Researchers have identified 12 DNA sequences that may help doctors determine which men will suffer from erectile dysfunction (ED) following radiation therapy for prostate cancer. Identifying these patients in advance of treatment may better inform men and their families as to which prostate cancer treatments are best for their specific cancer and lifestyle, according to a study to be published online September 27, 2012, in advance of the October 1, 2012 print issue, in the International Journal of Radiation Oncology• Biology• Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO). The findings could also guide doctors in recommending the most effective treatments that carry the least risk of patients developing ED.
The main treatments for prostate cancer – surgery, brachytherapy (seed implants) and external beam radiation therapy – are all very effective at curing prostate cancer. Unfortunately, each treatment places patients at risk for ED. Although many men will maintain their potency, doctors would like to identify which men are at greatest risk for the development of difficulty with sexual function.
In this multi-institutional, multi-national study, researchers from New York’s Mount Sinai School of Medicine, Albert Einstein College of Medicine of Yeshiva University in Bronx, N.Y., New York University School of Medicine, Florida Radiation Oncology Group in Jacksonville, Fla., and Maastricht University Medical Center in Maastricht, the Netherlands, examined 593 men who were treated with brachytherapy and/or external beam radiation therapy and hormone therapy. Of them, 260 reported erectile dysfunction.
“Through a two-stage genome-wide association study, 12 single nucleotide polymorphisms (SNPs) were identified that were associated with the development of erectile dysfunction after radiation treatment for prostate cancer,” said Barry S. Rosenstein, PhD, department of radiation oncology at New York’s Mount Sinai Medical School. “If validated further, these SNPs could provide the basis for a blood test that would enable radiation oncologists to predict more accurately which men are most likely to develop erectile dysfunction after prostate cancer radiation therapy.”
“Prostate cancer screening and treatment are undergoing major shifts,” said Harry Ostrer, MD, professor of pathology and genetics at Albert Einstein College of Medicine, director of genetic and genomic testing at Montefiore Medical Center and co-principal investigator of the study. “This is part of our ongoing effort to personalize and optimize treatment for prostate cancer.”
Bisphenol-A (BPA), a chemical used to make resins and strengthen plastics, has been linked to many health problems that affect men, not only potentially fatal diseases including heart disease, diabetes, and cancer, but also life-changing conditions such as decreased libido and erectile dysfunction. The latest study also finds that BPA may be responsible for impaired semen quality and a drop in sperm count.
BPA Lowers Sperm Concentration and Vitality, but Not Shape and Size
Although much research has been done on men and women who experience high-dose exposure, such as those that are exposed in their work settings, Dr. De-Kun Li, a reproductive and perinatal epidemiologist, has found that similar associations are found in those with general environmental exposure as well. Most Americans’ urine has evidence of BPA exposure, as the chemical is used in commonly used products like hard plastic drinking bottles, metal food container linings, dental sealants, and cash register receipts.
The most recent research, funded by the US National Institute of Occupational Safety, found that men with high amounts of chemical BPA in their urine had more than three times the risk of lowered sperm concentration and lower sperm vitality, more than four times the risk of a lower sperm count, and more than twice the risk of lower sperm motility than those without detectable urine BPA.
Li did not find an association between BPA and sperm shape or its volume.
Read: BPA Worsens Male Sexual Function
The data is based on a five-year study of 218 Chinese factory workers who provided researchers both urine and semen samples. The findings held even after accounting for other potentially influential factors such as smoking, prior exposure to other chemicals, and personal history of fertility issues.
Gail Prins, a reproductive physiologist not involved with the study, says that the findings make sense. “Evidence has indicated that for the past few decades, sperm counts have been declining In some human populations – and that this might be related to exposures to endocrine-disrupting chemicals such as BPA is very reasonable.”
Read: BPA Linked to Increased Testosterone Levels In Men
Dr. Li says that the findings confirm that the general public “should probably try to avoid exposure to BPA as much as they can.” Prins agrees, as chemical levels build over time. US News reporter Deborah Kotz suggests the following methods:
• Consume frozen or fresh fruits and vegetables instead of canned. In addition to their BPA-free benefit, fresh and frozen produce usually have more nutrients, which often get lost in the process of canning.
• Purchase beverages in plastic or glass bottles. Canned soda and juice often contain some BPA. If you do use plastic, look for those without a number 7 recycling code, which usually indicates the presence of BPA.
• Use powdered infant formula instead of ready-to-serve liquid. A separate assessment from the Environmental Working Group found that liquid formulas contain more BPA than powdered brands.
The U.S. Food and Drug Administration has been evaluating the safety of BPA with the assistance of the National Institutes of Health but declined to say if it is considering following Canada’s lead in declaring the chemical toxic and banning it from use.
FDA requested a recall of True Man Sexual Energy Nutrient Capsules and Energy Max Energy Supplement Men’s Formula Capsules, illegal drug products that contain potentially harmful, undeclared ingredients. The products, often advertised as “all natural” alternatives to approved erectile dysfunction drugs, could interact with medications and cause dangerously low blood pressure. They contain substances that have similar structures to active ingredients in approved prescription drugs.
The FDA has not approved True Man or Energy Max, and their safety and effectiveness are unknown.
The FDA requested the recall of all products distributed under both labels in a letter to Yin Kao, president and owner of America True Man Health Inc., of West Covina, Calif.
The products are often advertised in newspapers, retail stores, and on the Internet.
“The risk is even more serious because consumers may not know that these ingredients can interact with medications and dangerously lower their blood pressure,” said Janet Woodcock, M.D., deputy commissioner for scientific and medical programs, chief medical officer and acting director of the FDA’s Center for Drug Evaluation and Research.
As formulated, True Man Sexual Energy and Energy Max are classified as unapproved new drugs that do not declare the active ingredients thione, an analog of sildenafil; or piperadino vardenafil, an analog of vardenafil. Analogs may cause side effects and drug interactions similar to the approved drugs they resemble.
The undeclared ingredients may interact with nitrates found in some prescription drugs such as nitroglycerin. Men with diabetes, high blood pressure, high cholesterol or heart disease often take nitrates.
The FDA issued an alert on May 10, 2007, (http://www.fda.gov/bbs/topics/NEWS/2007/NEW01633.html) advising consumers not to buy or use True Man or Energy Max products. Today’s recall request comes as a result of the company previously failing to notify all of their consignees and involves True Man Sexual Energy packaged in blister pack cartons of 10 capsules and Energy Max packaged in blister pack cartons of 20 capsules. FDA is prepared to take further regulatory action should the firm refuse to accede to this request.
FDA chemical analysis has shown that Energy Max contains thione, an analog of sildenafil, a substance similar to the active ingredient in the approved ED drug Viagra. In addition, FDA investigators found that True Man contains the same analog or an analog of vardenafil, the active ingredient Levitra, another approved ED treatment. Neither of the analogs used in True Man or Energy Max are components of FDA-approved drug products.
Customers who have either product in their possession should stop using it immediately and contact their health care provider if they have experienced any problems that may be related to taking this product.
Why do men seek cosmetic surgery?
Men undergo cosmetic surgery for many reasons. Not only does our society value youth and beauty, but it rewards it. Psychologists have clearly demonstrated that given relatively equal qualifications, the more attractive man or woman is more likely to land the job. An attractive appearance is an attribute just as a bright mind, a pleasing personality, and athletic skills are.
Good and bad reasons for considering cosmetic surgery
Patients have many reasons for seeking cosmetic surgery. Many of these reasons are good ones. However, some people seek cosmetic surgery for the wrong reasons and should reconsider their decision.
The ideal patient is a well-motivated individual who has considered cosmetic surgery for some time. Most patients have seriously thought about having cosmetic surgery for 5 years or more.
Commonly stated good reasons for seeking surgery include the following:
- “I want to do it for myself.”
- “I look into the mirror and I don’t recognize that person.”
- “I feel young, I exercise, but I don’t look the way I feel.”
- “People keep telling me I look tired or angry.”
Ill-advised reasons for seeking cosmetic surgery include the following:
- “My husband/wife/girlfriend/boyfriend is leaving me. I’m looking for a boost.”
- “My husband/wife has died and I’m looking for a pick-me-up.”
Surgery is a significant investment in time, effort, and emotion.
Commonly asked questions
- “Am I vain?”
- “Will I look so different that people will know that I had plastic surgery?”
Good plastic surgery makes the patient appear more rested, happier, and younger. However, the person still looks like him- or herself.
The incidence (number of cases) of cosmetic surgery is increasing nationally. We have also noted a significant increase in cosmetic surgery in men. The fastest growing cosmetic procedure for men is liposuction, the removal of excess fat using a suction pump device. The next most common procedures are blepharoplasty (eyelid surgery) and facelift surgery.
At the initial consultation, the plastic surgeon will perform a detailed history, a physical examination, and a detailed analysis of the patient’s area of concern. Photography and computer imaging are performed and the results are shared with the patient to give him or her a clear picture of the planned changes.
Three procedures are discussed during the consultation:
- Eyelid surgery
- Facelift surgery
Each of these surgeries can be performed as an outpatient patient procedure under local anesthesia with intravenous (IV) sedation or general anesthesia. Recovery is approximately 2 weeks.
This procedure is most commonly performed under local anesthesia with sedation. Upper eyelid surgery is generally performed for excess skin, while lower eyelid surgery is generally performed for excess fat, and lesser amounts of skin are removed. Recovery is generally painless and takes 1 to 2 weeks.
Facelift surgery is a more lengthy procedure than eyelid surgery. It generally involves cutting in front of the ears, behind the ears and into the hairline and may involve an incision under the chin. While the facelift causes little pain after surgery, the discomfort is greater than it is after eyelid surgery. Most patients can return to work or casual social events 2 weeks following surgery.
Liposuction is a procedure that is performed to remove excess fat. It requires the skin to be elastic enough to contract over a smaller volume following fat removal. It is completed using either tumescent or ultrasonic techniques and involves small, inconspicuous incisions. Recovery is fast.
While complications for the above procedures are infrequent, a full discussion of the risks and complications should be carried out with your plastic surgeon before you undergo any cosmetic surgery.
A third study of Canadian men visiting primary care physicians indicates that about half of them report having erectile dysfunction, and that it is linked with cardiovascular disease, diabetes, future heart disease risk and increased fasting blood sugar levels.
“Primary care physicians are uniquely positioned to inquire about a patient’s sexual function during a routine office visit,” the authors write. “They can also screen for modifiable risk factors and treatable comorbidities. However, there is little information available regarding the prevalence of� � erectile dysfunction among patients seen in this clinical setting.”
Steven A. Grover, M.D., M.P.A., F.R.C.P.C., Montreal General Hospital and McGill University, Montreal, Quebec, and colleagues surveyed 3,921 men aged 40 to 88 years who visited one of 75 primary care physicians between July 20, 2001, and Nov. 13, 2002. Participants gave medical histories and received physical examinations, including measurements of fasting blood sugar and lipid levels.
Almost half (49.4 percent) of the men reported ED during the previous four weeks or were taking medication for erectile dysfunction, the authors report. Men with cardiovascular disease and diabetes were most likely to have erectile dysfunction. Among men without cardiovascular disease or diabetes, the calculated future risk of developing these conditions was linked to likelihood of having erectile dysfunction. “These data demonstrate that primary care physicians may find that taking a sexual history provides important clinical information beyond the detection of erectile dysfunction,” the authors conclude.
A quarter of the men who had vasectomies at a US clinic didn’t return for any follow up tests to make sure that the procedure had worked, according to research published in the April issue of the British� � � � � � � �”based urology journal BJU International.
And only a fifth of the 436 men turned up for both of the tests needed to finally put them in the clear, according to a study carried out by researchers at the Cleveland Clinic Glickman Urological Institute in Ohio, USA.
Of the 75 per cent that did attend their first, eight-week test, a quarter provided samples that still contained sperm. 80 of the 83 men were producing nonmotile (present but inactive) sperm, but three were producing motile (present and active) sperm, including one who was eventually diagnosed with a vasectomy failure.
65 of the 80 men producing nonmotile sperm were clear at their 12-week checks, but six months after their procedure eight men were still producing positive sperm samples. By ten months, all but the vasectomy failure were finally in the clear.
“Our results show that only three-quarters of the men in the study turned up for their eight-week sperm test, which means that a quarter of them had no idea whether the procedure had worked and whether their partner could still fall pregnant” says lead author Dr Nivedita Dhar, Chief Resident in Urology at the Clinic.
“It is impossible to assess the true vasectomy failure rate in the full study sample as many failed to turn up for follow-up tests, despite careful counselling.
“But what concerns us most is that a quarter of the men who had vasectomies did not return for any tests, despite us stressing the important of these follow-ups” adds Dr Dhar.
According to the researchers up to 90 per cent of urologists require two semen samples to confirm sterility and up to 95 per cent request further samples if nonmotile sperm are present. Doctors recommend that couples use additional contraception until vasectomy patients receive the all clear.
“The result of the study are consistent with other research which has estimated that non-compliance among vasectomy patients is between 25 and 40 per cent” says Dr J Stephen Jones, vice chairman of the Glickman Urological Institute, who directed the study.
“It may, however, be possible to improve full compliance among those who return for at least one test by simplifying the follow-up tests in line with current medical evidence and making sure that this is backed up by adequate counselling.
“For example, our study found that 65 of the men tested at eight weeks needed re-testing, but this fell to 15 when it came to the 12-week test. This suggests that a single test at 12 weeks may be adequate in the majority of cases.
“However, it is very important to stress that couples need to use additional contraception until the vasectomy patient has been given the all clear.”
Health fraud sells false hope. Whether fraud is packaged as exotic pills and potions, phony cures or “miracle” remedies, it thrives on wishful thinking, naivete, or desperation. Fraud wastes a consumer’s money, and in some cases, valuable time, especially when it causes a consumer to postpone proper treatment for a medical problem.
Recent advances in impotence treatment have opened the floodgates for bogus remedies for this condition. Using the Internet and direct mail solicitations, unscrupulous businesses are capitalizing on the publicity and popularity surrounding a new medical product, exploiting consumers who are desperate for a cure. The fact of the matter: Impotence is a medical condition for which treatments are available from qualified practitioners. Don’t be too embarrassed to see your physician before you begin any treatment regimen.
When it comes to healthcare or medical products that promise results – especially those for impotence – the Federal Trade Commission offers these tips for evaluating claims you may want to believe, but shouldn’t.
- If the product is advertised as effective for treating impotence – and no physician’s prescription is necessary – forget it. It won’t cure the condition.
- If the product is advertised as a “breakthrough” in impotence treatment , check with your doctor to see if it is legitimate.
- If the product is promoted by a “medical organization,” call your physician to check the credentials. Phony “clinics” and sham “institutes” are touting bogus cures for impotence.
- If the product says “scientifically proven” to reverse impotence in a high percentage of patients, check it out with your doctor. Some claims that “clinical studies” prove a product works are false; generally, high success rates should raise suspicions.
- If the product being pitched to cure impotence is “herbal” or “all natural,” dismiss it. To date, no “herbal” or “all natural” substance has been shown to be an effective treatment for impotence.