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Biomarkers for better prostate cancer screening

Biomarkers are "chemicals" that can indicate both normal and abnormal processes in the body. One of the most famous is prostate-specific antigen (PSA). The PSA test, which detects abnormally high blood levels of PSA, has been used for decades to screen for prostate cancer and potentially catch it early.

There are two problems with the PSA test. First, PSA levels can tell you that something is going on with the prostate — but that "something" isn't necessarily cancer. High levels may mean other benign prostate conditions. Second, when high PSA levels do turn out to be the result of prostate cancer, the PSA level alone won't tell you which cancers are aggressive and need treatment, and which are slow-growing and can be managed more conservatively.

Ask the doctor: Prostate surgery and ED

Q. I am scheduled to have my prostate removed and am concerned about the risk of erectile dysfunction (ED) after the surgery. I've heard that taking an ED drug daily during my recovery could help. Do you recommend this?

 

 

A. About half of men lose some erectile function after radical prostatectomy, which removes the entire prostate gland. ED drugs help men to have erections after surgery, but so far research has not shown that taking it daily produces better results than taking the medication as-needed—when you anticipate sexual activity.

Both work and parenting influence risk of early death

The health effects of balancing career and parenting have been studied a lot, but most of the attention has focused on a single period in the middle of a woman's life. Recently, researchers affiliated with Harvard University and the Harvard T.H. Chan School of Public Health decided to look at how sustaining that balancing act over decades affects a woman's risk of dying before age 75.

The team studied data on work histories, marriages, and parenting for more than 7,500 women in the U.S. Health and Retirement Study—an ongoing biennial survey of the health and lifestyles of thousands of women and men. They found that a woman's risk of dying between ages 55 and 75 varied substantially with her history of work, marriage, and childrearing. Married women who went back to work after staying at home with their children had the lowest death rate—around 5%—while single mothers who had never worked had the highest rate—12%. The death rate was just under 7% for nonworking married mothers, and slightly above 8% for single working mothers. The report appeared in the April 2015 issue of the American Journal of Public Health.

Draft recommendations on screening mammography continue to stir debate

The release of new guidelines on mammography never fails to renew the heated controversy over the potential benefits and harms of this procedure. The latest draft guidelines from the U.S. Preventive Services Task Force (USPSTF) are no exception. The USPSTF recommends that women begin having mammograms at age 50 and stop at age 75. (The American Cancer Society and other medical organizations recommend that women begin getting regular mammograms at age 40.) The draft recommendations say there isn’t enough evidence to recommend or discourage the use of a new technique called 3-D mammography for screening, and also say there isn’t enough evidence to recommend that women with dense breasts, who are at higher risk of breast cancer, should have an ultrasound or MRI in addition to screening mammography. Comments can be made on the USPSTF draft until 8:00 pm Easter Time today. A final version of the recommendations is expected to be released in the fall of 2015.

Cardiovascular consequences of hormone therapy

A large study reinforces the current thinking on hormone therapy after menopause: it doesn't shield women from heart disease and may slightly increase their risk of a stroke.

For decades, doctors believed that hormone therapy could prevent heart disease. But in 2002, findings from the landmark Women's Health Initiative revealed that long-term hormone use boosted heart attack, stroke, and breast cancer risk.

Hormone therapy works best when combined with radiation for locally advanced prostate cancer

Men with locally advanced prostate cancer who combine hormone therapy with a course of radiation therapy tend to live longer than men who only take hormone therapy.

No “best” treatment for common uterine fibroids

Fibroids are noncancerous tumors that grow in the uterus. They may be smaller than a seed or bigger than a grapefruit. Depending on their size, number, and location, fibroids can cause heavy bleeding and long menstrual periods (which can, in turn, cause anemia), pelvic pain, frequent urination, or constipation. Fibroids can also cause infertility and repeated miscarriages. About 7 in 10 women will develop this condition at some point. Given how common uterine fibroids are, it’s surprising how few randomized trials have been done to compare treatment options. A clinical practice article in today’s New England Journal of Medicine lays out the options for treating uterine fibroids and discusses the factors women and their doctors should consider when making treatment decisions.

Targeted prostate biopsies better at detecting dangerous cancers

Standard biopsies of the prostate gland often miss potentially aggressive prostate cancer. Adding MRI images to standard biopsies improves the detection of prostate cancer.

Are you really getting enough exercise?

Resistance machines can provide safe, effective strength training.

Image: Thinkstock

To get the full benefit of your workout, you need to know how hard you're exercising, and that can be different for everyone.

Menopause symptoms can last longer than you expect

Hot flashes and other symptoms can take a decade or longer to recede, but there is no reason to suffer in silence. There are new options for relief and new tools to guide you.

What we know about menopause has changed a lot over the past few decades, thanks to volumes of research. For example, studies reported in recent months indicate that hot flashes and other menopausal symptoms last longer than previously thought, affecting substantial numbers of women in their 60s. And randomized clinical trials have taught us that hormone therapy can be a safe and effective way to control symptoms, although it's no longer recommended for reducing risk of cardiovascular disease. "There's now a critical mass of research showing that, for many women, the benefits of hormone therapy for treating hot flashes and improving quality of life outweigh the risks," says Dr. JoAnn Manson, Michael and Lee Bell Professor of Women's Health at Harvard Medical School.

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