Archive for Diseases

Hepatitis, Cirrhosis & Erection Problems

Q. My fiance is 49 and has liver cirrhosis and is positive for the hepatitis C virus. His erection is short-lived and very weak, and it is not easy for me to get orgasm with him. He was a heavy alcoholic, but he stopped drinking completely six months ago. Do you think there is a possibility of improvement in his case? What medication or advice can you suggest? I am shy about telling him my problem with this, as he thinks he is perfect.

A. From what you are describing, your fiance has a very serious problem. First, hepatitis C is permanent, incurable and contagious. If you are not already infected, then please realize that unprotected sex puts you at risk for getting this dangerous virus. Hepatitis C causes end-stage liver failure requiring a transplant in up to 50 percent of the people it infects.

Secondly, cirrhosis damages the liver. Unfortunately, liver failure changes a person’s hormone metabolism. The liver controls the conversion of testosterone (the male hormone) to estrogen (the female hormone). A man with liver failure experiences excess estrogen and less sexual drive. Also, his body fills with toxins that affect cell metabolism throughout the body, not just in the liver. Unless and until his liver problem is corrected, there is no medication that will help his sexual function.

For cases such as this, some men use a vacuum erection device. The man puts this on the penis when he wants a erection. The device draws blood into the penis, allowing it to become hard. Once it is hard, a constriction band is released at the base of the penis that squeezes it tight to keep the blood in it. This not only provides erection, it can also help for some playful foreplay.

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Peyronie’s Disease Causes Pain, Psychological Trauma

Q. My husband, who is 53, has Peyronie’s disease and we think it was caused by Fosamax. It has gotten much worse and the penis curvature is so severe that intercourse is impossible. My husband’s urologist first gave him some POTABA and told him to take vitamin E. He now feels that surgery is the only option.

My husband would prefer not to have surgery. We have heard that Propoleum injection has been effective. Do you know anything about it? What nonsurgical treatment has been the most effective for your patients?

A. I doubt that taking Fosomax (used to treat and prevent osteoporosis) caused your husband’s Peyronie’s disease, because there is nothing in the medical literature linking this drug to that disease.

Although it is always wise to keep track of changes in health related to starting a new drug, two unrelated events may occur simultaneously.

Peyronie’s disease can be very painful as well as psychologically traumatic. It is a disorder in which an inflammatory fibrosis forms in the covering (tunic) around the spongy erectile tissue of the penis.

This fibrous plaque, similar to scar tissue, is contracted relative to surrounding tissue, causing a curvature of the erect penis that may make sexual intercourse difficult, painful or impossible. If the fibrosis extends into the erectile tissue, it can actually prevent erection.

Often there is also a narrowing of the shaft, causing an hourglass or hinge effect. Shortening of the erect penis length is also seen.

The cause of Peyronie’s disease is unknown, but it’s thought to begin as a local inflammation caused by trauma. Many also believe genetics play a part.

Some investigators see an association between Peyronie’s disease and hypertension and high cholesterol, among other conditions.

No absolutely effective treatment exists for all cases. There are a number of nonsurgical therapies available, but all of them appear only partially successful. For many, the disorder can even go away by itself over a period of weeks or months.

Vitamin E and potassium para-aminobenzoate (POTABA) have long been suggested as treatment for Peyronie’s disease, alone or in combination with other treatment. But these drugs have been effective only in some patients.

Injection of drugs, especially verapamil, a calcium channel blocker, directly into the plaque has been shown to be effective, again, in some cases. Steroid injections or ultrasound may relieve symptoms for some men.

Incidentally, I could not find anything in the medical literature on “propoleum” as a treatment for Peyronie’s disease.

In more severe cases, such as your husband’s, surgery may be recommended. Here again, no one procedure is likely to solve the problem in all men with this condition. A number of factors, such as the severity of the curvature and narrowing and the ability to achieve erection play a part in the selection of surgical method.

Surgical procedures for this condition consist of either incision of the tunic or excision (cutting away) of the fibrous material. Penile prosthetic implants that help straighten the curvature may also be recommended.

I understand your husband’s reluctance to undergo surgery. There are risks with any surgery, and this surgery carries the additional risk of more scar tissue formation and may even cause impotence.

I can only recommend that your husband meet again with his urologist and get further information, such as the expected risks and benefits of all treatment options available to him. With that information, he can balance the potential benefits against the potential risks when deciding what to do.

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Understanding Hepatitis B

The term “hepatitis” refers to inflammation of the liver – a condition characterised by nausea, malaise and yellowing of the body.

This last symptom, which is manifested by jaundice of the skin and icterus of the whites of the eyes, accompanied by darkening of the urine, is due to the liver being unable to process the bile pigment bilirubin, which then accumulates in the body, yellowing the tissues and overflowing into the urine.

While there are several viruses that can infect the human liver and cause hepatitis, the most important ones are designated hepatitis A, hepatitis B and hepatitis C. Although all these organisms have the common property of infecting the liver and causing hepatitis, they are quite different in the way they enter the body and the consequences of the hepatitis they cause.

How Does Hepatitis B Get Transmitted?

Hepatitis B, on the other hand, is a virus that lives in the blood and other body fluids of infected persons. More than two billion people the world over are estimated to have been infected with the hepatitis B virus, which spreads if body fluids from an infected person enter the body of someone else who is not immune to the virus.

Thus infected blood, seminal fluid, vaginal secretions, saliva, serum from open wounds and ulcers and even breast milk from someone with the condition can transmit this virus. It can also be transmitted from an infected mother to a child during childbirth. Having sex with an infected person is a common method of becoming infected.

Vaccination Against the Hepatitis B Virus

Vaccination against hepatitis B (the course involves three injections, the second taken six weeks after the first and the third taken six months after the second) affords effective protection against the virus. Sharing of personal items like toothbrushes and razors used by infected persons can increase the level of transmission

How does the Hepatitis B Virus Cause Disease?

Once the hepatitis B virus invades a healthy human liver cell, it reproduces itself and produces several new daughter virus particles. This results in the cell rupturing and releasing the virus particles into the circulation, and these daughter viruses reach other liver cells which they then enter. This process (invasion of cells; replication of viruses inside liver cells; discharge of particles into the bloodstream and invasion of fresh liver cells) continues. The signs and symptoms of hepatitis are essentially features of a malfunctioning liver.

Sequelae of Hepatitis B

Most patients who develop hepatitis B recover from the acute infection, but unlike in the case of hepatitis A, the infection places them at risk of complications such as liver cancer, cirrhosis and liver failure.

The main predictor of whether one develops chronic infection and the serious sequelae of hepatitis B is the age at which one acquires the infection:

  • Infants who get hepatitis B rarely manifest the features of acute infection, but 90% will develop chronic infection.
  • Children who get hepatitis B seldom manifest the symptoms of acute infection, but about a third of them will develop chronic infection.
  • Adults who get hepatitis B usually suffer the symptoms and signs of acute infection, but less than 10% will develop chronic infection.

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Surviving Prostate Cancer More Likely if You Eat Fish Regularly

A study from a team of researchers in Montreal has found that having eaten fish regularly is helpful to men who go on to develop prostate cancer.

Along with a healthy lifestyle and early detection, there is a tool for helping men to survive prostate cancer that is easily obtained and, it would seem, highly effective: fish. Men who regularly include fish in their diet and contract prostate cancer, a study from McGill University in Montreal says, have a much great chance of surviving the illness.

The study found there was no link between eating fish and getting prostate cancer and no link between eating fish and the prevention of prostrate cancer. It only found there was a link between having eaten fish regularly and surviving prostate cancer. It was published in the American Journal of Clinical Nutrition in September and released to the public October 7 2010.

“In the United States, one in six men will be diagnosed with prostate cancer over their lifetime,” Dr. Konrad M. Szymanski, a lead author of the study, told Reuters Health reporter Anne Harding. “One in six of these men will die of prostate cancer. Our study findings suggest that the number of men who die once diagnosed is lowered by more than 50 percent among men eating lots of fish.”

Regular Fish Consumption in Men

Dr. Szymanski, of the McGill University Health Center in Montreal, Quebec, and his colleagues found that after looking at the data from 31 studies that included a total of hundreds of thousands of patients, men who ate fish regularly were 44 percent less likely to develop end-stage cancers.

“All we can say is eating more fish can have some benefit. How many servings of fish or how many grams needed a day, unfortunately we cannot say,” he said.

The study speculated the reason for such a dramatic reduction in death-risk from prostate cancer may be the fish oil with omega-3 fatty acids found in fish. Fish oils have an anti-inflammatory effect that may help fight cancer from progressing to fatal stages, the report suggests. It did not analysis fish oil supplements but other studies suggest fish oil supplements are helpful in slowing cancers down by reducing inflammation, though more research needs to be done in this area.

Prostate Cancer can be Beaten

“Prostate cancer is a very common disease,” Dr. Szymanski said. “If we can possibly introduce a relatively cheap and easy-to-implement policy that could have even a small impact on how this disease affects men, we could make a very big impact overall.”

In the United States prostate cancer takes the lives over 35,000 men yearly and is diagnosed in over 200,000 men. In Canada 25,000 men are diagnosed with the illness and some 4,200 die from prostate cancer yearly. Lifestyle is considered an important component in preventing prostate cancer.

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Antiphospholipid Syndrome

Antiphospholipid syndrome (or antiphospholipid antibody syndrome) is a disorder of coagulation which causes thrombosis in both arteries and veins, as well as recurrent miscarriage. It is due to the autoimmune production of antibodies against cell membrane constituents. It is occasionally referred to as Hughes’ syndrome after the rheumatologist Dr Graham R.V. Hughes (St Thomas’ Hospital, London, UK).

A very rare form is the catastrophic antiphospholipid syndrome, in which there is rapid organ dysfunction and arterial hypertension. It carries a high mortality.

Signs and symptoms
The presence of antiphospholipid antibodies (APLAs) is suggested by thrombosis (arterial or venous) and recurrent miscarriage (especially in the second trimester, but often earlier). Other common findings, although not part of the classification, are thrombocytopenia (low platelet count) and livedo reticularis (a skin condition). Many patients report headaches.

APLAs are present in the blood in the context of a number of diseases, most notably systemic lupus erythematosus (SLE). One can only speak of antiphospolipid syndrome when there are no other symptoms of one of these diseases (e.g. arthritis suggestive of SLE). A number of patients with the syndrome (about 10%) will eventually develop SLE, but most never get signs of this disease.

The diagnosis is often entertained in cases of thrombophilia (recurrent thrombosis) or recurrent miscarriage. Tests that are often performed at the same time are a full blood count, liver enzyme studies and renal function studies.

Thrombophilia screening can consist of:

Screening coagulation studies: APTT, PT and TT.
Further studies for Factor V Leiden variant and the prothrombin mutation, Factor VIII levels, MTHFR mutation.
Levels of protein C, free and total protein S, Factor VIII, antithrombin, plasminogen, tissue plasminogen activator (TPA) and plasminogen activator inhibitor-1 (PAI-1)
Antiphospholipid syndrome is tested for in the laboratory by using a minimum of two coagulation tests that are phospholipid sensitive. The patient on initial screening will typically have been found to have a prolonged APTT that does not correct in a 80:20 mixture with normal human plasma (50:50 mixes with normal plasma are insensitive to all but the highest antibody levels). The APTT (plus 80:20 mix), dilute Russell viper venom time (DRVVT), the kaolin clotting time (KCT) or dilute thromboplastin time {TDT/DTT) are the prinicipal tests used for the detection of lupus anticoagulant. A further antibody can be detected using an enzyme-linked immunosorbant assay (ELISA) immunological test, which screens for the presence of antibodies to anticardiolipin.

Low platelet count and positivity for antibodies against β2-glycoprotein or phosphotidylserine may also be observed in a positive diagnosis.

The diagnosis is made in case of a clinical event (thrombosis or recurrent miscarriage after 10 weeks gestation) and repeated positive tests of lupus anticoagulant and/or anticardiolipin antibodies performed 6-8 weeks apart. Repeat testing is necessary due to the naturally occurring presence of transient high levels of antiphospholipid antibodies following infection and inflammation. Other antibodies, although implicated, are not yet considered relevant for diagnosis.

Antiphospholipid syndrome is an autoimmune disease, in which antibodies react against anionic phospholipids on cell membranes. Being an autoimmune disease, it is more common in women than in men. The exact cause is not known, but activation of the system of coagulation is evident.

Often, this disease is treated by giving aspirin to inhibit platelet activation, and/or warfarin as an anticoagulant. The goal of the prophylactic treatment is to maintain the patient’s INR between 2.0-3.0. It is not usually done in patients who have not had any thrombotic symptoms. During pregnancy, heparin is used instead of warfarin because of warfarin’s teratogenicity.

Women with recurrent miscarriage are often advised to take aspirin and to start heparin (or low molecular weight heparin) treatment after missing a period. This is the most effective treatment at the moment.

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Anorexia In Men

As we move into winter living, with the cold weather and dark nights upon us, for many of us our energies start to flag, and we look forward to the Christmas and New Year festivities. For some men, though, the festive season brings new challenges. With its emphasis on food and drink, men with eating disorders can feel particularly challenged. To mark this difficult time, I will focus my posts in the run-up to the New Year on eating disorders in men.

For many, “eating disorders” is synonymous with anorexia, but this is just one of several ways in which men experience eating distress. But what is anorexia in men?

The headline with anorexia is that the man restricts his intake of food to such an extent he becomes dangerously thin. When a man is this thin his brain is not sufficiently fuelled by nutrients, and this distorts his thinking further, and the illness can spiral out of control. If your body fat falls below 15% of your mass you are in the danger zone of anorexia. If you continue to restrict your intake of food, you may die.

Why do men get anorexia? The vulnerable time for men is in the teen years. It is during this period that we compare our physical capabilities and attractiveness with other boys. Not surprisingly, unlike girls, where our anorexia is motivated by the fear of fat, anorexia in men is often motivated by a desire to build a better physique. Anorexia in men is often associated with excessive exercise.

Trends in the media represent male beauty as involving a flat stomach with rippling abdominal muscles. For most men abdominal muscles are not visible until our body fat is at or below 14%. This is a dangerously low level to maintain our body fat. In fact professional models often “strip down” their body fat before a photo shoot and then allow it to creep up again after the shoot.

Representations of male beauty and what it means to be a man is only part of the story. For many men, they already have low self-worth before they started dieting and exercising excessively. In this sense anorexia might be a symptom of more complex underlying problems around feeling valued by family and friends. A proportion of anorexic men have had experiences of being bullied early in childhood for being overweight.

For many men with anorexia, their emotional world is extremely painful.  Anorexia, if anything, is a way of coping with that pain.  In a dark emotional world, sometimes controlling your weight is the only control you feel you have left.

For further information and support check out the Men Get Eating Disorders Too website.

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What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder (OCD) is an anxiety disorder effecting about 2% of men.  It’s characteristics are repeated and uncontrollable ‘obsessions’, which are intrusive thoughts that are not consistent with the man’s values, and ‘compulsions’, which are behaviours or thinking patterns that people use to neutralise the impact of the compulsive thought.

Examples of Obsessions include:

  • Thoughts that things are unclean or contaminated.
  • Thoughts of having sex with your mother or other inappropriate people.
  • Imagining your children being hurt by a stranger.
  • Thinking ‘gay thoughts’ even though you are straight.
  • Thinking you have knocked someone down in the car.

Examples of Compulsions include:

  • Repeated washing.
  • Repeated checking.
  • Doing things in even or odd multiples.
  • Performing rituals.
  • Excessive prayer.
  • Excessive hoarding.

Of course OCD is just an extreme form of what we all are capable of doing.  We are all familiar with the idea of setting off for the airport and getting anxious about whether we have locked the door or turned the gas off.  In OCD though, this feeling permeates all areas of the person’s life, and can be deeply disabling.  People can be in an anxiety state almost all the time.

We all tend to experience anxiety in different ways.  If you tend to experience anxiety with obsessions and/or compulsions, what can be done about it?

Well understanding your difficulty is a start.  You can get detailed information about OCD and hoarding at

Treatment from a psychotherapist involves understanding what triggers your obsessions and compulsions, and learning new patterns of behaviour which means you can tolerate intrusive thoughts more easily, and are therefore less likely to get caught up in them and indulge in neutralising compulsions.  Understanding your OCD is important because it will not go away on its own, and may well get worse.

Drug treatments are also available for OCD which may suit some people.  Drug treatment should be combined with psychotherapy to get the best results.

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How Colon Care Promotes Colon Health

The colon is the last part of the gastrointestinal tract. It absorbs water and nutrients from food, and eliminates toxins from the blood, intestines, and lymph. In the colon, water and salts from partially digested food are absorbed. Whatever remains is sent out from the colon into the rectal and out through the anal. Thus, the colon is the wastebasket of the human body.

A congested colon looks bloated and stretched with waste matter that can cause “self-poisoning.” Without a colon cleanse, the body functions will slow down, which will eventually lead to total system breakdown. Hence, it is important to help the colon eliminate waste to reduce the risks for colon diseases like colo-rectal cancer. However, only the proper colon care can stop colon neglect.

Know the Signs of Colon Congestion Warning

Colon congestion would make most people feel physical and mental strain. Poor colon functions can cause symptoms such as constipation or diarrhea. Colon congestion also make men and women strain to have a bowel movement. Other individuals could suffer from chronic abdominal discomfort and unexplained blood in the stool or weight loss.

Constipation can lead to “auto-intoxication,” which means that toxins and waste, which should have been expelled, will be reabsorbed in the body’s system. Then the congested waste accumulates on the lining of the intestine, which, in time, will become a thickened fecal matter. Once the mucoid plaque forms, the self-poisoning begins. Mucoid plaque is also a known cause of severe bloating, a condition that can lead to other colon diseases, which can lead to colon cancer.

Look closely at the eyes. Clear and vibrant irises mean good health condition. However, a muddy or yellowish tint could be a sign for colon congestion.

Colon Care Clears Colon Congestion

Colon care can begin with short-term fasting. Fasting is voluntarily eliminating food from one’s diet for a length of time in order to get rid of toxic substances in the body. Elimination diets such as juice fasts, miso soup fasts, and vegetable fasts can boost a weak colon. Start with a one day fast on a weekend. A short-term fast can help empty the remains of all the junk-food cravings. The process can even lead an individual to adopt a healthier eating habit.

Colon hydrotherapy is a colon care that can relieve constipation, stomach pains or small, hard, lumpy stools. Hydrotherapy uses warm and purified water to help clear congestion of fecal, gas, and mucus from the colon. Also called colonic irrigation, it is known to cure conditions such as gas, bloating, and constipation.

Enemas are commonly used as a cure for constipation. A small amount of purified water is flushed though the anus into the rectum to clear the bowel. The method is known to be effective for loosening fecal matter in the lower portion of the intestine. Likewise, laxatives cause the intestine to contract to help waste move out the body. Oral colon cleanse systems also soften the stool, but they carry with them a risk of dehydration.

Colon care products like laxatives are often the quick fix for many people when they are constipated or bloated. However, there are better methods for cleaning body waste. Oxygen-based colon cleansers thoroughly remove waste and mucoid plaque on the intestine walls. These are colon care products that uses activated oxygen to clear colon congestion by oxidizing the toxins and waste that the body had failed to move out.

A colon cleanse can result in bowel movements that are liquid in composition and some gas. The liquid wastes were once compacted wastes that have been oxidized naturally.

Health Begins in the Colon

The colon has been referred to as the body’s wastebasket. It is the place where the body stores toxins and wastes. Hence, a colon cleanse is important to eliminate waste and to reduce the risks of developing diseases. Aside from that, congested toxins and wastes can cause acne, bad breath, fatigue and weight gain.

When the colon is healthy, breath smells fresh, energy level is high, and digestive tract has no waste buildup. A clean colon can help prevent health problems from hemorrhoids, to obesity, to cancer. Proper colon care can keep the colon clean and waste matter free from harmful bacteria and parasites.

Colon care center offers colonic treatments with holistic, proactive health care and maintenance. A colonic therapy with infrared sauna treatment could reduce a bloated stomach and the level of gas. “Health begins in the colon,” says Dr. Edward Group III, the author of The Green Body Cleanse. Healthy colon is the key to a good health, well being, and a much longer life.

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Cluster Headache Tests and Treatment Options

Dealing with the pain of a cluster headache is not an easy task but one that can be done with a little help. There are at home treatments such as caffeine, over-the-counter medicines and getting a lot sleep in a dark quiet room. Some people are able to control the pain with these methods while other sufferers need the help of a doctor. Here are some tests to help diagnose and treatment options to help with the pain associated with cluster headaches.

Tests and Examinations to Diagnose a Cluster Headache

One of the things a doctor might ask a headache sufferer to do is keep a headache journal for at least two months. Each time a headache occurs, jot down the following information:

  • a description and severity of the pain
  • the location and duration of the pain
  • any medications that were taken before and during
  • the time
  • what was being eaten or drunk

A headache journal can offer valuable clues that may help a doctor diagnose a particular kind of headache and discover possible headache triggers.

A neurological examination can help a doctor detect physical signs of a cluster headache. Sometimes the pupil may appear smaller, or eyelids may droop, even between attacks.

Two common brain-imaging tests are computerized tomography (CT) and magnetic resonance imaging (MRI) scans. This is used to rule out a different cause of the cluster headaches such as a tumor or other blockage.

Cluster Headache Treatment Options

When dealing with a cluster headache the sufferer needs not only a short term solution or medication but also a long term one to help with future cluster periods. After the headaches are under control there is a good chance that the short term medication will be able to be discontinued.

Short term medications are used to help with the cluster headaches while waiting for the long term medications to kick in. While relief might not be as instant as the headache sufferer might like they are designed to make the pain manageable. Some common short term options include:

  • Corticosteroids Inflammation-suppressing drugs called corticosteroids, such as prednisone, are fast-acting preventive medications. Doctors usually prescribe corticosteroids after the first cluster headache diagnosis or after a long remission period. Since corticosteroids is part of the steroid family, doctors will want to monitor its use as long term use can be dangerous.
  • Nerve block – This includes injecting a numbing agent (anesthetic) and corticosteroid into the area around the occipital nerve to help prevent pain messages from traveling along that nerve pathway. An occipital nerve block is very useful for temporary relief until long-term preventive medications take effect.

Long-term medications are taken during the entire cluster period. Some people with chronic cluster headache may need to take two or more long-term medications simultaneously.

Calcium channel blockers are often the first choice for preventing cluster headache. Some people are able to be weaned off of the medications long after the cluster headache has subsided. Occasionally, longer term use is needed to manage chronic cluster headache. There are some side effects including swollen ankles which may hinder a sufferer’s ability to stay on these medications long term.

Lithium carbonate which is also used to treat bipolar disorder is also effective in preventing chronic cluster headache. While taking this medication, blood checks will be done at regular intervals to check for the development of a serious side effect, such as kidney damage.

Keep in mind what works for some people might not work for others. The key is finding the combination that works for each cluster headache suffer as even a little relief is better than nothing.

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Fighting More Advanced Prostate Problems

The prostate is a relatively small gland underneath a man’s bladder. It’s only about the size of a walnut, but as a man ages it often enlarges… and then problems start.

When It’s Just Enlarged Prostate

It’s fairly common for a man’s prostate gland to expand with age. When it does, it squeezes the urethra, the tube that allows for easy urine flow, and that makes passing urine difficult. This enlargement is called benign prostatic hyperplasia, or BPH, for short.

The article Treating Prostate Problems offers a fairly good discussion of more basic methods for treating BPH, but here’s one quick note: One of the major advances in fighting this enlargement since the mid-80s has been treating BPH with drugs instead of surgeries. In particular, medications called alpha blockers are excellent in helping regulate urine flow. Flomax, Hytrin, and Uroxatral are just three such drugs.

The main side effect of these drugs is that they can lower blood pressure. If a man feels dizziness after starting one of these drugs for BPH, it would be wise to consult his doctor and see if another medicine would help or if another treatment is necessary.

Surgery for BPH

The good news is the last decade has brought less invasive surgeries for BPH. There’s an outpatient procedure in which a microwave heats and destroys overgrown tissue and an inpatient procedure using a laser to vaporize obstructive tissue. Both allow for better urine flow.

The American Urological Association (AUA) also notes the use of spring-like contraption called a stent inside the prostate. This is done without any anesthesia and it’s generally recommended for patients who, for one reason or another, are not considered good candidates for aggressive surgeries.

A wide range of these and other surgical options (in much more detail) can be found at the Urology Health website.

The Cancer Surgery Debate

Sometimes the prostate isn’t enlarged due to natural aging, but because of prostate cancer. In men 60 or younger, the general attitude among health experts is to go after the cancer aggressively because it’s more likely to be fatal in this age group. The most common procedure, according to the National Cancer Institute (NCI) is radical prostatectomy, a procedure that removes the entire prostate and often nearby tissues.

One of the dangers of a prostatectomy is that it may damage the nerves that allow for an erection. The NCI notes that sometimes a technique called “nerve-sparing surgery” may be viable, but it’s not always an option.

In older men (especially 75 and up) prostate cancer tends to be fairly slow growing. So many doctors talking to older patients suggest a process called “watchful waiting.” That means coming back for regular check-ups to see if the cancer is progressing before trying surgery. Some may suggest radiation therapy to fight the disease. If an older patient is fighting several other health problems, watchful waiting may be the best option.

Ultimately every patient should be evaluated individually and then engage in a careful discussion with their physician, either primary care or urologist, about the pros and cons of various treatments.

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