T.J. Samson | Destination Health | August 2018

4 DESTINATION HEALTH Keeping an eye on prostate cancer What to know about act ive survei l lance Every year more than 160,000 men in the U.S. are diagnosed with pros- tate cancer. For those whose disease is caught early, that diagnosis may come with a decision: Should the disease be treated right now, or is it safe to monitor it and treat it only if it starts to grow? The latter approach is called active surveillance. It’s based on the fact that prostate cancer often grows slowly. So immediate treatment may not always be necessary. WHAT’S INVOLVED? Men who choose active surveillance typically see their doctor about every six to 12 months for digital rectal exams, prostate-specific antigen (PSA) tests and prostate biopsies.These tests are used to monitor the cancer, and treatment—such as radiation or surgery—begins only if the cancer changes or starts to grow. One potential benefit of active surveillance is that it can help a man avoid or delay potential side effects of treatment, including sexual difficul- ties and incontinence. One risk is that the cancer could grow in between tests. Also, the pros- tate biopsies that are part of this approach can be uncomfortable. WHO MIGHT BE A CANDIDATE? According to experts, men who choose active surveillance usually have a good prognosis. But it isn’t for everyone. It is more likely a possibility for men with small, slow-growing tumors. Many of these men are also older. A pathology report can help determine if a man is a candidate for active surveillance based on specific details about his prostate tumor. Doctors also look at other factors, including the cancer’s stage and the man’s personal and family health history. Of course, preference is also part of the choice—some men, for instance, may not feel comfortable delaying treatment. The bottom line: Men who think they may want to try active surveil- lance for prostate cancer should discuss the pros and cons of the plan with their doctor. Sources: American Society for Clinical Oncology; American Urological Association What is a bone density test? Osteoporosis, a disease of dangerously fragile bones, can sneak up on you. That’s because it doesn’t cause any symptoms. People usually don’t know they have it until a bone breaks unexpectedly, often from a minor fall. A bone mineral density (BMD) test mea- sures how strong your bones are. It’s the only test that can tell you if you have osteo- porosis or not. It can also: ■  ■ Predict your risk of fractures. ■  ■ Let you know if you have osteoporosis after a fracture. ■  ■ See if osteoporosis treatment is making your bones stronger. Should you get tested? Women are much more likely to develop os- teoporosis than men, and it’s more common later in life. As a result, a BMD test is advised for all women age 65 and older. Your doctor may also recommend it if you are at high risk for osteoporosis—whether you’re a man or a woman. A BMD test can be done several ways. The most accurate method is called dual-energy x-ray absorptiometry (or DXA for short). This test is painless and similar to having an x-ray. What do the results mean? The results of a BMD test are reported as T-scores, which compare the strength of your bones to those of a healthy 30-year-old. A low T-score means you have thinner, weaker bones than a healthy young adult. The more negative the number, the greater your risk of a broken bone. A T-score: ■  ■ Between +1 and -1 means your bones are normal and healthy. ■  ■ Between -1.1 and -2.4 means your bone density is lower than normal, but it’s not yet low enough to be diagnosed as osteoporosis. ■  ■ -2.5 or less means you have osteoporosis. Even if a BMD test shows you have osteopo- rosis, you and your doctor can work together to manage it and help prevent fractures. Sources: National Institutes of Health; National Osteoporosis Foundation; UpToDate Breathe better, sleep better Not all of us are getting the sleep we need—even when we’re sleeping. Millions of Americans have sleep apnea, a problem in which breathing becomes shallow or even stops during sleep.These breaks in breathing can last from a few seconds to minutes and may happen 30 or more times each hour. With these pauses in breathing, blood oxygen levels may drop briefly.These episodes may also keep you from enjoying a deep, restful sleep. Aside from leaving you feeling fatigued, untreated sleep ap- nea can cause serious health problems, such as high blood pres- sure and an increased risk of heart attack, stroke and diabetes. According to the National Institutes of Health, the most common signs of sleep apnea are choking or gasping during sleep and feeling very sleepy during the day. You might also have sleep apnea if you experience: ●  ● Loud snoring. ● Morning headaches. ● Trouble with mem- ory or learning. ● Feelings of irritability. ● Mood swings, per- sonality changes or depression. ● An inability to concentrate. ● A dry mouth or sore throat when you wake up. If you—or a loved one—suspect you have sleep apnea, talk to your doctor or call the Sleep Disorders Center at T.J. Samson Community Hospital at 270-651-1888 . Effective treatments are available.