Marion County Medical Center

Health Shorts

June 2008

Comparing Prostate Options
             Among men treated for prostate cancer, those getting surgery had the best chance of being alive 10 years later, according to a study of 844 patients under age 70.
            The 10-year survival rate for men having radical prostatectomy was 83 percent, but men choosing no treatment (watchful waiting) had a survival rate of 72 percent and men choosing radiation, 75 percent.
[SOURCE: “Facing incontinence after prostate surgery,” Johns Hopkins Medical Letter, Health after 50, June, 2008; from Archives of Internal Medicine]

Skin or Prostate: Choose Your Poison
            A large population-based study found a decreased risk of prostate cancer among men diagnosed with skin cancer. The authors wrote: “A growing body of evidence, including our findings, support the hypothesis that ultraviolet radiation protects against the development of prostate cancer, possibly through the formation of vitamin D3.”
            A smaller controlled study in Toronto found lower PSA levels in prostate cancer patients given vitamin D, suggesting that the vitamin may delay the progression of cancer.
[SOURCE: “Ultraviolet radiation may protect against prostate cancer,” Reuters Health, April 17, 2007; American Journal of Epidemiology, April, 2007; T.C.S. Woo, et al, “Pilot study: potential role of vitamin D in patients with PSA relapse after definitive therapy,” Nutrition and Cancer, 2005;51:32-32]

Walk Away from Cancer Fatigue
            Exercise may be the solution for men experiencing fatigue and deterioration of physical function after radiation treatment of prostate cancer. In one study, men advised to exercise (moderate walking for 30 minutes three days a week) had significantly less fatigue than men advised to continue normal activities and rest if they felt tired.
[SOURCE: “Study: exercise alleviates fatigue in men with prostate cancer,” IDEA Fitness Journal, November-December, 2004; Cancer, 2004;101(3):550-557]

Treating Cancer Has Downside Too
            A multi-center study of 1,200 patients and their wives found that all forms of prostate cancer treatment produced negative effects on quality of life, particularly sexuality and urinary function.
            About 44 percent of wives said they were distressed by their partners’ erection problems following surgery compared to 22 percent following radiation and 13 percent following brachytherapy (implanted seeds of radiation). Incontinence affected 15 percent of surgery patients and 6 to 10 percent of those getting radiation or brachytherapy. The brachytherapy group, however, had the highest prevalence of irritative urinary symptoms such as pain, burning and increased frequency.
            Bowel problems, such as pain and increased frequency, were more common among the patients treated with radiation or brachytherapy.
[SOURCE: New England Journal of Medicine, March, 2008]

Folate for Prospective Fathers Too
            To protect against birth defects, women are advised to get adequate quantities of folate (vitamin B9) from diet and/or supplements even before they become pregnant. A recent study indicates that prospective fathers may benefit from the same advice. Men consuming more than 700 micrograms a day of folate were less likely than other males to have chromosome abnormalities in their sperm. Foods high in folate include whole grains, fortified cereals, orange juice, beans and green, leafy vegetables. The recommended daily allowance is 400 micrograms.
[SOURCE: “Wellness made easy,” UC Berkeley Wellness letter, June, 2008]

Can Folate Head Off Dementia?
         Among 965 older adults (average age 75) those who consumed the most folate were less likely to develop Alzheimer’s dementia over the next six years than those who consumed less folate. This positive effect of folate came from a combination of sources–diet and supplements. Neither source alone was associated with a reduced risk.
[SOURCE: “Folate-Alzheimer’s link,” Duke Medicine HealthNews,; Archives of Neurology, January, 2007]

Good Preparation Reduces Anxiety

            The increased use of outpatient surgery for procedures such as tonsillectomy has made surgery less traumatic for children and their parents. A family-centered behavioral approach can also be helpful in easing anxiety and improving outcomes, according to a study presented at the meeting of the American Society of Anesthesiologists [January, 2007].
            The pre-operative sessions for pediatric patients and their families included: anxiety reduction measures; video modeling and education prior to surgery; use of distraction on the day of surgery; parental coaching; and inclusion of parents at the surgery and during post-operative care.
[SOURCE: “Preparation before surgery reduces children’s anxiety,” AORN Journal, May, 2007]

Outpatient Hip/Knee Replacements?
            With smaller incisions, improved visualization technology and regional anesthesia, some hip and knee replacement procedures are now being performed on an outpatient basis. Success requires carefully selected patients, a high level of surgical skill and an experienced team.
            At a meeting of the American Academy of Orthopaedic Surgeons [February 27, 2005], Richard A. Berger, M.D. of Rush University Medical Center in Chicago showed videos of hip replacement patients walking and climbing stairs four or five hours after surgery.
[SOURCE: Karla Harby, “Outpatient surgery in hip and knee arthroplasty requires comprehensive approach,” Medscape Medical News, February 24, 2005]

B12 Deficiency May Cause Dementia
            Many older persons exhibiting signs of Alzheimer’s dementia–memory loss, confusion, fatigue–may actually be suffering from a vitamin B12 deficiency. These symptoms are completely reversible once the condition is corrected.
            Although plentiful quantities of B12 are available from meat, fish, eggs and cheese, many persons over 60 have digestive problems making it difficult for them to absorb adequate quantities of B12. Those eating mostly vegetables and fruits may also develop a deficiency.
            It may take five or six years before a B12 dietary deficiency starts showing up in symptoms, and by that time multivitamins and oral B12 supplements may have little effect. In such cases, sub-lingual tablets or a B12 injection may be prescribed.
[SOURCE: Hans R. Larsen, “Summaries of the latest research concerning vitamin B12,” International Health News, February, 2006]

Do B Vitamins Prevent Cancer?
            Many alternative medicine advocates recommend high doses of B complex vitamins to treat and prevent cancer. This is based on the theory that B vitamin deficiencies weaken the immune system and make it vulnerable to cancer.
            Although many researchers are continuing to study relationships between vitamin intake and the risk of various cancers, there is no scientific proof at this time that B vitamins affect the growth and spread of cancer.
[SOURCE: American Cancer Society, “Vitamin B complex,” revised June 19, 2007]

Use the Wet Test when Buying Shoes
            When buying shoes for sports or exercise, you should take into account your foot type–whether you pronate, supinate or have a neutral stride. Athletes who pronate need motion control shoes with denser material on the inside of the shoe to keep the foot from turning inward with each stride. Those who supinate need less support and more flexibility.
            One way of determining your foot type is through the “wet test.” Get your feet wet and then walk on dry pavement or a piece of brown paper. If you pronate and have relatively flat arches, your wet foot print will be relatively wide. If you supinate, there will be a large gap on the inside from the big toe to the heel.
[SOURCE: Wendy Bumgardner, “Walking Shoe Guide,” About.com, updated July 30, 2007]

Don’t Guess Your Shoe Size
            Getting a correct fit is essential when buying shoes, particularly shoes used for execise. The fact that you wore a size 9 when you were age 18 does not mean that’s your size today. Feet change in size, even over a relatively short period. And sizes vary according to manufacture.
            Try on the shoe and walk or run in it briefly to see how it feels. There should be a thumb’s width between the front of your big toe and the end of the shoe, and the heel should not slip when you walk. You should be able to wriggle all of your toes inside the shoe.
            Don’t buy shoes made for the opposite sex. There are differences in shape and structure that are reflected in shoes sold for men and women.
[SOURCE: Christina Frank, “10 tips for choosing athletic shoes,” WebMD feature, reviewed by Brunilda Nazario, M.D.]

Midsole: EVA versus Polyurethane
            A prospective buyer should make careful note of the cushioning in the fore- and mid-sole of an athletic shoe. If this cushioning is made of EVA, it will offer lightweight cushioning and flexibility–best for athletes who are after speed and agility but who do not have a foot style requiring motion control. Polyurethane is a denser and more durable material that will hold up better over time and provide more stability for athletes who are heavier or pronate.
[SOURCE: “Tennis Shoe Buyer’s Guide,” dicksportinggoods.com]

Seniors Need Extra B12, D, Calcium
            Seniors age 70 and over need ample quantities of vitamin B12, calcium and vitamin D, and nutritionists emphasize that it’s better that they get these nutrients from food rather than supplements. Foods getting special emphasis in the modified Food Pyramid for Older Adults include whole grains, fruits, vegetables, low- or non-fat dairy products, low-fat meat, beans and fiber-rich foods. About 15 minutes a day of unprotected exposure to sunlight should provide adequate vitamin D, which helps preserve bone density and may protect against prostate and breast cancer.
[SOURCE: Alice H. Lichtenstein, et al, The Journal of Nutrition, January, 2008; Daniel J. DeNoon, “Over-70 adults get new food pyramid,” WebMD Medical News, December 20, 2007]