PROSTABLOG NZ: The ideological debate about prostate cancer screening hasn’t moved along much in New Zealand over the past few years.

I’m judging this from an anecdote a guest speaker at my journalism course told students this week.

An experienced journalist, she said a few years ago she was writing a piece for NZ Listener magazine about PSA screening, and the Ministry of Health would speak to her only on the condition they got to see the resulting article prior to publication.

That usually causes journalists to feel apprehensive, and in this case her fears were realised.

The Ministry people hit the roof over what she wrote (basically, that all men over 50 should be urged to get PSA tests), and made this plain to her editor.

Judging by what I heard from the Ministry team at the Health Select Committee hearing into prostate cancer screening late last year, the official view is still the same: PSA bad.

Speaking of which – I wonder when we’re going to hear anything further from the committee?

Chairman Paul Hutchison made the MOH people promise to deliver their final views last November.

Did they?

Are there more hearings?

When will we see the results?

Well, guys, it is a fact of life that as we age, the prostate gland enlarges, resulting in urinary difficulties. Not exactly cheery news. The most common symptoms are “hesitant” and weak urinary fl ow, urgency or leaking, and more frequent trips to the john, especially at night. So much for a good night’s sleep!

This condition is known as Benign Prostate Hyperplasia (BPH), which affects over half of men in their sixties. That figure grows to almost 90% for men in their seventies and eighties.(1) Clearly, a long life means you’ll probably be dealing with the annoyance of BPH.

A Natural Helper

Now, most people know that saw palmetto is a BIG help. But – they don’t know WHY.

Let me give you some insight.

The fruit of the plant was traditionally used by Native Americans as both a staple food and a medicine.(2, 3) Saw Palmetto is named for its sharp, saw-like leaves and it grows as a dense ground cover in pine forests from South Carolina down to Florida and across the southeast coastal plain to Louisiana.

The medicinal herbal extract is actually taken from the dried ripe berry of the saw palmetto plant. In fact, saw palmetto is now being grown commercially due to the popularity of using it for treatment for BPH in Europe. It is the number one initial treatment for BPH in Germany and Austria.(4) It is also used about 50% of the time for treatment in Italy.(5) No wonder thousands of tons of saw palmetto berries get shipped to Europe for use in herbal supplements.

And the Research Shows…

Sadly, Europe is way ahead of us in saw palmetto studies. One review of 18 placebo-controlled trials, involving 2,939 men, evaluated four types of urinary difficulty. Results showed the group using saw palmetto extract experienced the following improvements over the placebo group: 28% reduction in hesitancy, 25% reduction in nighttime urination, 28% improvement of urinary fl ow and 43% less urine remaining in the bladder after voiding.(6)

Another large, double-blind study (where neither doctor or patient knows what is being administered) of 1069 men compared saw palmetto against a prescription medication for six months. Symptom scores were very close. There was a 37% improvement in urinary symptoms with the saw palmetto and 39% with the drug. Quality of life scores were even better: 69% improvement with saw palmetto and 73% with the drug.(7)

So — How Does It Work?

The exact mechanism of how saw palmetto relieves BPH symptoms is still a matter of speculation. Research indicates that saw palmetto may block the conversion of testosterone to dihydrotestosterone (DHT), a more powerful form. Since it is known that men who do not produce DHT do not develop BPH, that may be a key factor. Saw palmetto may also have an anti-infl ammatory effect that relieves pressure on the urethra.(8, 9)

Is Saw Palmetto For You?

My focus continues to be on preventive medicine and natural treatments whenever possible, so I find the studies on saw palmetto to be fascinating and informative. With BPH affecting almost all men as they grow older, a natural, inexpensive herb that can improve uncomfortable urinary symptoms really adds value to everyday life.

That’s why, by popular demand, I’ve recently brought ProstaBlast back to our product line at Chesapeake Nutraceuticals. ProstaBlast contains a WHOPPING 1000 mg of saw palmetto in a soft gel tablet.

Of course you need to contact your health care provider before making any change to your diet, exercise or supplement program.

I’ll be back soon with more health news.
Source:

1. “Prostate Enlargement: Benign Prostatic Hyperplasia”, National Kidney and Urologic Diseases Information Clearinghouse, NIH Publication No. 07–3012, June 2006
2. “Saw Palmetto”, National Institutes of Health, NCCAM Publication No. D275
3. “Saw Palmetto”, University of Maryland Medical Center
4. “Saw Palmetto, Herb Treatment for Benign Enlargement of the Prostate Gland (Benign Prostate Hypertrophy)”, MedicineNet.com
5. Gordon Andrea E, M.D, Shaunessy, Alan F, PHARM.D., “Saw Palmetto for Prostate Disorders”, American Family Physician, March 15, 2003
6. “Saw Palmetto, Herb Treatment for Benign Enlargement of the Prostate Gland (Benign Prostate Hypertrophy)”, MedicineNet.com
7. “Saw Palmetto, Herb Treatment for Benign Enlargement of the Prostate Gland (Benign Prostate Hypertrophy)”, MedicineNet.com
8. “Saw Palmetto, Herb Treatment for Benign Enlargement of the Prostate Gland (Benign Prostate Hypertrophy)”, MedicineNet.com
9. “Prostate Enlargement: Benign Prostatic Hyperplasia”, National Kidney and Urologic Diseases Information Clearinghouse, NIH Publication No.
   07–3012, June 2006

ESPN -What can you say about them? Besides the fact that they are a beast at reporting sports news. While they may be great at what they do, they still encounter some controversies. Erin Andrews and Hannah Storm to name a few. It has been said that ESPN has a Bat Phone… so when Brian Westbrook, formerly of the Philadelphia Eagles, was on the Bat Phone they jumped at the opportunity to interview him live on air. Since he was released on Tuesday from his 8 year run with the franchise it would have been an exclusive. BIG DEAL. HUGE DEAL. REPORTING GOLD!!! Then this happened…

Scott Van Pelt didn’t seem very happy. I have to say I think they handled themselves pretty well after realizing on air that the man on the other end of the phone was not Brian Westbrook, but someone from the Howard Stern camp.

(This is the first in a series of posts to give more context. In so doing, this one does review a few details from the first post; you don’t need to worry about that happening often. If you’re interested only in current posts, skip over any post with a title beginning with “Backstory x…”)

December 2003
My primary care physician includes a PSA in some otherwise routine bloodwork.

January 2004
He has me come in for a F2F consult on the results — unusual. Typically he mails out a copy. He says the PSA of 18 is unusual, especially since I’m only 47; routine PSA’s typically begin at age 50. He points out that it could be any number of things — and he wants me to see a urologist. Quickly.

February 2004
The urologist tells me that the high PSA and what he feels via physical exam could indicate a fairly common infection or some other relatively innocuous condition. Still, he wanted me to get a bone scan, CT scan, and eventually fMRI. When the assistant found the next regular opening late in March and yet pushed to schedule me for the next Monday, February 16, I realized he evidently didn’t consider this routine.

He couldn’t perform a biopsy that day because I’d had aspirin recently. We scheduled it for the next viable date, eleven days later.

As the associate doctor finishes up said biopsy, he matter-of-factly says (while facing the wall and writing) that the tumor has advanced into the pelvis. I have advanced prostate cancer, the single most common form of solid tumor among human beings.

Hmf. I don’t appreciate being dismissed as “common.” If I must have cancer, I’d prefer something a little more unique.

(Hint on bedside manner, doc: If you’re going to tell someone really unpleasant news, maybe it’s a good idea to stop writing, or at the very least, turn and face the patient.)

Statistically, from the moment I heard this, another American man heard the same diagnosis 2.6 minutes earlier; another man would hear the same diagnosis 2.6 minutes later. Every 13 minutes a man dies from this cancer—over 31,000 American men each year, and 190,000 will survive.

Here’s a rare case of where I set aside my nonconformist streak and hope to go with the majority.

Soon I meet with a medical oncologist. Given all circumstances, indications, and contraindications, we begin with a series of hormone treatments. On the first day of those, I email a friend: “Been an hour since the first pill and I don’t feel any differe&nb bs8 but I ws-0091*7~”[av90 ¡ @897 -aaarc zxcp*

The hormones do begin to tame the tumor. I asked point blank about the expected impact on my lifespan. I think I recall correctly that one doctor early on said that the unusual emergence of such an aggressive tumor at a relatively young age, already metastasized, will probably reduce my expected lifespan by maybe ten years or so. OK, no immediate crisis. But it must have been my medical oncologist who said more precisely and more likely, three to five years.

Not five to one, girl, one to five, but three to five, and still the rest of the verse rings true. I just happen to have a little bit more focused preview of my likely timetable. If I fall within the middle of the bell curve, as, by definition, most people DO, and if I continue surviving my daily commute of 13 miles, an hour or so each way, this will probably add me to the statistics somewhere in 2007, 2008, or, if I’m lucky, early 2009. Still nothing to justify maxing out my credit, but maybe I should re-evaluate the mortgage . . .

As I get on the the train to go home, I mull this over. (Well, duh, did I expect to focus on reading Dilbert?) I look around at all the people around me. No one in this car has any idea I’ve just heard my de facto death sentence; if they did know, I’d like to know why, but that’s another issue. I look just like anyone else, except with the usual less organized hair. So I wonder likewise: What’s that lady dealing with? What’s his worry? What has this person learned in the last week or two? What medical, emotional, or social disease has that person contracted without knowing it? Who’s on first? What’s on second? Does anybody really know what time it is? Does anybody really care?

This puts the world into a fresh perspective. One never knows what another may be facing.

I have a very unique opportunity available tonight in Nanaimo BC. We have a simply terrific health and wellness expert appearing tonight only. Check out Mariann Node because to night she is  Spilling the Beans .  This event is also a fundraiser for Nanaimo Unique Kids Organization. Show your support come out for a coffee.

Time: 7PM bc time

Location: Beban Park Social Center- Room 20- Bowen Rd. Nanimo

For more infor call 1-877-655-1405

Reps $10 Guest as always free. 

If you are a guest checking it out. Sign in and tell them Dave Metituk invited you.

Millions of men suffer from EjD or ejaculatory dysfunction.  The most common variety is premature ejaculation followed by retarded ejaculation or not being able to achieve an orgasm.  Another less common EjD is retrograde ejaculation or seminal fluid going back into the bladder instead of exiting the penis at the time of orgasm.  This article will discuss the three common EjD conditions and what can be done to resolve them.

It is estimated that one-third of American men suffer from premature ejaculation or ejaculation within seconds of vaginal penetration.  This is of great concern and embarrassment to those who experience this malady.

One folk remedy that is available to all men is self-stimulation or masturbation. Having repeated orgasms will bring on delayed ejaculation in nearly every man. The best premature ejaculation tip is to double the number of orgasms a man has per week. And if that doesn’t work, double it again.  Now isn’t that a great assignment?

Another method that requires cooperation with the partner or significant other is the “pull out technique.” This consists of having sex for a few minutes then pulling out and stopping for a few minutes to postpone orgasm.

Another method is to decrease the stimulation of the penis using desensitizing cream such as topical xylocaine.  Also, using one or more condoms can decrease the sensation and can prolong ejaculation.

When these non-pharmacologic techniques are ineffective there are medications that can help prolong the time from penetration to ejaculation. Selective serotonin reuptake inhibitors, or SSRIs — are known to cause delayed ejaculation.  Using an SSRI four to six hours before intercourse, men prone to premature ejaculation can last longer.

Delayed ejaculation (or retarded ejaculation) affects a much smaller number of men.  With this problem, men cannot reach orgasm at all, at least not with a partner.  It is most common associated with aging where more stimulatin is required for a man to reach an orgasm with advancing years because the nerve endings in the penis become less sensitive.  Delayed ejaculation may be caused by medicines – like antidepressants– are common culprits.

Retrograde ejaculation is the least common of the ejaculation problems. Retrograde ejaculation can be caused by diabetes, nerve damage, and various medications such as alpha-blockers like Flomax, which are used to treat enlargement of the prostate gland. Retrograde ejaculation is harmless and won’t interfere with the feeling of orgasm. (It can also make for an easy post-sex clean-up.) But since it does affect fertility, some men may need treatment if their partners are trying to get pregnant.

Bottom Line

EjD is a common medical condition that can be overcome.  Be open and communicate with doctor and share your concern with your partner.  Don’t suffer in silence and let the tension mount up and compounding the problem.  Most men with some advice and perhaps some medication form their doctor can over come this problem.  This translates to less worry and more sex.  Who could ask for anything more?

Dr. Neil Baum is a urologist in New Orleans, Louisiana and can be reached via his website, www.neilbaum.com or (504) 891-8454

A middle age bike rider, who was perfectly potent, noted that his penis went numb at the end of a two-day, 200 mile charity ride.  The numbness continued for nearly six months and was accompanied by the inability to achieve an erection adequate for sexual intimacy or impotence.  After a work-up revealed arterial damage at the base of the shaft of the penis, his potency returned after treatments that increased the blood supply to his penis.

When you’re riding a bicycle, your weight is being focused on the perineum, the area between the rectum and the scrotum, and that’s where the arteries and nerves that feed the penis are located. Since the arteries are essentially unprotected, they’re prone to damage from constant  pressure from the bike seat.   When a man sits on a bicycle seat he’s putting his entire body weight on the artery that supplies the penis.

There are a number of things you can do to protect your potency:

• Penile numbness and excessive genital shrinkage are warning signs that there may be too much pressure on your perineum. The nerves in the perineum are being pinched, which means the artery that feeds the penis is also being compressed.

• Make the following changes in your riding style and/or your positioning on the bike: 1) Make sure your saddle is level, or point the nose a few degrees downward. 2) Check to see that your legs are not fully extended at the bottom of the pedal stroke. Your knees should be slightly bent to support more of your weight. 3) Stand up every 10 minutes or so to encourage blood flow.

• There are a multitude of anatomic racing saddles on the market, ranging from ones with a flexible nose to models with a hole in the middle. You may want to experiment with a wider, more heavily padded brand or a “double bun seat” that places the weight on the bones and off of the perineum.

• Heavier riders may be more at risk of arterial compression damage because of the greater weight that’s placed on the perineum. If you’re in this category, you should consider a wider saddle with extra padding.

• When riding a stationary bike, the tendency is to stay seated and grind against big gears for long periods. Get off of the seat as frequently as you would on your regular bike and be certain that it’s set up the same in regards to riding position.

•  Get off of the seat when riding over rough or irregular terrain. Use your legs as shock absorbers.

Most men are not aware of the relationship between their bike and their erections. My final advice for good health is that men shouldn’t necessarily ride farther but ride a lot smarter.

Dr. Neil Baum is a urologist in private practice in New Orleans and can be reached at 866 4825.