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Ask the doctor.

Q I'm undergoing hormone therapy for my prostate cancer. Is it true that this therapy will make my bones weaker?

A Androgen-deprivation therapy (ADT) works by blocking the development of male hormones called androgens--mostly testosterone--that contribute to the growth of cancerous cells in prostate tumors. Studies have shown that blocking androgens can contribute to a loss of bone density in men. However, men's bones are generally bigger and slower to deteriorate than women's. Your doctor should be advising you to take calcium and vitamin D supplements, and to do weight-bearing exercises or weight-lifting several times a week. This should keep your bones healthy. You might also be a candidate for medications that treat osteoporosis--essentially the same condition.

Q My husband has diabetes and is afraid of losing his vision to diabetic retinopathy. What can we do to prevent this?

A If your husband has no vision loss yet, that's good news. Diabetic retinopathy is a progressive disease. Between 40 and 45 percent of Americans with diabetes have diabetic retinopathy to some extent. There are usually no symptoms to signal its development, so it's vitally important for people to see their ophthalmologists every year to catch it before it progresses. With early intervention, vision loss can be prevented. It's also important for patients to control their diabetes as well as possible, to help prevent the onset of the disease. Your husband should monitor his blood sugar levels carefully, keep his blood pressure and cholesterol down, get exercise, and, if he's overweight, try to trim down to a normal weight.

Q I have occasional bouts of pain in my right shoulder that make it difficult to use my arm. The pain lasts two or three days, and subsides when I take Motrin. Is this bursitis?

A It does sound like bursitis, but you should discuss the next flare-up with your doctor so that other possibilities can be considered.

Bursitis is an inflammation of one or more of the bursa sacs in your body that ease friction between tendons, bones, muscles, and the skin. Bursas normally contain small amounts of lubricating joint fluid, but when an area, usually a joint, is stressed by overuse or unusual movement or injury, or compromised by infection or an autoimmune disorder like rheumatoid arthritis, a bursa can become inflamed and swell up with more fluid, causing pain and immobility.

Bursitis of the shoulder is very common. You should think about any pattern to the arrival of these bouts--are they related to sweeping, sports, carrying groceries or grandchildren? Try to minimize any activities that trigger the bursitis. Non-steroidal anti-inflammatories like Motrin do help, as do ice packs, rest, and targeted physical therapy exercises. For acute, chronic bursitis, treatment with corticosteroid injections may be necessary. These bring relief quickly, but usually need to be repeated.

Editor-in-Chief Bruce A. Ferrell, MD

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Title Annotation:prostate cancer and diabetic retinopathy
Author:Ferrell, Bruce A.
Publication:Healthy Years
Geographic Code:1USA
Date:Aug 1, 2006
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