Herbal Health
Herbal Remedies Blog
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THE EXPLANATION FOR LINGERING BACTERIAL PROSTATITIS
One of the explanations for lingering bacterial prostatitis may be the presence of infection in tiny stones, called calculi, in the prostate. Prostatic calculi (the prostate’s version of gallstones or kidney stones) are quite common—about 75 percent of middle-aged men and 100 percent of elderly men have them. They can be detected with an imaging process called transrectal ultrasound. They’re usually small, found in grapelike clusters, and, most important, harmless. But when they get infected—as they often do in men with chronic bacterial prostatitis—prostatic calculi can cause an infection to persist, and symptoms of urinary tract infections and prostatitis to return again and again. (What causes calculi? Molecular analysis has shown that these stones contain ingredients generally found in urine but not prostatic secretions—which suggests they form when urine somehow “backs up,” or refluxes, into the prostate.)
When a man has both prostatic stones and a history of chronic bacterial prostatitis, it’s pretty safe to assume that the stones are infected. The significance of this is that infected calculi have never been cured by medication alone, although antibiotics can certainly treat the symptoms. The only way to cure infected prostatic stones permanently is to remove them surgically, by a procedure known as transurethral resection of the prostate.
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Men's Health-Erectile Dysfunction Erectile Dysfunction, Men’s Health
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BPH TREATMENT:LESS INVASIVE PROCEDURES. BALLOON DILATION
For more than a century, doctors have tried to find mechanical means—using catheters, for example—of opening up the urethra constricted by BPH. In this technique, originally designed for expanding clogged arteries, a balloon is passed into the narrowest part of the urethra and then inflated to stretch the opening, and thus improve urine flow. This procedure has a lot of advantages: It’s safe and simple, can be done on an outpatient basis using a local anesthetic, and so far has shown no signs of causing impotence or retrograde ejaculation. Even the most high-risk patients, those in precarious health, are eligible and can get immediate relief of symptoms.
But does it work, and for how long? The answer is, symptoms may improve at first, but the results don’t last. One study found a 50 percent improvement in urinary flow at one month; however, this improvement disappeared after one year. Current studies suggest that balloon dilation is not a long-term cure, that the urethra does not stay open for years, as it does with prostatectomy. (As one urology textbook puts it, “It would appear that the objective, long-term results will be measured in months, rather than years.”) Much more research is needed. Also, not everyone is a good candidate for this procedure; for example, it’s not recommended in men with a decompensated bladder, middle lobe enlargement, or an active urinary tract infection. Finally, the procedure does not yield any tissue samples for a pathologist to inspect for prostate cancer, so a digital rectal examination and PSA blood test are as important now as ever.
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Men's Health-Erectile Dysfunction Erectile Dysfunction, Men’s Health
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UNDERSTANDING BPH AND HOW IFS DIAGNOSED: WHAT SETS ALL THIS IN MOTION?
There probably isn’t one clear-cut explanation for BPH; it involves too many disparate factors. But we do know that the development of BPH has at least two prerequisites—the testes, and aging. And new research suggests that a third condition, family history, may also be important.
The testes, housed in the scrotum, are the main source of the male hormone, or androgen, called testosterone, which is responsible for secondary sex characteristics, like post-puberty body hair and deepening of the voice, and for fertility. Testosterone acts on the prostate, but it’s not the only thing that makes the prostate grow. In fact, as it turns out, testosterone is not even the primary troublemaker in BPH; it just initiates the process. The trouble starts when testosterone is converted by an enzyme called 5-alpha-reductase to DHT (dihydrotestosterone). DHT is the major androgen, or male hormone, inside the prostate cell. (The thermostat that regulates all this activity is the hypothalamus, located in the brain.)
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Men's Health-Erectile Dysfunction Erectile Dysfunction, Men’s Health
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PROSTATE CANCER: THE VERY UNDERSTANDABLE PROBLEM
The very understandable problem most people have in accepting this approach is the uncertainty associated with it. What is my cancer going to do? Will it just sit there for years, or will it begin to spread quickly? And, the biggest worry of all, how long have I got to live? Am I going to die soon?
No doctor can answer these questions, because in every man, prostate cancer is different. However, although we don’t know the absolute answers for your specific cancer, we do know some things, and they are reassuring.
We know what generally happens to men in your situation who are followed carefully with watchful waiting: Gradually, over time, the PSA level will go up. At some point, the bone scan will become positive. This is the time to begin hormone therapy. Once hormone treatment is under way, the PSA level almost always falls dramatically and stays low indefinitely—for some men, this can mean many years. However, at some point down the road, if the patient lives long enough, the PSA will begin to rise again, as the hormone-resistant cells start to multiply. This is when both patients and their physicians begin to worry, because if these cells cannot be stopped, a man’s lifespan is generally only one or two years from this point.
Now, having said this, we also add that for men facing this today, there is great hope. Within the next five to ten years, we expect major new advances that will make it possible for us to control these hormone-resistant cells. Monumental research efforts are being focused on finding new and better ways to treat advanced prostate cancer. And it is entirely possible, if and when you ever reach the point where the hormonal therapy is no longer working, that more effective treatments will be there waiting for you.
Therefore, it is impossible to tell any man with prostate cancer how long he will live today because there is great and reasonable hope that he will have a much brighter outlook tomorrow.
So, to sum up: All of this means that if you have positive lymph nodes and embark on a plan of watchful waiting, you will be avoiding unnecessary side effects today from treatments that will not prolong your life; that these treatments will be there tomorrow, if you develop symptoms and need them. And that, in the future, there is a strong likelihood that we will have new treatments available for you that will do a better job of controlling this cancer.
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Men's Health-Erectile Dysfunction Erectile Dysfunction, Men’s Health
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RESULTS OF RADIATION SEEDS: MOST IMPLANTATION PROGRAMS DON’T DO ANYTHING TO FIGHT CANCER OUTSIDE THE PROSTATE
Studies have found that men with higher tumor stage and grade were more likely not to be cured by radiation seeds (which makes sense, considering that most implantation programs don’t do anything to fight cancer outside the prostate). Also, some studies have found that a significant number of men—20 percent in one study—who got radioactive iodine implants required radical prostatectomy to help fight cancer that had returned. With external-beam radiation therapy, this number is much lower, about 8 percent. (Note: Many urologists feel that radical prostatectomy after any radiation treatment is not going to be very successful and will not perform the operation on these men.)
And in studies comparing seed implantation’s results in controlling cancer to other therapies, the seeds have come in a distinct third to radical prostatectomy and external-beam radiation therapy. In no major study has interstitial brachytherapy ever proved a better method than the other two main forms of treatment for prostate cancer. However, many studies looking at “relapse-free survival” have shown, at ten years after seed implantation, that 58 percent or more of men are still alive and cancer-free, and one study found that 53 percent of men who didn’t have cancer in the lymph nodes were alive and cancer-free after fifteen years. The bottom line from a host of studies seems to be that seed implantation—if it doesn’t ultimately cure prostate cancer—can at least delay it significantly, for years.
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Men's Health-Erectile Dysfunction Erectile Dysfunction, Men’s Health