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Wed, 9th November 2016
 

"Men Only" - that means the door with the two legs sign, not the skirt and short legs! Which simply means we are talking about prostate, and the horrible risks in guys. It is the second most common cause of cancer death in males and most will develop it if one lives long enough.

Fortunately, many die of something else, usually a heart attack or stroke. Some are slow growing, others very aggressive and spread rapidly to bones, lungs, brain and other regions. Every male say over fifty should undergo the most simple of tests, the DRE. That means a twenty second rectal examination by your GPs gloved finger.

ROUGH SURFACE

If hard, enlarged with a rough surface, risks escalate. This will probably lead to a trans-rectal ultrasound. This shows the prostate on a screen and suspect spots can be readily biopsied with a fine needle, and cells examined under the microscope for suspect cancer cells. It is mildly uncomfortable.

A widely used PSA (Prostatic Specific Antigen) blood test is an indicator, but unreliable. A figure between 0 and 3 was once considered normal, but this has changed. Guys in this range are possible targets but there is no guarantee. Nevertheless, the higher the figure, the greater the risk. So if it's 15, 20, 50 or 70, chances of cancer are much higher.

Treatment varies often depending on the "grade" of the cancer cells. Partial or total removal of the gland is widely carried out. Laparoscopic removal is the most recent. There is much less blood loss, but cost is greater. Robotic removal is possible, but few places have the very expensive equipment. The relatively recent green tipped laser is claimed to offer good results specially for non-cancerous BPH (non malignant enlargement making urination difficult)

Radiation, using a variety of methods is also often very successful, often given with "androgen deprivation" - cutting back male hormone. "A relatively new drug called Docetaxel is the first agent to show increased survival in advanced cases", Sydney urologist Dr Andrew Richards told me recently week. After surgery, PSA falls dramatically, and is then often used to monitor any recurrence. "But we are still seeking an accurate 'molecular marker' for early detection."

 
EUTHANASIA

Q: 

Surely a person with an incurable debilitating and painful disease should have the right to end their life. Why don't they legalise euthanasia.

A: 

This topic has been hot for the past fifty years. It is such a hot potato, no government wishes to make a decision (and have already rescinded State law at least once). Some make the trek to South America to buy Nembutal capsules, which was legally prescribed here by the truckload as a nocturnal sedative. But no more. The matter may be a decision of the patient, who may simply refuse to eat or drink. That is 100 per cent effective.

 
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SNOTTY NOSE

Q: 

I hate having clogged up nostrils, but dislike using nasal drops.

A: 

Simplest method is irrigating the nasal passageways with weak warm salty water. This may be inhaled into the right nostril (say half a cup), letting it run back when it is then expectorated from the back of the throat. Then do the left side. This eliminates mucous, present in most colds and sinus infections. This allows the cilia, microscopic hairs on the mucous membrane surface to work normally again. They gradually automatically push unwanted debris outwards. Use a soft blow and paper tissues, and discard. Narium Mist is the same product in a plastic squeeze container. Do not use other chemical vasoconstrictor nasal drops for more than 3 days. I do not recommend them in any case.

 
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TRIPPING

Q: 

My ageing mum recently slipped on a couple of sheets of shiney paper from a magazine lying on the floor, fell and fractured her hip.

A: 

This is extremely common. Please keep floors, walkways, and paths free from any possible obstruction. Cords, loose mats, paper, objects, are often unseen by elderly people, whose bones are much more brittle as they age. A vision check is worthwhile. So is a bone test (densitometry). Maybe new spectacles, lens transplant, more calcium and vitamin D (and sunshine) will strengthen the bones.

 
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THE KILL

Q: 

I was brought up under the Christian ethic that "Thou shall not kill". This was given to a generation who daily sacrificed lambs, sheep, bulls, goats and birds for repentance of sins. Today, the law forbids killing a human, but says nothing about killing anything else, unless there is specific cruelty.

A: 

I am a vegetarian, because I do not like killing a living animal simply to satisfy hunger. There are heaps of fruits, vegetables, legumes, dairy products, berries, nuts that give adequate nutrition. Then comes the ethical question about wearing leather shoes and clothing. Today most are made of plastic and I am not sure where this comes from. Everything in life eats something else, even my fruit and vegetables are part of a plant life cycle.

 
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BENT BACKS

Q: 

Do you think the current generation of teenagers will have permanently bent backs from constant use of computers and the endless back bending this entails?

A: 

Absolutely yes. Unless the operator has a definite plan for regular exercises, stretching of neck, shoulder and back muscles, the back will inevitably develop a permanent forward curve. In due course this will set, and could impede normal respiration.

 
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This health advice is general in nature. You are advised to seek medical attention from your doctor or health care provider for your own specific symptoms and circumstances.

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