Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

19 Iyar 5763 - May 21, 2003 | Mordecai Plaut, director Published Weekly









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Home and Family

Your Medical Questions Answered!
by Joseph B. Leibman, MD

Diplomate, Board Certification of Emergency Medicine

Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua Hospital

Let's finish up with the prostate. The prostate sits under the bladder and as we mentioned it can enlarge as a male ages. Cancer can develop and it is a debilitating one with death common. Detection is tricky, as the prostate is hidden in the body. Detection can be made by following a blood test for PSA in at-risk individuals and by rectal exam, by which the prostate can be partially felt. An ultrasound -- again done through the rectum -- is an excellent test. Men must come to terms with this uncomfortable exam to prevent a bad cancer. The prostate also gets infected, and this can lead to fever and pain. Treatment is with antibiotics, which is often less than perfect, as the blood supply to the prostate isn't great. Occasionally chronic prostatitis occurs, leading to vague chronic rectal pain. Treatments are not that effective.

This concludes our discussion of the urinary tract. Urologists also deal with male problems, but this is not the forum for this, other than one disease I will mention due to the need to act fast. Teenage boys are susceptible to torsion of the testes, that is the teste can rotate and cut off its own blood supply, There can be vomiting and acute abdominal pain. Here, one must urgently get a urologist involved to save the teste. Like teeth that have fallen out, heart attacks, stroke, and cancer -- waiting can often lead to missed opportunity for cure.

I have been asked to speak about vitamins and homeopathy. Alternative medicines are a huge business, but evidence is often lacking as to safety and effectiveness. Let me start by saying that conventional medicine has nothing against natural medicine -- but it has to be grounded in the same rigorous evaluation for its ability to help and not hurt. Also -- and this is an important point -- we in medicine already know enough to usually reject research which has sponsorship from companies who will profit from the results. In the attacks on epidurals for example, were a number of letters from those who presented very questionable evidence in order to promote their product -- whether it be a book they wrote, or a method they provide. One even copyrighted their letter. How committed can these people be to the independent circulation of true information?

Natural medicines in the USA and the UK do not have to undergo trials. One good source to gain knowledge on these medicines is the German E Commission and the Prescriber's Newsletter's Natural Medicine Database. Some natural medicines work well and have been adopted by the medical community (digoxin, aspirin) some work marginally (saw palmetto) some don't work at all (ginkgo for dementia) and some are dangerous (Kava and Chaparral can cause liver damage). Be careful, do not depend on well-meaning neighbors, and make sure your doctor knows you are taking these medicines. More next week. Write me in care of the Yated.

A message from Glaxo, sponsor of this column. Allergy season is here, and Glaxo's dermatology creams-- eumovate, betnovate and dermovate -- can alleviate itching that comes with contact dermatitis, poison ivy, mosquito bites, and eczema. No need to suffer -- these creams work!


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