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The Healthy Geezer

—Fred Cicetti

 

Q. I know I have an enlarged prostate. Is this a sign of cancer?

Most men with enlarged prostates don’t develop prostate cancer, but there’s a lot more to this question.

The prostate is a walnut-sized organ that surrounds the tube (urethra) that carries urine from the bladder. The urethra also transmits semen, which is a combination of sperm plus a fluid the prostate adds.

Benign prostatic hyperplasia (BPH) is the term used to describe an enlarged prostate, which is common in men 50 and older. An enlarged prostate may squeeze the urethra, making it hard to urinate. It may cause dribbling after you urinate or a frequent urge to urinate, especially at night.

Some men with prostate cancer also have BPH, but that doesn’t mean that the two conditions are always linked. However, because the early symptoms are the same for both conditions, you should see a doctor if you have these symptoms.

The following are other symptoms of prostate problems: blood in urine or semen, burning urination, difficulty getting an erection, painful ejaculation, frequent pain, or stiffness in the lower back, hips, or upper thighs.

Treatment choices for BPH include:

  • Observation. If your symptoms don’t bother you a lot, your doctor may suggest that you delay treatment and come in for regular checkups.
  • Alpha-blockers. These are medicines that can relax muscles near the prostate and ease symptoms.
  • Finasteride (Proscar) acts on the male hormone (testosterone) to shrink the prostate.
  • Surgery. An operation can relieve symptoms, but it can cause complications.

Prostate cancer is one of the most common types of cancer among American men. Treatment for prostate cancer works best when the disease is found early.

In a physical exam, the doctor feels the prostate through the rectal wall. Hard or lumpy areas may mean that cancer is present.

Your doctor also may suggest a blood test to check your prostate-specific antigen (PSA) level. PSA levels may be high in men who have an enlarged prostate gland or prostate cancer. PSA tests are used for early cancer diagnosis. But PSA test results alone do not always tell whether or not cancer is present.

When doctors suspect cancer, they also may perform a biopsy. Doctors can take out a small piece of the prostate and look at it under a microscope.

There are many options for treating prostate cancer:

 

  • Observation. If the cancer is growing slowly, you may decide to wait and watch.
  • Hormone therapy. This stops cancer cells from growing.
  • Surgery. There are several surgical options. These include radical prostatectomy or removal of the entire prostate, cryosurgery that kills the cancer by freezing it, radiation therapy to shrink tumors, and implant radiation that places radioactive seeds into the prostate.

Surgery can lead to impotence and incontinence. Improvements in surgery now make it possible for some men to keep their sexual function.


What’s new about Medicare in 2011

—BOB MOOS, Southwest public affairs officer for the Centers for Medicare & Medicaid Services
The New Year brings changes to Medicare, many of them a result of the new Affordable Care Act. Here’s a brief rundown of what to expect in 2011:

  1. Original Medicare will cover the full cost of an annual wellness visit with your doctor. The yearly check-up will include routine measurements like your blood pressure, a review of your prescriptions and medical history, and a personal assessment of any risks to your physical and mental health. Until now, you’ve been entitled to one “Welcome to Medicare” exam during the first year you sign up for Medicare’s Part B, which covers outpatient services. If you’re enrolled in a private Medicare Advantage health plan, check with your insurer about whether it, too, will cover the wellness visit at no cost in 2011.
  2. If you have a drug plan and reach the coverage gap, or “donut hole,” you’ll receive a discount on your prescriptions. You’ll get 50 percent off the price of brand-name drugs and 7 percent off generics. And even though you’ll pay less for a brand-name drug, you can count the prescription’s full price toward the amount you’re required to spend on drugs to qualify for catastrophic coverage.
    That way, you’ll enjoy lower out-of-pocket costs while in the “donut hole,” but you’ll still become eligible for Medicare’s catastrophic coverage as quickly as you would without the discount.
  3. If you have Original Medicare, you’ll pay nothing out of pocket for most preventive services. Until this year, you’ve usually paid 20 percent of the Medicare-approved amount for lab tests and screenings after you met your annual deductible. But starting in 2011, you won’t have to worry about a deductible, co-payment or coinsurance for a broad range of preventive services.
    Those include colonoscopies, mammograms, Pap tests and prostate cancer screenings. If you’re in a private Medicare Advantage plan, contact your insurer to find out whether it has also eliminated out-of-pocket costs for tests and screenings.
  4. Medicare Advantage health plans are now required to have annual out-of-pocket maximums and other consumer protections. In the event you need an expensive treatment, you’ll be protected from exorbitant out-of-pocket costs. For many Advantage plans, out-of-pocket expenses (excluding premiums and prescription costs) will be capped by law at $6,700 in 2011. Some plans have voluntarily set lower maximums. In addition, if you’re in a private health plan, you can no longer be charged more for some services (like chemotherapy) than if you were in Original Medicare.
  5. Your Medicare premiums may change. Most people on Medicare will pay the same Part B premiums this year as they did in 2010 – either $96.40 or $110.50 per month. But there are several exceptions. If you enroll in Part B for the first time in 2011, or if your premiums aren’t deducted from your Social Security check, you’ll pay $115.40 a month. For higher-income beneficiaries (single people with annual taxable incomes over $85,000 or married couples with incomes above $170,000), Part B premiums will range from $161.50 to $369.10. Plus, starting this year, beneficiaries in those income brackets will pay a monthly surcharge of $12 to $69.10 for their prescription drug coverage.
  6. There are new times to switch your coverage. Dissatisfied with your private Medicare Advantage health plan? A new annual “disenrollment” period allows you to switch to Original Medicare and a drug plan between Jan. 1 and Feb. 14. That replaces a January-to-March enrollment period when you could switch between Original Medicare and the Medicare Advantage program or move from one private plan to another. In 2011, you’ll have more time to choose and join a private health or drug plan when the annual open enrollment period gets an earlier start than usual in the fall. In past years, it’s run from Nov. 15 until Dec. 31. This year, it will kick off on Oct. 15 and wrap up on Dec.
  7. As always, your new coverage will take effect on January 1.

As I said, this is only a quick look at Medicare’s more noteworthy changes. The best way to understand what’s new is to refer to your “Medicare and You 2011” handbook, which you should have received by mail this fall.

 If you still need one, call 1-800-MEDICARE and request a free copy, or visit www.medicare.gov and download it. With the book in hand, you’ll be able to make better informed decisions about your health in the New Year.


Five Tips for Brain Fitness in 2011

While millions of us have resolved to make 2011 the year for getting our bodies into better shape, an expert on neurological fitness suggests we also make this the year to get our minds into tip-top condition.

“With Alzheimer's and other neurodegenerative diseases now starting to affect adults in their 30's, it's never too early to begin a simple program geared to maintain brain health and stimulate cognitive function,” says neuroscience researcher Mark Underwood.

Underwood says many researchers now believe brain health and memory can be positively influenced by simple things we can do physically, mentally, and nutritionally:

  1. Stay physically active. Regular activity, not necessarily planned exercise, seems to relate to brain fitness. Activities like gardening, dancing and cleaning could increase chances of maintaining brain health.
  2. Challenge your brain. Calculate, do word search games and crossword puzzles, and go to lectures, concerts and museums. Learn a foreign language or how to play a musical instrument.
  3. Stay socially active. People who are active in clubs and social networks may hold up better cognitively than those who are less socially active.
  4. Feed your brain. The brain and nervous system are comprised of 60 percent fat, so ensure your diet is rich in the Omega 3 essential fatty acids found in coldwater fish, fish oil, and flax oil. Google “brain foods” on the computer and try a few.
  5. Lower brain calcium levels with supplements. Proper levels of calcium within the neurons are required for optimum brain function. As we reach middle age, brain calcium levels begin to rise because our bodies stop producing a protein responsible for regulating calcium concentration within the cells.

“Too much calcium in a neuron will 'short circuit' it and it stops working,” says Underwood.

“When millions and millions of neurons become over-calcified and stop working, an individual can feel blank, forgetful, slow-witted, and begin to experience symptoms sometimes associated with diseases such as Alzheimer's and Parkinson's.”

Underwood and fellow researchers have discovered that a protein produced by jellyfish is able to lower calcium levels in the neurons and thereby restore normal function to the human brain and nervous system.

“When individuals are given a dietary supplement containing this special “calcium binding protein” their memory returns and they feel alert and focused,” says Underwood.

By increasing physical activity, proper nutrition, and lowering brain calcium levels, Underwood says most adults will notice a definite improvement in alertness and cognitive ability within 90 days.

ABOUT MARK UNDERWOOD
Mark Underwood is neuroscience researcher and co-founder and president of Quincy Bioscience in Madison, Wisconsin.  Mark is responsible for researching the “calcium binding protein” found in jellyfish and developing it for use as a calcium regulator in the human nervous system. He is the author of the book “Gift from the Sea.”

     

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