenever the flow of urine is impeded, it puts added pressure on your kidneys, which can lead to kidney damage or infection. In rare cases, an enlarged prostate can actually make it impossible to urinate. If this happens, a doctor can insert a tube into your bladder to hold the urethra open until the problem can be resolved.

Treatment Options
. Cut out caffeine and alcohol as they cause muscles in your bladder to tighten.
. Your doctor can treat you through medication
. Surgery to remove the enlarged tissue


. Testicular cancer

Stat: In 2005, 162 new cases of testicular cancer were diagnosed, and there were 4 deaths.

What is testicular cancer?
Testicular cancer is a cancer that arises in the testes. It is usually diagnosed among young men in their early 20s, however, it can occur in the younger age group and indeed up to the age of 50.

There are two main types of testicular cancer: malignant seminoma (the most common type) and non-seminoma. Malignant seminomas frequently present earlier, are most common in the 25-35 year old age group and are more frequently localised to the testes at diagnosis i.e. they don't have any evidence of spread.

The cure rate is very high for this type of seminoma (about 95 percent). Once treated with surgery and radiation, it almost never ever comes back. In cases where the disease has spread to other organs chemotherapy is extremely effective and the cure rate is higher than 90 percent.

What causes testicular cancer?
In most cases, the exact cause of testicular cancer is unknown. Although it is still quite rare, the number of men who develop testicular cancer has been steadily increasing for the past few years. The reason for this is not known, but research is going on all the time into possible causes. In 2005, 162 new cases of testicular cancer were diagnosed, and there were 4 deaths

Testicular cancer is more common in men with an undescended testicle or who have a testicle that did not descend until some time after birth. You are also slightly more at risk if you have had testicular cancer in the past. There is a very small increased risk of developing testicular cancer if your father or brother had the disease.

Testicular cancer does not occur because of any sexual practice or lifestyle. No link between injury or sport strains and testicular cancer has been found, but injury may cause a tumour to become more obvious. If you have a lump or a swelling in the testicle as a result of an injury or for any reason you must have it checked out by a doctor as soon as possible. The doctor will decide whether further investigation is required.
Testicular cancer is not infectious and cannot be passed on to other people.

What are the symptoms of testicular cancer?
If you answer YES to any of the following questions do not delay in speaking with your doctor:

. Can you feel a painless lump or swelling in either testicle?
. Do you notice any hardening of the testicle?
. Is the testicle tender to touch?
. Can you feel a sensation of heaviness in your scrotum?
. Can you feel a dull ache in your lower abdomen or groin?

Most lumps in the testicles do not turn out to be cancer. However, if your doctor confirms that you have an unusual lump or swelling, you may be sent to a specialist (called a urologist) for further tests.

Treatment Options
. Surgery: removal of part or all of the testicle
. Radiotherapy: the use of radiation treatment to destroy cancer cells
. Chemotherapy: the use of drugs that kill cancer cells

Source /
Question from last week: Danny is 39 and from Kildare. He has a small lump on his left testical which changes size and colour regularly. Does the doctor have any advice for him?

. Erectile Dysfunction

What is erectile dysfunction?
Erectile dysfunction, also known as impotence, is the inability of a man to achieve or maintain an erection sufficient for sexual intercourse. Occasional failure to achieve an erection is a common phenomenon and does not constitute a medical problem. However, if the problem is recurring, it may be erectile dysfunction and you should consult your doctor.

Erectile dysfunction can refer to a total inability to have an erection, an inconsistent ability to do so, or the ability to sustain only brief ones. The risk of erectile dysfunction increases with age.

What causes erectile dysfunction?
Often, erectile dysfunction has a physical cause, such as an injury or because of drug side effects. However, there may also be psychological reasons, such as depression and anxiety.

An erection is the result of an interaction between the blood circulation system, the nervous system, the hormonal balance and a number of psychological factors. Because this is such a complex mechanism, disruption at any level can result in erectile dysfunction.

Causes of Erectile Dysfunction can be both physical and mental.

What are some of the physical causes of erectile dysfunction?

. Excessive drinking
. Heavy smoking
. Side effects from certain drugs, such as some antidepressants or some drugs used to treat high blood pressure (anti-hypertensives)
. A disease of the nervous system, such as MS (multiple sclerosis)
. Diabetes can, in some cases, result in erection difficulties
. Heart or circulation problems
. Other serious, long-term illnesses - such as liver or kidney disease.

What are some of the psychological causes of erectile dysfunction?

. Depression
. Performance anxiety (worrying about how you will perform during sex)
. Stress
. Relationship problems.

Sometimes an occasional erection problem can set off a cycle whereby the worry and stress caused by the initial problem becomes a cause of further erection difficulties.

Treatment Options
. If problem is psychological, you may be referred to a psychotherapist to get to the root of the problem.
. If it is suspected that erectile dysfunction is a side-effect of a medication, switching to a different class of drug may solve the problem.
. Your doctor may also recommend lifestyle changes, such as reducing your alcohol intake or cutting down on smoking.
. Otherwise, you may receive some sort of drug therapy.