Your Health & Happiness: Prostate Cancer – Have you any options?
Dr. Iain Corness
Last week we published one medical viewpoint on the
desirability of treating early stage cancer. The writer was of the opinion that
treatment is always necessary, however, this is not necessarily agreed to by
all medical schools of thought. Since the treatment for prostatic cancer can
alter one’s lifestyle dramatically, Quality of Life has to be considered, as
does the age of the patient. Here is an alternate view.
This week, three of my friends contacted me to say they had
just been diagnosed as having prostate cancer. They range in age between 50 and
70. One has had already had the operation to remove the prostate gland
completely, the second is waiting till November to have his prostate removed,
while the third has gone to Europe, hoping for a magic cure. Unfortunately, he
will find there isn’t one.
Prostate cancer is also extremely common, something we men
have to live with. After all, our women are always telling us how lucky we are
to be men and not have to go through childbirth for example, so it’s probably
only right and equitable that there is a male downside. In fact this year in
the United States, almost 180,000 men will be told that they have prostate
cancer. That’s 180,000 downsides.
With all our older friends getting prostate problems, does
this mean there is a rise in the incidence? Has the urbanized world or
greenhouse gasses struck as all a death blow? Or is it just underpants that are
too tight? Simple answer – No! One reason for the ‘apparent’ increase in
prostate cancer is the fact that prostate cancer is a disease of aging, and
thankfully, we are all living longer. The statistics would show that by age 50,
almost 50 percent of American men will have microscopic signs of prostate
cancer. By age 75, almost 75 percent of men will have some cancerous changes in
their prostate glands. Do the maths. By 100 we’ve all got it!
So does this mean that life really ends at around 76?
Fortunately no. Most of these cancers stay within the prostate, producing no
signs or symptoms, or are so slow-growing, that they never become a serious
threat to health.
The good news is that in other words you die of something
else before the prostate gets you! You die with it, rather than from it. It may
be a sobering thought to all you spritely chaps who are still 10 foot tall and
bullet-proof, that despite all medical research and advances, the death rate
will always be the same – one per person. We all have to die of something –
even me, and I just hope it isn’t from boredom! That would be a real killer.
While the numbers quoted above look fearsome, the real
situation is not quite so bad. A much smaller number of men will actually be
treated for prostate cancer. About 16 percent of American men will be diagnosed
with prostate cancer during their lives; 8 percent will develop significant
symptoms; but only 3 percent will die of the disease. Put another much more
positive way, 97 percent won’t die from prostate cancer. This means I must be
OK, as my three friends hopefully make up the three percent of my
While prostate cancer can be ‘aggressive’, breaking out
from the prostate gland itself and attacking other tissues, including brain and
bone, fortunately this is the minority scenario. The great majority of prostate
cancers are slow growing, and it can be decades between the early diagnosis and
the cancer growing large enough to produce symptoms.
So let’s look at diagnosis and get the “blood test”
out of the way first. The blood test is called Prostate Specific Antigen, or
PSA for short (we medico’s love acronyms). Up till then we had another
acronymical test called DRE (digital rectal examination), which, quite frankly,
was not all that popular. As medical students, we were taught “If you don’t
put your finger in it, you’ll put your foot in it!” Despite this, ‘buyer
resistance’ was high, so when news came through about a “blood test”,
millions of men began rejoicing and the sale of rubber gloves plummeted.
Unfortunately, PSA is not a go-no go test. A normal range test doesn’t
guarantee you haven’t got it, and an elevated result doesn’t automatically
mean that you are about to claim early on your life insurance (or your
However, there is good news. We are becoming smarter with
the PSA test. Elevated PSA levels in the blood correlate roughly with the
volume of cancer in the prostate, with the stage and grade of the tumor, and
with the presence or absence of cancer metastases or growths in other tissues.
Serial PSA examinations can also show the rate of this growth, another good
reason for regular check-ups.
Like many other cancers, prostate cancer can only be fully
diagnosed by examining prostate tissue samples under the microscope. When your
doctor suspects prostate cancer on the basis of your symptoms, or the results
of a clever finger rectal examination (DRE), and/or a PSA test – the
definitive diagnosis will need a biopsy.
So let’s imagine that now you have had a positive biopsy.
You’ve got it! What are the real options? Actually very many and depend
mainly upon the ‘stage’ of the cancer and your age at the time of
‘Staging’ has four main grades. Stage I cannot be felt
and is diagnosed through pathological testing. Stage II can be felt, but it is
confined to the prostate. Stage III is coming out of the gland and Stage IV has
grown into nearby tissues.
Treatment can be ‘watch and wait’, surgery, radiation,
hormone therapy, eating herbs or muttering mantras. Often it will be a
combination of some of the above (but I’d forget the mantras, if I were you).
This is where you need to discuss your options with your
doctor. If you are a young man with stage IV, then you have to make up your
mind quickly. But if you are 75 with stage I or II, then you have more time, as
you will most likely die of other causes before the prostate cancer gets you.
Watch and wait has much going for it, but you must be prepared to get to
know your urologist on first name terms. You will be seeing a lot of him over
the years, so pick a young one!
The Doctor's Consultation: Exercise for Health. Does that include sexercise?
by Dr. Iain Corness
Probably the commonest advice a doctor gives is to lose
weight and some exercise. Does that ring a bell in your memory? Was that part
of the advice after your annual physical check-up?
Unfortunately, there seems to be very little real
understanding of what exercise should consist of, how often, what type, how
long and what about sex? For example, I was reading an article on exercise the
other day and it said authoritatively that one should wear comfortable
clothing and socks with the correct size of non-slippery, shock-absorbing
shoes. If this includes sexercise, there are some strange shoe fetishes out
there that I haven’t heard of yet!
However, getting a little serious, exercise will be good
for you, provided that you pick a form of exercise that is not harmful for
you! Now I know that looks as if I have put my money on both horses in the
race, but take that sentence at its face value. Enough research has been done
to show that regular exercise is beneficial for everybody, in both the
physical and psychological aspects, but, and it is a big ‘but’, all forms
of exercise have relative bodily risks, and this has to be taken into account
before you buy a pair of expensive jogging shoes and tackle a 10 km trot in
the middle of the day. True stories – a medical colleague in Australia took
up playing squash when he turned 50 and dropped dead on the court of a heart
attack, and another acquaintance of mine turned 40, decided he wasn’t fit,
bought a bicycle to ride to work each day and was run over by a bus.
The same article that advised non-slippery shoes, did have
some wise words however. These included to choose appropriate exercise
according to your ability. Never exceed your limit. Remember that it is not
the harder the better. If you have acute medical problems (such as fever, or
pain), stop exercising. If you have chronic medical conditions (such as
hypertension, diabetes, ischemic heart disease and arthritis), seek advice
from your doctor or physiotherapist beforehand. All of these I agree with. If
you are happy to take your body to your medical advisor when it is sick, take
it back to your doctor for advice on how to tone it up as well.
The other words of wisdom suggested that for prolonged
exercise such as hiking, continually drink water to supplement the loss of
body fluid due to sweating. Do not wait until you are thirsty. Take
appropriate breaks during exercise. Do not over-exert yourself. Forget about
“powering through the pain barrier”. Leave that for Olympic cyclists.
As well as the form of exercise, there is the frequency. At
least three times per week, 20-30 minutes (or more) is necessary each time, to
derive the maximum benefit. And always remember, if there is dizziness,
fainting, shortness of breath, chest pain, vomiting, nausea or severe pain
during exercise, stop exercising immediately and seek medical advice as soon
Now I did mention at the start of this week’s article,
the word “sexercise”, and some of you have been impatiently reading, while
nervously fiddling with your expensive packet of Viagras, Kanagras, Cialis and
other lead-in-your-pencil medications (I draw the line at tiger willy). OK,
what about sex? The advisability of this form of exercise when you have some
chronic complaint (such as hypertension, diabetes, ischemic heart disease
etc), should be part of the advice you get from your doctor beforehand. The
danger of over the counter willy stiffeners is that you don’t get advice
Finally, the learned article did say “Exercise with
friends. Company provides enjoyment, mutual encouragement and support.” That
goes for sexercise too!
I enjoy your Heart to Heart column every week, but am wondering why
you print and respond to mistersinga? It is becoming a distraction from
your otherwise entertaining and educational material.
Steve “Red” Barron
Dear Steve (Red Baron Von Richtofen?),
Do you know the definition of a sadist? It’s someone who is nice to a
masochist. I have this horrible feeling that I am becoming a masochist
even by reading his emails. However, deep down inside, underneath this
gruff exterior I have a heart of chocolate, and I end up feeling sorry for
him. Enough of the entertainment value!
Since you want educational material as well as advice for the love-lorn,
your namesake, the famous Red Baron, also used several names. Richthofen
was known as der rote Kampfflieger (Red Battle-Flyer) by the Germans,
Petit Rouge (little Red) or le Diable Rouge (Red Devil) or Johnny by the
French, and the Red Knight or the Red Baron in the English-speaking world.
The German translation of ‘Red Baron’ is Der Rote Baron, and
Richthofen is known by this name in Germany as well. If you own a dog, you
should not call him Snoopy (as per the Peanuts comic strip), as Captain
Arthur “Roy” Brown, was the British Sopwith Camel pilot who chased the
Red Baron to his death, thought to be from an Australian AA gunner on the
However, there appears to be no such grandeur with mistersingha’s nom de
plume. I think he probably coined it after drinking too much of the amber
produced by Boon Rawd Breweries. With a little luck his liver will soon
fail, and we will be rid of him for ever!
A couple of weeks ago, someone wrote in complaining of the ding-dong
that happens when you open the door of the very large world wide
convenience store chain. I can’t see what he is complaining about. At
least someone then welcomes you to the shop with the “Chern, Kha” and
that puts me in a good mood. I reckon some people complain about nothing.
Like you, my Petal, I see (hear) nothing wrong with the welcoming chimes
from the 7-11’s, but I do get worried by the plethora (nice word for a
Friday) of them. On my local soi there is one on each corner of the mouth
on to the main road. How do they survive?
There are two very nice girls I have met recently and I would like to
take them out. My problem is the fact that they both work in the same
office as me! If I take one out, it will be all over the office the next
day, so I am worried the other then will not come – or vice versa. I
have no intention of settling down and my contract runs out anyway soon.
What do you advise, wise Hillary?
Why are you cluttering up your life agonizing over ridiculous decisions
that don’t have to be made? You have already said you are only here for
a short time, so stop worrying! If you are so desperate to take them both
out then ask them both at the same time and invite them to go to the local
psychiatric hospital with you. I think you might like it.
One of my workmates has been coming round to our house a lot recently
and I think he is keen on my wife, who is a very beautiful Thai girl. He
will come over to our condominium and ask me for advice about things at
work, when he could easily come and see me in my office during working
hours. He also looks at her a lot. I am suspicious – what is your
opinion Hillary? Should I talk to him or just bust him on the nose?
There is a very easy way around all this, my unhappy Petal. Why are you
seeing him at home, when, as you say, he could see you at work to discuss
these so-called problems. If he rings, just say you are too busy and to
see you in the morning at work, or if he’s the type to arrive uninvited
just refuse to entertain him at home and again tell him to see you in the
morning at work. An Englishman’s home is always his castle. Protect it.
He’ll get the message in the end, unless he is as thick as two short
I hate bartering for goods. I really would just prefer to know the
price and pay for it, but my friends all tell me that you have to barter
as it is an accepted part of trade in Asia. What can I do, Hillary? There
must be more people like me.
Dear (No)Barter Betty,
Simple! You just pay the first asking price and live with the knowledge
that you have been ripped off. Or you can shop only in large supermarkets
which have fixed prices. Or send the maid out to do the shopping for you.
It is an Asian “ethnic” practice you get used to, like queuing in the
United Kingdom, or going mad over the Superbowl in America.
Camera Class: Cats and kids – you have been warned!
by Harry Flashman
pic by Ernie Kuehnelt
When someone says you take great photos and asks you to take
a photograph of their offspring – forget the warm glow this gives you and turn
down the offer! Staying away from kids and animals used to be the maxim for
stage performers. It is the same for photographers. While every mother and pet
owner wants wonderful photographs of their charges, it is very difficult to get
one that you will be happy with, let alone the owner of kid/pooch/cat (delete
those not applicable).
The biggest problem is the short attention span demonstrated
by children and pets. Something they can be interested in will last around 2
milliseconds if you are lucky. Hang about composing, focussing and other
fiddling will see the child turn round, the dog will start licking something you
would not want recorded for posterity and the moggie will just stalk off, tail
in the air. Or it can be a combination of all three.
The answer is to be fore-warned and therefore fore armed. You
have to visualize the shot first and make it happen second. It is not a case of
following the child around and going snap, snap, snap and hoping one will turn
out OK. It won’t, and you’ll get tired.
What does help is to look at photographs in magazines and
books, and when you find a pose that you like, then work out just how did the
photographer get the shot. This is important if you are going to try to capture
that same “look” with your shots. By the way, this is not cheating or
blatant copying, which I am totally opposed to, all you are doing is seeing how
you can technically get a pleasing result.
Chances are, when you have found the shots you like, that you
will find that to get the shot, the camera is on the same level as the subject.
This goes for about 99 out of 100 shots of alert kids/pooches/cats. When they
are asleep, then take from above – the 1 in a 100 shot!
It is for this reason that pro photographers have a couch
they put kids on – just to bring them up to normal camera level. Likewise,
those demented photographers who make their money by photographing animals do
the same. After all, you look a right proper idiot crawling round on your belly
taking shots in front of the startled owners!
OK, let’s get down to action with your kids and animals.
Begin by setting the scene and you begin with the background. A dull mottled
material background works well as it does not have fussy details to take your
eyes away from the main subject. You should also position this background at
least 1 metre away from where the subject will be placed. You can either paint
this background yourself, or you can buy rolls of it from professional camera
Now position something in front of the camera to represent
Phido or Philip. Place it where you expect the subject to sit and pre-focus and
set your exposure details (or just set the camera on Auto and let it do the
work). Now look through the viewfinder and make sure you have all of the
background material in the frame, as well as the child/animal sized dummy. A
large stuffed toy can be used for this purpose. If you have a tripod, it is a
good idea to use it here too.
Now get a favourite toy (for the humans) and some bacon fat
for cats and a box of matches for dogs. Speed is now the name of the game.
Position the child where the stuffed toy or whatever was seated and give it to
the child. Start snapping NOW! If you are lucky, you will have caught that
“magic moment” of childish glee. If you’re lucky.
With the cat, have the owner smear the bacon fat on its mouth and it will
reward you with the tongue lick shot. With the dog, rattle the matches and it
will prick its ears up for that “alert dog” look. That is just before it
lunges at you from the table! Stay away from kids and animals. You have been
Money Matters: Investing closer to home - Part 2
MBMG International Ltd.
Stocks are on occasions cheap for good
reasons. One such reason rests on the perceived prospect for an imminent
downturn in the relevant industry. For instance, many portfolio investors
are concerned with petrochemicals and shipping hitting a cycle peak in
2005-6. While we do not dispute that the broad petrochemical and shipping
industries could both be in for a period of product and service prices
levelling off beginning in 2006, we also see exceptions to the general
expectation. We believe that the small handy dry-bulk shipping sector is not
about to be flooded by oversupply of new vessels in the next 12 months. We
also believe the aromatics cycle is likely to see new capacity come on line
later than other sub-sectors in the petrochemical industry.
In common with other emerging economies in Asia, we
expect the Thai economy to grow at a decelerating rate. Rising interest
rates around the world and high crude prices for the second year in the row
would slow down growth in consumer expenditure and turn Thailand’s trade
account into a deficit.
The SET trades at about 12x 2004 market EPS and 10x 2005
market EPS at present. The average PER of the SET between 1988 and 2004 is
about 13.5x. Given the outlook for slowing macro-economic growth in Thailand
and in the rest of the world, tightening credit and crude prices remaining
stubbornly high, a top down approach to portfolio investing would likely
avoid interest sensitive stocks, such as banks, consumer finance companies
and residential property developers, and treat with caution cyclical stocks,
growth companies and exporters in 2005. Based on a typical top down
approach, investors would likely select infrastructure plays, defensives,
such as big cap energy companies and reliable dividend payers. As stated
before, there is better value to be had by the bottom end approach.
Seamico, as usual, has been pretty spot on so far, but by
the year end, we’d want to see more signs supporting M.R. Pridiyathorn’s
optimism and less justification for our caution or else we’d move from
long to short in our SET view. It’s interesting that everyone seems to be
jumping on the bandwagon right now - last week the International Herald and
Tribune chipped in by reporting that certain hedge fund operators and the
media services have been in overdrive these days, warning of a repeat of the
1997-98 Asian financial crisis. The Indonesian Rupiah has been said to be in
freefall with reports of the same happening in Thailand and elsewhere. The
reason for this is the oil price hit to Asian trade balances and government
failure to follow the market and raise local fuel prices and lift interest
The article reports that while most Asian countries are
heavily dependent on imported oil and most do have high energy ratios to
GDP, partly due to low energy prices, with the cost of energy subsidies
having a negative impact on government budgets and energy distributors
profitability, but these prices are being held down for short-term political
reasons and most subsidies will be removed as soon as possible.
Furthermore Indonesia, for example, while said to be in a
current mini-crisis, is an energy exporter of coal and gas, which offset the
small net oil imports. The impact is not on its balance of payments but on
Thailand is reported to be in a danger zone due to the
current account deficit cited above. The IHT was significantly less detailed
than M.R. Pridiyathorn attributing most blame to the tsunami’s damage to
tourism income. It rightly stated that Thailand’s fiscal position cannot
stand permanent domestic price subsidies but also that currently domestic
demand requires a temporary cushion against a sudden fall in consumer
Malaysia, also said to be acting irresponsibly with
regard to oil prices, is helping its economy sustain consumption at a time
when the current account surplus is running at more than 15% of GDP, money
which is mostly going to prop up the spending of deeply indebted households
in the US, UK and other developed countries.
In all of these instances it failed to take account of
the future impact of global slowdown. Thailand is healthier and in many ways
better positioned than in 1997 but the sustained high oil prices feared by
M.R. Pridiyathorn and the sustained global economic downturn feared by many
analysts could be a very unfortunate combination.
However, it may be that the best news for the Thai
economy happened a couple of thousand miles away, where incumbent Japanese
Prime Minister Junichiro Koizumi’s Liberal Democratic Party (LDP) won 296
seats in the 480-member House of Representatives, well above the 241 seats
needed for a majority and above the 249 seats the party held when Koizumi
dissolved the chamber, and a landslide affirmation of his stated intention
to reform Japanese society. By calling the snap election in August, Koizumi
effectively set a national referendum on his bid to privatize Japan Post, a
financial-services giant with $3 trillion in savings and insurance assets.
The move would effectively create the largest bank in the world.
Postal privatization is pivotal to Koizumi’s
wide-sweeping reform agenda. “The election was carried out under difficult
circumstances at first,” Koizumi told a news conference. “In the end, we
got much more support from the people of Japan than expected. I accept the
judgment of the people with a sense of great responsibility, and will work
to pass the postal reform bills as soon as possible. I intend to push
forward policies on other issues of concern to the people, such as social
insurance, in parallel with postal reform,” he said, without giving
Both the stock markets (the Nikkei finished above 12,850 at a four-year
high) and the yen gained responded positively to the news. While we don’t
expect progress in Japan to be straightforward we do expect Japan to take 2
steps forward for every step back - the converse of the ratio that we expect
to see in the West. Japan may represent some economic salvation for emerging
Asia, although we would start to increase exposure to Japan cautiously right
now and wait a little longer to see how the picture develops for Thailand,
ASEAN and emerging Asia.
The above data and research was
compiled from sources believed to be reliable. However, neither MBMG
International Ltd nor its officers can accept any liability for any errors
or omissions in the above article nor bear any responsibility for any
losses achieved as a result of any actions taken or not taken as a
consequence of reading the above article. For more information please
contact Alan Hall on [email protected]
Life in the Laugh Lane: Laugh Lane Spam Attack!
by Scott Jones
unsolicited email arrives from Elpidius Barberio. Subject says - Re: mastodon
whitening. Hmm, possible in Thailand. Land of Smiles, lots of whitening creams,
elephants with off-white tusks. Another from Innocenzo Lakes - Re: dancing
salesman. Hmm. Does he sell dancing lessons or will a festive, door-to-door,
vacuum cleaner peddler gyrate up my walk doing the mambo with an Electrolux to
the tune of “Suck It to Me, Baby”? Re: toad defrost. Re: spontaneous
tortilla. Re: monsieur buffoonery. Re: innermost hemorrhage. Over the next few
weeks, 12,000 more spam emails litter my bulk folder. I open some at an
internet shop in case they contain a virus that explodes computers. They all
list the same four drugs for sale, none of which I’ve ever heard of, but are
obviously very versatile since they can take care of mastodon whitening, toad
defrosting and your innermost hemorrhage.
This is not a marketing technique that I understand.
Thousands of sales geeks named Rashida Ranallo, Ganesha Laws, Shahrizad Kent
and Fabian Nail babbling in my virtual front yard does not whip me into a
shopping frenzy. “Grizzled guillotine! Repeated toweling! Yogurt accessory!
Entrails guarantee! Syphilitic limekiln!” I assume some random word and name
generator devised to slink past spam filters is despoiling mankind, but I
cannot find one other person who is having this problem. Who would spend this
much energy bothering only me? As young scamps, we’d harass the neighborhood
meanie, Old Man Gruber, by putting dog poop in a paper sack on his step,
setting it on fire, ringing his door bell and laughing till we wet our pants as
he stomped out the flames, but he must be dead by now.
The perpetrators may be Alvin Plummer and Diane Jensen, two
unfortunate souls who took the brunt of our elementary school class harassment.
When I met Alvin in 6th grade, he’d already flunked twice so he was taller
and older, but had the mental capacity of an eraser. His social doom was sealed
in gym classes during a push-up session as the teacher paused in his chant of
“Down…down…down…” to say, “Alvin, you have to push up between the
downs.” I moved on but he remained in 6th grade where he may still be.
I don’t know why we picked on poor Diane since she
wasn’t fat, ugly or stupid - deadly traits in grammar school. She may have
been from the wrong side of the tracks, but hey, the whole state of North
Dakota is still on the wrong side of the tracks, the wrong side of America, and
as far as I’m concerned now, the wrong side of the world. We’d play a
terrible game of tag where someone would touch Diane and then tap anyone else
while yelling, “You’ve got Diane Jensen Germs!” Pandemonium broke loose
as everyone tried to get rid of her germs. We never did this to anyone else. I
still feel bad about it. I’d hoped she’d attend a high school reunion so I
could grovel and apologize, but she never wanted to see us despicable monsters
again. I suspect the victims of this current email virus are my 6th grade class
and the masterminds are Alvin and Diane who have since married, became
millionaire computer geniuses and decided it’s finally payback time: “You
want Jensen Germs? Take this!!!”
It takes days to wade through the spam to assure I don’t
delete anonymous charitable contributions or clues to Diane’s correct email,
but I’m learning novel ways of combining English words (tuba panic,
misconception table, unbaked bra, crotch photomicrograph, moleskin
mispronunciation), considering new professions (compost nurse, hammock
botanist, contextual cosmetologist, oil derrick knitter, lumberman debater,
turpentine smuggler, handrail finder, applecart roguery, electric copulation,
lizard pharmacy, parliamentary fornication, scrooge authentication) and
discovering choice names for a hard rock band: Thong Trembler, Spurious Crumb,
Swill Decanter, Satanic Universe, Sextant Glandule, Niggle Lineament, Squawk
Airport, Armored Alcoholics, Bazooka Dixie and Oleomargarine Blowfly. If you
ever meet Diane, please tell her I’m sorry.