Confusing Statin Reports.

The Daily Mail issued a warning to male patients taking statins who are undergoing regular PSA tests.

The Mail and other UK papers report that statins taken by millions of men could dampen a key indicator of prostate cancer, following a warning by UK doctors.

It appears that men using statins are having a reduction of some 46% in their PSA readings. This could lead to misleading scores from the test for prostate specific antigen (PSA), as higher levels indicate that the disease is more likely.

Are users of Proscar, a drug used to reduce Benign Prostatic Hyperplasia, BPH, (an enlarged prostate), warned about the effects of this drug which has been know for over a decade. It to reduces PSA readings by 50%.

Increasing PSA concentrations "may not be a harbinger of bad news and prostate cancer progression but, rather, may indicate that the body is attempting to fight cancer by producing its own anti-angiogenic proteins," writes Dr. Anne Fortier and her co-workers from EntreMed, Inc., U.SA.

Yet the researchers advise the study was too small and too short to tell whether statins might protect against prostate cancer.  In other words is a lower PSA indicative of a curing effect. 

Strange how different views can be drawn from the same findings isn’t it ? In the U.S. there is talk of a possible curing effect and in the UK it is worry that men will not be tested adequately.

There is an association between chronic inflammation and cancer although I have not read of any direct association between prostatitis, (prostate inflammation), for instance leading to prostate cancer.

I all leads me to the conclusion that a great deal more money needs to be spent on research to clear up the confusion. (PD).

Building on a Good Foundation

The Pelvic Floor.

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In the past we have received letters from men who, following a TURP operation, find themselves unable to control their urine flow.  I recall I wrote to one man and suggested he contacted his continence advisor, via his clinic, to get some pelvic floor exercises sorted out.  He later advised he had been told that pelvic floor exercises were for women only.  He did not say who had produced this advice, probably the receptionist.  Lord, we hope so and trust it was not a medic...... !!!

Male and female alike have Pelvic Floor Muscles  (PFM) and these have an important role to play in bladder and bowel control. 

The floor of the pelvis is made up of layers of muscle and tissue.  This area stretches like a hammock from the tail bone at the back across to the pubic bone at the front of the body.  The PFM not only stretch from front to back but they also form a virtual ring around the base of the colon and the urethra.  Basically by tightening this muscle ring urine is kept from escaping.  Weak or damaged PFM will allow urine to escape. 

The Urethral Sphincter Muscles (USM) exert a constant pressure on the urethra, keeping it closed, which requires no conscious effort at all.   They can also increase pressure without a person being aware of any change, a reflex action if any coughing or lifting is engaged in for instance.   It is possible to produce a positive action of these muscles, as when you contract the USM to stop passing urine mid-stream or when a toilet is not available and the action has to be delayed until you can find one..

When the bladder is emptying these USM relax allowing the urine to flow uninterrupted.  This, like the reflex action above, is an involuntary action.       

HOW CAN THE PFM BE WEAKENED ?

There are several reasons that can bring about a decline in the strength and effectiveness of these muscles.  As most of you know damage can be caused by prostate surgery.  Constipation can also weaken the PFM by the continual straining to empty the bowels, as can constant coughing, (caused by smoking or chronic bronchitis), persistent heavy lifting and  a general lack of fitness.  This includes, of course, being overweight.

HOW TO CONTRACT THE PFM

Initially it is essential for you to identify the PFM muscles so that you know what to exercise.

First, sit or lie comfortably with all the muscles of the thighs, buttocks and abdomen completely relaxed.

Secondly, tighten the ring of muscles around the back passage as if you are trying to control diarrhoea or wind.  Then relax it.  Practice this movement several times until you are sure you are exercising the correct muscle.  Try not to squeeze the buttocks. 

Third, when you are passing urine, try to stop the flow mid-stream,  then restart it.  Only do this to learn which muscles are the correct ones to use and do it only once a week to check your progress.

Fourth,  with one hand, lift your penis and testicles out of the way.  Press one finger of your other hand firmly upwards on the pelvic floor just in front of your back passage.  Use your pelvic floor muscles to tighten and pull up the muscles around the anus and the urethra.  You may feel the tightening of the muscle with your finger and even the muscle lifting away from your finger.  You will also feel your muscle relax when you let go.

REGULAR PELVIC FLOOR EXERCISES.

Now that you can feel the muscles working exercise by:-

1.  Tightening and drawing in strongly the muscles around the rectum and the urethra all at once.  Lift up inside.  Try and hold this contraction as you count to five and then release and relax.  You should have a definite feeling of ‘letting go’.

2.  Repeat, (squeeze and lift) and relax.  It is important to rest for about 10 seconds in between each contraction.  If you find it easy to hold for a count of five, try it for longer - up to ten seconds.

3..  Repeat this as many times as you are able to a maximum of 10.

4..  Next  try a similar amount of short, fast,  contractions, say another 10.

You do not need to hold your breath, or tighten your tummy, buttocks or thighs.   Neither should you push down instead of squeezing and lifting up..

Once you have become accustomed  to these basic movements you will find that you can do them during your normal daily activities.  Whilst sitting, standing, or lying.  You might find it useful to settle on four or five regular times during the day.

Once you begin, continue them.  It is no good stopping after a week thinking that you have done the work.  These exercises only take a short time and do not impinge on a normal working or leisure day.  So be positive and decide to continue once you have begun.

Finally, remember, share the lifting of heavy loads.  Avoid constipation and ensure you do not strain.  Go for medical advice if you suffer from hay-fever, asthma or bronchitis to ensure you reduce your sneezing and coughing to a minimum.

Keep your weight down to that suitable for your height and age.

Before you begin any exercises it would be wise to check with your GP on any drugs that you are taking, for some of them, or their side-effects may be causing your problems.