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Dr. Donohue: Prostate cancer comes in many varieties

Syndicated Columnist
Published Monday, April 14, 2003

DEAR DR. DONOHUE: I have prostate cancer. I am being treated with hormone shots. What do you think of this treatment? Does it have advantages over other treatments? I also want to know if the semen secreted during intercourse is harmful to my wife. -- J.

ANSWER: Prostate cancer has many faces, and each variety behaves and is treated differently. Some prostate cancers are petty criminals, not causing much trouble for years and years. Others are felons that create great damage in short order. The cancer's appearance when viewed with a microscope indicates which kind of prostate cancer a man has and how it is best treated. Some very slowly growing cancers in elderly men can often be left alone.

Cancer confined to the gland is often eradicated by surgical removal of the entire gland. Radiation of a cancerous gland by a machine that directs a beam of irradiation into the gland is another option. Inserting rice-sized, radioactive pellets into the gland is a third way of treating prostate cancer.

Which treatment is best depends on a man's age, the kind of prostate cancer he has and any spread of the cancer out of the gland.

Male hormones foster growth of prostate cancer. Your hormone shots block male hormones' influence on cancer growth and spread. Often this treatment is advised when prostate cancer has spread to sites outside the gland.

Removing the testicles, the primary production site for male hormones, is another approach to containing a cancer that has spread from the gland.

You have no worry about transmitting prostate cancer to your wife through sexual relations.

The pamphlet on enlarged prostates, cancerous prostates and erectile dysfunction can give people a better understanding of this small but often troublesome gland. Readers can order a copy by writing: Dr. Donohue -- No. 1001, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: The article you wrote about kidney stones implies that people should not eat oxalate-containing foods. Yet every day I hear doctors on the radio telling us to eat them for other reasons. They say we should drink tea, for instance, because it has lots of good antioxidants. Are all these doctors wrong? Is there a blood test to measure oxalate levels? -- G.B.

ANSWER: Most kidney stones are calcium oxalate stones. Previously, people who had repeated episodes of such stones were put on a low-calcium diet. Today they are put on a low-oxalate diet. A low-calcium diet, paradoxically, favors stone formation, but a low-oxalate diet prevents stones.

Oxalate foods include chocolate, tea, spinach, squash, cucumbers, blueberries, grapes, strawberries and raspberries. The ban applies only to those who have had repeated attacks of kidney stones. As long as you have no kidney stones, you and most other people can enjoy those foods with abandon.

There is no blood oxalate test, and there is no need for one.

DEAR DR. DONOHUE: I wrote you about my 9-year-old grandson's ear and have not seen a reply. His ear gets really hot and burns. It's not all the time, but it happens a lot. We have taken him to several doctors, but none knows what he has. Please provide some information on this condition. -- L.E.

ANSWER: I didn't answer your letter because I didn't (and don't) have a good answer for you. Nor does the cadre of long-suffering experts whose patience with my pestering grows thin.

A far-out guess is relapsing polychondritis. It is rare and consists of repeated inflammation attacks on cartilage that produce symptoms similar to your grandson's. Ears are the most common target, but the nose, joints and breathing tubes can also be involved. The malady peaks between the ages of 40 and 50 but has been reported in children.

A biopsy of the inflamed ear cartilage establishes the diagnosis. The earlobes are not involved because they do not contain cartilage.

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