Why Does the PSA Velocity Matter?

The PSA (prostate specific antigen) test has been used extensively around the world to detect and monitor for prostate cancer.

For many years, physicians have been using the absolute value of PSA to determine a man's risk for prostate cancer or whether his cancer has returned or progressed. In recent years, however, it has become more obvious that the rate of change of the PSA level (or PSA velocity) may be just as important as the raw number itself.

The New Role for PSA Velocity

Many prostate cancer experts now consider not only the PSA level, but how fast it is changing when determining whether to order further tests, when to start treatment, or what to tell their patients about prognosis.

Numerous studies have now shown that a high PSA velocity (for example rapid doubling time of PSA or a rise of 0.35 ng/mL or more per year) may signal a rapidly growing cancer regardless of how high the absolute PSA level is.

Here's an example of what I mean:

A man goes for his routine screening PSA test and it comes back at 2.0 ng/mL. He is otherwise healthy and his physician is unconcerned by the result since 2.0 is not a "high" level in most cases. But, last year his PSA level was 1.0 ng/mL and the year before it was 0.5 ng/mL.
Should these results worry him or his doctor?

Based on mounting evidence, the answer is likely "yes." In this example, a relatively low PSA level of 2.0 could be waved off as "normal." However, this man's PSA has doubled each year for two years. This is a high rate of change of PSA (such as a high PSA velocity) and could likely signify a rapidly growing cancer.

It is important to keep track of your own PSA levels over the years and alert your doctor to any trends that you notice. Physicians see thousands of patients a year and may simply overlook the fact that your PSA has been increasing rapidly.

_Sources: 

Carter HB, Ferrucci L, Kettermann A, et al. Detection of life-threatening prostate cancer with prostate-specific antigen velocity during a window of curability. Journal of the National Cancer Institute 2006; 98(21):1521–1527.
Ng MK, Van As N, Thomas K, et al. Prostate-specific antigen (PSA) kinetics in untreated, localized prostate cancer: PSA velocity vs PSA doubling time. BJU Int. 2008 Oct 16.

Foods That Cause Man Boobs

The most important thing to take away from this lesson is that you learn the foods that raise estrogen levels.

Don't take the title of this article too literally. Obviously, it's not like you'll eat some obscure food and wake up the next morning with Gynecomastia. Foods that bring on Man Boobs, do so by raising estrogen levels, causing your body to store fat cells behind the nipples and around the breast tissue.
When you're trying to lose man boobs, the whole point is to tone and burn your pectorals, working off that fatty tissue and replacing it with a tighter and more toned chest. If you're eating foods that raise estrogen levels, you'll be unknowingly working against your main goal.

So here I'll be listing the foods that will naturally raise your body's estrogen levels or reduce your body's testosterone levels and make it harder to burn chest fat. These tips not only apply to those with Gynecomastia, but also to those with Pseudogynecomastia because I include fatty foods in the "avoid it" list.

In case you've forgotten what Pseudogynecomastia is, it's Man Boobs caused by an overall excess amount of body fat rather than hormonal imbalances. People with Pseudogynecomastia should still avoid the foods mentioned below while they are on their weight loss regimen. The results will be much faster when you're fueling your body the right way. So without further ado...

Foods that Sabotage a Gynecomastia Diet


Marijuana

Okay, well technically it's not a food, but marijuana will definitely work against you when it comes to burning chest fat. Marijuana has been proven to increase the size of fat cells in men and women.
It also lowers testosterone levels which in effect creates a higher estrogen rich environment in the body. The effect? You guessed it, more fat store creation in the chest and breast area. No good.

Fatty Foods

This is just plain common sense. You shouldn't be munching on salty potato chips and cartons of ice cream. Keep trim and toned and you won't be giving your body any excuses to pack on additional fat.

Understanding Gynecomastia - Cures and Treatments

What is Gynecomastia?

Gynecomastia is the enlargement of breast tissue in males. These are usually benign masses that are located behind the nipple area. The mammary glands will increase in size and proliferation caused by an imbalance of the hormones estrogen and testosterone. Commonly, it will emerge as a male goes through the puberty process, or later in life as hormone levels decrease beyond 50 years of age. Occasionally, the condition will remain throughout adulthood.

Every newborn infant begins life full of the female hormone estrogen from their mother at birth. Typically, this hormonal imbalance will correct itself naturally and the body develops into adulthood normally. However, a significant percent of males will develop what is commonly known as 'Gyno' or "man boobs". The medical term for this condition is called gynecomastia.

The Effects of Gynecomastis

Generally, gynecomastia does not present any major medical problems. However, it can cause a number of very difficult issues in terms of a man's self-esteem and lifestyle. Going through puberty is difficult enough without developing breasts in the locker room. Up to 65 % of 14-year-old boys have enlarged breasts, according to the American Academy of Family Physicians.
Adult males may not partake in activities that involve removing a shirt from embarrassment or shame. Even the most stringent workouts and diets may seem effective everywhere - except the chest. This is a frustrating condition that can interfere with a man living the life he really wants.

Hormonal Imbalance Explained

Androgen are the hormones that create male characteristics, such as hair growth, muscle and bone size, and a deeper voice. Estrogen is the hormone that contribute to female aspects such as breasts. Everyone has some of each in their bodies, it is the levels of hormones that matter.

Simply put, when these hormones are not in proper balance then development in unwanted areas can occur. Gynecomastia develops when a male has a higher ratio of estrogen to androgen than normal.

Cures and Treatments

The longstanding fix for gynecomastia has been ultimately resorting to cosmetic surgery to remove the excess tissue. Male breast reduction surgery is a costly and somewhat risky venture. Beyond that, it doesn't solve the problem and the breasts can resurface because the cause is still there.

Nature's Cancer Remedies: Organic Prostate Cancer Treatments

Prostate cancer affects more than 200,000 men every year in the United States alone. Worldwide statistics for prostate cancer continue to grow exponentially, and with the continued modernization of 2nd and 3rd world nations the number of cases is likely to increase. While these numbers may seem grim, when detected early the recovery rate for men with prostate cancer is very high. Men approaching their mid to late forties should make it a point to have regular screenings for this form of cancer, as early detection is the first step to any successful treatment.

The precise cause of prostate cancer remains undetermined, but certain factors do seem to be linked to the occurrence of the disease. Heredity, hormone imbalances, advancing age and exposure to environmental toxins all appear to be linked to the onset of prostate cancer in most men. In its early stages, prostate cancer may present few, if any, outward symptoms. As the cancer develops, however, symptoms will begin to manifest themselves. These include difficulty urinating, blood in the urine, back and genital pain, fatigue and weight loss.

Conventional treatments for prostate cancer continue to rely on invasive techniques to combat the disease. Chemotherapy, drugs and surgery remain the standard of treatment for most instances of prostate cancer. But these treatments come with a number of unpleasant side effects. Chemotherapy, while destroying the cancerous cells, also seriously compromises the patient's immune system. Surgery can also have adverse effects on a man's general health and quality of life. Rather than endure these unwanted side effects, many men are turning to more natural treatments. Men with prostate cancer are finding that through a combination of holistic therapies and faith they can return to optimal health.

Prostate Cancer and Nutrition

Nutrition plays a large part in the recovery from any disease, and prostate cancer is no different. Strategic changes to a patient's diet can have significant pro-active effects on their health. Cancer patients should first begin to remove potentially harmful items from their daily diets, including refined sugars, salt, processed meats and dairy products. The benefits of a largely vegetarian diet continue to gain credence in cancer studies around the world. While it can be a definite challenge for some, moving away from a meat based diet can have great therapeutic effects for men with prostate cancer.

As men make changes to their dietary routine, it is important that they begin to add nutritionally powerful foods to their regular menu. Fresh organic fruits and vegetables, seeds and nuts contain nutrients that retard the growth of cancer cells and should be a part of every cancer fighting diet. Tomatoes, carrots and other rich sources of lycopene and beta-carotene also aid in the fight against cancer, and should be added to an already healthy diet.

Nutritional supplements may also be taken to help prevent the growth and reproduction of cancerous cells. Specifically vitamins A, D and E are powerful antioxidants that help the body fight off new cancerous growths. Minerals, such as selenium, calcium and magnesium, also have distinct anti-cancer properties that make it increasingly difficult for the cancerous cells to thrive. Men who have been diagnosed with prostate cancer will want to consult a holistic clinician to help them devise a dietary regimen, complete with nutritional supplements, that addresses their specific needs as a cancer patient.

Prostate Treatment: Best Ways To Tackle The Problem

In the condition of an enlarged prostate, the flow of urine is blocked, as the prostate cells multiply gradually and exert pressure on the urethra. Because of this, the bladder now has to push the urine forcefully out of the urethra. As this condition worsens, the muscles of the bladder may become thicker and overly sensitive. During this stage, the bladder muscle starts to contract even with small amounts of urine, which causes the frequent urination. The muscle becomes overly narrowed and thus does not allow the bladder to become completely empty. You can find effective prostate treatment that targets the most popular symptoms.

Some of the common symptoms of an enlarged prostate include -

· Slow urination
· Difficulty in starting the urination
· Frequent urination
· Incomplete emptying of bladder
· Strain during urination
· Dribbling of urine
· The stream of urination is intermittent
· Frequent urination during the night

It is always recommended that men with these above mentioned symptoms should see the doctor immediately and find the best prostate treatment. There are a range of treatments for this condition. You can take medication, go for surgery in advanced cases or opt for less or minimally invasive surgical procedures. This treatment is heavily influenced by your general health conditions and age. As a person ages the kind of treatment varies. Many of the less invasive treatment are considered as beneficial as, they allow the patient to recover quickly and there are fewer side effects. For people with urinary retention, or bothersome symptoms, doctors suggest that medication is best bypassed. To have relief from such a condition, a less invasive surgery is recommended.

Heat therapies are also quite beneficial for treating this condition. Heat is delivered through the urethra under a local anesthetic. This treatment is a quick process and ensures fast recovery. Heat is usually applied through microwave therapy, electro vaporization or laser therapy. Surgical therapy includes transurethral resection, Open Prostatectomy or transurethral incision of the prostate. This condition is completely treatable and the choice of treatment depends upon the consulting doctor and the severity of the condition.

Gynecomastia: Determining If You Have It

Gynecomastia is a very misunderstood medical condition, largely owing to the fact that it gets very little attention in the mainstream media. While liposuction and other surgical procedures get all the press, those who suffer from this condition find themselves left out of the spotlight. The fact that most men with what is commonly known as "man boobs" don't care to discuss it merely compounds the issue. There are many causes of the condition, but the most common is fluctuating hormone levels during puberty. While it will go away on its own in many instances, this isn't always the case. Before you can treat it, however, you need to know whether or not you have it.

Visual Inspection

The first step to determining if you are suffering from gynecomastia is a visual inspection. It's important to note that the condition is not simply an accumulation of excess fat in the chest area. It is very common for men to carry adipose tissue in the chest region, which is actually more commonly referred to as "man boobs" in a colloquial sense than the actual condition. It is not always easy for obese individuals to make the determination between actual gynecomastia and regular fatty pockets. If you are on the thinner side, however, it should be easier to see any engorgements around the nipple.

Symptoms

Gynecomastia is often accompanied by symptoms other than simply an excessive growth of tissue around the nipples. Watch for tingling or soreness around the chest area. Any swelling, excessive sensitivity, or dimpling in the areola can also be symptoms of the condition. In some cases, the man may experience enlarged lymph nodes, which can be felt under the armpits. In occasional cases, there may be discharge coming from one or both of the nipples. What is certain is that a doctor should evaluate any of these symptoms, even with the absence of visual indicators.

Risk Factors

Before you schedule your doctor's appointment, you may find it instructive to create your own risk factor profile. There are certain men more disposed to developing gynecomastia than others. If you have any of the higher risk factors in your profile, it may point to a greater chance of having developed the condition. Some factors include diseases surrounding the liver or kidneys, certain types of medicine, anabolic steroid use, and simply going through adolescence. Remember all of these risk factors and present them to your doctor when going in for your examination.

Male Breast Reduction: Dealing With Gynecomastia

As a response to the development of gynecomastia, some doctors will recommend male breast reduction to their patients. What is gynecomastia (sometimes called gyno in circles where the condition is discussed casually)? It is the development of female-associated breast tissue in men, something that can be brought about at any age for a variety of reasons. It is not to be confused with men who simply tend to store fat in their chest, although this can be addressed with surgery as well. While no man wants to be told he needs surgery to treat the problem, it may be the best and only way to bring a permanent end to the condition.

Characterizations of Gynecomastia

Before you can decide whether or not male breast reduction is right for you, you need to first determine if you are really suffering from gyno. Obviously, this is best done with the aid of a doctor, but you can make some preliminary determinations on your own. The condition is characterized by a few common symptoms. The first is an excess of local fat. This is easier to see visually in someone who is thin in the first place. Glandular enlargement is another common sign, which can be felt under the armpits. A combination of both of these is a likely sign that you have gynecomastia.
Good Candidates

To determine whether or not you are a good candidate for male breast reduction, your doctor will first look for the presence of gynecomastia. Once it has been determined that it is present, some options will likely be discussed. There are alternatives to surgery, although they are not as reliable. If you want to move forward with the procedure, the doctor will want you to be at a normal weight, in good health, and with some stabilization of the chest tissue growth. In other words, it makes little sense to do the procedure if it will continue to grow afterwards.

The Surgical Option

You may be wondering what separates those patients for whom male breast reduction is considered the best option from those for whom alternative treatments (including doing nothing) is more appropriate. Doctors will often recommend surgery for those men whose condition is not going to get better through other methods of treatment. They will also look for men who are not on drugs or have at least stopped using any drugs that may have led to the development of gyno in the first place. In many cases, though, the decision will be left with the patient.

Types Of Prostate Disease

The first disorder I want to cover is BPH(Benign Prostatic Hyperplasia). Link here: http://en.wikipedia.org/wiki/Benign_prostatic_hyperplasia.

This is basically what is referred to as an "enlarged prostate". This disorder is classified in 3 different categories as slightly enlarged,moderately enlarged,& severely enlarged. This disorder can affect men of all ages & race. A man's prostate grows with age.

When a man reaches 30 it starts to grow more rapidly. It's suggested that all men by the age of 40 to have a prostate exam. This exam is called a Digital Rectal Exam(DRE). This exam will allow a doctor to manually examine the prostate by inserting his finger into the rectum.

The doctor is feeling for any abnormalities of the prostate which is the central location for a male's reproductive area. The exam will only last a few seconds & the doctor will feel for any tumors or other problems. This isn't a comfortable exam especially if the prostate is enlarged.

However, it is a good exam to check for prostate issues. If a diagnosis of an enlargement is determined then the usual treatment route is to prescribe alpha-blockers such as doxazosin, terazosin, alfuzosin and tamsulosin. Another popular drug for treatment is Proscar. Link here: http://en.wikipedia.org/wiki/Finasteride

Symptoms of BPH are urinary frequency, urgency (compelling need to void that cannot be deferred), urgency incontinence, and voiding at night (nocturia). Voiding symptoms include weak urinary stream, hesitancy (needing to wait for the stream to begin), intermittency (when the stream starts and stops intermittently), straining to void, dysuria (burning sensation in the urethra), and dribbling.

While prescription meds are used to treat BPH I will be chatting in the future about alternative treatments for this disorder. I'm in no way suggesting to not try prescription drugs. I've just come up with a plan without prescription meds to treat BPH & other prostate problems. I will outline these in the future.

The next prostate disorder I want to cover is Prostatitis(http://en.wikipedia.org/wiki/Prostatitis). This very troubling disease is divided into 4 separate categories. It affects men of various ages but is more common for men in the age range 0f 30-40. Prostatitis diagnosis is now considered to 1 out of 4 men(25%). The four categories of prostatitis are:

1. Acute bacterial prostatitis
2. Chronic bacterial prostatitis
3. Chronic prostatitis/chronic pelvic pain(my diagnosis)
4. Asymptomatic inflammatory prostatitis

Common symptoms of these are generally the same but more severe in certain types. Some of the symptoms include:

- pain or burning during urination(symptom of mine)
- difficulty urinating such as dribbling(mild symptom of mine)
- frequent urination especially at night(major symptom of mine)
- the urgent need to urinate(moderate symptom of mine)
- pain in the back & lower abdomen(mild symptom of mine)
- pain in the penis(urethra) & testicles(major symptom of mine)
- painful ejaculation(off & on symptom of mine)
- pain in the perineum(area between penis & rectum)(mild symptom)
- golf ball feeling under the testicles(major symptom of mine, maybe the worst)

Now, I will cover these 4 types in detail. My diagnosis was "chronic prostatitis" & this is the more common diagnosis for most men. The other types fall into a smaller area of men. The word "chronic" is defined as long term & recurring. I was determined to not let the word "chronic" derail me from finding ways to deal with this illness. I was told by doctors that I'd have to "live with it the rest of my life". Anyhow, now onto the different types of prostatitis in detail.

Type 1: Acute bacterial prostatitis,

Additional symptoms to the above are:

- fever
- chills
- vomiting
- feeling unwell

Type 2: Chronic bacterial prostatitis,

The key component in this is frequent urinary tract infections. There will be a between episode of this type of prostatitis in which there will be no symptoms at all to severe symptoms. Chronic bacterial prostatitis is hard to diagnosis due to bacteria from the prostate not showing up from a urine test. 95% of all urine test come up negative for bacteriathat may cause a prostate infection.


Type 3: Chronic prostatitis,

As stated before this was my diagnosis. This diagnosis is considered if the symptoms have been going on for more than 3 months. Some men may go through cycles or even stay the same over time. Some men may have more severe cycles as I seemed to have suffered. In a small amount of cases symptoms just disappear over time without treatment.

Type 4: Asymptomatic inflammatory prostatitis,

This condition is usually only found by accident like undergoing test for other problems. It presents with no symptoms & is less common as the other ones as well.

I will now go over some of the treatment options for prostatitis. This will be a quick summary at this time but I will be providing a more detailed approach in the future.

Treatment Options For Prostatitis:

Acute & chronic bacterial prostatitis options:

Acute bacterial prostatitis is usually treated with a shorter course of antibiotics. The normal course of treatment is from 2-4 weeks.

Chronic bacterial prostatitis is also treated with antibiotics as well but normally a longer period of time. Also, there may be a need for repeated courses of treatment with antibiotics.

Chronic prostatitis/Pelvic Pain options:

This is the hardest type of prostatitis(I can back this) to treat. Therapies that may help manage this type include:

- alpha blockers
- pain relievers
- prostatic massage(will cover more later)
- other treatments like microwave therapy

There is also the alternative route of treatment for prostate related problems. This I'll be covering in great detail coming soon. This has been my main area of treatment for the past 1 1/2 years.

The final prostate disorder I want to cover is prostate cancer. Link here: http://en.wikipedia.org/wiki/Prostate_cancer. This is probably one of the leading health concerns for a man. Breast cancer is at the top of the list of concerns for women. I have to say that I was dead-set that I had prostate cancer. I was in panic mode but still as a man I thought the worst.

A tumor forms somewhere on the prostate. Symptoms of prostate cancer doesn't differ much from other prostate disorders. The biggest factor is to catch the cancer early & not wait. I did delay going to the doctor but decided to face whatever my diagnosis. Being a man I was kind of shameful & didn't wanna be considered soft in admitting I have a problem with a manly body part. I'm glad I followed through with getting some initial test results & treatment.

The PSA(Prostate Specific Antigen,http://www.cancer.gov/cancertopics/factsheet/detection/PSA) test is a test used to help diagnosis prostate cancer. It's not perfect however in the means of diagnosing a prostate tumor.

Prostate Cancer Symptoms:

- weak urine flow
- frequent urination at night
- trouble urinating
- pain or burning during urination
- blood in the urine or semen
- pain in pelvic area that doesn't go away
- painful ejaculation

Prostate Gland Disease

The prostate gland is a mystery to most people, and doctors have not understood its function until quite recently. It is situated in the body behind the base of the penis. The bladder is above and behind the gland, and the tube which carries the urine from the bladder to the outside (the urethra) passes through the centre of the prostate. It is found only in men, and there is no female equivalent.

It is the size of a golf ball, is made of glands, fibrous tissue and muscle, and its prime purpose is the production of a secretion which makes up part of the semen a man ejaculates during intercourse. The contents of this secretion are essential for the nutrition of the sperm as they try to fertilise an egg (ovum) in the woman. Most men are totally unaware of the presence of the prostate unless it causes trouble.

The most serious disease to strike the prostate is cancer. Because this is a very slow-growing cancer, it may give no symptoms until many years after it has developed. The symptoms usually start with difficulty in passing urine, but the condition may not be diagnosed until pain occurs due to the spread of cancer to the bones of the pelvis and back.

Cancer of the prostate is rare before 50 years of age, and its incidence rises steadily with age. A very large proportion of men over 90 years of age have some degree of prostatic cancer. There are specific blood tests available that can detect most cases of prostatic cancer. It is treated with a combination of surgery, drugs and irradiation. Unless it is highly malignant, early stages of cancer of the prostate may not be treated in the very elderly, because it is unlikely to cause trouble in their life time.

Doctors can often diagnose disease of the prostate by feeling the gland. This is done by putting a gloved finger in the back passage, and the size and hardness of the gland can then be gauged.

The earlier any cancer of the gland is detected, the higher the chance of long-term survival. If the cancer is localised to the gland itself, the five-year survival rate is over 90%. With local spread, the survival rate drops to about 70%, but with spread to the bone, only 30% of patients survive five years.

Because of the discomfort, and the more serious possibility of cancer, any man who has difficulty in passing urine is risking fate if he delays having his prostate gland checked by a doctor.

Prostate Enlargement

Up to 20% of all men over 60 may have an enlargement of the prostate which causes difficulty in passing urine. This benign enlargement is usually associated with a drop in sexual activity. As the gland enlarges, it squeezes the urine-carrying tube which passes through it, making it steadily harder to urinate. Eventually the tube can be completely blocked, and the patient becomes extremely distressed as the pressure of urine in the bladder increases.

In the acute situation, doctors can normally pass a rubber tube through the penis into the bladder to relieve the sufferer, but sometimes a needle must be pushed through the lower wall of the abdomen, into the bladder, to release the urine. To prevent this acute situation, an operation is usually performed, although there are some medications that can relieve milder enlargements of the gland.

The operation can take several forms, from simply dilating the urine tube, to scraping away the part of the prostate constricting the tube by passing a specially shaped knife up the urine tube (trans-urethral resection of prostate, or TURP), or completely removing the gland.

In some cases, a drug called prazosin can be used to shrink the enlarged prostate slightly, and allow urine to escape more easily from the bladder.

The treatment for a benign enlargement of the prostate gland is almost invariably successful, with no subsequent effect on the sexual or general health of the patient.

Prostatitis (Prostate Infection)

In younger men, the most common cause of disease in the prostate is infection, when the gland may swell up and become very tender. Prostatitis can occur due to bacteria moving up the urethra from the outside, or uncommonly, from an infection spreading from other parts of the body. The symptoms include pain behind the base of the penis, a discharge from the penis, pain on passing urine, fever and passing urine frequently. The diagnosis can be confirmed by taking a swab from the urethra, and identifying the bacteria present.

Treatment involves a long course of antibiotics. The acute case usually settles with this treatment, but recurrences are common and a low-grade chronic infection may develop. These recurrent infections may become difficult to treat.

It is possible for the infection to spread to the man's sexual partner, in whom it may cause pelvic inflammatory disease.

The Facts On Prostate Nutrition And Diet

If you are on prostate therapy you may think that prostate nutriton is marginal. No, it is essential ! Any foods which are likely to cause inflammation are just going to worsen the situation. Usually the urologist recommends a prostate diet that limits such foods as coffee, spicy foods, lots of red meat and alcohol. Actually a study just published shows that a little red wine which contains flavanoids actually will do the prostate good so that will encourage some wine lovers. Moderation, as in all things,is the key. Basically I have found that you need to eat a wide variety of foods which have a lot of essential vitamins , minerals and nutrients. I try to avoid getting into a rut as well. Variety is the spice of life ! Some people claim that all they need do is to take a few supplements and all will be well. Would that it were so !

• 1. Fish - especially those that contain the ‘good' fats such as Omega 3 are recommended so you need to get salmon, mackerel and trout on the table at least a few times a week. Avoid other foods such as biscuits, cakes and fried stuff which contains trans fats which are not good.
• 2. I drink and consume very few dairy products because they contain too much calcium which is a No- No for the prostate. Instead I use SOYA milk and other soya products. It is also easier for me to do this as I have become lactose intolerant over the years. Research has shown too that the people of the Far East (ie Hong Kong) have become more susceptible to cancer because they no longer consume so much soya, preferring the fast food from the West. Yikes !
• 3. Fruit is also at the top of my list - maybe it should be number one. The more coloured the fruit the better so cherries, apricots, peaches, apples, bananas and pears. The latter are great for keeping you regular as constipation is another factor which puts more pressure on the prostate.
• 4. Nuts - all kinds. I try to eat a few fistfuls a day but not too many as they do contain quite a lot of oil and fat - but the healthy kind ! They are also shown to be heart protective.
• 5. Olive oil - great for salads and pouring over your veggies. So, forget about those other awful salad dressings. Olive oil is full of antioxidants. Steer clear of corn oil and canola.
• 6. Lots of vegetables and I favour the broad leafy ones such as spinach, chicory and then Brussels sprouts and broccoli are great too. They are cancer protective as indeed are cabbage and cauliflower if you can stand the smell! I love broad beans so I have added them to my list.
• 7. Green tea is a powerful antioxidant so substitute that for coffee when you are in a withdrawal state !. Green tea contains caffeine so you will still get your caffeine kick and so you will need to know how to limit that in accordance with your sleeping habits!
• 8. Red wine as I said is fine in moderation as indeed are all red berries so red grapes are recommended too.
• 9. Tomatoes contain lycopene which helps the prostate so that can go into salads. Watermelons and pink grapefruit contain lycopene as indeed does any kind of tomato sauce you can use in your favourite pasta or pizza dish.
• 10. The king of the supplements is Selenium which you can find in fish and nuts (see above). It can also be found in mushrooms, bran, wheat germ, oats and brown rice. And that is where my healthy breakfast cereal makes its entry with non fat milk or soya milk.

The HPV Vaccine in Men

One of the big debates about using the HPV vaccine in men has had to do with the fact that it's mostly been promoted as an anti-cancer vaccine. Although HPV related cancers - such as rectal, throat and, penile cancers - do affect men, they are not generally considered to be as big an issue as cervical cancer is in women. Furthermore, many of these cancers are more common in men who have sex with men, a category which many parents - rightly or wrongly - do not think contains their sons. Thus, the benefits of the vaccine for young men have largely been seen as indirect - protecting their partners - even though they should see some direct benefits as well.

These direct benefits were recently confirmed by the publication of the results of a large Phase III vaccine trial of Gardasil in 16-26 year old men. The study, which appeared in the February 3 issue of the New England Journal of Medicine, found that Gardasil was quite effective in reducing genital warts in men who had not been previously exposed to the covered types of HPV. This adds to the evidence which, only last month, led to the FDA approval of the vaccine for preventing anal cancer in both men and women.

Right now, universal vaccination of young men is unlikely to be recommended for a variety of reasons - including the fact that the vaccine is expensive and vaccination simply may not be a cost effective solution to HPV related health problems. Still, there is a growing amount of evidence that HPV vaccination may be, at least, worth talking about with your teenage sons. If nothing else, doing so may be a good way to initiate important discussions of safe sex.

High-Dose Rate Brachytherapy for Prostate Cancer

Brachytherapy is a form of radiation therapy that utilizes radioactive implants placed directly into the body. These implants are placed in or very near the tissue that is to be treated.

For prostate cancer conventional brachytherapy, tiny implants or “seeds” are implanted directly into the prostate where they remain permanently. For a set amount of time, these seeds are radioactive and deliver radiation to the prostate, hopefully eliminating any nearby cancerous tissue.

With high-dose rate (HDR) brachytherapy, the same idea is at work. Tiny implantable radioactive sources are used to deliver radiation from within the prostate itself. The difference is that HDR brachytherapy uses radioactive sources of very high energy that can deliver adequate amounts of radiation to the prostate in a short amount of time.

How Is HDR Brachytherapy Done?

HDR brachytherapy uses very high energy radioactive sources (often straw-like in shape) which are inserted into the prostate and then withdrawn again a few minutes later. Several radioactive sources are inserted, one at a time, during a treatment session.

What Are the Advantages of HDR Brachytherapy Over Conventional Brachytherapy?

• There is no required hospital stay. A short hospital stay is often required with conventional implantable seed brachytherapy. HDR brachytherapy is completed over a few outpatient visits.
• There is no radiation exposure to other people. With conventional implantable seed brachytherapy, the radioactive seeds remain in place permanently. They only emit radiation for a number of days after implantation, but, the time you spend around other people (especially small children or pregnant women) may need to be limited during this time. With HDR brachytherapy, the radioactive sources are inserted and withdrawn during the treatment session, thus you carry no radioactivity with you when you leave.
• There is no shifting of seeds within the prostate. Permanently implanted seeds may shift or migrate within the prostate. This is usually not a significant issue, but it can result in some prostate tissue not receiving the appropriate radiation dose or tissue that was not intended to be treated receiving too much dose. With HDR brachytherapy, this complication can be reduced.

  What Are Possible Disadvantages?

  The biggest disadvantage to HDR brachytherapy is that it has not been as well-studied as conventional brachytherapy. Research is continually being done that looks at the effectiveness, rate of complications, and long-term outcomes of patients treated with HDR brachytherapy, but there is far more information about the effectiveness and safety of conventional brachytherapy.
  
  Additionally, HDR brachytherapy is not available at all hospitals or radiation treatment centers.

Managing the Side Effects of Hormonal Therapy for Patients Suffering From Prostate Cancer

Intermittent hormonal therapy for the treatment of prostate cancer is often done by patients to mitigate the effects of testosterone deficiency. But a recent study revealed that this intermittent treatment can be dangerous as it can lower a patient's life expectancy.

Hormone therapy for prostate cancer is a procedure that suppresses the production of androgen hormones that stimulates the growth of cancer cells. Prostate cancer cells depend on male hormones in order to grow, and thus, reducing the hormone can shrink or slow its growth.

The study showed that the chance of survival with intermittent androgen deprivation therapy was lower by almost two years in contrast with the results of continuous hormone therapy. For this reason, researchers advised patients with minimal cancer spread to undergo continuous treatment. For patients with tumors that have spread farther, doctors must discuss their treatment options to let them understand the risks involved.

Another concern for those planning to undergo continuous therapy for prostate cancer is the fatal side effects of low testosterone. A hormone therapy study conducted by a team of endocrinologists in 2011 concluded that androgen deprivation therapy can lead to the development of cardiovascular diseases, osteoporosis, and diabetes. The same conclusion was reached in an earlier study published in The Open Prostate Cancer Journal in 2010 with the additional note stating that 46% of those with prostate cancer died of other causes, with cardiovascular disease as the most common.

For these reasons, it is recommended that doctors carefully monitor changes in blood sugar, cardiac activity, and bone health in their patients undergoing therapy in order to control complications as soon as possible. They also suggested diet and exercise as possible ways to manage the side effects of the treatment.

A diet high in fruit and vegetables, and consumption of low-fat dairy and meat can help regulate blood pressure, cholesterol levels, and blood sugar levels. Avoiding sweets and alcohol is also recommended, and eating regular meals can help regulate insulin levels throughout the day.

Aerobics and resistance training can also help patients avoid weight gain, improve joint mobility, and build lean muscle mass that can reduce body fat and strengthen bones. It can also help patients manage the depression and fatigue experienced due to low testosterone levels.

Discussing the possible risks of hormone therapy for prostate cancer with a knowledgeable physician, and following a recommended diet and exercise regimen can help patients manage the side effects of low testosterone levels and increase their life expectancy.

Prostate Cancer Prevention and Treatment

Prostate cancer affects more men in North America than any other cancer type. Among men over the age of eighty, 80% of them will be affected by prostate cancer.

Your risk of developing cancer increases with age. An unhealthy lifestyle can also increase your risk. If any blood relatives have developed prostate cancer, your chances of developing it are higher as well.

Prevention

Studies have proven that diet and lifestyle can affect your likelihood of developing prostate cancer. In particular, vitamin D has been shown to boost resistance to it.

Low fat dairy products are a good source of vitamin D. So too is direct sunlight.

Red wine in moderate amounts is also helpful, although excessive alcohol use should be avoided.

Some attribute the benefits of wine drinking with the chemical resveratrol found in grapes.

To help avoid high fat foods like meats and cheese, try substituting with soy products.

Oysters, nuts and beans are good sources of zinc. So too are pumpkin seeds. Make sure you get the seeds still in the shell.

Tuna, eggs, shellfish, onions, garlic, mushrooms, wheat germ, herring, kelp, Brazil nuts, sesame and sunflower seeds and cashews are all good sources of selenium, a chemical that helps boost your immunities.

Anti-oxidants which help fortify the immune system are found in blueberries and broccoli. Fruits and vegetables in general carry high concentrations of anti-oxidants.

Just as some foods may help you avoid prostate cancer, some unhealthy foods may jeopardize your efforts.

• Foods high in fat, like meats and dairy
• Red meat
• Processed sugars and fatty foods

While red meat always seems to show up in lists of food that are not good for you, it is perhaps not even the red meat itself that is unhealthy. During processing the hormones and other chemicals the meat is treated with may be what make it unhealthy.

Prostate Exam

If you're a man over 50, you should speak to your doctor about prostate cancer and get checked. A digital prostate exam takes just a few minutes and can help your doctor catch any problems early. Early detection increases your chances of surviving prostate cancer markedly.
Another test your doctor can do is to have your blood checked for PSA or Prostate Specific Antigen. This can determine very early whether your prostate has been infected with cancer.
In addition, there are a number of symptoms you should be on the lookout for.

• Frequent urination, especially at night
• Intense need to urinate
• Difficulty starting or difficulty stopping urine flow
• Sometimes you cannot urinate at all
• Weak flow of urine
• Bladder not completely empty after urination
• Pain or a burning sensation while urinating
• Pain occurring during orgasm
• Blood in urine or semen

Cancer Diagnosis & Treatment

If you have been diagnosed positively, consider alternative prostate cancer treatments other than surgery and radiotherapy. High Intensity Focused Ultrasound or HIFU is often recommended as a first treatment for patients where their cancer is confined to the prostate gland and has not yet grown beyond it.

With fewer and less harmful side effects than traditional treatments, you can survive cancer of the prostate - especially if it is diagnosed early on and is organ confined. The key to treating cancer is to get it in the early stages, making early screening crucial for men over 50.

Do You Know The 17 Different Signs and Symptoms Of Prostate Cancer?

One of the reasons prostate cancer is so common is because it's very difficult to detect in the early stages. Around 50% of sufferers are 75 years of age or older, and often the symptoms are simply put down to old age. Prostate cancer is sometimes called the silent disease, simply because it sneaks up on the sufferer without any obvious warning.

It's a sad fact, but many men don't take the threat of prostate cancer in the manner they should. Perhaps this is because of the embarrassment and joking surround the idea of a prostate examination. Unfortunately, the more advanced the cancer is when it's discovered, the harder it is to cure. Early detection gives a high chance of recovery. Some medical professionals have suggested an annual blood test to determine if prostate cancer is present, but so far this suggestions hasn't met with widespread acceptance.

Some of the most common symptoms of prostate cancer are listed below. It's important to realize that many of these symptoms can be caused by other conditions as well, so the presence of one or more may not indicate prostate cancer. However if you experience these symptoms regularly, it's a good idea to have yourself checked by your doctor, so that he can make an accurate diagnosis of the problem. The symptoms to look for include:

Difficulty commencing urination

Increased frequency of urge to urinate, particularly at night

Feeling like you need to hurry when urinating

Feeling that your bladder isn't empty when you've finished urinating

It takes a long time to finish urinating, with the last part coming out as a dribble

Pain upon urinating

Much weaker urine stream than usual

Painful ejaculations

Urine that contains blood

Pain occurring in the genital area

Difficulty getting or maintaining an erection

Pain isolated in the lower back

Pain in the hip area and pelvic regions

As the disease can progress unnoticed for some time, many men don't recognize they have a problem until they develop more severe symptoms, such as:

An unexplained weight loss

Extreme tiredness or fatigue

Isolated pain in the bones of the back, hips, thighs and neck

Anemia 

 

Another element to be aware of is that prostate cancer may run in families. So if you have a close male relative diagnosed with prostate cancer, such as a brother, then your risk of developing the cancer yourself is three times higher than average. If your brother was still under sixty, then your risk is four times higher. Even if the male relative isn't so closely related, it's possible your risk level is higher, so annual examinations over the age of fifty are a good idea.

It's important to consider the age at which male relatives develop prostate cancer, because if the sufferers are fairly young (i.e. between 50 and 60) then it's highly likely a faulty gene is causing the cancer - and it's also highly likely that you have the same gene. There's no way of testing this, so the only prevention possible is to keep having the prostate gland checked by your doctor, so that at least any problems can be detected as early as possible, which gives you a much better chance of a cure.

Prostate Problem Symptoms - The Signs To Look For

When prostate problems first appear there are often very few if any symptoms and this is one of the major difficulties with prostate problems, and in particular prostate cancer, as many men do not even realize that they have a problem until it is quite well advanced.

The first signs of any problem are often spotted during a routine medical examination by your doctor, as many doctors will now routinely carry out a simple blood test, know as a prostate specific antigen, or PSA, test for male patients over a certain age. This is not however done in all cases and so there are still a large number of men for whom even a routine medical examination will not detect the presence of a problem.

However, if screening is not carried out the problem will nonetheless become apparent at some point as more and more prostate problem symptoms slowly begin to appear.

One of the first prostate problem symptoms to emerge will be the need to urinate more frequently and a difficulty in maintaining a steady flow or urine. It may also be difficult to start urinating and you may need to strain to begin the flow of urine. There may also be some mild pain when urinating.
As problems continue to develop you'll find that it is difficult to get through the night without having to visit the bathroom and may find urination becoming increasingly difficult and possibly painful. There may also be some signs of blood in the urine.

The presence of prostate problems can also affect your sexual experience and you may find it difficult to get and to maintain an erection. Ejaculation may also prove painful and blood may start to appear in your semen.

At this stage these prostate problem symptoms clearly indicate that something is wrong, but don't necessarily point to prostate cancer as being the cause. Indeed, in many cases these symptoms will result from an enlargement of the prostate gland which is a benign condition often referred to as benign prostatic hyperplasia, or bph. This condition can often be treated quite easily, although treatment does of course become more difficult if the problem is left unattended for too long.

The real problem however is that these symptoms can also be caused by prostate cancer and, while this is a wholly treatable condition if it is caught early enough, once cancer begins to spread outside of the prostate gland, treatment becomes increasingly difficult. Indeed, should the cancer spread to other areas of the body before it is detected, it may not be possible to cure the disease and any treatment would simply be to slow the progression of the disease and to manage its symptoms.

Prostate problem symptoms are frequently ignored as, in the early stages, they are often mild and don't really pose any great problem in terms of day to day living. Also, many men simply put them down to part of the inevitable process of aging. However, prostate cancer is a killer and it kills on a massive scale each year with a substantial proportion of deaths being wholly preventable.

So, if you are experiencing any of the symptoms above, or indeed are symptom free but over the age of 40, it's a good idea to ask your doctor to run a simple prostate screening test at your next physical examination. It may just save your life!

Quit Smoking and Save the Skin

Finding out how to stop smoking can benefit the physical body in many ways. Quitting smoking decreases the risk for certain cancers, heart and cardiovascular diseases, improves general health and mood and prevents the development of respiratory illnesses. However, quitting smoking can also hinder ageing and one cosmetic-related reason to quit smoking is younger looking skin. Let's take a look at some of the ways that smoking impacts the skin in order to further underscore the importance of smoking cessation:

· Skin tone: Smoking causes people to have a poor skin tone. Smokers' skin tends to be blotchy, sallow, pale and uneven. This is because the skin is continuously deprived of the vital nutrients, oxygen and especially fluid it needs to stay healthy when people inhale tobacco smoke.

· Skin that sags: Smoking causes the skin to sag. The plethora of chemicals and toxin in tobacco smoke destroy collagen and elastin over time-the compounds responsible for keeping the skin young and elastic.

· Smoker's pucker: Smokers' use muscles around their mouths that create a wrinkle effect-a permanent pucker wrinkle.

· Wrinkles: Smoking cigarettes damages the blood vessels in the skin and causes it to age faster. As a result, people develop deep lines and wrinkles at a younger age and they have an overall look to their face that is unhealthy.

Above are just a few of the main ways that tobacco smoke can damage the skin if it is chronically inhaled over time. Many people who start smoking in their teens or twenties do not worry about these effects because they are basking in the glory of youth-how can their skin ever get wrinkles? The trouble is that youth has a time limit and smoking makes that time limit critically short. Once smokers hit their thirties, the ageing process accelerates rapidly.

The good news is that the adverse effects of smoking can always be mitigated by learning how to stop smoking. As soon as a smoker gives up cigarettes, the health damage begins to reverse and over time the body heals. It is never too late to quit smoking.

Smoking is indeed a difficult habit to kick, but that is just what it is-a habit. When smokers learn that the power to stop smoking is in their own minds, they can then channel their thought process towards positive health choices that steer them away from tobacco.

Taking Steps to Avoid Heart Disease

Your body's strongest muscle also gets the most exposure to risk factors that can cause it to slow down, or stop functioning well. Inasmuch as most of your body's functions rely greatly on your heart's ability to supply blood throughout your body, you need to take good care of it to sustain its energy. The things we do every day and our lifestyle can greatly affect our heart's health, which means that we have full control over its health, that is, if we choose to.

A healthy life means a healthy heart, and a healthy heart means a healthy, not to mention longer life. What we do to our body can directly affect the functioning of our heart, and most of our habits put our heart at risk for diseases. Heart diseases have been recorded to be the number one cause of mortality in the world's population, and whilst it's early, it's better to tread a path away from them. Here are some of the things you can do to avoid getting heart diseases easily and effectively, leading to a healthier, longer life.

1. Have a heart-friendly diet. Too much fat, cholesterol and calories are harmful to your heart. These are commonly linked to an elevated blood pressure, which puts you at risk for developing heart diseases. On the other hand, consumption of food that is high in Omega-3 fatty acids as well as fruits and vegetables can help prevent the development of heart diseases, aside from protecting your heart from other risk factors.

2. Be nicotine-free. Smoking poses a great risk for your heart to develop diseases. The tons of harmful contents of a single stick of tobacco can compromise your heart's health, making it vulnerable to damages in the blood vessels and arteries which may lead to atherosclerosis, which leads to heart attack. Moreover, avoiding secondhand smoke may just be as effective as avoiding or quitting that smoking habit. The carbon monoxide one can get from second hand smoke will replace some of the oxygen as soon as it hits our system, making the heart work harder, thereby increasing our blood pressure.

3. Work those muscles. At least thirty minutes of exercise daily is good for the heart, not to mention it has great effects to our physical appearance, too. It's like hitting two birds with one stone. Even making walking a habit is beneficial to the heart, and you can do this if you don't have enough spare time for a thirty-minute exercise every day.

4. Visit your doctor regularly. Also have your blood pressure, cholesterol, and blood sugar checked regularly. Any significant change in the values or levels of the aforementioned can pose a risk to your heart in developing diseases, no matter how much you try to avoid them.

Caring for Prostate Health

The prostate gland, as a part of the male reproductive system, plays an essential role in the normal function of the male fertility. This gland that's situated just beneath the bladder of males is crucial in ensuring healthy sperm cells for an optimum fertility condition. With its milky, white secretions, this gland acts as a buffer, neutralizing the detrimental acidic environment of the uterus for fertilization to commence. Furthermore, this gland also produces a particular enzyme called prostatic specific antigen (PSA), which is used as an indicator in diagnosis possible prostate health problems, including prostate cancer and benign prostatic hyperplasia, where the prostate goes through an abnormal tissue growth.
 
As prostatitis, benign prostatic hyperplasia and prostate cancer continue to affect more males nowadays; the concerned fraction of the male society has become more vigilant in observing the various signs and symptoms that may point out prostate problems. Among the most common prostate symptoms every male should watch out for would include pain along the genital, the secretion of bloody semen and urine, and the flow of a weak urine stream. If these symptoms become evident, it would be wise to immediately seek for medical assistance, for these symptoms may not only mean simple prostate enlargement. Nonetheless, it is still best to have a doctor assess and evaluate your current status to be sure.

As the number of males affected by prostate disorders continues to escalate over the years, the concerned citizens have started to seek for convenient ways to hamper the development of prostate problems, and the ingestion of some "special foods" has become one of the most popular approaches. Among the most common recommended foods that are known to be very beneficial for the prostate would include Saw Palmetto, Nettle, Pygeum, Green tea and Kelp. While Saw Palmetto is used for its shrinking properties, the Nettle is beneficial in bolstering the prostate. Additionally, the catechins found in green tea are considered by many as a "medicine" for prostate problems, just as much as they use Kelp as a supplement to lower the prevalence of prostate problems. Pygeum, on the other hand, has been used for many years for urinary and prostate diseases.

The prostate gland can also go through several deviations that may affect its overall function. Alongside with the inevitable wear-and-tear process that every individual goes through, the exposure of men to the hazardous chemicals from vices like cigarette smoking and excessive alcohol drinking are greatly affecting the total health of the prostate, leading now to health problems. On this light, males are advised to include the following "special" foods in their diet: Saw Palmetto to shrink enlarged prostate, Pygeum for prostate and urinary diseases, Kelp as a supplement to help reduce incidence of prostate problems and green tea for its catechins, which are believed to help treat prostate problems.

Today, prostate cancer can be treated through several modalities, taking into account certain factors that would help ensure a better prognosis in the end. In the case where the tumor is found inside the prostate gland, the employment of radical prostatectomy and the introduction of radiation therapy are most commonly used. Moreover, the use of a yet another treatment method called "watchful waiting" can also be applied. In this said mode of treatment, where the older men would very much benefit from, the tumor is observed and necessary actions are only taken when the abnormal starts enlarging. Furthermore, for less serious scenarios, the use of non-invasive hormone therapy can be utilized.

Men suffer more alcohol related atrial fibrillation

A study from Denmark suggests alcohol consumption may increase men's risk of developing atrial fibrillation - an irregular heartbeat. In their follow up study of 22,528 men and 25,421 women (average age 56 years), Dr Lars Frost and Dr Peter Vestergaard, from Aarhus University Hospital, Denmark, found a modest increase in the risk of atrial fibrillation or flutter that corresponded with increasing alcohol consumption in men, but not women.

The study, which recruited over three and a half years and followed up the group after an average of 5.7 years, involved patients from the Danish Diet, Cancer, and Health Study. Reported in The Archives of Internal Medicine (Oct. 2004) the authors found that the average consumption of alcohol per day was 28.2 grams for men and 13.9 grams for women. More than half of the women consumed less than one unit of alcohol per day, or less than 10 grams of alcohol. The percentage of men and women who were abstainers at the beginning of the study was 2.1 percent and 3.0 percent, respectively.

Consumption Increases Atrial Fibrillation Risk

During the follow-up period (average of approximately 5.7 years), 556 participants developed atrial fibrillation (including 374 men [1.7 percent] and 182 women [0.7 percent]). There was a modest increase in risk of atrial fibrillation that corresponded with increasing alcohol consumption in men, but not among women.

Compared to men who drank the least amount of alcohol (first quintile), men in the second, third, fourth and fifth quintiles (increasing alcohol consumption), had a 4 percent increase in risk, 44 percent increase in risk, 25 percent increase in risk and 46 percent increase in risk for atrial fibrillation, respectively.

Compared to women in the lowest quintile of alcohol consumption, women in the second, third, fourth and fifth quintiles had a nine percent increase in risk, 27 percent increase in risk, 23 percent increase in risk and 14 percent increase in risk, respectively.

"Consumption of alcohol was associated with an increased risk of atrial fibrillation or flutter in men," the researchers write. "In women, moderate consumption of alcohol did not seem to be associated with risk of atrial fibrillation or flutter."


Article source: Dr Lars Frost, Dr Peter Vestergaard Aarhus University Hospital Denmark.

Moderate Drinking- Overview

Moderate drinking is difficult to define because it means different things to different people. The term is often confused with "social drinking," which refers to drinking patterns that are accepted by the society in which they occur. However, social drinking is not necessarily free of problems. Moderate drinking may be defined as drinking that does not generally cause problems, either for the drinker or for society. Since there are clearly both benefits and risks associated with lower levels of drinking, this Alcohol Alert will explore potentially positive and adverse effects of "moderate" drinking.

It would be useful if the above definition of moderate drinking were bolstered by numerical estimates of "safe" drinking limits. However, the usefulness of quantitative definitions of moderate drinking is compromised by the likelihood that a given dose of alcohol may affect different people differently. Adding further complexity, the pattern of drinking is also an important determinant of alcohol-related consequences. Thus, while epidemiologic data are often collected in terms of the "average number of drinks per week," one drink taken each day may have different consequences than seven drinks taken on a Saturday night (1).

Despite the complexity, numerical definitions of moderate drinking do exist. For example, guidelines put forth jointly by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services (2) define moderate drinking as no more than one drink a day for most women, and no more than two drinks a day for most men. A standard drink is generally considered to be 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits. Each of these drinks contains roughly the same amount of absolute alcohol--approximately 0.5 ounce or 12 grams (3).

These guidelines exclude the following persons, who should not consume alcoholic beverages: women who are pregnant or trying to conceive; people who plan to drive or engage in other activities that require attention or skill; people taking medication, including over-the-counter medications; recovering alcoholics; and persons under the age of 21 (2). Although not specifically addressed by the guidelines, alcohol use also is contraindicated for people with certain medical conditions such as peptic ulcer.

The existence of separate guidelines for men and women reflects research findings that women become more intoxicated than men at an equivalent dose of alcohol (4). This results, in part, from the significant difference in activity of an enzyme in stomach tissue of males and females that breaks down alcohol before it reaches the bloodstream. The enzyme is four times more active in males than in females (5). Moreover, women have proportionately more fat and less body water than men. Because alcohol is more soluble in water than in fat, a given dose becomes more highly concentrated in a female's body water than in a male's (6).

Since the proportion of body fat increases with age, Dufour and colleagues recommend a limit of one drink per day for the elderly (7).

Benefits of Moderate Drinking

Psychological benefits of moderate drinking. A review of the literature (8) suggests that lower levels of alcohol consumption can reduce stress; promote conviviality and pleasant and carefree feelings; and decrease tension, anxiety, and self-consciousness. In the elderly, moderate drinking has been reported to stimulate appetite, promote regular bowel function, and improve mood (7).

Cardiovascular benefits of moderate drinking. There is a considerable body of evidence that lower levels of drinking decrease the risk of death from co ronary artery disease (CAD). This effect has been demonstrated in a broad range of older epidemiologic studies (9). More recently, Boffetta and Garfinkel (10) found that white American men who reported in 1959 that they consumed an average of fewer than three drinks per day were less likely to die during the next 12 years than men who reported abstinence. This finding was due primarily to a reduction in CAD. In a similar study using a wide range of ethnic groups, De Labry and colleagues (11) found that rates of overall mortality were lowest for men who consumed fewer than three drinks per day over a 12-year period.

Similar results have been obtained with female subjects. Stampfer and colleagues (12) analyzed data on middle-aged women and determined that consumption of approximately one drink per day decreases the risks of coronary heart disease. Razay and colleagues (13), using a random population sample, found consumption of up to two drinks per day to be associated with lower levels of cardiovascular risk factors in women. In postmenopausal women, the apparent protective effect of alcohol may be explained in part by an alcohol-induced increase in estrogen levels (14).

Various researchers have suggested that moderate drinking is not protective against CAD, arguing that higher mortality among abstainers results from including among them people who have stopped drinking because of ill health. Higher mortality among these "sick quitters" would explain the comparative longevity of moderate drinkers (15,16,17). However, studies investigating the "sick quitter" effect do not support that conclusion; including "sick quitters" in the abstinent category cannot completely explain the apparent protective effect of moderate drinking against CAD (10,18,19,20).

Risks of Moderate Drinking

There are risks that might offset the benefits of moderate drinking. Research shows that adverse consequences may occur at relatively low levels of consumption (1).

Stroke. A review of epidemiologic evidence concludes that moderate alcohol consumption increases the potential risk of strokes caused by bleeding, although it decreases the risk of strokes caused by blocked blood vessels (21).

Motor vehicle crashes. While there is some evidence to suggest that low blood alcohol concentrations (BACs) bear little relationship to road crashes, impairment of driving-related skills by alcohol has been found to begin at 0.05 percent BAC or lower, with rapidly progressing deterioration as the BAC rises (22). A man weighing 140 pounds might attain a BAC of 0.05 percent after two drinks.

Interactions with medications. Alcohol may interact harmfully with more than 100 medications, including some sold over the counter (23). The effects of alcohol are especially augmented by medications that depress the function of the central nervous system, such as sedatives, sleeping pills, anticonvulsants, antidepressants, antianxiety drugs, and certain painkillers. There is a consequent increased danger of driving an automobile after even moderate drinking if such medications are taken (24). In advanced heart failure, alcohol may not only worsen the disease, but also interfere with the function of medications to treat the disease (25).

Cancer. Although most evidence suggests an increased risk for certain cancers only among the heaviest drinkers, moderate drinking may be weakly related to female breast cancer. In one study (26), breast cancer was approximately 50 percent more likely to develop in women who consumed three to nine drinks per week than in women who drank fewer than three drinks per week. Although evidence concerning large bowel cancer is conflicting, one study suggests the possibility of a weak relation to consumption of one or more drinks per day (27).

Birth defects. Several ongoing studies are exploring the fetal risks associated with low levels of alcohol consumption. In one study (28), chil dren whose mothers reported consuming an average of two to three drinks per day during pregnancy were smaller in weight, length, and head circumference and had an increased number of minor physical anomalies when examined at intervals through the age of 3. In addition, mothers' self-reported consumption of as few as two drinks per day during pregnancy was found to be related to a decrease in IQ scores of 7-year-old children (29).

The question of whether moderate drinking is a risk factor for the fetus is not altogether settled, because mothers' self-reports of alcohol consumption may be underestimates (30). However, animal research provides additional evidence for adverse fetal effects from low levels of drinking. Nervous system abnormalities occurred in monkeys whose mothers were exposed weekly to low doses of alcohol. An effect occurred at a maternal BAC as low as 0.024 percent (31). A 120-pound woman might attain this BAC after one drink. Similarly, low prenatal alcohol doses produced biochemical and physiological changes in rat brains (32,33).

Shift to heavier drinking. Recovering alcoholics, as well as people whose families have alcohol problems, may not be able to maintain moderate drinking habits (2). Once a person progresses from moderate to heavier drinking, the risks of social problems (for example, drinking and driving, violence, trauma) and medical problems (for example, liver disease, pancreatitis, brain damage, reproductive failure, cancer) increase greatly (34).

References

(1) WERCH, C.E.; Gorman, D.R.; & Marty, P.J. Relationship between alcohol consumption and alcohol problems in young adults. Journal of Drug Education 17(3):261-276, 1987. (2) U.S. Department of Agriculture/U.S. Department of Health and Human Services. Home and Garden Bulletin No. 232. Nutrition and Your Health: Dietary Guidelines for Americans. 3d ed. Washingt on, DC: Supt. of Docs., U.S. Govt. Print. Off., 1990. (3) WHELAN, E.M. To your health. Across the Board, Jan. 1988, pp. 49-53. (4) JONES, B.M., & Jones, M.K. Alcohol effects in women during the menstrual cycle. Annals of the New York Academy of Sciences 273:576-587, 1976. (5) FREZZA, M.; Di Padova, C.; Pozzato, G.; Terpin, M.; Baraona, E.; & Lieber, C.S. High blood alcohol levels in women: The role of decreased gastric alcohol dehydrogenase activity and first-pass metabolism. New England Journal of Medicine 322(2):95-99, 1990. (6) GOIST, K.C., & Sutker, P.B. Acute alcohol intoxication and body composition in women and men. Biochemistry & Behavior 22:811-814, 1985. (7) DUFOUR, M.C.; Archer, L.; & Gordis, E. Alcohol and the elderly. Clinics in Geriatric Medicine 8(1):127-141, 1992. (8) BAUM-BAICKER, C. The psychological benefits of moderate alcohol consumption: A review of the literature. Drug and Alcohol Dependence 15:305-322, 1985. (9) MOORE, R.D., & Pearson, T.A. Moderate alcohol consumption and coronary artery disease: A review. Medicine 65(4):242-267, 1986. (10) BOFFETTA, P., & Garfinkel, L. Alcohol drinking and mortality among men enrolled in an American Cancer Society prospective study. Epidemiology 1(5):342-348, 1990. (11) DE LABRY, L.O.; Glynn, R.J.; Levenson, M.R.; Hermos, J.A.; LoCastro, J.S.; & Vokonas, P.S. Alcohol consumption and mortality in an American male population: Recovering the U-shaped curve--findings from the normative aging study. Journal of Studies on Alcohol 53(1):25-32, 1992. (12) STAMPFER, M.J.; Colditz, G.A.; Willett, W.C.; Speizer, F.E.; & Hennekens, C.H. A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. New England Journal of Medicine 319(5):267-273, 1988. (13) RAZAY, G.; Heaton, K.W.; Bolton, C.H.; & Hughes, A.O. Alcohol consumption and its relation to cardiovascular risk factors in British women. British Medical Journal 304:80-83, 1992. (14) GAVALER, J.S., & Van Thiel, D.H. The association between moderate alcoholic beverage consumption and serum estradiol and testosterone levels in normal postmenopausal women: Relationship to the literature. Alcoholism: Clinical and Experimental Research 16(1):87-92, 1992. (15) MARMOT, M., & Brunner, E. Alcohol and cardiovascular disease: The status of the U shaped curve. British Medical Journal 303:565-568, 1991. (16) SHAPER, A.G. Alcohol and mortality: A review of prospective studies. British Journal of Addiction 85:837-847, 1990. (17) SHAPER, A.G.; Wannamethee, G.; & Walker, M. Alcohol and mortality in British men: Explaining the U-shaped curve. Lancet 2(8623):1267-1273, 1988. (18) KLATSKY, A.L.; Armstrong, M.A.; & Friedman, G.D. Risk of cardiovascular mortality in alcohol drinkers, ex-drinkers and nondrinkers. American Journal of Cardiology 66:1237-1242, 1990. (19) JACKSON, R.; Scragg, R.; & Beaglehole, R. Alcohol consumption and risk of coronary heart disease. British Medical Journal 303:211-216, 1991. (20) RIMM, E.B.; Giovannucci, E.L.; Willett, W.C.; Colditz, G.A.; Ascherio, A.; Rosner, B.; & Stampfer, M.J. Prospective study of alcohol consumption and risk of coronary disease in men. Lancet 338(8765):464-468, 1991. (21) CAMARGO, C.A., Jr. Moderate alcohol consumption and stroke: The epidemiologic evidence. Stroke 20(12):1611-1626, 1989. (22) Council on Scientific Affairs. Alcohol and the driver. Journal of the American Medical Association 255(4):522-527, 1986. (23) SHINN, A.F., & Shrewsbury, R.P., eds. Evaluations of Drug Interactions. 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Why Men Snore

Snoring is noisy breathing that occurs during sleep. Women may snore too, but men snore more than women: Four out of every ten men snore, compared to roughly three out of ten women. At any particular time, around 25 percent of people are habitual snorers.

Causes of Snoring

Snoring has many potential causes, including obesity, anatomical variations, and several illnesses affecting the upper airways. It results from the vibration of soft tissues of the upper airways and often is associated with obstruction of airflow. If it's due to a significant airway obstruction, snoring is associated with serious health problems, like high blood pressure and heart disease.

• Snoring is made worse by alcohol and other sedatives.


• Overweight people are more prone to snoring.


• Sleeping on your back increases the chances of snoring.


• Colds, nasal polyps, and allergies make snoring worse.


• Older people often snore due to muscular weakness that occurs with age.


• Certain medications may cause dryness or minor irritation of the nasal passageways and increase the incidence of snoring.


• A larger-than-usual uvula can limit airflow and cause snoring.


• Injuries to the nose that result in a deviated septum may result in snoring.


• Smokers are more likely to snore.

Sleep Apnea

Sometimes, people who snore also suffer from sleep apnea. Apnea refers to periods of interrupted breathing that can last ten seconds or longer. It's essentially the same physiological process as snoring, except that the muscles relax so much they cause a complete, rather than partial, obstruction of the airway. When sleep apnea occurs, carbon dioxide accumulates in the bloodstream and oxygen levels fall. The brain detects these changes and reacts by waking the person up so that normal breathing can resume. Sleep apnea can occur several times a night, disrupting normal restorative sleep. Clues that your snoring is more than just a nuisance include falling asleep during normal daytime activities, a frequent need to urinate at night (nocturia), or morning headaches.

Self-Help Ideas to Prevent or Minimize Snoring

• Losing weight may help prevent snoring.


• Avoid alcohol and rich foods before bedtime.


• Quit smoking.


• Try raising your head by putting pillows under it.


• Sleep on your side. Some people sew a tennis ball on the back of their pajamas to help them avoid turning onto their back.


• Blow your nose before going to bed.

Medical Help for Snoring

If none of the self-help ideas work, you may need a doctor's help. The first step might be to try an oral appliance that helps to keep your airway open. Other treatment options, such as nasal sprays or nasal plasters, may also be considered. Surgery could be performed if the cause of the snoring is a deviated septum or enlarged tonsils or adenoids.

The Effects of Cardiac Arrest

Not until after a heart attack do many people consider the effects of cardiac arrest. Before an episode, what lies after such an incident is not something that crosses many people's minds. In the effect of such a situation, it would be valuable and undoubtedly beneficial to know what to expect after the on slot of cardiac arrest.

Survival rates vary depending on the condition of one's health prior to an episode of cardiac arrest. Those that have a history of heart disease and high blood pressure have a much slimmer chance of survival than those who were in a state of moderate to excellent health conditions. With this in mind, it is important to realize that the effects of cardiac arrest will also be affected by one's health history. Someone who was in poor health prior to a heart attack, should they be fortunate enough to survive, will also have a longer, more complicated recovery.

Most of the effects of a heart attack are linked to the amount of time that passes before cardio pulmonary resuscitation is begun. Studies show that those who are treated in an immediate matter, with less than two minutes passing before CPR is begun, have less side effects, and those that they do have are not of the severity of those who had a longer period of time pass before the resuscitation process was begun.

A few of the effects of cardiac arrest include hypoxia and acidosis, both of which are linked to the accumulation of carbon dioxide in the tissues of the body. Since the heart is not pumping, proper oxygen is not reaching the tissues, CO2 is taking the place of where the oxygen should be. In these conditions, the tissues of the body begin to break down and are unable to function properly.

Metabolic problems and decreased circulation have also been reported. This is caused by a weaker than normal heart that cannot provide the same amounts of oxygen as it did prior to the heart attack.

There has also been evidence linking heart attacks to neurological problems and damage to the nervous system. Studies on monkeys have been done in an attempt to reveal the effects that a heart attack has on the brain. In one study, the monkeys were taught various tasks including differentiating between colors. After inducing cardiac arrest, the monkeys were resuscitated at different lengths of time. Those that were resuscitated quickly were able to distinguish the difference in the colors within one to eight days. Those that were forced to wait for the longer periods were not able to recover these abilities for anywhere from eleven to sixty-four days. These findings seem to show that the effects of cardiac arrest can destroy memory function as well as causing other neurological problems. One again the length of time that passes before resuscitation has great impact on the aftermath of a heart attack.

Cardiac Arrhythmia- Overview

The heart functions as a machine which receives impure blood from all the organs in the body, sends it to the lungs for purification, receives the pure blood from the lungs and sends it to the other parts of the body. This is enabled by the presence of four chambers and two major valves in the heart. The process occurs in a rhythmic manner where during each heartbeat, the heart expands and contracts to receive the blood (from the other parts of the body and the lungs) and push it out (to the lungs and other parts of the body). The lub-dub sound of the heart during this process is generated as a result of the closure of the two major valves as the heart is pumped out.

This rhythmic process occurs as a result of electrical stimulation from a bunch of tissues known as the sinoatrial node or the SA node. This node generates electrical impulses which are transferred to the heart muscles, enabling them to expand or contract in a rhythmic manner. Any condition that disrupts the impulse generation from the SA node or its transfer to the heart muscles can lead to arrhythmia.

Arrhythmia -Types, Risk & Treatment

When the heart is beating too fast, the condition is known as tachycardia [ABC1] and if the heart rate is too slow, it is termed bradycardia[ABC2]. Details about the symptoms and causes of tachycardia and bradycardia have been enumerated in the individual articles about these conditions.

While it may not be bothersome in many, arrhythmia can often lead to life threatening situations if left untreated. The commonest complications of arrhythmia include stroke and heart failure.
The treatment options available for arrhythmia include:

Medications - such as calcium channel blockers, beta blockers, and digoxin

Pacemaker - a device implanted in the chest which functions like the SA node

Defribillator - a device used to deliver a jolt of electricity to the heart muscles to rectify abnormal heart beat

Catheter ablation - procedure where the abnormal regions in the heart muscles/tissues that are responsible for abnormal rhythm are destroyed

Surgical therapy - for the repair of heart valves or other underlying abnormalities that cannot be rectified with medications or medical procedures

Outlook

With proper care, individuals with cardiac arrhythmia can lead a normal life. Medications when advised need to be taken regularly. Periodic visit to the healthcare provider is necessary to monitor the condition. A healthy lifestyle with a proper diet can prevent the occurrence of complications.

Diabetic Men and Impotence

Men with type 2 diabetes suffer from a certain side effect which seems to remain as a taboo topic especially in conservative communities. Erectile Dysfunction or ED even when it is not caused by diabetes is often an ignored or minimally discussed issue because of its rather embarrassing nature especially for men who take pride in their sexual strength. However, with around 80% of diabetic men experiencing the same symptom, it is crucial to learn more about the relationship of Type 2 diabetes and impotence in the aim to treat it properly.

When not addressed the right way, erectile dysfunction could become an immense obstacle in maintaining a healthy relationship with your partner. Men have to deal with the stress, pressure and depression that may come from not being able to deliver during sexual intercourse. This consistent inability to get an erection may well affect other areas in their personal and professional lives with the emotional and mental effects it causes.

As in other parts of the body, high glucose level also has its detrimental effects on the nerves and tissues of the penis. When the blood sugar in the body is not controlled under the ideal amount, it causes damages to the blood vessels leading to diverse symptoms such as erectile dysfunction. Hence, consulting your doctor will be the most suitable action in order to guide you in lessening the risks of being impotent especially in your early years. With diabetes, men are more likely to suffer from ED around their 40s and even 30s which is why diagnosis and getting treatment early on are very essential to prevent this side effect from occurring.

For men with type 2 diabetes, it is crucial to avoid worsening their conditions by taking care of their health to prevent heart diseases which doubles the risk of ED. Cholesterol levels must be properly managed as well as maintaining the proper weight. This will only be possible through applying the right diet and exercise routine every day. Men should also veer away from nasty habits such as smoking and drinking of alcohol that could aggravate their conditions.

There are also many prescribed medicines like Viagra in the market today to address the issue of erectile dysfunction apart from surgery and injections. However, it is important to get the doctor's opinion first before taking these oral medications as these could have negative side effects on the body. Urologists could best give you the proper advice about erectile dysfunction in addition to educating you on the full picture on what this condition is all about. Therapies would also effectively help men especially when they are feeling low and insecure when erection consistently does not occur.

Men with type 2 diabetes have different ways in dealing with this common symptom. They also react differently to a treatment which is why talking to their doctor for a specialized treatment plan is imperative to address their specific issues. In the end, men could hope for the best even if they have ED due to diabetes since the medical field is continuously advancing to cure this widespread condition.

Cigarette Smoking and Lung Related Cancers With More Reason Go Hand in Hand

Countless individuals realize that smoking cigarettes and lung cancer are inherently intertwined, that is, you rarely have one and not another. With all the remedy alternatives open to individuals these days, is there still a correlation between smoking and lung disease? What is the likelihood that someone who smokes will develop this disease? Is there anything a doctor can carry out to cure?
The bad news is cancer of the lungs and smoking tobacco products are even moreso substantially connected. Smoking cigarettes is the foremost cause of the condition and there continues to be no recognized cure.

Cancer of the lungs occurs when the tissue of the lung grows turbulently. This could provoke transmutation, invasion of adjacent fibers and intrusion besides the lungs. Diseases of the lungs are the most common way of cancer-affiliated fatalities in males and second most typical for females. There are an estimated 1.3 million fatalities worldwide caused each year from this disease.

Cigarette smoking causes lung cancer in close to ninety percent ofnine in ten circumstances. A man that smokes cigarettes has a 17 percent likelihood of contracting lung disease, that means for each man that smokes tobacco products, one out of five will contract the disease. For women, the numbers are almost at 11%, or one in every ten.

Tobacco manufacturers intentionally add a number of chemicals to their cigarettes in order to make certain they are even more addictive and many of these chemicals are harmful on their own or metamorphose as noxious amid the chemical preparation of being burned.

Cigarette fumes includes more than sixty acknowledged cancer causing chemicals, including radioisotopes from the radon decomposition reaction nitrosamine and benzopyrene. Moreover, nicotine is thought to encumber the immune system's comeback to diseased growths in prone tissue.

Worse still, even non-smokers are not exempt from the link between cancer of the lungs and smoking. Environmental smoking, the taking in of smoke from another man or woman's smoking is a contributor to lung related cancers in non smoking men and women. Studies from the United States of America, Europe, the UK and Australia have continually divulged an important development of associated risk among those not protected from second hand smoking. Current exploration of passive smoke suggests it is more harmful than first hand ingestion of fumes.

Worse still, even with medicine the five year expectancy quota is only 14%.

Anyhow, there are other factors that lead to or add to an individual's case of lung disease, including contamination, being open to asbestos, parentage and residing in a smoky background.

Nonetheless, there isn't any misunderstanding the truth that cigarette smoking and lung disease are all the more related, giving any adult who smokes with a further explantion of why it is critical to stop smoking!

Benefits of RT Immediately After Prostate Cancer Surgery

Giving radiotherapy immediately after prostate cancer surgery is beneficial (particularly in some subgroups), but it remains unclear whether immediate radiotherapy is preferable to salvage radiotherapy.

These findings come from the long-term follow-up (median, 10.6 years) of the European Organization for Research and Treatment of Cancer (EORTC) 22911 study, and were published online October 19 in the Lancet.

In this trial, 1005 men with high-risk prostate cancer who had undergone radical prostatectomy were randomized to receive immediate postoperative external irradiation or to receive subsequent treatment (radiation or other) only at biochemical or clinical relapse (wait-and-see policy).

The 10-year results show a significant improvement in biochemical progression-free survival in the immediate group, compared with the wait-and-see group (61.8% vs 39.4%; hazard ratio, 0.49; P < .0001). The immediate group also had significantly better locoregional control, so were less likely to need hormonal therapy, the researchers report.

However, in contrast to the results reported after 5 years of follow-up, after 10 years, the results were no longer significant for clinical progression-free survival, distant metastases, or overall survival. At 10 years, overall survival was 76.9% in the immediate group and 80.7% in the wait-and-see group, and cumulative rates of distant metastases were 10.1% and 11.0%, respectively.

Late adverse events were more frequent in the immediate group than in the wait-and-see group (70.8% vs 59.7%; P = .001).

The researchers, headed by Michel Bolla, MD, from the Centre Hospitalier Universitaire A Michallon in Grenoble, France, note that the improvement in biochemical progression-free survival and local control with a wait-and-see policy is "in agreement" with results from 2 other phase 3 clinical trials: the German Arbeisgemeinschaft Radiologische Onkologie (ARO) trial (J Clin Oncol. 2009;27:2924-2930); and the American Southwest Oncology Group (SWOG) 8794 trial (J Urol. 2009;181;956-962).

However, they also note that, unlike their 10-year results, long-term follow-up in the SWOG trial did find a significant difference in overall survival and distant metastases. Dr. Bolla and colleagues suggest that this might be because of the large difference in the wait-and-see groups between the SWOG trial and their EORTC trial (66.0% vs 80.7%). In their trial, salvage treatment was initiated in the wait-and-see group at a lower concentration of prostate-specific antigen than in the immediate group.

Benefit in Specific Patient Groups 
 
Dr. Bolla and colleagues suggest that postoperative radiation might not be the best approach for all patients. "Exploratory analyses suggest that postoperative radiotherapy might improve clinical progression-free survival in patients younger than 70 years and in those with positive surgical margins, but could have a detrimental effect in patients aged 70 years or older," they write.
This sentiment is echoed in an accompanying comment by Jason Efstathiou, MD, from the Department of Radiation Oncology at the Massachusetts General Hospital, Harvard Medical School, Boston.

The results from this EORTC update still support the use of postoperative irradiation in patients younger than 70 years and in those with positive margins, Dr. Efstathiou writes.

"When surgery has probably not cured a patient, prospective data still support postoperative radiation," Dr. Efstathiou concludes. The long-term morbidity and quality of life seem acceptable, and morbidity is probably lower than with systemic alternatives, especially because postoperative radiation reduces the need for future androgen-deprivation therapy, he adds.

However, questions remain, he notes.

In this EORTC trial, as well as in the SWOG trial, the salvage radiotherapy that was given in the wait-and-see group was often delivered too late, Dr. Efstathiou explains. "Hence, these 2 studies are probably better characterized as having compared adjuvant or early salvage with late or no salvage radiation," he writes.

It is hoped that ongoing randomized trials — including the Radiotherapy and Androgen Deprivation in Combination After Local Surgery-Hormone Duration (RADICALS-HD), Radiotherapy Adjuvant Versus Early Salvage (RAVES), and Groupe d'Etude des Tumeurs Uro-Génitales (GETUG-17) — will establish the optimum timing of postoperative radiation (immediate adjuvant vs early salvage), he notes.