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Prostate Cancer: When Active Surveillance Wins Out Over Immediate Treatment

The word “cancer” strikes fear in everyone who is told they have it. It conjures up images of a fast-moving, life-threatening disease.

That isn’t necessarily the case for men with newly diagnosed prostate cancer. More than half of them have a type of cancer that is confined to the prostate gland and that grows so slowly it will never affect their health or their lives. Yet almost 90% of men told they have prostate cancer opt for immediate treatment with surgery or radiation therapy—which often cause trouble getting or keeping an erection and an assortment of urinary problems.

Two weeks ago, a panel of experts convened by the National Institutes of Health recommended that many men with localized, low-risk prostate cancer be closely monitored, and that treatment be delayed until there was evidence that the disease was progressing.

“It’s clear that many men would benefit from delaying treatment,” Dr. Patricia A. Ganz, conference panel chairperson and director of the Division of Cancer Prevention and Control Research at the Jonsson Comprehensive Cancer Center at the University of California in Los Angeles, said in a statement, adding that Read more »

*This blog post was originally published at Harvard Health Blog*

Which Is More Important: To Be Thin Or To Be Fit?

These days, most adults are overweight, not active, or both. If you could change just one—become active or lose weight—which would be better?

At least for men, being more fit may have a bigger health payoff than losing weight, according to a new study of more than 14,000 well-off middle-aged men who are participating in the Aerobics Center Longitudinal Study. Researchers followed their health, weight, and exercise habits for 11 years. They estimated how physically fit the men were by calculating their metabolic equivalents (METs) from a treadmill test.

Compared with men whose fitness declined over the course of the study, those who maintained their fitness levels reduced their odds of dying from cardiovascular disease or any other cause by about 30%, even if they didn’t lose any excess weight. Those who improved their fitness levels saw a 40% reduction.

Body-mass index (BMI), a measurement that takes weight and height into account, was not associated with mortality. The results were published in the journal Circulation.

What is “fitness”

Fitness is a measure of Read more »

*This blog post was originally published at Harvard Health Blog*

Harvard Medical School Provides Tips For Improving Bladder Control

I was hiking in the woods recently with a group of women friends when something caught my attention. It wasn’t an interesting bird or plant, but the surprising number of “pit stops” my friends needed to make.

Their frequent detours into the bushes struck me because I had just finished working on Better Bladder and Bowel Control, the latest Special Health Report from Harvard Medical School. According to the report, incontinence is the unintended loss of urine or feces that is significant enough to make it difficult to do ordinary activities without frequent trips to the restroom. In the United States, about 32 million men and women have some degree of incontinence. For women, incontinence is a common but rarely discussed result of childbirth and aging—that could explain the pit stops of my hiking friends, who were all mid-life mothers. For men, incontinence is most often a side effect of treatment for prostate disorders.

Many things can go wrong with the complex system that allows us to control urination. Read more »

*This blog post was originally published at Harvard Health Blog*

Vaccine For HPV May Prevent More Than Cervical Cancer

Oropharyngeal cancers caused by the human papillomavirus (HPV) are on the rise in the United States since 1984, as changes in sexual habits further the virus’ spread. But the focus of the HPV vaccine will remain on preventing genital warts and cervical cancer.

Reuters reported one clinician’s opinion that throat cancer linked to HPV will become the dominant cause of the disease, ahead of tobacco use.

To study the issue, researchers determined HPV-positive status among 271 of all 5,755 oropharyngeal cancers collected by the three population-based cancer registries in Hawaii, Iowa and Los Angeles from the Surveillance, Epidemiology, and End Results (SEER) program from 1984 to 2004. Prevalence trends across four calendar periods were estimated by using logistic regression. The study appeared online Oct. 3 in the Journal of Clinical Oncology.

HPV prevalence Read more »

*This blog post was originally published at ACP Internist*

Inspiring Story About A Man Making Changes To Transform His Life

It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories about people who run marathons a year after surgery to bypass cholesterol-clogged arteries or who climb Mt. McKinley after being diagnosed with diabetes are interesting, but they don’t resonate with me. Mostly it’s because they often leave out the hard work needed to change and the backtracking that invariably accompanies it.

I ran across a truly inspiring story the other day in the American Journal of Health Promotion—one that shows how most of us ultimately manage to make changes that improve our lives. The journal’s founder and editor, Michael P. O’Donnell, wrote a moving essay about his father, Kevin O’Donnell. Once an overweight workaholic who smoked and drank heavily, ate mostly meat and potatoes, and didn’t exercise—and who eventually needed a double bypass—Kevin O’Donnell gradually made changes to improve his health. Now, at age 85, he has the cardiovascular system of a 65 year old and is working on a house-building project in North Korea.

How did Kevin O’Donnell engineer such a remarkable transformation? Read more »

*This blog post was originally published at Harvard Health Blog*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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