New study, same old drug | Urology | 08-2010
I don t distinguish between finasteride Proscar and dutasteride Avodart in PSA results. I expect the PSA to drop 40 after 6 months and 50 after a year. I tell ...
Genetics of breast cancer | Oncology | 06-2009
If you re simply asking the absolute risk of a man with breast cancer s offspring developing breast cancer versus a woman s offspring, then the man is more likely ...
Testing testosterone | Urology | 04-2009
Testosterone testing may be considered for two conditions to see if castrate level has been achieved for men undergoing hormone treatment for prostate cancer, and secondly to assess dysfunctional sex ...
PSA testing in the elderly | Urology | 02-2009
The idea behind stopping the testing at age 70 is based on the fact that the average male life span in Canada is 78. As it may take about 10 ...
How long before testosterone kicks in? | Urology | 02-2008
I checked this question with Peter Chan, our urologist-andrologist at the McGill University Health Centre. He tells me that he checks for benefits at 3 months, and often again at ...
The testosterone paradox | Urology | 10-2007
Actually, there is no disconnect. There was a time when testosterone was thought to cause an enlarged prostate and perhaps even prostate cancer. We now know that testosterone can act ...
PSA guidelines for the young and old | Urology | 08-2007
PSA guidelines keep changing, but I have no hesitation in recommending the test. I start at age 40 for men with a family history of prostate cancer or with an ...
Can DHT-inhibitors treat prostate cancer? | Urology | 06-2007
Testosterone can be converted into dihydrotestosterone, an androgen five times more powerful than testosterone. This reaction is mediated by an enzyme called 5-alpha-reductase. Drugs such as finasteride or dutasteride blot ...
Can a hot diet cool cancer? | Urology | 03-2007
Prostate cancer rates do appear to be lower in East India, a part of the world that consumes a lot of capsaicin, the hot spice in curry and red peppers. ...
Negative prostate biopsy: what next? | Urology | 06-2006
You describe an unfortunate scenario that can occur when an aggressive cancer starts in the inner part of the prostate rather than in the outer part, where more than 70 ...
Does sex prevent cancer? | Urology | 06-2006
We probably should know the answer to this question, but we don't. It's only in recent years that we've accepted the fact that masturbation is universal and not harmful. Nuns ...
Can bisphosphonates be useful in bony cancers? | Oncology | 05-2006
Bisphosphonates amp amp 151 specifically, pamidronate, zoledronic acid and clodronate amp amp 151 have all been studied in individuals with cancer. When given to patients with known bony metastasis, they're ...
Are anabolic steroids advisable in older men? | Urology | 02-2006
I'm not aware that medical bodies have an official stand on this. As a urologist who deals with prostate enlargement and cancer, I'll simply state my understanding of the facts. ...
Revisiting the risks of vasectomy | Urology | 02-2006
There's no increased risk for infarction, prostate cancer, arthritis or any other health problem after a vasectomy, despite scare stories that were suggested earlier on. Vasectomy has stood the test ...
Seeing red over bloody semen | Urology | 12-2005
There was a time when hematospermia was considered a sign of prostatitis and most urologists prescribed a course of antibiotics. We now believe blood in the semen is like a ...
Does finasteride prevent prostate cancer? | Oncology | 09-2005
Good question The prostate cancer prevention trial, a seven-year clinical trial asking if finasteride could prevent the development of prostate cancer, was published in lt i gt NEJM lt i ...
Does finasteride prevent prostate cancer? | Urology | 09-2005
Finasteride might lower the risk of developing prostate cancer by as much as 25 , according to the large U.S. study cited above. The recommendation for its use, however, is ...
Is there a place for PSA? | Urology | 01-2005
The PSA blood test is the best single marker we have to monitor prostate cancer after surgery or radiotherapy. The count should be less than 0.2 ng mL after radical ...
Supplements to offset prostate Ca risk | Urology | 11-2004
Research is underway to determine if selenium and vitamin E do, in fact, reduce the likelihood of developing prostate cancer, but the results won't be known for another 10 years ...
What's testosterone got to do with prostate Ca? | Oncology | 07-2004
The initial treatment of advanced prostate cancer involves using luteinizing hormone-releasing hormone analogues along with radiation therapy. Testosterone is often measured to ensure that it returns to normal after the ...
Does chlamydia cut prostate Ca risk? | Infection | 05-2004
The only reference that I could find in the medical literature to suggest such a link was a meeting abstract referenced in AIDS Patient Care STDs 2002 16 620 . ...
Is sildenafil contraindicated with terazosin? | Urology | 01-2004
Not many patients with prostate cancer profit from terazosin. I presume he's on hormone therapy as well, or else we're talking about a patient with benign prostatic hyperplasia. In either ...
Approaches for andropause after prostate cancer | Endocrinology | 08-2003
Despite all the concern about andropause, I think it's essential to document a testosterone deficiency before considering treatment with androgens in any man. This patient is certainly at risk of ...
Is andropause a real diagnosis? | Geriatrics | 08-2003
This is an excellent question -- unfortunately, there's not enough evidence from randomized controlled trials to give an excellent answer. At the negative end of the spectrum are comments that ...
Are we ready for routine PSA screening? | Oncology | 07-2003
PSA screening for prostate cancer is an extremely controversial topic. Although regular PSA testing clearly detects many early cases of prostate cancer, it's not certain whether such early detection translates ...
Bisphosphonates and survival in advanced Ca | Oncology | 05-2003
There s good evidence that regularly giving potent bisphosphonates cuts the incidence of bone complications pathologic fracture, need for palliative radiation, hypercalcemia in patients with bone metastases from breast cancer, ...
Is testosterone replacement safe with high PSA? | Urology | 05-2003
A PSA reading of 7.21 ug L is worrisome regardless of his age, which isn t stated. I think an ultrasound examination of his prostate, along with sextant biopsies, are ...
Making the most of PSA testing | Urology | 05-2003
A PSA reading of 4.4 ug L in a 50-year-old is reason enough for transrectal ultrasound and ultrasound-guided biopsies. If the sextant or more biopsies are negative, I d repeat ...
Cancer screening in dermatomyositis | Dermatology | 04-2003
The relationship between adult dermatomyositis and malignancy is controversial, but several studies support a true link between the two. The best studies show a higher association with malignancy in adults ...
Gleason score in prostate Ca: what does it mean? | Oncology | 04-2003
The Gleason score is an indication of tumour grade in prostate cancer, calculated after evaluating the histologic characteristics of two fields of the tumour. The higher the score, the greater ...
Is there a link between BPH and sexual dysfunction? | Urology | 04-2003
There's no scientific evidence that BPH predisposes to sexual dysfunction. I see many patients with various degrees of symptoms from BPH, and prostates of different sizes, and haven't seen any ...
How to handle hematospermia | Urology | 03-2003
Finding blood in their semen terrifies a lot of men, who come rushing to the office for answers. Extensive investigations -- from urine cultures and cytology to imaging, such as ...
Could finasteride prevent prostate Ca? | Oncology | 02-2003
Finasteride inhibits 5-alpha-reductase, which transforms testosterone into dihydrotestosterone, a more potent androgen with greater effects on the prostate gland. In benign prostatic hypertrophy BPH , the drug shrinks prostatic bulk ...
WHICH MEDS CAN AFFECT PSA? | Urology | 07-2002
Finasteride Proscar 5 mg daily will drop the PSA count by 40 in six months, and 50 in one year. Saw palmetto may lower the PSA, but how frequently and ...
DOES BRCA MAKE A DIFFERENCE IN SCREENING? | Oncology | 02-2002
The presence of a breast cancer susceptibility gene in patients obviously indicates a significant risk for the development of a breast malignancy 85 at age 70 . In practice, this ...
psa testing in primary unknown cancer | oncology | 11-2001
PSA has a specificity of over 90 , meaning that the false negative rate is less than 10 . In most cases of primary unknown cancer, the finding of a ...
psa screening: get with it | Urology | 11-2001
The arguments against PSA screening are weakening every year. The PSA picks up prostate cancer twice as often as the digital rectal exam, and cancers diagnosed because the PSA is ...
INVESTIGATING GYNECOMASTIA IN ELDERLY MEN | Endocrinology | 06-2001
Gynecomastia frequently shows up in elderly men and is almost always benign. It's due to an imbalance in the estrogen testosterone ratio, either in the circulating hormones or at the ...
TOO OLD FOR CANCER SCREENING TESTS? | Oncology | 12-2000
There's no definite answer to this excellent question. I believe that flexibility in screening elderly patients for cancer is very important. The decision to screen an elderly person or anyone ...
DON'T FORGET THE DRE | Urology | 11-2000
The practice guideline for family doctors doesn't consider digital rectal exams DREs necessary. I happen to disagree. Carefully done, a rectal exam can help in the early diagnosis of prostate ...
WHAT'S NEW IN ADJUNCTS TO PROSTATE CANCER SURGERY | Oncology | 03-2000
Postoperative radiation therapy has been shown to reduce local pelvic recurrence in high-risk T3 and T4 prostate cancer, but it doesn't reduce the risk of distant metastases or death from ...
CAN MRIS FIND PROSTATE CANCER? | Imaging | 08-1999
As both imaging and laboratory technologies advance, our detection rate for prostate cancer is improving, although there's still a long way to go. Positive predictive values PPV for digital rectal ...
CRYOTHERAPY FOR PROSTATE CA: WHAT'S THE NEWS ON IMPOTENCE? | Urology | 02-1997
The treatment of early prostate cancer with cryotherapy is highly experimental and no meaningful results are currently available. It is a procedure being investigated by a few reputable centres and ...
DATA DISPROVES VASECTOMY HEALTH RISKS | Urology | 01-1997
Adverse consequences, like increased risk for coronary heart disease, arthritis and impotence, have all been disproved. About four to five percent of patients report lingering discomfort from increased fluid pressure ...
PSA PROMOTION | Urology | 06-1995
If you believe, as I do, that early diagnosis of prostate cancer can translate into a potential cure, it makes sense to do a simple blood test that's twice as ...
