Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
Let's finish up with the prostate. The prostate sits under
the bladder and as we mentioned it can enlarge as a male
ages. Cancer can develop and it is a debilitating one with
death common. Detection is tricky, as the prostate is hidden
in the body. Detection can be made by following a blood test
for PSA in at-risk individuals and by rectal exam, by which
the prostate can be partially felt. An ultrasound -- again
done through the rectum -- is an excellent test. Men must
come to terms with this uncomfortable exam to prevent a bad
cancer. The prostate also gets infected, and this can lead to
fever and pain. Treatment is with antibiotics, which is often
less than perfect, as the blood supply to the prostate isn't
great. Occasionally chronic prostatitis occurs, leading to
vague chronic rectal pain. Treatments are not that
effective.
This concludes our discussion of the urinary tract.
Urologists also deal with male problems, but this is not the
forum for this, other than one disease I will mention due to
the need to act fast. Teenage boys are susceptible to torsion
of the testes, that is the teste can rotate and cut off its
own blood supply, There can be vomiting and acute abdominal
pain. Here, one must urgently get a urologist involved to
save the teste. Like teeth that have fallen out, heart
attacks, stroke, and cancer -- waiting can often lead to
missed opportunity for cure.
I have been asked to speak about vitamins and homeopathy.
Alternative medicines are a huge business, but evidence is
often lacking as to safety and effectiveness. Let me start by
saying that conventional medicine has nothing against natural
medicine -- but it has to be grounded in the same rigorous
evaluation for its ability to help and not hurt. Also -- and
this is an important point -- we in medicine already know
enough to usually reject research which has sponsorship from
companies who will profit from the results. In the attacks on
epidurals for example, were a number of letters from those
who presented very questionable evidence in order to promote
their product -- whether it be a book they wrote, or a method
they provide. One even copyrighted their letter. How
committed can these people be to the independent circulation
of true information?
Natural medicines in the USA and the UK do not have to
undergo trials. One good source to gain knowledge on these
medicines is the German E Commission and the Prescriber's
Newsletter's Natural Medicine Database. Some natural
medicines work well and have been adopted by the medical
community (digoxin, aspirin) some work marginally (saw
palmetto) some don't work at all (ginkgo for dementia) and
some are dangerous (Kava and Chaparral can cause liver
damage). Be careful, do not depend on well-meaning neighbors,
and make sure your doctor knows you are taking these
medicines. More next week. Write me in care of the
Yated.
A message from Glaxo, sponsor of this column. Allergy
season is here, and Glaxo's dermatology creams-- eumovate,
betnovate and dermovate -- can alleviate itching that comes
with contact dermatitis, poison ivy, mosquito bites, and
eczema. No need to suffer -- these creams work!
