Ask Dr. Lang.
Q How do I know if I have prostate cancer? Does it offer any warning signs?
A Prostate cancer usually causes symptoms only when it has reached an advanced stage. The symptoms can include trouble starting to urinate or an inability to urinate, increased urinary frequency, burning or painful urination, blood in the urine or semen, painful ejaculation, erectile dysfunction, and pain in the lower back, hips, or thighs.
However, most of the time, these symptoms result from a condition other than prostate cancer. For instance, increased urinary urgency and frequency or difficulty starting to urinate are more commonly associated with benign prostatic hyperplasia (BPH). These symptoms, as well as burning or painful urination and pain in the lower back, pelvis, and lower abdomen, also may be signs of chronic prostatitis/chronic pelvic pain syndrome, a noncancerous inflammation of the prostate.
The only way to know what's causing your symptoms is to seek an evaluation from your physician. And, if you're concerned about prostate cancer, talk to your doctor about the pros and cons of prostate cancer screening.
Q Should I be worried if the blood pressure in one arm is higher than the other?
A Blood pressure readings can vary from arm to arm. That's why experts recommend that physicians take blood pressure readings in both arms when they first examine a patient. The arm with the higher pressure is then used to assess and monitor the patient's blood pressure.
In most people, the difference in blood pressure between arms is only a few millimeters of mercury (mmHg), but larger differences (such as 10 to 15 mmHg or more) may signal a problem, such as a narrowing of the main arteries to the arm, and should be evaluated by your physician.
When measuring your blood pressure, avoid nicotine, caffeine, exercise, or anything else known to increase blood pressure for at least 30 minutes beforehand. Sit relaxed in a firm chair, with your back supported, your feet resting flat on the floor, and your arm supported at the level of your heart. Place the blood pressure cuff on bare skin, and make sure it fits snugly, not too tight or too loose. Use the arm with the higher pressure to determine if you have normal blood pressure (120/80 mmHg or lower), prehypertension (121 to 139 mmHg systolic and 81 to 89 mmHg diastolic) or hypertension (140/90 mmHg or higher).
Q What are hemorrhoids, and how can I prevent them?
A Hemorrhoids are varicose veins in the anus and rectum that can cause itching, pain if the vein develops a clot, and bleeding. Constipation and activities such as heavy lifting contribute to hemorrhoids.
Preventing constipation and the strain associated with difficult bowel movements can help to prevent hemorrhoids. When you have the urge, don't postpone bowel movements to a more convenient time of the day. Eat plenty of high-fiber foods, such as fruits, vegetables, and whole grains, and drink plenty of fluids. If you don't get enough fiber in your diet, consider over-the-counter fiber supplements, such as Metamucil[R] and Citrucel[R]. Staying active also can reduce pressure on the veins and may help prevent constipation. Sitting for too long, especially on the toilet, can raise pressure on the veins in the anus.
When hemorrhoids flare up, avoid excessive wiping, and use moist wipes. Soak in a warm bath, or use a sitz bath (placed on a toilet) filled with warm water. Over-the-counter topical treatments or painkillers may help relieve the pain temporarily. Your doctor may recommend treatment for persistent bleeding or painful hemorrhoids.
Richard S. Lang,
M.D., M.P.H., EA.C.P.