Many men with low-risk prostate cancer get aggressive treatment, increasing the risk of serious side effects.

More than 40 percent of men who fell below the current standard for getting a biopsy had their prostates removed surgically, and a third had radiation therapy.

They argue that current efforts to lower the threshold of what is considered an abnormal prostate cancer screening test would add significantly to the number of men who are overtreated for cancers that might never harm them.

"The tremendous improvement in survival has been attributed to early detection and treatment," Yu-Hsuan Shao of the Cancer Institute of New Jersey in New Brunswick and colleagues wrote in the Archives of Internal Medicine.

"However, there have been concerns about the potential overdiagnosis and overtreatment of localized prostate cancer."

A U.S. study published last year found that routine prostate screening has resulted in more than 1 million American men being diagnosed with tumors who might otherwise have suffered no ill effects from them.

Prostate cancer screening is most often done with a blood test that measures blood concentrations of prostate-specific antigen or PSA, a protein made in the prostate that becomes elevated men with prostate cancer.

Generally, a PSA reading of 4 nanograms of PSA per milliter of blood is considered normal. But in one large study, prostate cancer was diagnosed in 15.2 percent of men with a PSA level at or below 4 nanograms per milliter, or about 2.4 percent overall.

Shao and colleagues studied treatment practices among 124,000 men in this low-risk group who were newly diagnosed with prostate cancer between 2004 and 2006.

In men with PSA values of 4 nanograms per milliliter of blood or lower -- the current threshold for getting a biopsy -- 44 percent had their prostates removed, and 33 percent of men had radiation treatment.

"Despite their lower risk of having clinically significant disease, treatment rates for men with PSA values of 4.0 nanograms per milliliter or lower were comparable to those of men presenting with PSA values between 4.0 and 20.0 nanograms per milliliter," Shao and colleagues wrote.

They estimate that lowering the treatment threshold from 4.0 to 2.5 nanograms per milliliter would double the number of men considered to have abnormal PSA levels to 6 million.

And they estimate that 82.5 percent, or 1.9 million of these men would get an aggressive treatment, even though only 2.4 percent would have high-grade cancer.

"These results underscore the fact that PSA level, the current biomarker, is not a sufficient basis for treatment decisions," Shao and colleagues wrote.

They said without technology that allows doctors to distinguish aggressive from mild cancers, lowering the biopsy threshold "might increase the risk of overdiagnosis and overtreatment."

Prostate cancer is the second most common cancer in men after lung cancer, killing around 254,000 men a year around the world. Overdiagnosis can lead to treatments such as surgery, radiation or hormone therapy that can cause serious side effects such as impotence and incontinence.

                                                                                                                                                                     2010-08-09

An updated edition of a mental health bible for doctors may include diagnoses for "disorders" such as toddler tantrums and binge eating, experts say, and could mean that soon no-one will be classed as normal.

Leading mental health experts gave a briefing on Tuesday to warn that a new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is being revised now for publication in 2013, could devalue the seriousness of mental illness and label almost everyone as having some kind of disorder.

Citing examples of new additions like "mild anxiety depression," "psychosis risk syndrome," and "temper dysregulation disorder," they said many people previously seen as perfectly healthy could in future be told they are ill.

"It's leaking into normality. It is shrinking the pool of what is normal to a puddle," said Til Wykes of the Institute of Psychiatry at Kings College London.

The DSM is published by the American Psychiatric Association (APA) and contains descriptions, symptoms, and other criteria for diagnosing mental disorders. It is seen as the global diagnostic bible for the field of mental health medicine.

The criteria are designed to provide clear definitions for professionals who treat patients with mental disorders, and for researchers and pharmaceutical drug companies seeking to develop new ways of treating them.

Wykes and colleagues Felicity Callard, also of Kings' Institute of Psychiatry, and Nick Craddock of Cardiff University's department of psychological medicine and neurology, said many in the psychiatric community are worried that the further the guidelines are expanded, the more likely it will become that nobody will be classed as normal any more.

"Technically, with the classification of so many new disorders, we will all have disorders," they said in a joint statement. "This may lead to the belief that many more of us 'need' drugs to treat our 'conditions' -- (and) many of these drugs will have unpleasant or dangerous side effects."

The scientists said "psychosis risk syndrome" diagnosis was particularly worrying, since it could falsely label young people who may only have a small risk of developing an illness.

"It's a bit like telling 10 people with a common cold that they are "at risk for pneumonia syndrome" when only one is likely to get the disorder," Wykes told the briefing.

The American Psychiatric Association did not immediately respond to a request for comment.

The scientists gave examples from the previous revision to the DSM, which was called DSM 4 and included broader diagnoses and categories for attention deficit hyperactivity disorder (ADHD), autism and childhood bipolar disorders.

This, they said, had "contributed to three false epidemics" of these conditions, particularly in the United States.

"During the last decade, how many doctors were harangued by worried parents into giving drugs like Ritalin to children who didn't really need it?," their statement asked.

Millions of people across the world, many of them children, take ADHD drugs including Novartis' Ritalin, which is known generically as methylphenidate, and similar drugs such as Shire Plc's Adderall and Vyvanse. In the United States alone, sales of these drugs was about $4.8 billion in 2008.

Wykes and Callard published a comment in The Journal of Mental Health expressing their concern about the upcoming DSM revision and highlighting another 10 or more papers in the same journal from other scientists who were also worried. DSM 5 is due to be published in May 2013.

                                                                                                                                                              2010-08-07

According to a survey of users indicated in a variety of contraceptive methods, coitus interruptus in second place! See a lot of people are using this way of contraception. However, ejaculation on men and women are much harm!

1. Easily lead to men's sexual neurasthenia

Men in the sexual life of the whole process, the reaction is done under the control of the cerebral cortex. Sexual intercourse in the psychological and physical stimulation will cause a series of changes, and a high level of excitement will make the mental stress, heart rate, blood pressure and so on.Meanwhile, the reproductive organs showed vascular congestion and muscle contraction penis moving onwards. If this is interrupted sexual intercourse, a great sense of divertissement not entirely bound to have adverse psychological effects of the passage of time, prone to sexual neurasthenia, causing premature ejaculation, impotence and so on.

2. Is not apt to cause functional ejaculation

In the men during sexual intercourse, as sexual excitement was at its height, accompanied by the penis before ejaculation, erection, hard, so when the forced suspension of intercourse, the penis out, will the Department of the nervous system and spinal ejaculation center features dice that barriers, long time, they susceptible to functional non ejaculation.

3. Could easily lead to marital discord

Normal amount of a harmonious sexual life but can enhance the feelings between husband and wife, but the ejaculation of this unscientific method of contraception often caused by the gap between husband and wife. Once the woman be pregnant, the man often do not think that a small part of his semen (ejaculation small part of the pre-spill) into the vagina caused by contraceptive failure, but mistaken for a woman having an affair and infidelity, the ensuing quarrel, resulting in the family misfortune. The forced interruption of intercourse, the woman not completely satisfied, psychological suppression of sexual aversion, the same feelings to cast a shadow over the couple.

4.Tends to produce frigid woman

During sexual intercourse, when the male orgasm, the woman at this time often did not get sexual gratification, forcibly terminated if the man at this time sexual intercourse, ejaculation in vitro, the long run, will lead to women's frigid. From this, ejaculation taking insufficient, and if contraception or contraceptive methods with scientific good.

                                                                                                                                                                 2010-08-07