الثلاثاء، 4 سبتمبر 2018

Bad Habits That Wreck Your Teeth

Bad Habits That Wreck Your Teeth

We all know the basics when it comes to keeping your teeth healthy: brush, floss, visit the dentist twice a year. But there are habits and lifestyle choices that could be harming your dental health that will surprise you.

In this article, you will learn some of the nasty habits to avoid to protect your teeth from tooth decay and discoloration. Learn what causes teeth grinding, the best ways to keep your teeth white, and how to avoid cavities by making simple, effective changes to your daily habits.

Avoid Chewing Ice
Chewing ice is a seemingly harmless, often unconscious habit. But ice chewing can cause permanent damage to our teeth, putting small cracks in the enamel.

These cracks can grow larger over time and ultimately cause a tooth to fracture, requiring a visit to the dentist and unnecessary expense to get the cracks fixed. If you find yourself chewing ice as a habit, try opting for chilled water instead, or order your drinks without ice to resist the harmful urge to chew those cubes.

Bad Dental Habit: Sports Without a Mouth Guard

You wouldn't play football without a helmet, would you? Why play a sport without a mouth guard then? Going out on the playing field without something to protect your teeth is as important as wearing a helmet and other protective body gear.

Believe it or not, an estimated 5 million teeth are knocked out every year through sports. According to the American Dental Association, mouth guards prevent 200,000 sports-related mouth injuries every year. Those who lose teeth from rough play probably wish they had put their mouth guards in first. Wouldn't you?

Who Should Wear a Mouth Guard?

Your teeth are vulnerable to being knocked out or damaged from high impact sports such as

water polo,
mixed martial arts, and

In fact the Academy for Sports Dentistry recommends mouth guards for more than 40 different sports. A sports mouth guard helps cushion hard blows to the teeth and jaw. It has the added health benefit of protecting the soft tissues of your

cheeks, and

from being sliced by your teeth. Not only that, some believe it may offer a little shock absorption to protect you from a concussion as well.

Choosing a Mouth Guard
When it comes to mouth guards, you have four choices based on level of protection.

Medium protection: These are soft like light protection mouth guards, but they offer more protection and are more suitable to rougher activity. Athletes playing basketball, soccer, rugby, and softball could get good use out of this category of mouth guard.

Heavy protection: Like its name implies, a heavy-protection mouth guard is going to prepare your teeth for a stronger impact. Boxers and martial arts enthusiasts often use mouth guards at this level of protection.

Extra heavy protection: This is the highest level of protection offered by a mouth guard. If you play a sport with a high chance of intense collision, such as kickboxing, this is the mouth guard for you. These mouth guards are also useful when playing sports that require a stick or racquet in close quarters, such as hockey or lacrosse.

Bad Dental Habit: Baby Bottle Tooth Decay

Tired parents might be tempted to do anything to get their restless babies to sleep. Although it is tempting, avoid sending your bouncing bundle of joy to bed with a bottle in his or her mouth. That's because of a condition called baby bottle tooth decay.

What Is Baby Bottle Tooth Decay?

Bottles of milk at bedtime increase the risk of early dental decay in baby's mouth. Prolonged exposure of the sugar in milk works with mouth bacteria to break down tooth enamel and results in rampant decay.

Here are some tips to help you protect your baby's teeth to ensure a healthy upbringing:

Don't send baby to bed with a bottle unless that bottle only contains water.

Skip the sippy cup: only use regular cups and begin introducing them between ages six and eight months.

Wean your baby off the bottle by the time he or she turns 1.

As soon as you see the teeth pop up, start brushing them at least once a day.

Avoid sticky, sweet, starchy snacks that can lead to tooth decay. Instead try whole grains, cheese, plain yogurt, fruits, and vegetables.

Encourage your children to drink water instead of sugary drinks like soda, juice, and sports drinks.

Dental Danger: Tongue Piercings

Tongue piercings are a trend that can come at a hefty price in terms of cost to your health. Highly discouraged by dentists, tongue piercings can cause lots of problems to the teeth, and to the mouth overall. Here are some of the potential health hazards of tongue piercings:

They may cause teeth to chip or break, requiring dental work.
They can also rub against the gums and cause permanent gum recession, which can lead to sensitivity and even tooth loss.

The mouth has millions of bacteria. Mouth jewelry can encourage bacterial buildup, creating an overall unhealthy situation.
Repeatedly clicking the jewelry against teeth can damage teeth and fillings, and so can accidentally biting down too hard on the piercing.
Piercings can become infected. This is especially dangerous in the mouth, where a swollen tongue could cut off breathing, causing you to choke.
Some people experience allergic reactions to the metal in piercings.
Piercings can numb your tongue due to nerve damage. This is usually temporary, but it may wind up being permanent.
The piercing can interfere with dental x-rays.
In some cases, tongue piercings can cause teeth to gap by being forced between them repeatedly.

الخميس، 27 يوليو 2017

If Your Child is Not Feeling Well


Photo of baby with diarrhea getting diapers.

An infection, trouble digesting certain foods, or too much fruit juice are among the causes. If your child gets it, keep her at home and hydrated. If she's on solids, avoid high-fiber and greasy foods. Call the doctor if she isn't better in 24 hours, is under 6 months old, or has other symptoms, such as a fever of 101 or higher, vomiting, peeing less than usual, fast heart rate, bloody or black stool, or belly pain.


Photo of mother taking temperature of baby with fever.

Call the doctor immediately if
  • A baby under 3 months has a rectal temperature of 100.4 or higher.
  • A baby 3 to 6 months old has a temperature of 101 or higher.
  • Or if an infant is crying, irritable, and can't be comforted.
Watch for ear pain, a cough, lethargy, a rash, vomiting, or diarrhea. Soothe your little one with fluids, a lukewarm bath, and by dressing him in lightweight clothes. Ask your doctor about safe ways to lower a fever.

Little Children and Constipation

Photo of constipated baby drinking prune juice.

Some babies poop several times a day; others go a few days between bowel movements. Don't worry if your baby or toddler doesn't go as often as you'd expect. True constipation is when stools are hard and painful to pass. Your doctor may suggest adding a few extra ounces of water or a little bit of prune juice to your child's bottle or sippy cup. If constipation continues or your baby has other symptoms, such as abdominal pain or vomiting, call the doctor.


Photo of baby with pimples rash.

Babies have sensitive skin. Rashes can range from pimples to little white bumps (milia) to red, dry, itchy patches (eczema). To avoid diaper rash, change diapers often, and apply an ointment for protection. For eczema, avoid harsh soaps and keep skin moisturized. Most rashes aren't serious, but call the doctor if your baby's rash is painful or severe, or if he also has a fever or blisters.

Cough: Babies and Toddlers

Baby with cough humidifier.

Babies' coughs come in many varieties. A seal-like barking cough could be croup. Coughs with a low-grade fever are often from a cold, but a higher fever may mean pneumonia or the flu. Wheezing with a cough could be asthma or an infection. Babies with pertussis -- whooping cough -- make a "whooping" sound. A cool-mist humidifier and fluids can ease symptoms. Cough medicines should not be given to babies or children under 4.

Stomach Ache Symptoms

Photo of baby spit up stomach ache.

Uncontrollable crying, back arching, and spitting up are all symptoms of an upset tummy. It could be caused by colic, gastroesophageal reflux, food intolerance, virus, or other reasons. Toddlers can also have problems as they try different foods. Most stomach aches aren't dangerous and will go away. If it doesn't improve, or your child vomits, has diarrhea, becomes lethargic, or runs a fever, call the doctor.

Teething Pain

Photo of baby teething ring.

By about the sixth month, baby's first teeth will start poking through her gums. Sore gums can make babies very cranky. Relieve teething pain by giving your baby something to chew on. A rubber teething ring works well. Gently massaging baby's gums with your finger can also help.

Babies, Toddlers, and Gas Pain

Photo of mother burping baby.

Burping, crying, and flatulence can be signs of infant gas. Gas isn't the same as colic, which can lead to inconsolable crying. Because gas is often caused by swallowing air, feed your baby slowly and burp often. Toddlers can get gas from high-fiber or fatty foods, or by drinking too much juice.

Stuffy Noses

Photo of runny nose bulb syringe.

When babies have colds, their noses can get very stuffy. Over-the-counter cold medicine should not be used in children under 4 years. Instead, use saline drops to thin out mucus and then suction it out of baby's nose with a bulb syringe. Turn on the vaporizer to help your child breathe easier at night.

Nausea and Vomiting

Photo of toddler drinking electrolyte solution.

Babies often spit up after eating, but forceful or persistent vomiting needs a doctor's evaluation. Vomiting with diarrhea may signal a virus. Fluid loss from vomiting can lead to dehydration. Keep your child hydrated with small, frequent amounts of an electrolyte solution. If vomiting doesn't stop in a few hours, or is accompanied by a fever in an infant, or your child can't keep down fluids, call your doctor.

Keeping Calm When Baby's Not

Photo of mother keeping crying baby calm.

There's nothing more distressing to a new parent than a sick baby. Try not to lose your cool. Trust your instincts, but stay alert for signs that you need to call your health care provider or seek emergency care. Some warning signs include changes in appetite, extreme fussiness, lethargy, breathing problems, rash, neck stiffness, seizure, high fever, and a lack of wet diapers

The Facts on Childhood Illnesses

The Facts on Childhood Illnesses

A sick child wipes his nose.

There are so many childhood diseases, infectious and noninfectious, that it would be impossible to list them all here. However, we will introduce some of the most common ones, including viral and bacterial infections as well as allergic and immunologic illnesses.


RSV (respiratory syncytial virus) is the top cause of bronchiolitis.

A number of different viruses cause bronchiolitis (inflammation of the small airways), which affects children less than 1 year of age. Most commonly, it is caused by RSV (respiratory syncytial virus), but it can also be caused by influenza and other common viruses associated with upper respiratory symptoms such as fever, runny nose, and cough. A common symptom of bronchiolitis includes all of the above and wheezing (the same symptom observed in children with asthma). It is common in the winter months, and some infants will require admission to a hospital when the respiratory symptoms are very severe. The treatment of bronchiolitis is different from asthma; however, some of the same medications might be used. For a small percentage of infants, this first wheezing episode may be a harbinger of a future diagnosis of asthma, but for most, it is a onetime event.

Ear Infections

Illustration of the ear.

Ear infections are very common in children and are caused by a dysfunction of the Eustachian tubes, the tubes that connect the inner ears to the throat and serve as a drain for any fluid that may collect there. When fluid collects, it attracts bacteria and other germs, which may multiply and cause a symptomatic infection. Symptoms include fever, ear pain, tugging on the ear, or even drainage from the ear canal. Treatment of ear infections may involve observation or antibiotics. Occasionally, the fluid inside the middle ear may need to be drained.

Glue Ear

A tube inserted in the ear to secrete fluid from a patient with glue ear.

When fluid in the middle ear builds up and fails to clear up on its own or after treatment, it may need to be surgically drained. This procedure is called tympanocentesis. A needle is inserted into the middle ear and fluid is removed. Sometimes, because of recurrent infections or a chronic effusion (fluid that persists for at least three months), a tympanostomy tube may need to be inserted in the tympanic membrane (eardrum), which allows the middle ear to drain and function appropriately. The tubes remain in place and generally fall out by themselves after about a year. In most cases, the eardrum heals and functions normally after this procedure.


A boy is sick with croup.

Croup is common in young children. A number of different viruses cause croup, and inflammation of the upper airways, including the larynx (voice box) and trachea (windpipe), cause symptoms. These symptoms include a barking cough and stridor, a wheeze on inspiration. Most children with croup can be treated at home, but occasionally, when severe enough, hospitalization may be required. Treatment may include steroids and inhaled medications for the more severe cases. Always check with your doctor if you are concerned or if your child appears ill.

Hand, Foot, and Mouth Disease

Blisters on the palms of the hands are a characteristic of hand, foot, and mouth disease.

Coxsackievirus causes hand, foot, and mouth disease. It is extremely common during the summer and early fall and resolves on its own after about 10 days. The virus causes fever, sore throat, and blisters inside the mouth, on the palms of the hands, and the soles of the feet, There is no medical treatment for the infection, except supportive care including pain relievers.


A child with pink eye.

Pinkeye is also called conjunctivitis. A virus is the most common cause of pinkeye, but a bacterial infection can cause it on occasion. Pinkeye is very contagious and can spread through schools and day cares quickly. Always talk with a health-care professional to determine whether additional therapy is needed, but most cases resolve within five days.

Fifth Disease

Fifth disease is also called slapped-cheek disease.

A virus called parvovirus B19 causes fifth disease. This very common infection appears in the majority of children as a cold followed by a rash on the face and body. The typical description of the rash is a "slapped-cheek" appearance, since the rash is usually bright and appears as a reddish patch. The rash usually resolves within a week to 10 days. The only major risk of parvovirus is to pregnant women who have never been exposed to parvo in the past. There is a significant risk to the fetus for those individuals.


Photo of rotavirus

Rotavirus infection is responsible for significant morbidity and mortality in children in less developed countries where access to the rotavirus vaccine is limited. The infection causes significant fever, vomiting, and diarrhea in children. This can often lead to serious problems with dehydration, especially in very young children and infants. Before the introduction of the vaccine in the United States, rotavirus infection was a very common cause for hospital admission. Current studies indicate that the virus has resulted in up to 95% fewer admissions due to rotavirus infection to hospitals as result of vaccination.

Kawasaki Disease

A child with Kawasaki disease.

Kawasaki disease is a very serious disease that can mimic many infections. When unrecognized and untreated, it can result in severe damage to the coronary arteries of the heart, resulting in heart attack and sudden death in children. Luckily, most pediatricians are taught to look out for Kawasaki disease and learn to recognize the illness based on common signs and symptoms. These include high prolonged fever (greater than five days), a rash, cracked and dry lips, red eyes, enlarged neck lymph nodes, and swelling of the hands and feet. Hospitalization is recommended, and administration of IVIG (immunoglobulin) and aspirin are necessary. This treatment, when started early enough in the course of illness, prevents progression of the heart problems. The cause remains unknown.


Chickenpox causes itchy red blisters.

The varicella virus causes chickenpox. Vaccination is routine now, and it is rare to see a regular case now. Before the vaccine, it was a very common cause of hospital admission. Though chickenpox infection is usually a benign (but uncomfortable) event in a child's life, there is a significant risk of severe complications, including bacterial skin infections, pneumonia, and others. That is the reason that vaccination is recommended and routine.


Measles on a child's back.

The rubeola virus causes measles, and it used to be an extremely common childhood infection prior to routine vaccination. Unfortunately, due to an increased rate of vaccination refusals by parents, we are starting to see sporadic outbreaks amongst those groups. Measles is an acute viral illness that can lead to serious complications, even death, and generally begins with nonspecific symptoms such as high fever, runny nose, and cough. Following these symptoms, patients develop a rash that spreads from the face to the feet. Symptoms generally start one to two weeks after exposure, and the symptoms last for less than a week.


Mumps causes painful swelling of the salivary glands.

Mumps is a viral illness that typically starts with flu-like symptoms and then results in acute painful swelling of the salivary glands (parotitis). Prior to routine vaccination, this was a very common illness. Symptoms generally appear more than two weeks after exposure, and the illness lasts seven to 10 days. As with many of the childhood viral illnesses, though most infections are mild, there is a real risk for complications, including meningitis and death.

Rubella (German Measles)

Rubella (German measles) causes a rash and fever.

Rubella, also known as German measles, causes mild illness in most individuals. This is not the case for unvaccinated pregnant women. The virus can cause serious and fatal birth defects in the fetus. Vaccination is routine and has resulted in a huge decrease in the spread. The virus begins as a fever and rash and, in most cases, resolves after two to three days.

Whooping Cough (Pertussis)

Photo of whooping cough virus (pertussis)

Bordetella pertussis is the bacteria that cause whooping cough. It is highly contagious and is sometimes fatal in young children, especially babies. The infection is preventable with vaccination; however, it is often unrecognized in older children and adults. The infection usually begins with cold symptoms and then develops into a cough that is persistent and violent, making it hard to catch a breath. Whooping cough got its name due to the deep whooping inspiration many children and infants make after the cough stops. Vaccination is recommended for young children, teenagers, and adults.


An MRI shows meningitis.

Meningitis is an inflammation of the tissue surrounding the brain and spinal cord (meninges). Viruses or bacteria may cause meningitis. Symptoms include headache, stiff neck, fever, and malaise. Routine vaccination has decreased the incidence of many bacterial causes; however, viral causes are still common. Bacterial meningitis can result in severe outcomes, including permanent hearing loss, brain damage, and even death.

Strep Throat

Photo of strep throat.

A strain of Streptococcus, a common skin bacterium, causes strep throat. Symptoms include a sore throat and fever that lasts more than a few days. Often there may be a white-colored discharge (pus) in the back of the throat and enlarged lymph nodes on the neck. Strep throat will resolve on its own, however, antibiotics are recommended due to the risk of developing rheumatic heart disease, a serious but preventable consequence of strep infections.

Scarlet Fever

A child with scarlet fever rash.

A strep infection causes scarlet fever, which may appear after the throat infection. It is a common infection and starts with a fever and possibly sore throat, followed by a rash that begins on the chest and spreads to the rest of the body. Antibiotics are recommended to eradicate the bacteria and to prevent rheumatic fever and rheumatic heart disease.

Reye's Syndrome

Aspirin should never be given to children.

Aspirin and aspirin-containing medications should never be given to children. Reye's syndrome is a potentially fatal illness that is caused by exposure to these medications and results in life-threatening liver failure and subsequent brain swelling. It is luckily an uncommon illness today since the recognition of aspirin exposure as a cause.

MRSA (Staph Infection)

MRSA is an antibiotic-resistant organism that causes skin infections.

MRSA, or methicillin-resistant Staph aureus, is an antibiotic-resistant organism that causes skin infections such as boils and abscesses (deep skin infections) or even worse. It is becoming more common and can spread and cause life-threatening infections in health-care facilities. What makes this more challenging is that many individuals are asymptomatic carriers and can spread it to susceptible individuals. Treatment may include antibiotics but not all require this.


Characteristic golden crusts of impetigo appear below the mouth of a child.

Staph or strep, two very common skin bacteria, may cause impetigo. It generally appears as a bunch of small blisters that pop and form honey-colored crust. Impetigo can appear anywhere on the body and is most commonly diagnosed in young children. Antibiotics are necessary in most cases.


A common fungus causes ringworm.

A common fungus causes ringworm. This is not a "helminthic" disease (no worms involved). The name was developed due to the "worm-like" ring that is seen during these infections. Antifungal medications treat ringworm. It can spread from child to child, so care needs to be taken.

Lyme Disease

Lyme disease causes a bull's-eye rash.

Lyme disease is a common infection caused by a bacterium carried by a specific deer tick. Once bitten by an infected tick, there is a risk that the individual will develop the symptoms of Lyme disease, including rash, fever, body aches, and sometimes more severe symptoms involving the nervous system and joints. The rash is somewhat specific and appears as a large target-looking eruption one to two weeks after exposure. Lyme disease is hard to transmit unless the tick is attached for more than 24 hours. Antibiotics are the treatment of choice.


Photo of a flu virus cell

The flu typically is seen during the winter months and causes high fever, chills, body aches, and other symptoms. It usually resolves on its own, but in some, it can result in serious complications including pneumonia. Currently, annual vaccination is recommended universally for all people aged 6 months and older.

Seasonal Allergies

Photo of allergens

Seasonal allergies are the bane of many children and adults. Runny noses, sneezing, and puffy eyes are all common symptoms. Unfortunately, there is no cure for these; however, there are medications that can be taken to lessen the symptoms. Antihistamines are available as both prescription and nonprescription formulations and can be taken orally, used as nasal sprays, and even as eyedrops. The goal is to decrease the severity of the symptoms

What Is Prostate Cancer ?

What Is Prostate Cancer ?

Photo of normal and cancerous prostate diagram.
Prostate cancer is the development of cancer cells in the prostate gland (a gland that produces fluid for semen). It is the most common cancer in men; some cancers grow very slowly while others are very aggressive and spread quickly to other organs.

How Does Prostate Cancer Develop ?

Like all cancers, prostate cancer begins when a mass of cells has grown out of control and begins invading other tissues. Cells become cancerous due to the accumulation of defects, or mutations, in their DNA.

Most of the time, cells are able to detect and repair DNA damage. If a cell is severely damaged and cannot repair itself, it undergoes so-called programmed cell death or apoptosis. Cancer occurs when damaged cells grow, divide, and spread abnormally instead of self-destructing as they should.

Prostate Cancer Symptoms

Photo of man with prostate cancer in hallway.
Symptoms of prostate cancer are variable; some men have no symptoms until the cancer develops over years. However, symptoms that can develop include the following:
  • Urinary frequency
  • Difficulty starting or stopping urination
  • Interrupted or weak or slow urinary stream
  • Blood in urine or in semen
  • Discomfort (pain or burning sensation with urination or ejaculation)
  • Intense pain in the low back, hips, or thighs, often present with aggressive or prostatic cancer spread to other organs

Prostate Cancer or Enlarged Prostate?

Photo of an enlarged prostate.
Two conditions can cause some symptoms that mimic those seen in prostate cancer described previously.

Benign prostatic hyperplasia (BPH)

BPH results from the prostate growing larger. BPH causes symptoms by creating pressure on the bladder, urethra, or both. BPH commonly occurs in elderly men and is a relatively benign condition.

Prostatitis (inflammation or infection of the prostate gland)

In the case of prostatitis, prostate tissue becomes inflamed, causing the prostate gland to swell. Any bacteria that can cause a urinary tract infection (UTI) can also cause prostatitis, and it may be caused by sexually transmitted diseases (STDs) including chlamydia and gonorrhea.
Both conditions are treated medically but some individuals with BPH may require surgical treatment.
Prostate cancer is differentiated from the above conditions by identifying cancer cells in a biopsy of the prostate.

Who Is at Risk of Prostate Cancer ?

Photo of men who are at risk fro prostate cancer.
Aging in men (beginning at age 50) is the greatest risk factor for both BPH and prostate cancer. In addition, having a father or brother with prostate cancer doubles the risk for prostate cancer; however, African American males have the highest risk for prostate cancer. Research suggests that the majority of men at age 70 have some form of prostatic cancer with most of them showing no symptoms.

Preventing Prostate Cancer

Photo of a slice of pizza, food that increases risk of prostate cancer.
Researchers suggest a diet low in fruits and vegetables but high in meats and high-fat dairy products increases the risk for prostate cancer. The mechanism(s) for this is being investigated, but current speculation suggests meat and high-fat foods contain compounds that augment the growth of cancer cells.

Can Too Much Sex Cause Prostate Cancer ?

Photo of couple in a convertible.
There are many myths about why prostate cancer develops. However, there is no evidence that "too much sex," masturbation, benign prostatic hyperplasia (BPH), or a vasectomy increases the risk or causes prostate cancer. Current research is investigating if STDs, prostatitis, or alcohol use increase the risk of developing prostate cancer.

Prostate Cancer Screening Guidelines

Photo of man on exam table, about to be screened for prostate cancer.
Although screening tests are not routinely done for prostatic cancers, the American Cancer Society guidelines suggest some men should be screened.

Screening Guidelines Based on Age and Risk

  • Men aged 40 with more than one close relative (father, brother, or son) diagnosed with prostate cancer at an early age
  • Men aged 45 that are African American or have a father, brother, or son diagnosed with prostate cancer before age 65
  • Men aged 50 or older who have average risk and expect to live at least 10 more years
However, not everyone agrees with these guidelines; clinicians should explain that treatments can have severe side effects, may have little or no effects on the cancer, and that some cancers are so slow-growing.

Digital Rectal Exam and PSA Test

Photo of digital rectal exam.
Two tests are particularly helpful in screening for prostate cancer.

Digital rectal exam (DRE)

A DRE is done to determine if the prostate is enlarged and is either soft, has bumps or is very firm (hard prostate). During a digital rectal exam, a doctor checks for prostate abnormalities using a gloved, lubricated finger (digit).

PSA Test

Another test is done on a blood sample to determine the level of a protein (prostate-specific antigen or PSA) produced by prostate cells. The PSA test may indicate a person has a higher chance of having prostate cancer but controversies about the test exist (see following slide). The patient and his doctor need to carefully consider the meaning and the use of these test results.

PSA Test Results

Photo of blood sample used to test for prostate cancer.
In general, a PSA level less than 4 nanograms per mililiter (ng/mL) of blood is considered a normal level while a PSA greater than 10 ng/mL suggests a high risk of having cancer. Unfortunately, some men have intermediate levels (5 to 9 ng/mL), making their situations more difficult to judge. To make matters worse, some men have prostate cancer despite showing PSA levels of less than 4 ng.

PSA Test False Positives

BPH and prostatitis can increase PSA levels resulting in a false positive test.

PSA Test False Negatives

Some drugs may lower PSA levels and result in a false negative PSA test. Your doctor can help decide the meaning of both the PSA test and the digital rectal exam results and determine if additional tests need to be done.

Prostate Cancer Biopsy

Photo of prostate biopsy.
If your doctor determines that the PSA and digital rectal exam suggest prostate cancer, the physician may suggest that a biopsy of the prostate is warranted, depending on your age, medical condition, and other factors. A biopsy is done by inserting a needle through the rectum or between the rectum and scrotal junction and then removing small samples of prostatic tissue that can be examined under a microscope for cancer tissue. The biopsy may detect and determine the aggressiveness of prostatic cancer cells.

Prostate Cancer Gleason Score

Photo of gleason diagram.
Biopsy samples from the prostate gland are examined by a pathologist. The pathologist makes determinations based on the samples as to the aggressiveness of the cancer. This determination is called the Gleason score.

How the Gleason Score Is Determined

The pathologist gives the prostate biopsy tissue a grade of 1 to 5, with 5 as the worst grade of tumor pattern. Then the pathologist looks at the individual cells in the tumor pattern and grades the cell types from 1 to 5 with 5 being the most aggressive cancer cell type. The Gleason score is based on the sum of these two numbers (tissue grade and cell type grade). A Gleason score of 5 + 5 = 10 indicates a highly aggressive prostate tumor while a low score (2 + 2 = 4) indicates a less aggressive cancer.

Prostate Cancer Imaging

MRI of prostate cancer.
The spread of prostate cancer may be detected by several different tests such as ultrasound, CT, MRI, and a radionuclide bone scan. Doctors will help determine which tests are best for each individual patient.

Prostate Cancer Staging

Photo of stages of prostate cancer.
Prostate cancer staging is a method that indicates how far the cancer has spread in the body and is used to help determine the best treatment method for the patient. Cancer that has spread to other body sites or organs is termed metastatic cancer.

The Stages of Prostate Cancer

In terms of prostate cancer, the cancer stages are as follows:
  • Stage I: The cancer is small and still contained within the prostate gland.
  • Stage II: The cancer is more advanced, but is still confined within the prostate gland.
  • Stage III: The cancer has spread to the outer part of the prostate and to the nearby seminal vesicles.
  • Stage IV: The cancer has spread to lymph nodes, other nearby organs, or tissues such as the rectum or bladder, or to distant sites such as the lungs or bones.
  • Aggressive prostate cancer often reaches stage IV but others that are less aggressive may never progress past stage I, II, or III.

Prostate Cancer Survival Rates

Photo of grandfather, a prostate cancer survivor, and grandson.
In most individuals, prostate cancer progresses slowly through stages; about all individuals diagnosed with stage I through III prostate cancer survive 5 years or longer and with current treatments, the outlook is even better for future survival.

Stage 4 Prostate Cancer

Even stage IV has a 5-year survival rate of about 31% and this figure may also increase with advancement in treatment methods.

Prostate Cancer Treatment: Watch and Wait

Photo of doctor discussing prostate exam results.
"Watch and wait," is a phrase that is being used more frequently to describe a program of active surveillance without other cancer treatment for some patients with prostate cancer. It means that if your cancer is not aggressive (based on the Gleason score and the cancer stage), treatments may be deferred and your condition periodically checked. This approach is used because the risks of urinary and sexual problems inherent in most prostate cancer treatments are serious and may be put off or avoided if the cancer is not aggressive. However, aggressive prostatic cancer is usually treated even if secondary complications of treatments are serious.

Prostate Cancer Treatment: Radiation Therapy

Photo of CT scan of pelvis.
Radiation, focused as a beam, can be used to kill cancer cells, especially those cells that have migrated (metastasized) from the prostate gland. Beams of radiation can be used to reduce bone pain caused by invasive cancer cells.

Low Dose Rate Brachytherapy

In another type of radiation therapy termed low dose rate brachytherapy, radioactive pellets about the size of a grain of rice are inserted into the prostate.

High Dose Rate Brachytherapy

High dose rate brachytherapy applies more radioactive sources temporarily into the cancerous prostate gland.
Both methods have side effects that can include erectile dysfunction, urinary tract problems, diarrhea, and other side effects.

Prostate Cancer Treatment: Prostate Cancer Surgery

Photo of prostate cancer surgery.
Radical prostatectomy is the surgical removal of the prostate gland. Usually, this treatment is performed when the cancer is located only in the prostate gland. New surgical techniques help avoid damage to nerves, but the surgery may still have the side effects of erectile dysfunction and impaired urinary control. However, these side effects may gradually improve in some patients. Surgeons today may use robotic technique to assist in the operation.

Tips: Coping With Incontinence

Urinary incontinence is a common complication for men following prostate cancer surgery, and this problem can persist even five years after the surgery takes place. In one survey of 111 men published in 2003, 69% reported incontinence after prostate surgery. Most of these men used pelvic muscle exercises (Kegel exercises) to help. Many used containment devices, including pads, special underwear, and sanitary napkins to manage incontinence.
Here are some post-surgical incontinence tips:
  • Keep a diary of how much you drink, and when and how often you use the bathroom. Note when you leak, and consider whether something could have caused the leak, such as bending in a certain way or drinking too much coffee or soda. The diary can give your doctor powerful in formation to help further your treatment.
  • Practice double-voiding, meaning that after you finish urinating, wait a minute and try again.
  • Drink less caffeine and alcohol. Both of these drugs can irritate the bladder and increase your need to go. Reducing or eliminating them from your diet can help stave off the frequent need to urinate.
  • Avoid food triggers that for some men include chocolates, artificial sweeteners, spicy, or acidic foods. Other men find that food plays a small role or no role at all in their incontinence problems.
  • Quit smoking. Along with all of its other many health hazards, tobacco has been linked with aggravated urinary incontinence in men.

Prostate Cancer Treatment : Hormone Therapy

Photo of syringe with droplet, hormone therapy for prostate cancer treatment.
Hormone therapy is designed to use drugs to shrink or slow the growth of prostate cancer cells, but it does not kill the prostate cancer cells. It is used to reduce the symptoms of prostate cancer and to slow the spread of aggressive prostatic cancers by blocking or reducing the production of male hormones (androgens) like testosterone.

Hormone Therapy Side Effects

  • Impotence
  • Breast tissue growth
  • Hot flashes
  • Weight gain

Prostate Cancer Treatment: Chemotherapy

Photo of chemotherapy treatment for prostate cancer.
Chemotherapy is designed to kill fast-growing cancer cells anywhere in the body so it is often used when aggressive prostate cancer cells metastasize to other body sites. Usually, chemotherapy is given through a special intravenous line in a series of treatments over several months. There have been new advances in both the hormonal and chemotherapy treatment of prostate cancer. Unfortunately, chemotherapy often kills other fast-growing body cells like hair cells, mucosal cells, and cells that line the gastrointestinal tract. This can result in several unwanted side effects.

Prostate Cancer Chemotherapy Side Effects

  • Hair loss
  • Mouth sores
  • Nausea
  • Vomiting
  • Other body ailments

Prostate Cancer Treatment: Cryotherapy

Photo of prostate cancer cells.
Cryotherapy is a treatment that kills cancer cells by freezing the cells which break apart when they are rewarmed. The treatment is less invasive than surgery, but the long-term effectiveness is still under study.

Prostate Cancer Cryotherapy and Impotence

Unfortunately, freezing damages nerves, sometimes including those near the prostate that control erections. Many men (up to 80%) become impotent after cryotherapy. Erectile dysfunction is a more common side effect following cryotherapy than following a radical prostatectomy.

Prostate Cancer Treatment: Prostate Cancer Immune Therapy

Photo of prostate cancer vaccine.
Please note that the term prostate cancer immune therapy has been called a vaccine, but that is somewhat misleading because it does not prevent prostatic cancer from developing in men. The prostate cancer “vaccine” is a highly individualized treatment method, designed to provide immune cells derived from a single patient's own cells. These cells are laboratory enhanced immune cells that become capable of killing or damaging the patient's own prostate cancer cells.

Like hormone therapy, this "vaccine" does not kill off all cancer cells and is currently used to slow the progression of aggressive cancers, especially those unresponsive to other treatments. Research is ongoing and perhaps this or similar methods may be developed to be more effective in the future.

Hope for Advanced Prostate Cancer

Photo of grandfather walking with grandson.
Follow-up of diagnosed prostate cancer is important. Whether the decision is to use the "wait and see" approach or any of the above-mentioned treatment methods, the prostate cancer may advance so additional tests like the PSA test or treatments may be necessary. In addition, follow-up can monitor how changes in the patient's lifestyle (appropriate diet and exercise, for example) can lower the risk of death from prostate cancer.

Prostate Cancer: Coping With Erectile Dysfunction (ED)

Photo of a couple holding hands.
Erectile dysfunction (ED or failure obtain or sustain an erection) is a very common side effect of most prostate cancer treatments. In some men, especially those under age 70, improved erectile function may occur within about 2 years after surgery. Additionally, the patient may benefit from various ED medications and therapies, including several types of devices specific for men with ED. Men with ED should discuss the various options with their doctor and partner to determine the best individual treatment method(s).

Cancer-Conscious Diet

Photo of lentils and spinach, prostate-healthy foods.
As stated previously, a good diet and lifestyle may help lower the risk for prostate cancer; the same is true for those men diagnosed with prostate cancer in terms of cancer recurrence. Consequently, it is appropriate to review diet and lifestyle changes.

Diet Tips to Avoid Recurring Prostate Cancer

  • Increase frequency and portion sizes of fruits and vegetables. A 2014 study of more than 40,000 Japanese men found that fiber (found in abundance in fruits and vegetables) may reduce the risk of prostate cancer.
  • Eat whole grains and avoid processed grains and white flour. As with fruits and vegetables, whole grains provide more fiber than their processed counterparts. Adding more fiber may help reduce prostate cancer risk.
  • Reduce or stop eating high-fat dairy products and meats, especially processed meats like bacon, sausage, and baloney. The World Health Organization found in 2015 that diets high in red meat were linked to an increased risk of prostate cancer. Consuming a lot of high-fat dairy products seems to slightly elevate prostate cancer risk as well.
  • Some research suggests that spinach, orange juice, and other foods may decrease the risk of cancer; prostate cancer patients may get additional diet and lifestyle recommendations when they follow up with their doctors.

Prostate Cancer: Beware of Supplements

Photo of supplement pills.

Prostate cancer patients and other cancer patients should be very cautious about taking supplements and other items marketed as cancer preventives or cures. Before taking any such compounds, the person should discuss the compound with their doctor. In addition, cancer patients are advised not to self-medicate or change medication dosages without first conferring with their doctor(s).

Additional Information on Prostate Cancer