As men age, their testosterone production begins to slow. As men get into their 50s, 60s, and beyond, they may start to have signs and symptoms of low testosterone including reduced sex drive and sense of vitality, erectile dysfunction, decreased energy, lower muscle mass and bone density, and anemia. In some cases, supplemental testosterone may help. However, doctors disagree over the wisdom of prescribing testosterone to prostate cancer survivors.

Today, about 10% to 20% of patients who have their prostate surgically removed are told that they have positive surgical margins, meaning some cancer cells may have been left behind. In this roundtable discussion, three Harvard physicians discuss positive surgical margins what patients with positive margins should consider next.

Dr.

Researchers

No consensus exists about what type of medical follow-up is in order for this “precancerous” condition or whether to treat it. Marc B. Garnick, M.D., explains the condition and outlines your options.

Study shows that men with BPH typically eat less garlic and fewer servings of onions per week than those without BPH.

Many urologists prescribe alpha blockers to treat chronic prostatitis, but study shows that one such drug is ineffective in easing the condition.

Research shows that combining the anti-inflammatory drug celecoxib (Celebrex) and the cholesterol-lowering statin drug atorvastatin (Lipitor) halted the progression of prostate tumors in mice. Investigators are now planning to test the combo in prostate cancer patients.

Research has shown that testosterone levels decline as men age. In theory, taking testosterone supplements should counter that natural process. But a Dutch study concluded that they few benefits.

Physicians and researchers have long believed that consuming high amounts of calcium and dairy products increases the risk of prostate cancer, although study results have been inconsistent. Two recent studies make clear that the jury is still out.

Obese men tend to have lower PSA concentrations than men with healthier weights. As a result, fewer obese men undergo biopsies, potentially leaving prostate cancer undetected.

Studies reveal that lycopene, a nutrient found in tomatoes, does not seem to reduce prostate cancer risk.

I have used finasteride (Proscar) to treat my BPH, and it has reduced the size of my prostate. However, my body’s production of semen has diminished, too. Will switching to dutasteride (Avodart) solve that problem?

In short, yes. If you take Flomax (tamsulosin), be sure to tell your eye doctor before having cataract surgery.

Three doctors describe some surgical options for treating an enlarged prostate, including the ones they think patients prefer.

PSA testing is not merely a prostate cancer screening tool. After treatment, PSA monitoring is the primary method of measuring treatment success and detecting early signs of cancer recurrence.

In a business, due diligence means doing your homework, exploring all the options, and taking reasonable steps to protect yourself. When trying to make a decision about how to treat early-stage prostate cancer, taking time to conduct due diligence is absolutely vital for three reasons:

• No expert consensus exists about which treatment for early-stage prostate cancer is best (or when treatment is best postponed).

Understanding PSA

Ejaculation or vigorous bicycle riding can cause a small increase in your PSA level. Consider repeating your PSA test in two weeks, after you’ve avoided bicycle riding and intercourse for at least 48 hours. If your repeat PSA level returns to normal (less than four), this is excellent news. If your PSA test remains elevated, further evaluation is probably needed. Your options include:

• referral to a urologist (prostate specialist)

Understanding PSA – Introduction

Welcome to this Decision Guide about PSA testing.

Prostate-specific antigen, or PSA, is a blood test used by many doctors to screen for prostate cancer. If you’ve had your PSA level checked, you may have been told that your results were “normal” or “abnormal.” However, some men would like to know more about what their PSA level means.

This tool provides more information about PSA levels, and what’s considered to be reassuring or worrisome for men of different ages.

Transrectal ultrasonography (TRUS) can create images of the prostate gland using sound waves. Doctors may recommend TRUS when they suspect prostate cancer based on an abnormal DRE or an elevated PSA.

Researchers are developing more screening tests for prostate cancer. Like the PSA test, they rely on biomarkers, such as antigens or proteins, which are elevated or may only be present in men who have prostate cancer. The hope is that these newer tests will better detect existing cancers (better sensitivity), and will not raise the alarm for cancer when it is not present (better specificity).

In this test, the doctor inserts a lubricated, gloved finger into the rectum and feels the surface of the prostate to determine whether it is swollen or has any lumps or abnormally textured areas (see Figure 1). This exam also helps doctors screen for diseases of the rectum, such as rectal cancer.