The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 31 Jul 2011 05:46 AM PDT Is your hubby's urination habits affecting your lifestyle? ARE you affected by your partner's urination habits? How has his frequent night-time visits to the bathroom affected your sleep?How has it affected your lifestyle when your partner has to plan his travel route and timing around visits to the toilet when you are out? Ever experienced being stuck in a traffic jam with him or whilst at the movies, and he has a sudden urge to urinate? These are signs that your hubby may have some form of prostate enlargement. Enlarged prostate 101 For some fortunate men, the size of their prostate does not change. Unfortunately, about 75% of men over 50 years of age have measurable enlargement of the prostate. This condition is called benign prostatic hyperplasia (BPH). It reduces a man's ability to control his urination, and if not properly cared for, can lead to serious problems. Growth of prostate tissue is stimulated by dihydrotestosterone, a male hormone. As long as this hormone is present, the prostate will keep enlarging. As the prostate enlarges, the layer of tissue surrounding it prevents it from expanding, causing the gland to press against the urethra, like a clamp on a garden hose. The bladder wall then becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself. Urine remains in the bladder, which leads to incomplete emptying of the bladder sensation. The narrowing of the urethra and partial emptying of the bladder causes many of the problems associated with BPH. The best thing we can say about BPH is, it's not cancer. To make sure that point is clear, BPH has nothing to do with cancer of the prostate. However, BPH does seriously interfere with the PSA (Prostate Specific Antigen) test. The PSA is a blood test that measures the level of a protein known as prostate-specific antigen. While elevated PSA levels may indicate prostate cancer, these PSA scores can also be the result of BPH, prostatitis and other conditions. In any event, consider an elevated PSA an early detection or warning sign. PSA is measured by nanograms per millilitre of blood, with most healthy men having under 4ng/mL. According to the American Cancer Society, a PSA level between 4 and 10 indicates a 25% chance of it being prostate cancer. A PSA higher than 10 means there's at least a 50% chance its prostate cancer. Treatment options Prescription medication Urologists sometimes prescribe medication to help relieve bothersome, moderate to severe urination problems caused by BPH. If you stop taking the medication, the symptoms will usually return. Prescription medications used to treat BPH include finasteride, terazosin and tamsulosin. Though these drugs can reduce urinary symptoms in men with BPH, it is not clear whether they slow the progression of the disease. For many, the undesirable side-effects are a major drawback, and many seek natural alternatives such as well-known herbal extracts with a long history of usage to support prostate health. Herbal supplements Saw palmetto (Serenoa repens) is one of the most researched herbal remedies for the treatment of BPH. There have been many clinical trials done with saw palmetto in BPH. A three-year preliminary study in Germany found that 160mg of saw palmetto extract taken twice daily reduced night-time urination in 73% of patients and improved urinary flow rates significantly. In a double-blind trial at various sites in Europe, 160mg of saw palmetto extract taken twice per day treated BPH as effectively as finasteride. A review of all available double-blind trials has concluded that saw palmetto is effective for the treatment of men with BPH. Most recent studies have shown that to achieve the optimal benefits with saw palmetto, it is essential that fat-soluble saw palmetto extracts are standardised to contain 85% to 95% fatty acids. (Note: Most of the older preparations in the market are using the crude extract of saw palmetto berries. The problem with the crude extract of saw palmetto is that the quality of the powder may not be consistent, hence the potency may not be consistent.) Pygeum (Pygeum africanum) is the second most popular herb for correcting enlarged prostate. It has been approved in Germany, France, and Italy as a remedy for BPH. Controlled studies published over the past 25 years have shown that pygeum is safe and effective for men with BPH of mild or moderate severity. Lycopene contains phytosterols that gives tomatoes their bright red colour. Lycopene gets high marks from researchers for its apparently potent antioxidant properties. Antioxidants can neutralise harmful substances in the body called free radicals which can contribute to cancer and cardiovascular diseases. Research shows that high levels of lycopene consumption have been associated with long-term protection of prostate health. The popular use of stinging nettle (Urtica dioca) extract in Germany has encouraged the onset of numerous clinical trials. Collectively, these trials have demonstrated the benefits of using the extract for the treatment of BPH. This extract may increase urinary volume and the maximum flow rate of urine in men with early-stage BPH. It has been successfully combined with both saw palmetto and pygeum to treat BPH in double-blind trials. Pumpkin seed (Curcubita pepo) extract contains phytosterols, curcubitin and selenium. The extract inhibits 5-alpha-reductase, preventing the conversion of testosterone to dihydrotestosterone, which ultimately prevents prostate enlargement. The above mentioned herbal extracts can help with: ● Decreasing day-time as well as night-time urinary urgency and frequency. ● Increasing the flow rate of urine, thereby improving weak urine stream and trickling. ● Decreasing the "incomplete emptying of bladder" sensation. ● Reducing prostate size by encouraging hormonal balance. Generally, when shopping for herbal product(s), choose products that contain standardised extract(s) of herbs as they can guarantee the consistency of the product. The reason for using standardised extracts is to ensure that each herb contains the same amount of biologically active compounds. In the case of crude powder/extract (non-standardised), the levels of the plants' active compounds fluctuate widely, depending on factors such as weather, soil quality, age of the plant and time of the year it's harvested. There are many prostate supplements in the market. Some are as a single herb while others can be found in various combinations. Choose one that can help regulate and improve urination in men. References: 1. Bach D, Ebeling L. Long-term drug treatment of benign prostatic hyperplasia—results of a prospective 3-year multicenter study using Sabal extract IDS 89. Phytomedicine 1996;3:105–11. 2. Carraro JC, Raynaud JP, Koch G, et al. Comparison of phytotherapy (Permixon®) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996; 29:231–40. 3. Wilt TJ, Ishani A, Stark G, et al. Saw palmetto extracts for treatment of benign prostatic hyperplasia. A systematic review. JAMA 1998; 280:1604–9. ■ This article is courtesy of Live-well. For more information, email dshoon@live-well.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. Full Feed Generated by Get Full RSS, sponsored by Used Car Search. |
| Posted: 31 Jul 2011 05:44 AM PDT The impact of hepatitis in the Asia Pacific region is set to rise if the issue is not tackled on multiple levels. LEADING experts in viral hepatitis, in conjunction with World Hepatitis Day on July 28, have urged governments and the public across Asia Pacific to become more aware of the devastating effects of hepatitis on individuals, their families and the community at large. The group, known as CEVHAP (Coalition to Eradicate Viral Hepatitis in Asia Pacific) was recently formed to address the lack of awareness and political will to tackle issues associated with viral hepatitis. Incorporated in October 2010, CEVHAP membership is comprised of many world-renowned hepatitis and virology experts, utilising the collective expertise of its members to assist the region through partnership with a broad range of stakeholders, including government bodies in public policy formulation and health education. Viral hepatitis, particularly hepatitis B and C, affects one in 12 people worldwide, claiming the lives of approximately one million people every year. Asia Pacific carries the major part of the global burden of viral hepatitis. China and India together have an estimated 123 million people chronically infected with hepatitis B and 59 million people chronically infected with hepatitis C, accounting for almost 50% of all infections worldwide. On the local front, there are an estimated 2.5 million Malaysians who are infected with chronic hepatitis B or C, and some 25% of these individuals are at risk of serious liver damage. "Viral hepatitis is a life-threatening disease, a situation made worse by the fact that a large proportion of those infected do not know that they carry the virus. Awareness of the disease has become a critical issue," said Prof Dr Rosmawati Mohamed, consultant hepatologist at University Malaya Medical Centre and an executive council member of CEVHAP. "Compounding the problem, viral hepatitis is mostly a silent disease and many people are also ignorant about how it is transmitted and how it can be fatal if diagnosed at a late stage," she added. The number of people chronically infected with, and annually dying as, a result of viral hepatitis exceed the prevalence and death due to HIV/AIDS and any cancer. Despite having a similar social impact, hepatitis lacks the same level of awareness and political momentum. This is the first year that July 28 is recognised as World Hepatitis Day globally, as a result of the World Health Assembly's Resolution on Viral Hepatitis (WHA63.R18) of May 21, 2010. The resolution also expresses concern about the lack of progress in the prevention, control and treatment of viral hepatitis around the world. "WHO is calling for a global approach to tackle the problem of viral hepatitis, and we see that it is our role, as experts in the field, to ensure Asia Pacific is part of, if not leading, some elements of the global approach," said Prof Stephen Locarnini, divisional head of the Victorian Infectious Diseases Reference Laboratory in Melbourne, Australia, and co-founder of CEVHAP. CEVHAP's goal is to act as a bridge between the WHO Resolution and the Asia Pacific region. Its early focus is on Hepatitis B and C, the two types of hepatitis with the greatest impact in the region. "While chronic hepatitis is a silent disease with little or no symptoms for many years, it is also a silent disease when it comes to public awareness and government attention. "This has led to the situation we find ourselves in today, where a large population with viral hepatitis do not seek medical attention or receive treatment – and this is also true for countries where the treatment is reimbursed by the government," said Prof D. S. Chen, distinguished chair professor of the College of Medicine at National Taiwan University and co-founder of CEVHAP. "The burden of hepatitis B on the health system will continue to rise unless effective public policy interventions are implemented by governments across the region," said Prof Locarnini. "We are not saying that nothing has been done – there has been progress in countries particularly in the area of universal vaccination – it's just that a lot more can and needs to be done to effectively tackle this issue." The Malaysian Campaign on World Hepatitis Day 2011, led by its organising chairperson, Prof Dr Rosmawati, has been scheduling a series of events over the period from June 15 to July 30 to observe World Hepatitis Day 2011 and draw public attention to the serious health threats posed by viral hepatitis. In line with the campaign theme, "Know your liver, B aware, C a Dr", the organising committee aims to improve prevention, diagnosis and treatment for hepatitis B and C in the country. Activities, such as public forums, hepatitis B and C testing, and counseling on treatment and vaccination for viral hepatitis have been conducted in 27 centres, including 18 hospitals nationwide to create better awareness of the disease among the public. The campaign objective is to not only raise the profile of viral hepatitis, but also promote greater awareness of how it is transmitted, as many who are infected are unaware that they carry the virus. Full Feed Generated by Get Full RSS, sponsored by Used Car Search. |
| Living in a probabilistic world Posted: 31 Jul 2011 05:38 AM PDT Risk is not certainty. There is seldom a 'one on one' nexus between any risk factor and a negative health outcome. WHENEVER I give a talk on "Smoking and Cancer", one question inevitably pops up. "Doctor, my grandfather smoked 40 cigarettes a year for 60 years and he never contracted lung cancer. Can you comment on this, please?" Sometimes, the tone of the questioner's voice is laced with disbelief. Does smoking really cause lung cancer? Not infrequently, the questioner is a smoker himself and is trying hard to justify his bad habit. There are times when there is a genuine desire to learn. The short answer is: "Smoking greatly increases your risk of lung cancer. For 100 non-smokers, two will get lung cancer in their lifetime. For 100 heavy smokers, 20 will be diagnosed to have lung cancer and almost all 20 will die from it. The link between smoking and lung cancer was unequivocally proven decades ago." A corollary question is: "Doctor, my sister is a non-smoker, teetotaller and also not married (where did this come from??), and yet she has been diagnosed to have lung cancer. How is that possible?" Here is the longer answer to both questions. Risk is not certainty. There is seldom a "one on one" nexus between any risk factor and a negative health outcome. Heavy smoking, excessive alcohol consumption, eating heavily fat- and calorie-laden foods three times a day, and a sedentary lifestyle are all risk factors for cancer, and heart disease. You can hear the naïve and wishful-thinking saying, "My uncle is obese, plays Farmville and other dumbing-down games the whole day long on his iPad 2 and snacks on tons of fries and tomato ketchup. Yet he is alive and kicking." He won't be both for long, I assure you. In almost all diseases there are susceptibility genes. We now know there are three sets of susceptibility genes for lung cancer. These susceptibility genes may be inherited from your biological parents or they may be acquired. Environmental factors can alter the genes you are born with or their expression. The way you were brought up as an infant and child (way beyond your control) is an important environmental factor. Even more important is smoking. The first set of these genes determines your inherent risk of getting lung cancer. The second set has to do with DNA repair mechanisms. Some cancer patients have genes that are faulty and do not sufficiently repair the damage done to the DNA of the cells in their lungs. The third set of cancer susceptibility genes codes for factors that make you acquire the smoking habit and your addiction potential. What does all this mean? Well, if you do not have the lung cancer susceptibility genes (not possible to know by routine tests at present), you may not get lung cancer even if you are a heavy smoker. But heavy smoking will, in all likelihood, lead to other cancers (mouth, larynx, oesophagus, stomach, bladder, kidney), heart disease and obstructive airway disease (bronchitis, emphysema), which are major killers by themselves. If you do not smoke and have a high genetic susceptibility (sets 1 and 2 genes overexpressed), you may get lung cancer if you are the unlucky two in 100. What can you do if you are diagnosed with lung cancer? Go for the best treatment money can buy. There is some good news. The majority of non-smokers who get lung cancer will do well with conventional chemotherapy, as well as the new relatively costly molecular drugs like gefitinib, erlotinib and crizotinib. Instead of an average life span of eight months (in smokers with lung cancer), non-smoking patients with lung cancer, especially in those with the "activating" or "good" mutations in their tumours, can live an average of 24 months with current anti-cancer drugs. The short answer, the longer answer, and now, some philosophical musings. I said that the causative or risk factor of a disease is not "one-on-one". No risk is absolute. Only the simple and literal-minded see the world as black and white. I am a relativist even in questions of ethics and morals. I am a moral relativist as opposed to the Man With The Golden Ring, who is a moral absolutist. I have often heard it said that because science cannot provide all the answers, we must look to the realms of fantasy, fiction and faith. But cosmology, quantum physics and evolutionary biology have given me a satisfying, albeit provisional, picture of the universe. It makes an uncertain world less uncertain. It is a probabilistic world we live in. Science may not reveal the ultimate truth but at least it gives me honest, penultimate answers. It is good enough for me for now. All or nothing at all? Not me. I will make do with the answers science provides me – be it the treatment of cancer or hypotheses about the beginning and end of the universe – as I continue my search. For all the cliché that it is, it is no less true. The journey, not the end, is all there is: its inadequacies, disappointments, triumphs, and glories. Come, walk with me. ■ Dr Albert Lim Kok Hooi is a consultant oncologist. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. Full Feed Generated by Get Full RSS, sponsored by Used Car Search. |
| You are subscribed to email updates from The Star Online: Lifestyle: Health To stop receiving these emails, you may unsubscribe now. | Email delivery powered by Google |
| Google Inc., 20 West Kinzie, Chicago IL USA 60610 | |
0 ulasan:
Catat Ulasan