Prevent Prostate Cancer: Masturbate

The scene above is from Seinfeld. The episode is called "The Contest." The phrases "master of my domain" and "king of the castle" are in this episode. Check it out above to see the beginning of the episode. What does this have to do with preventing prostate cancer? Well, I'll let the story below explain itself:

Men who frequently masturbate appear to have a lower risk of developing prostate cancer, Australian researchers reported. Researchers from the Cancer Council of Victoria found that men who masturbated more than five times each week were one-third less likely to develop the cancer.

Researchers told the BBC last week that the prostate produces one of the fluids involved in ejaculation and that frequent masturbation appears to flush out carcinogens. Sexual intercourse may not have the same effect because it increases the risk of contracting a sexually transmitted disease, which could raise the risk of cancer.

Uh, yeah. Can you see me giving this advice to my patients? However, I can see some people bringing me this story this very afternoon and asking me about it. Usually for research studies, I say that I need to see more studies done. But, in this case, I think I'll pass on that. What do you think?

Update: This afternoon, US News & World Report is now questioning this entire study and story - even questioning the FoxNews.com quote from above. It really doesn't matter to me. It's kind of a funny story. But, I guess it shows that even the masturbation deniers are out there! hehe

Kevin MD & USA Today

Kevin Pho, from the Kevin MD blog (and former guest on The Doctor Anonymous Show), is one of the most recognized medical bloggers out there. This morning, Kevin has an op-ed published over on the USA Today website about defensive medicine entitled "Wasted Medical Dollars." Here's an excerpt:

A recent analysis by PricewaterhouseCoopers concluded that more than half of the dollars in our $2.2 trillion health care system are wasted.

Medical errors, inefficient use of information technology, and poorly managed chronic diseases were all cited as factors. Dwarfing these reasons is a phenomenon in which doctors order tests to avoid the threat of a malpractice lawsuit. This is known as 'defensive medicine.'

At $210 billion annually, defensive medicine is one of the largest contributors to wasteful spending, and it can manifest in many forms: unnecessary CT scans, MRIs, cardiac testing and hospital admissions. A 2005 survey in the Journal of the American Medical Association found that 93% of doctors reported practicing defensive medicine.

Kudos to Kevin for not only bringing more light on this subject, but also bringing more light onto the medical blogosphere through his writing and opinions. Spread the word about his op-ed today. Blog about it. This topic is very important, and Kevin has done so much for our blogging community. Keep it up, Kevin MD!

Reality Check: Surgeon Shortage Looms

There have been many in the medical blogosphere who have (correctly) predicted the soon-to-be disaster of a shortage of primary care physicians. I, of course, agree with my primary care and family physician brethren on this point.

Well, now, there is new data from the University of Washington stating that General Surgery as a specialty is soon going to be in a world of hurt because - frankly, there are no medical students going into it. Obviously, this is part of the super-specialty revolution where generalists - whether they be general medicine physicians or general surgery physicians - are going to be more rare.

I find it ironically funny (in some strange way) that the quote below used to describe the shortage for general surgeons is vaguely familiar and kind of deja vu like when I remember why medical students are not choosing primary care:

Young doctors put a higher value on their personal lives, making fields that require frequent and unpredictable hospital duties less attractive, said Dr. Dana Lynge, a general surgeon and lead author of the study from the UW. In addition, he said, many students leave medical training with a "mountain of debt" in school loans. By necessity, they are looking for careers that will help them get out of the hole. The combination of less-demanding fields and more lucrative payoffs draws students away from general surgery.

We're definitely feeling this in our small little community in Northeastern Ohio. When there is a demand like this, students who actually choose general surgery can go wherever they want. Why would they want to come to NE Ohio? So, recruiting new docs (in all specialties) has been difficult and will be difficult.

So, to the leaders of the general surgery specialty, all I can say is "I feel your pain" and "Welcome to my world." If you figure out a way to somehow increase the supply of general surgeons, let me know, because I'll "steal" your techniques to try to increase the primary care physician workforce. Because without primary care PHYSICIANS (not just primary care "providers"), general surgeons (and other specialties) will have no referral base. How 'bout them apples!

Grand Rounds

Grand Rounds 4.31 is now up and running over at Dr. Val and the Voice of Reason. She has grouped the post by feeling, which I don't think has ever been done before. And, she added a little cute tagging system to point out the especially good posts of the week.

I admit that I have been a slug and not writing as much and contributing to Grand Rounds. I feel badly about that. But, I'm feeling a little resurgence, so maybe the posts will start flying again. Thanks to Dr. Val for including my post this week:

Dr. A from Doctor Anonymous wonders if peace and contentment come from accepting one's lot in life. His post is called, "With Age Comes Happiness?"

If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science? Next week, Grand Rounds moves to the site called Doc Gurley.

Pee brings the world together

Now, you're going to think that I'm totally making this story up and that it's untrue. Well, it's from MSNBC, so you can make your own conclusions there. Anyway, here's the first sentence from the story, "Pee from more than 4,000 volunteers shows that people from different nations often have spectacularly different metabolisms."

And, off we go! Ok, so, I'm trying to visualize the newspaper ad that had to go out on this one: "Seeking pee from people worldwide for research study." And, they got 4,000 people to participate? Fascinating. What did they find? Well, different people from different nations had different metabolites in their urine (no kidding).

"For instance, Chinese and Japanese people are almost identical genetically, which isn't surprising, since they diverged culturally only a few thousand years ago — but they are very different metabolically," said researcher Jeremy Nicholson, a biological chemist at Imperial College London.

"We know there's a huge difference in the diseases that different nations risk — broadly speaking, the Japanese tend to die of strokes, the Chinese of heart attacks — and we see those differences reflected in their urine," he added. "Of course they're different in terms of lifestyle — the Japanese tend to eat more fish than the Chinese as a whole do — but their gut bacteria are also very distinct as well."

Now, why is this important? According to the article, the substances found may help shed light on things like diabetes, vascular diseases, obesity, and even cancer. Sure, that's great. But, I'd hate to be the poor freshman college student asked to do all the grassroots work on this paper. Is getting a published research paper worth it to work with all this urine? I guess so. Wonder what the follow-up research will hold?

Surgical "Cure" for Diabetes

So, one of my patients today asked me about a surgical cure for diabetes. The only things I ever heard about were experimental procedures with the islet cells of the pancreas or something along those lines. But, then, the patient said something about gastric bypass surgery. I was mildly intrigued.

This person said that they they saw a report on 60 minutes. "Oh great," I thought to myself. So, I checked out the website over there and there is not one but about four videos over there talking about this. You're going to love this. The titles of the reports are the following: The ABCs of gastric bypass surgery; Diabetes cure?; Immediate relief; and Here's the hitch.

So, if for anything else, to get me up to speed with what my patients are watching, these reports claim a "cure" for diabetes - meaning to them that their patients leave the hospital following their surgery without any diabetes meds. And, one of the final reports says that it's a shame that more people (meaning non-obese people) do not qualify for this surgery. No wonder a lot of people asked me about this surgery today at the office.

Now, I know that I may get beat up by some people out there, but this situation is so much a reflection of our society today. People are looking for the quick fix and then everything will be better. "All I need is this surgery and then I can start living my life again," people think to themselves.

It's so interesting how people think. I can't give away flu shots or pneumonia vaccines because "they cause the flu" or "I get a rash from it." For gastric bypass surgery, just reading from the webmd website, has risks for blood clots and infection. And, something called "dumping syndrome" which goes something like this.

Another risk of gastric bypass is dumping syndrome, in which food is "dumped" from the stomach into the intestines too quickly, before it's been properly digested. About 85% of people who get a gastric bypass have some dumping. Symptoms include nausea, bloating, pain, sweating, weakness, and diarrhea. Dumping is often triggered by sugary or high-carbohydrate foods, and adjusting the diet helps. However, some experts actually see dumping syndrome as beneficial, in that it encourages people to avoid foods that could lead to weight gain.

But, the same people who won't take this pill or that pill because of the 10 page side effect list they received at the pharmacy - these same people - would like to be considered for gastric bypass surgery. Can someone explain this to me? I'm confused....

Blog Fatigue and Podfading

The Clinical Cases and Images blog picked up on my recent post named "The Pressure of Posting." They raise the question of whether blogging in general has kind of become passe and yesterday's news. With so many different ways to express yourself like Twitter (guilty of being on too much), Facebook, and other social networking sites, has the blog become kind of ancient?

In the world of podcasting (of which I would call myself a very minor player), there is a term called "Podfading." It is a situation in which a podcast either becomes more and more infrequent or just stops abruptly - thereby leaving the audience not quite knowing what to do. A definitely parallel can be made with blogs, video blogging, or any other new media product.

In applying all of this to me (since this is my blog, you know), I guess a hobby or a project like this - something that you think about almost every day - has a cycle of increased interest and decreased interest. In what I call "the old media world" (meaning everything not considered new media), either your career is considered rocketing to the top or fading back to the oblivion where you came from. The main stream media loves to build people up, tear them down, hype up the comeback, and tear them down again. One day you're the best thing since sliced bread and tomorrow you're a has-been hanging on to the past.

For me, I sometimes have to ask myself, what is the core of all of this? I don't blog to make money. I do not seek sponsorship for any of the new media stuff that I do. Some people do, and I don't begrudge them for that. I write, or record audio, or shoot video, just for the joy of doing it. And, I guess, there are times when I'm not as interested and other times when I am very interested. But, just like life, I have to take the good with the bad.

At least for this second, I don't see myself going anywhere. I guess I just have to keep challenging myself in this world of new media. And, I encourage all of you out there to do the same. If you have a blog, consider recording some audio and make a podcast. For those of you with that, consider shooting some video and express yourself that way. Don't know what Twitter or Facebook are? Check them out - you may actually like it.

Hmmm. Maybe I will talk about some of this stuff on the show this week. Doesn't hurt to be introspective every once in a while...

Misuse of 911 emergency

For the state of affairs around these parts, this story from our local newspaper is shocking, and yet, sad at the same time. I'll let this story speak for itself...

Warren – A man who police say kept them busy searching for his missing 2-year-old son has been charged with misuse of 911. Police reported that [the man] called 911 Saturday afternoon to report his son missing. 

Six police officers searched the area for an hour, but couldn’t find the boy. When his wife returned home with her son, [the man] reportedly told police he knew his son was with her. According to the report, [the man] was under the influence of drugs and alcohol.

The pressure of posting

This post is going to ramble. So, consider yourself warned. It doesn't take a genius to figure out that I have not been writing that much on this blog. And, I just wanted to get some thoughts out there so that they don't keep smoldering inside me.

Every time I sit down to try to write something, I feel nothing there - at least lately. The evolution of this blog is such that I started talking about patients a little bit. Then, move onward to talking about current events and topical things. And, now, I'm experimenting a little bit with a live internet radio show format and video blogging.

Especially in this latest chapter of my blogging life, I've always wanted to continue with writing on this text blog. I just don't know what I do to myself. I know I have written about this feeling here before. Of course, I want to write what I think is quality stuff. But, when I've sat down in the past 3-4 months, when I start typing, I have the thought of "If this is not the best thing you have ever written, then stop writing."

Now, it doesn't help that life has (definitely) been getting in the way of blogging over the past few months. But, when you think about it, everyone has a life outside of blogging (don't they). So, pretty much everybody has to find that balance between blog life and real life.

Since I have no scheduled guest this week on the show, this is something that I can talk about. It probably sounds too simple, but maybe the solution to writers block is - just writing. I think back to when I started this blog. I didn't care who was reading this. But, as people start to read and subscribe to this blog, something happens to the blog writer. I just have to continually remind myself that I blog for the joy of blogging and not for anything else....

With age comes happiness

Every day, older people come to see me in my office saying, "Doc, I don't know why they call this 'The Golden Years' because there is nothing golden about them." And, then, they go into their medical concerns that, hopefully, I can help them out with. But, I do have good news for older Americans because there is new research being released stating that the happiest Americans are the oldest (Associated Press).

A certain amount of distress in old age is inevitable, including aches and pains and the deaths of loved ones and friends. But older people generally have learned to be more content with what they have than younger adults, [researcher] Yang said.

This is partly because older people have learned to lower their expectations and accept their achievements, said Duke University aging expert Linda George. An older person may realize "it's fine that I was a schoolteacher and not a Nobel prize winner."

The rest of this article goes into examples of people and their point of view at the older part of life. The balance between being hard-charging to succeed and being content is something that I struggle with everyday. That stress level really bothers me sometimes. Maybe the lesson from this study is that sometimes (only sometimes) that it's ok to lower expectations and accept achievements. My life would be a a little more content and less stressful.