• March 21, 2012 – 12:59

    ISMH India – First National Conference on Men’s Health

    The launch of the ISMH India will take place at the First National Conference on Men’s Health in India from April 5th-7th in Delhi, India. “Why Men Die Earlier and Suffer More” will be the title of this First Indian Conference on Men’s Health. The reason for this greater interest in men’s health is the overwhelming irrefutable evidence from many scientific studies of the significant disparity in gender health.

    All over the world, men live shorter than women and suffer more from heart disease and cancer. When the administrators of Indian Government admit that for decades India has been struggling to achieve the National Health Program target related to women, children and communicable and non-communicable diseases, men’s health was inadvertently ignored. Indian and International Faculty from Men’s Health Society of India (MHSI) and International Society of Men’s Health (ISMH) will meet and exchange their thoughts. Take a look at the Scientific Program of the First Indian Conference on Men’s Health 2012 (MHSI Scientific Program) and register now (First Indian Conference on Men’s Health 2012)!

  • March 12, 2012 – 15:30

    Colonoscopy Prevents Colorectal Cancer Deaths

    Colorectal cancer is the third most common cancer and the fifth leading cause of cancer death in men worldwide.  The majority of colorectal cancers arise from adenomatous polyps, which can be detected with screening colonoscopy.  Previously, the investigators of the National Polyp Study (NPS), found that colorectal cancer can be prevented by colonoscopic removal of adenomatous polyps.  However, it has been unclear if the cancers prevented were those that had the potential to cause death.  Recently, Zauber and colleagues reported* the effect of colonoscopic polypectomy on mortality from colorectal cancer.  The researchers conducted a long-term prospective  study of the NPS cohort of patients to determine the mortality among patients with adenomas removed compared with the expected mortality from colorectal cancer in the general  population.   The death rate of patients with adenomas was also compared with an internal control group of patients with nonadenomatous polyps.  Among 2,602 patients who had adenomas removed, 12 died from colorectal cancer over a median  period 15.8 years, compared with 25 expected deaths in the general population, suggesting a 53% reduction in mortality.  Mortality from colorectal cancer among patients with adenomatous polyps was similar to those with nonadenomatous during the first 10 years after polypectomy.  Thereafter, mortality increased for patients with adenomas, when strict surveillance was not organized by the study’s investigators.  The researchers concede several limitations of the study.  A small number of skilled endoscopists performed the colonoscopies, thus the observations may not be applicable to a community practice, for which the reported rates of colorectal cancer after polypectomy are higher than those reported in the NPS.  The results of the study may not be  representative of the general population, since the study was not a randomized, controlled trial.  In conclusion, the study’s findings further support the belief that colonoscopic removal of adenomatous polyps prevents colorectal cancer death.  The results also underscore the importance of longterm-term surveillance for patients after the initial removal of adenomatous polyps.  More randomized, population-based trials are necessary to determine the effectiveness of screening colonoscopy  on colorectal cancer mortality.

    Zauber AG, et al. Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths. N Engl J Med 2012;366:687-96.  

    Bretthauer M, Kalager M.  Colonoscopy as a triage screening test. N Engl J Med 2012;366:759-60.

  • February 7, 2012 – 13:47

    HIGH RISK OF ERECTILE DYSFUNCTION IN MEN WITH COLORECTAL CANCER

    In patients with colorectal cancer, especially those with rectal cancer, quality of life can be affected by bowel, bladder and sexual problems. Erectile dysfunction (ED) is often reported among men who have been treated for rectal cancer. It may result mainly from injury to pelvic nerves by surgery, radiation or chemotherapy. In addition, in every patient, individual risk factors have to be considered (age, co-morbidities).

    In a recent study, Dowswell and colleagues assessed 28 men aged 34 to 80 years who had been treated for colorectal cancer. Despite some limitations (e.g., small group, descriptive approach), the study provides several interesting pieces of information. In survivors of colorectal cancer, ED is frequent. However, many patients do not seek help for ED for various reasons (e.g., unawareness of the association between experienced symptoms and colorectal cancer or cancer therapy, lack of knowledge about the possible treatment for ED, embarrassment, lack of confidence, perception of ED as a subject which is inappropriate for the medical office).

    Even more importantly, among those who sought help for ED, almost none were receiving adequate, effective and affordable care. The patients emphasized lack or inadequacy of information about the risk of ED, inability or unwillingness of health care providers to speak about sexual function or even unintentionally offensive remarks, especially in regard to older men. In some cases, patients did not obtain any help from professional healthcare providers and sought medication on the internet.

    Thus, from the practical point of view, three points are important. First, neither information about ED nor treatment for ED are incorporated into routine care of men with colorectal cancer.  Second, in these men, it may be necessary to explore problem of sexual function sensitively but routinely. Third, in case of older men, making assumptions about their sexual behavior or motivation (in particular, about lack thereof) may be inadvertently offensive.

    Dowswell G, Ismail T, Greenfield S, Clifford S, Hancock B, Wilson S. Men’s experience of erectile dysfunction after treatment for colorectal cancer: qualitative interview study. BMJ. 2011 Oct 18;343:d5824. doi: 10.1136/bmj.d5824.

  • February 7, 2012 – 13:43

    Models predicting erectile function after treatment for localized prostate cancer

    Management of localized prostate cancer aims at achieving the trifecta of cancer control, urinary continence, and preservation of erectile function. With optimal cancer control being achieved through most interventions, the focus is currently on the other two outcomes that form a major quality of life issue in these men who are expected to be cured of their primary disease.

    Pre-treatment prediction of post-intervention erectile function would be useful in patient counseling. The Prostate Cancer Outcomes and Satisfaction with Treatment Quality Assessment (PROSTQA) is a prospective, multicenter study that in 2003, began enrolling men with localized prostate cancer scheduled for definitive therapy with radical prostatectomy, external beam radiotherapy or brachytherapy.  Apart from baseline patient data, the investigators recorded details of the treatment planned including nerve sparing surgery, hormonal therapy and radiation protocols. Post-intervention patient reported outcomes were recorded by third-party interviews using validated questionnaires.

    In a recent trial by Alemozaffar and colleagues published in JAMA, the study investigators reported patient assessed erectile function in 1027 men who had completed 24 months after intervention. A significant increase in erectile dysfunction was reported in all 3 intervention groups: 63% vs 28% in radical prostatectomy, 63% vs 47% in the external radiotherapy group and 57% vs 33% in the brachytherapy group. Among men who were potent prior to intervention, 52% had ED after intervention; 60% in the prostatectomy group, 42% in the external radiotherapy group and 37% in the brachytherapy group. The authors were able to generate models that accurately predicted the occurrence of erectile dysfunction in the three treatment strategies.  Models such as this one suggest that stratification by pretreatment patient characteristics and treatment details enables prediction of erectile function 2 years after prostatectomy, external radiotherapy, or brachytherapy for prostate cancer.  While such a model cannot be used to judge superiority of one treatment strategy over another, it does aid in counseling patients about their individual outcome probabilities.

    Alemozaffar M, Regan MM, Cooperberg MR, Wei JT, et al. Prediction of erectile function following treatment for prostate cancer.  JAMA 2011;306:1205-14.

  • September 30, 2011 – 09:09

    Why do men tolerate bothersome urinary symptoms rather than seek medical advice?

    Many men over the age of 50 experience clinical (or symptomatic) benign prostatic hyperplasia (BPH), but often delay in speaking to a healthcare professional about the bothersome urinary symptoms that accompany this condition.1,2 Why do men tolerate these symptoms? To answer this question, GlaxoSmithKline (GSK) has funded The BPH survey: a male perspective, a European survey that aims to reveal male attitudes and behaviours towards bothersome urinary symptoms.

    Professor Siegfried Meryn, General Secretary of the International Society of Men’s Health, explains:

    “Male attitudes towards urinary symptoms have been neglected in medical research and this is one of the very few surveys that asks ‘how do men feel?’ and ‘why don’t men seek help?’ This survey will provide a unique insight about men and their health and it is vital that we, as healthcare  professionals, understand the attitudes and behaviours of the men we are treating.”

    The BPH survey: a male perspective was developed by an expert steering group of urologists and GPs, and explores:

    • What discourages men from seeking medical attention
    • What prompts men to seek help
    • Who men consult about their bothersome urinary symptoms

    It is hoped that the insights will help healthcare professionals have more meaningful conversations with men about their prostate problems so that their condition can be rapidly diagnosed and managed. Findings from the survey should also help men to understand that bothersome urinary symptoms are not an inevitable part of ageing.

    First findings from the survey will be released online during the Men’s Health World Congress 2011 in Vienna, Austria.

    GlaxoSmithKline (GSK) is committed to supporting research to help educate and increase understanding of Benign Prostatic Hyperplasia (BPH), a common prostate disorder. As part of this commitment GSK has developed and funded this project – “The BPH survey: a male perspective” through the creation of a steering group of healthcare professionals – urologists and GPs – to advise on the content of the survey, as well as the implementation of the project across the largest European markets (UK, France, Italy, Germany and Spain).  GSK has supported and paid the International Society of Men´s Health (ISMH) for the opportunity to launch the results of this project in the press contact section of their website during their annual Men´s Health World Congress, taking place in Vienna in 2011. All rights relating to the project and the data published are property of GSK.

    References

    1. Garraway WM, Collins GN, Lee RJ. High prevalence of benign prostatic hypertrophy in the community. Lancet. 1991; 338: 469-71.

    2. Banks I, Mayor S, Meryn S. Talking prostates. Journal of Men’s Health. 2010; 7: 221-226.

    Date of preparation: September 2011 , Job bag code: URCE/BPH/0022a/11

  • September 26, 2011 – 11:07

    Testosterone Deficiency as a Risk Factor for Cardiovascular Disease

    Male gender, diabetes mellitus, and obesity, are known risk factors for the development of cardiovascular disease. Increasing attention has been given in recent years to the link between testosterone deficiency and increased risk of cardiometabolic disease. Recent meta-analyses have demonstrated a correlation between metabolic syndrome (e.g., commonly defined as obesity, diabetes/insulin resistance, hypertension, dyslipoproteinemia and gout) and lower serum testosterone levels.

    Hypogonadotropic hypogonadism occurs in up to 33% of men with type 2 diabetes. The Massachusetts Male Aging Study found that low levels of testosterone and sex hormone binding globulin (SHBG) are independent risk factors for the development of type 2 diabetes. In addition, this study demonstrated that low serum testosterone predicts the development of metabolic syndrome.

    Declining serum testosterone levels throughout a man’s life are associated with an increase in all-cause mortality and an increase in atherosclerosis, visceral obesity, insulin resistance, dyslipidemia, and hypertension, the key components of the metabolic syndrome. Prospective clinical trials in men with prostate cancer who have undergone androgen deprivation therapy have found increased cardiovascular risk by increasing body weight, reducing insulin sensitivity, and/or resulting in dyslipidemia.

    Reference: Ullah MI, Washington T, Kazi M, et al. Testosterone deficiency as a risk factor for cardiovascular disease. Horm Met Res 2001;43:153-164.

  • September 2, 2011 – 11:34

    IPAB: What it Means for Medicare Patients

    You may have been hearing a lot about the Independent Payment Advisory Board, or IPAB, in the media lately. Maybe you’ve been wanting to learn more about the Board and what it could mean for Medicare beneficiaries.  The IPAB was established by the 2010 Affordable Care Act, and it is charged with making recommendations to reduce the growth in Medicare spending, if Medicare exceeds a certain growth rate. The Board consists of 15 members nominated by the President and confirmed by the Senate.

    More needs to be done to ensure sustainable healthcare costs, but there are flaws with IPAB that patient advocates believe will ultimately limit seniors’ access to quality healthcare.  The way that IPAB is currently designed will give the Board the ability to dramatically cut payments to healthcare providers and physicians who provide services to Medicare beneficiaries. Great concern has been expressed that doing so may result in fewer providers being willing to accept Medicare patients, ultimately, limiting seniors’ access to quality providers.

    Advocates are concerned by the lack of oversight of IPAB. The Board has the power to change laws previously enacted by Congress. When IPAB puts forth proposals, the Secretary of the Department of Health and Human Services is required to implement the board’s recommendations unless Congress passes a law with the same cost savings. If Congress fails to adopt a substitute proposal, IPAB’s proposal must be implemented, meaning that IPAB’s proposal does not need Congressional approval to go into effect.

    Furthermore, the Secretary’s implementation of IPAB’s recommendations is exempt from judicial and administrative review. Patient advocates are also troubled that there is no patient representation on the Board and that IPAB is not required to hold public meetings where the voices of patients, caregivers and families can be heard. Important health care decisions that can dramatically impact patients will be made by an unelected Board without accountability to the public.  Efforts are underway to explore repeal options within the United States Congress.

    Source: http://www.womenagainstprostatecancer.org/2011/07/ipab-limiting-access-for-seniors/

  • September 2, 2011 – 11:02

    What Affects The Degree of Penile Deformity In Peyronie Disease?

    Peyronie disease (PD) is an acquired pathologic condition that results in inflammation and definitive fibrosis within the tunica albuginea, occurring in 4-7% of men.  While the exact pathogenesis is not completely understood, the current theories posit that the condition results from repetitive microtrauma with subsequent scar formation.  The aim of this study was to evaluate the relationship between the degree of penile curvature and clinical features of (PD) to determine predictive and causative factors.

    Over 18 years, 1001 men with PD were evaluated retrospectively with regard to penile deformity, erectile function, and risk factors for cardiovascular disease.

    The authors concluded that PD was predominantly determined in men during their fifth decade of life, proving that age is a positive correlating factor for development of ED.  The most common comorbidities were diabetes mellitus (26%), hyperlipidemia (24%), hypertension (18%), and ischemic heart disease (8.5%).  Systemic vascular risk factors were more commonly observed in patients with both PD and erectile dysfunction.  Lateral side of deformity was also found to be a positive correlate as well.  As a presenting symptom of PD, previous studies have reported ED in 4% to 80% of men.  The authors admit that this study lacked definitive demographic data including controls of smoking, testosterone levels, obesity and marital status.  Future research will investigate the relationship between these cofactors and PD severity.

    Kadioglu A, Sanli O, Akman T, et al.  Factors affecting the degree of penile deformity in Peyronie Disease: an analysis of 1001 patients.  J Androl 2011;32:502-508.

  • September 2, 2011 – 10:58

    First European Men´s Health Report: Europe’s black hole: Deaths among men of working age are double those of women

    The European Men’s Health Forum is today warning that unless a fundamental change is made in the whole approach taken to men’s health, the EU will suffer both socially and economically.

    The Forum were responding to The State of Men’s Health In Europe Report, which has been launched in the European Parliament in June 2011. The Report shows that every year twice as many men of working age (16-64) die as women with some 630,000 male and 300,000 female deaths across the EU27 countries in this age group. The Forum are calling for this group of men to be explicitly targeted.

    EMHF President Ian Banks explains: ‘We’ve seen great improvements in life expectancy because older people – if they make it to retirement age – are living longer. The great black hole is men of working age where we’ve seen very little improvement in the death rates in recent years. These men have been neglected for too long. We need a wide-ranging and fundamental change in policy. This is the group we need to be targetting.’

    The Report proves that lifestyle changes can make a real difference if only men can be enabled to make them.  But it also places a responsibility on policy-makers and politicians to consider the health implications of other policies such as on the economy, education, employment and housing.

    Men are dying prematurely but the rates at which they do this vary enormously from country to country and even within countries according to region or social group. This is evidenced by the massive differences in male life-expectancy: just 66 years in Latvia compared to 80 in Iceland, for example – a 21% longer life.

    The Report says that the data proves men’s health disadvantage is an issue of inequity and not biological inevitability.

    Dr Banks says, ‘The challenge for all of us working in healthcare is to find male-friendly policies that can change this in terms of information-giving, facilitating healthier choices, screening and access to services.  But it’s also about the bigger society, the wider socio-economic policies. Men can’t make healthy choices if the work they do – or don’t do – and the social and economic structures within which they live prevent them.’

    The EU-commissioned State of Men’s Health in Europe brings together the official epidemiological data from across Europe and across all major disease areas from cancer and heart disease to mental health. The Report’s lead author Professor Alan White of Leeds Metropolitan University in England said:   ‘For the first time we have a clear picture of men’s health across the EU.  Previously we had a series of partial pictures by country or disease area. This brings it all together so that policy-makers at all levels across Europe can see exactly what they’re dealing with and learn from each other.

    Let’s make no mistake, it can be done. To give one example, if every country had the accident rate of the Netherlands we’d save 100,000 lives a year.’

    The Report makes a strong business case for keeping men alive. ‘This is not just about health,’ said Dr Banks. ‘Premature male death undermines the economy, undermines families, undermines women and their health and undermines our social security and health services.’

    ‘Europe will have far fewer men of working age in the years to come so if we’re to succeed economically we need them to be in decent health.’

    Read more

  • August 8, 2011 – 11:50

    New Research around Adolescent and Teen Development

    During adolescence, boys and girls often experience their peak of physical health, strength, and mental capacity, and yet, for some, this can be a hazardous age.

    • Mortality rates jump between early and late adolescence.
    • Rates of death by injury between ages 15 to 19 are about six times that of the rate between ages 10 and 14.
    • Crime rates are highest among young males and rates of alcohol abuse are high relative to other ages.

    Even though most adolescents come through this transitional relatively well, it’s important to understand the risk factors for behavior that can have serious consequences. Genes, childhood experience, and the environment in which a young person reaches adolescence all shape behavior. Adding to this complex picture, research is revealing how all these factors act in the context of a brain that is changing, with its own impact on behavior.

    Powerful new technologies have enabled researchers to track the growth of the brain and to investigate the connections between brain function, development, and behavior.

    The research has turned up some surprises, among them the discovery of striking changes taking place during the teen years. These findings have altered long-held assumptions about the timing of brain maturation. In key ways, the brain doesn’t look like that of an adult until the early 20s.

    The more we learn, the better we may be able to understand the abilities and vulnerabilities of teens, and the significance of this stage for life-long mental health.  The fact that so much change is taking place beneath the surface may be something for parents to keep in mind during the ups and downs of adolescence.

    To learn more visit:  http://www.nimh.nih.gov/health/publications/the-teen-brain-still-under-construction/complete-index.shtml