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Prostate Cancer Survivorship

Surviving Prostate Cancer – What’s Next?

Prostate cancer is one of the most common cancer’s affecting men, but today’s treatment therapies offer greater than ever chances for survival.   In fact, more than 2 million men in the U.S. are prostate cancer survivors.1

Radical prostatectomy (surgical removal of the prostate) may provide excellent long-term survival outcomes.  However, there can be side effects from the surgery such as urinary incontinence and erectile dysfunction. 2,3,4,5

As you move into the recovery phase of your journey, it is important to remember that there are a number of effective treatment options available for incontinence and ED.  The bottom line: There’s real help available that can significantly improve a man’s health and well-being.

Getting Help

Finding the Right Doctor

Finding a satisfying treatment for ED or urinary incontinence can be a life-improving event.  If you’re suffering from these conditions and not getting the results you seek, talk to a specialist like a prosthetic urologist about all the available options.

Prosthetic urologists have specialized expertise in the full range of treatment options for ED and urinary incontinence. They can be an excellent source of information about the risks and benefits of each, and help you determine which option may be right for you.

Track Your Progress

The Stress Urinary Incontinence (SUI) quiz and Sexual Health Inventory for Men (SHIM) quiz can be a useful tool in discussing your progress with your doctor.

Connecting with Someone Who’s Been There

Some men also find it helpful to talk with others who have been in their situation.  You can connect you with a patient who has had the type of procedure that you are considering, and is willing to share his story.   For more information, call 1-800-328-3881.

Resources

UROLOGY CARE FOUNDATION (UCF). The American Urological Association (AUA), founded in 1902, is the premier professional association for the advancement of urologic patient care.  UrologyHealth.org offers a wealth of patient education and information written and reviewed by urology experts in partnership with the Urology Care Foundation.

EDCURE.ORG A comprehensive resource for information about ED.  You’ll find plenty of information here to inspire and educate you on today’s satisfying solutions – including the most advanced penile implants.

MALE CONTINENCE.COM Provides you, your partner and medical professionals a place to not only learn about the condition of male urinary incontinence, but also to interact with others who are seeking similar information. It can be a useful tool in your search for information and solutions to take control of your bladder.

Last modified: December 4, 2014

Alopecia

The American Medical Association (AMA) states that 95% of persons with baldness have “androgenetic alopecia” or “pattern baldness.”  Alopecia is an inherited condition affecting approximately 25% of the male population. Androgenetic alopecia affects most of these men before the age of 30, and two-thirds of all men prior to age 60. This form of baldness may develop in older adults as well.

Last modified: May 31, 2014

Alzheimers

Many people think that Alzheimer’s disease is uncommon. It would be great if that were true, but according to the Alzheimer’s Association, as many as one in nine Americans will face the diagnosis. Above the age of 85, almost two out of five show signs of this disease. Alzheimer’s is considered the most common cause of major loss of mental function in the elderly, accounting for two out of three cases. At this time, almost two thirds of those diagnosed with Alzheimer’s are women.

About

  • Alzheimer’s is a type of dementia, a term that’s used to describe brain disorders where gradual decline in memory or other thinking skills interferes with daily life.
  • The disease starts forming in the brain 5–10 years before symptoms appear.
  • Abnormal clumps (amyloid plaques) and tangled fibers (tau tangles) start spreading in the brain.
  • The connections between nerve cells (neurons) stop working.
  • The brain tissue shrinks over time.
  • Although genetics and age play a large role in causing Alzheimer’s, it is not a normal part of aging.

FYI

  • Alzheimer’s is the 6th leading cause of death in the United States.
  • Men represent approximately 45% of all caregivers in the United States.
  • An estimated 1 in 9 Americans ages 65 and over have Alzheimer’s.
  • Today, more than five 5 million Americans have Alzheimer’s disease; by 2050, that number is expected to grow to 16 million.

Symptoms

Signs and Symptoms of Alzheimer’s

  • Stage 1: Normal. No difficulties with memory, judgment, communication, or conducting daily activities. People remember their name, where they live, and what time of day it is.
  • Stage 2: Normal Aged Forgetfulness. Your loved one may have some “senior moments” – occasional difficulties remembering things. Friends and family aren’t usually aware of these cognitive problems.
  • Stage 3. Mild cognitive Impairment. Small changes in memory, behavior, communication, personality, or mood. For many, symptoms never get any worse. But for most, symptoms become more severe within two to four years.
    • Trouble remembering names (people and things).
    • Repeating questions and stories.
    • Difficulty remembering something recently read.
    • Misplacing important items.
  • Stage 4. Mild Alzheimer’s. Symptoms become more obvious now. Treatments are available that may make the disease advance more slowly. May last about two years.
    • Difficulty remembering recent events/personal details.
    • Withdrawing from social interaction.
    • Depression and moodiness.
    • Confusion about where commonly used household items typically go.
  • Stage 5. Moderate Alzheimer’s. Memory worsens and everyday activities become difficult. Your loved one needs 24/7 monitoring and cannot live alone. She or he should definitely not be cooking anymore and will need help with everyday tasks (cleaning, dressing, feeding, bathing, and so on). May last 1 ½ years.
    • Severe memory loss; remembering some things but not others.
    • Difficulty remembering the date/season/country.
    • Wandering around (may get lost).
    • Difficulty bathing, cleaning, and dressing oneself.
  • Stage 6. Moderately Severe Alzheimer’s. Can’t recognize people or do basic, everyday activities. Family, friends, and loved ones typically find this stage to be the most painful.
    • Continued severe memory loss.
    • Inability to identify friends/family.
    • Confusing one person for another.
    • Restlessness, agitation, and frustration when the sun goes down into evening (called sundowning).
    • Inability to use the toilet; may have accidents and require adult diapers.
    • Threatening/violent verbal outbursts.
  • Stage 7. Severe Alzheimer’s. This is the final, most severe stage. Your loved one can’t move, can’t communicate, and depends on a caretaker for everything. She or he has little muscle control and spends all day in bed. Body functions slowly shut down.
    • Losing the ability to talk.
    • Decrease in vocabulary – forgetting words.
    • Inability to walk, smile, sit, swallow, and hold head up.
    • Mouth sucking reflex.
    • Inability to move joints, or it could be too painful to move or movement could be too painful.
    • Gets sick easily. May develop pneumonia or ulcerated infections.

Prevention

One way to reduce the impact that cognitive aging can have—as well as to possibly slow the advance of Alzheimer’s symptoms—is to make “healthy aging” a regular part of your life. Healthy aging is really nothing more than maintaining an active, healthy lifestyle. Besides being good for your brain, healthy aging will help improve your overall health. Here’s what you and your loved one need to do:

  • Visit the doctor regularly.
  • Be active. Exercise at least 30 minutes every day.
  • Eat healthy foods (fruits, vegetables, whole grains, and those rich in Vitamin C, E, and folic acid).
  • Get enough sleep.
  • Limit alcohol consumption.
  • Find ways to reduce stress (meditation, yoga, etc.).
  • Take part in mentally stimulating activities (puzzles, games, cards, books, etc.).
  • Have a social network of family and friends. Besides keeping you emotionally healthy, this may prevent mental health issues, such as depression.
  • Manage medications that can have cognitive health effects.

Diagnosis

If you suspect that someone you love might be suffering from Alzheimer’s, you may want to explore some of the available, non-invasive screening tests. The Alzheimer’s Foundation of America (contact info is in the Caregiver Resources and Tools section) has a National Memory Screening Program that uses a number of those tests. Keep in mind that these tests are not intended to (nor are they able to) diagnose Alzheimer’s or any other illness. If the results of the screen are troubling, schedule an appointment with your loved one’s healthcare provider right away. He or she may be able to administer additional tests and make a diagnosis in the office.

Questions to Ask Your Health Care Provider

Here are some questions you may want to ask:

  • What’s the actual diagnosis?
  • Is it certain that this is Alzheimer’s?
  • What tests are needed and why?
  • What medications are available?
  • What’s the best treatment option and why?
  • What non-drug therapies are available for us?
  • What are the possible side effects of medications and how common are they?
  • What signs and symptoms should I expect in the upcoming stages?
  • How will this diagnosis affect my loved one’s overall health?
  • Will we need to see other doctors or specialists?
  • How can I best prepare for each visit to the doctor’s office?
  • Do you have any tools that I can use to monitor my loved one’s daily activities and symptoms?
  • Who should we talk to about Alzheimer’s care?
  • Are there any life-threatening situations I should be aware of where I need to act quickly?
  • Are there any clinical trials my loved one can be a part of?
  • Are there any caregiver training classes or support groups near where I live?
  • Do you have any brochures or other educational materials I can take home?
  • How do I talk to my kids and other family members about this?
  • How can I include family into the caregiving process?

Treatments

NON-DRUG TREATMENTS
Managing your loved one’s behavior and/or finding ways to provide comfort and a sense of security can be very effective. You’ll find more information on managing behaviors in the Caregiving Tips & Understanding Behaviors: Tips on Everyday Things section.

MEDICATIONS
The Food and Drug Administration (FDA) has approved treatments that may improve your loved one’s quality of life. These treatments help maintain memory, learning, awareness, information processing, thinking, and speaking skills.
They may also control some of the common behavioral symptoms, such as depression, agitation, hallucinations, and delusions. It’s important to understand that these drug treatments do not stop the changes that are caused by Alzheimer’s, or prevent brain cells from dying. But they may temporarily slow the symptoms, which, in turn, may help your loved one perform everyday life functions for a longer period of time.

ALZHEIMER’S DRUGS FALL INTO TWO BROAD CATEGORIES:

  • Cholinesterase inhibitors, which help prevent the breakdown of a brain chemical (acetylcholine) that is important for memory and thinking. These drugs are donepezil, galantamine, and rivastigmine.
  • N-methyl-D-aspartate (NMDA) receptor antagonists, which block the activity of a different brain chemical (glutamate) by binding to NMDA receptors on brain cells. When the body overproduces glutamate, brain cells may die. If it doesn’t produce enough glutamate, cognitive problems can develop. Memantine is an NMDA receptor.

Common Alzheimer’s Drugs Based on Severity:

Mild to Moderate = Galantamine
Moderate to Severe = Memantine
Moderate to Severe = Memantine + Donepezil
All Stages = Donepezil
All Stages = Rivastigmine

Resources

National Institute on Aging:
www.nia.nih.gov/alzheimers

National Institutes of Health:
www.clinicaltrials.gov

Alzheimer’s Association:
www.alz.org/trialmatch

Alzheimer’s Foundation of America:
www.alzfdn.org/ClinicalTrials/findatrial.html

The Center For Information & Study on Clinical Research
Participation (CISCRP):
www.searchclinicaltrials.org or 1-888-CISCRP3

ResearchMatch:
www.ResearchMatch.org/roar

Last modified: September 30, 2016

Osteoporosis

Osteoporosis is a disease that weakens the body skeleton to the extent that the bones can break. Although often thought of as a woman’s issue, it is a significant threat to millions of men in the U.S.

About

Osteoporosis is called a “silent disease” because it grows without symptoms until you suffer a fracture. It develops less often in men than in women because men have larger skeletons. Bone loss in males starts later and progresses more slowly than in females.  There is also no period of rapid hormonal change and subsequent bone loss. Recently, the problem of osteoporosis in men has been recognized as an important public health issue, particularly in light of the number of men estimated to live beyond the age of 70 will continue to increase as life expectancy continues to rise.

Our bones are constantly changing as we progress from child to adult, as old bone is replaced by new bone. In their 30s, men have typically accumulated more bone mass than women because their skeletons are larger. Bone mass begins to deteriorate at different rates in men than in women. Excessive bone loss means that older bones are more likely to fracture.

Fractures resulting from osteoporosis commonly occur in the hip, spine and wrist, and can be permanently disabling. Hip fractures are especially dangerous. Because hip fractures tend to occur with older men, men who sustain hip fractures are more likely than women to die from complications.

FYI

Osteoporosis can be classified as primary or secondary. Primary osteoporosis is caused by age-related bone loss. Secondary osteoporosis is caused by certain lifestyle behaviors, diseases or medications. The most common causes of secondary osteoporosis in men include exposure to glucocorticoid medications (anti-inflammatory compounds), hypogonadism (low levels of testosterone), alcohol abuse, smoking, gastrointestinal disease, hypercalciuria (high levels of calcium in the urine) and lack of exercise.

  • One in 4 men over age 50 will break a bone due to osteoporosis.
  • Approximately 2 million American men already have osteoporosis. About 12 million more are at risk.
  • Each year, about 80,000 men will break a hip.
  • Men are more likely than women to die within a year after breaking a hip, due to related complications.
  • Men can break bones in the spine or hip, but this usually happens at a later age than women experiences their breakages.

Risk factors for Osteoporosis in Men

  • Chronic diseases affecting kidneys, lungs, stomach, and intestines or alter hormone levels
  • Regular use of certain medications, such as glucocorticoids
  • Undiagnosed low levels of the sex hormone testosterone
  • Unhealthy lifestyle habits such as: smoking, excessive alcohol use, low calcium intake and little to no physical activity
  • Age. The older you are, the greater your risk of developing bone health issues
  • Race. Caucasian men appear to be at particularly high risk, but all men can develop osteoporosis

Causes of Osteoporosis in Men

Symptoms

Osteoporosis does not have symptoms in the early stages of the disease. The only way to tell for sure is when looking at your family history and having bone scans performed at your medical visit.

Symptoms include:

  • Back pain
  • Loss of height and stooped posture
  • A curved upper back
  • Broken bones (fractures) that might occur with a minor injury, especially in the hip, spine camera.gif, and wrist
  • Compression fractures in the spine potentially causing severe back pain. Often these fractures cause only minor symptoms or no symptoms at all.

Prevention

  • Avoid smoking
  • Limit alcohol usage
  • Increase your level of physical activity
  • Take calcium & Vitamin D supplements (if recommended by your provider)
  • Exercise. Do weight-bearing exercises that are recommended by your provider after examining you for abilities.
  • Discuss with your doctor the use of medications that are known to cause bone loss, such as glucocorticoids.

Recognize and seek treatment for any underlying medical conditions that affect bone health (i.e. low testosterone)

Diagnosis

Osteoporosis can be effectively treated if detected before significant bone loss has occurred. Your health care provider will perform tests to diagnose osteoporosis including a complete medical history, x-rays and urine and blood tests. They may also order a bone mineral density test, which can identify osteoporosis, determine your risk for fractures (broken bones) and measure your response to osteoporosis treatment.

Once your DEXA scan is complete you will get a T-score and a Z-score.

  • The T-score – This is a bone density report that shows how much your bone mass varies or deviates from the bone mass of an average healthy 30 year old adult in your gender.
  • The Z-score  – This is an average that compares your bone density score to the average bone density of people the same age and gender as you.  This type of score assists in diagnosing secondary osteoporosis and for looking at the bone density of children and young adults who have not yet achieved adult bone mass.
World Health Organization Definitions Based on Bone Density Levels
Level Definition
Normal Bone density is within 1 SD (+1 or −1) of the young adult mean.
Low bone mass Bone density is between 1 and 2.5 SD below the young adult mean (−1 to −2.5 SD).
Osteoporosis Bone density is 2.5 SD or more below the young adult mean (−2.5 SD or lower).
Severe (established) osteoporosis Bone density is more than 2.5 SD below the young adult mean, and there have been one or more osteoporotic fractures.

Questions to Ask Your Health Care Provider

  • What can I do to stop my osteoporosis from worsening?
  • Can the medicines I take for other health problems cause bone loss?
  • How can I prevent fractures?
  • How frequently should I have a bone density test?
  • How much calcium and vitamin D do I need every day, and how can I get enough of these nutrients?
  • How much exercise do I need to boost bone strength, and which exercises do you recommend?
  • Is hormone replacement therapy safe for preventing osteoporosis?
  • What osteoporosis treatments are available that prevents bone loss?
  • What are some other lifestyle changes I should make now to keep my bones strong?
  • What does my T-score mean?

Treatments

Once you have been diagnosed with osteoporosis, your health care provider may recommend you take calcium and Vitamin D supplements, prescribe medication and also provide you with nutrition, exercise and lifestyle guidelines for preventing further bone loss.

Last modified: June 17, 2014