Ask Dr. Lang.
Most people with kidney stones have an abnormality in their blood or urine that makes them more likely to form the stones. These abnormalities may cause a buildup of calcium, oxalate, urate or uric acid--the common components of kidney stones--in your urine. For the general public, inadequate fluid intake raises the risk of kidney stones. Drink 8 to 10 glasses of liquid each day --at least 4 to 5 glasses should be water--to dilute your urine and lower the concentration of stone-forming minerals. Reducing the amount of salt in your diet can lower the amount of calcium in your urine. Don't add salt to your food, avoid high-sodium processed meats such as salami and other deli fare, and refrain from salty processed foods such as canned soups or flavored pasta or rice products. Avoid foods and beverages that can increase oxalate and uric acid levels, including chocolate, anchovies, berries, scallops, peanuts, tea, dark leafy greens and rhubarb. Although many experts once advised kidney stone patients to restrict their calcium intake, later research suggests that including at least two servings of high-calcium foods daily may slow calcium kidney stone formation. Talk to your doctor about which dietary changes you should make.
I've read that repairing an inguinal (groin) hernia through laparoscopic surgery may make subsequent prostate surgery difficult or impossible. Can I have open surgical repair of the hernia and not have that type of repair affect any later surgery for prostate cancer?
In laparoscopic hernia repair, a surgeon inserts tiny trocars through small incisions into the abdomen to view and repair the hernia with surgical mesh. This minimally invasive surgery generally offers quicker recovery time and less post-operative pain; however, the procedure can produce scar tissue that surrounds the prostate and nearby tissues, seriously complicating future prostate removal (radical prostatectomy). Open surgical repair--in which the surgeon makes a larger incision and repairs the weak spot with mesh--generally causes less scarring, and therefore would be advisable for anyone who might need future prostate surgery. Also, some experts recommend that younger patients considering laparoscopic hernia repair first be screened for prostate cancer. That screening should include a prostate-specific antigen (PSA) test and a digital rectal exam, in which a physician inserts a gloved finger into the rectum to feel for abnormalities in the prostate.
For years, I've used aspartame to cut down on my sugar intake, but critics say aspartame may increase your risk of cancer. Is this true?
Aspartame is the sweetener used in such products as Equal, NutraSweet and others. Results of studies on a possible aspartame-cancer connection have been mixed. In two separate studies of rats--one published last year, the other in March 2006--Italian researchers linked aspartame consumption to leukemia, lymphoma and development of other cancers. However, a study from the National Cancer Institute (NCI), presented at the American Association for Cancer Research's annual meeting in April, reportedly found no link between aspartame use and leukemia, lymphoma and brain tumors. This study, conducted on people, comes after animal studies conducted by the National Toxicology Program found no cancer-causing effects of aspartame. The NCI maintains that no clear evidence links aspartame (or any other artificial sweeteners available in the U.S.) to cancer risk in humans, and other health organizations, including the American Dietetic Association, agree that the sweetener is safe. Still, some experts say further studies on aspartame are warranted. If you have concerns, avoid or cut down your use of products containing aspartame, such as desserts, sugar-free breath mints, and diet soft drinks and other beverages. Also, you can try another non-nutritive sweetener--such as sucralose (Splenda), saccharin (Sweet & Low, Sugar Twin) or acesulfame potassium (Sweet One, Sunett)--or sweeteners that have fewer calories, such as sugar alcohols (sorbitol).
Editor-in-Chief Richard S. Lang, M.D., M.P.H., F.A.C.P.