Erectile dysfunction after radiation treatment prostate cancer,10 best leadership books of all time,chronicle of higher ed jobs music - New On 2016

admin | Category: What Causes Ed 2016 | 28.11.2013
Erectile dysfunction is a common complaint of patient’s receiving radiation therapy for prostate cancer and men undergoing this treatment are often prescribed ED drug tadalafil to prevent the loss of sexual functioning. But daily use of this drug did not prevent erectile dysfunction from occurring, when compared with a placebo, according to a study in the Journal of the American Medical Association.
Split into two groups, the first group received five milligrams of tadalafil, and the other received a placebo.
The study was conducted widely, at 76 sites throughout North America, between 2009 and 2012.
Radiation therapy, also sometimes referred to as radiotherapy, is a general term used to describe several types of treatment, including the use of high-powered X-rays, placement of radioactive materials into the body or injection of a radioactive substance into the bloodstream. Is also referred to as "seed therapy" or a "prostate implant." Brachytherapy involves the insertion of a radioactive material, commonly referred to as a source, into the body.
There are two approaches to brachytherapy for prostate cancer: low-dose rate (LDR) and high-dose rate (HDR). An ultrasound study may be performed prior to the day of the procedure to ensure there are no bones interfering with the placement of needles into the prostate. Alternatively, HDR brachytherapy may be utilized to place a highly radioactive source temporarily into the prostate.
Radionuclide therapy: Radioactive substances may also be used for treatment of prostate cancer that has spread to the bones. Radionuclide therapy: The principal side effect of radionuclide therapy is a decrease in blood counts following treatment. Brachytherapy (Internal Radiation Therapy)Also known as implantation or interstitial radiation therapy, where small radioactive pellets (or “seeds”) the size of a grain of rice are placed directly into the prostate.
ChemotherapyAnti-cancer drugs are taken orally or injected into a vein and enter the bloodstream then spread throughout the body to stop the growth of prostate cancer cells by killing them or restricting their division to other parts of the body.
Cryosurgery (Cryotherapy)Also known as cryoablation, transrectal ultrasound (TRUS) is used to guide multiple needles directly into the prostate through the skin between the anus and scrotum.
Cyberknife®A form of stereotactic body radiation therapy (SBRT) that delivers high doses of radiation directly to the cancerous prostate by the use of a robotic arm that moves around the body. External Beam Radiation Therapy (EBRT)The prostate gland is targeted with beams of radiation (x-rays or proton) from a machine outside of the body.
High Intensity Focused Ultrasound (HIFU)Precision-focused ultrasound waves are used to heat and destroy the targeted prostate cancer tissue.
Laparoscopic Radical Prostatectomy (LRP)Several small incisions are made and the prostate is removed through the use of special long medical instruments.
Radical Perineal Prostatectomy (Open)An incision is made in the skin between the anus and scrotum (perineum) and the prostate is removed.
Radical Retropubic Prostatectomy (Open)An incision is made in the lower abdomen from the belly button to the pubic bone and the entire prostate is removed along with nearby tissues and seminal vesicles.
There’s nothing like celebrity malfeasance to give an obscure topic newfound salience, and the recent discovery of an unconscious Lamar Odom — former NBA player, reality-TV star and Kardashian-in-law — in a Nevada brothel has done just that for so-called “herbal Viagra.” (Odom had apparently been popping the purported sexual stimulant over several days of partying.) What is the stuff, though? Testosterone deficiency syndrome (TDS, or Low T), as its name implies, is a medical condition in which a man’s level of testosterone, the male hormone, is insufficient. One of the most poorly understood aspects of American medicine today, especially in the realm of men’s health, is prostate-cancer screening. Our urologists have more than 30 years of combined experience helping men achieve and maintain a healthy sex life. Obsidian Men’s Health is a boutique medical practice that focuses solely on men’s health and well-being. Shane Geib and Marc Richman are urologists, board-certified by the American Board of Urology.
The most significant time period during the study was between 28 and 30 weeks after the therapy had begun. Many prostate cancer patients are benefiting from radiation therapy techniques that decrease side effects and may lead to higher cure rates. The emergence of EBRT as a treatment for prostate cancer occurred in the 1950s with the development of high-powered X-ray machines called linear accelerators. Usually several radiation beams are used to shape the radiation to the prostate, called three-dimensional conformal radiation therapy. Attempts to treat prostate cancer by placing radioactive materials into the prostate date back to the early 20th century.
The ultrasound probe is placed into the rectum to obtain pictures of the prostate and surrounding structures.

Narrow hollow plastic tubes called catheters are pre-positioned in the prostate using a technique similar to LDR brachytherapy.
These radioactive drugs, known as radiopharmaceuticals or radionuclides, are injected intravenously (IV). Obstructive symptoms including difficulty with urination are somewhat more common, however, as the prostate usually swells due to the insertion of needles into the prostate for the procedure. Permanent Brachytherapy (low dose rate) inserts radioactive (iodine-125 or palladium-103) pellets directly into the prostate with the use of a needle by going through the skin in the area between the anus and the scrotum. Extremely cold gases are then sent through the needles, which then create ice balls that freeze and destroy the prostate.
Using the guidance of real-time imaging to automatically adjust to the movement of the prostate, the Cyberknife system accurately and continuously targets the prostate during each treatment. The Da Vinci Robotic surgical system is made up of three major components, which include a vision system with high magnification and resolution, robotic arms and instruments, and a console to provide the surgeon with a view of the operative field and control the instruments. EBRT is a three-dimensional conformal radiation therapy (3D-CRT) which creates a precise map of the location of your prostate through the use of special computers. It is performed on an outpatient basis and can be repeated as necessary with each treatment taking anywhere from 1 to 3 hours. These tools vary in use, as one will have a tiny camera on the end to allow the surgeon to see inside of the abdomen. I’m always hesitant to criticize people in my line of work, but in all of these recent cases, the docs in question were employed at regional “hormone replacement clinics" — not exactly a hotbed of medical rigor. They serve Northern Virginia patients in Vienna, McLean, Great Falls, Arlington, Reston, Herndon, Oakton, Fairfax, Annandale and surrounding areas. Tadalafil, commercially known as Cialis, is often prescribed to patients post treatment and is usually deemed very successful. 79% of those who received tadalafil retained sexual functioning, compared with 74% who had received the placebo, a scant difference of 5%. These circumstances include primary treatment of localized prostate cancer, secondary treatment for cancer recurring within the region of the prostate and for relief of pain and other symptoms related to prostate cancer that has spread to other parts of the body. The intensity of each beam may be altered to further shape the radiation using a technique called intensity modulated radiation therapy (IMRT). However, the lack of a reliable way to ensure that the radioactive materials were placed in their desired locations limited the use of brachytherapy to treat prostate cancer.
Radioactive seeds (which are smaller than a grain of rice) are loaded in individual needles that are passed into the prostate gland through the skin between the scrotum and anus. The patient is then awakened and typically two or three treatments are given over the next several days after which the catheters are removed. Less than 10 percent of men will experience complete urinary obstruction within several weeks of the procedure requiring use of a catheter.
However, an increase in pain may occur in the first several days or weeks after radionuclide therapy but can be managed with increased use of pain medications until the therapy begins to have its desired effect.
Warming catheter is inserted into the urethra to protect it from the freezing temperatures. If cancer cells are found in lymph nodes during surgery, the operation may be cancelled, as surgery alone will not cure the patient. In recent decades, a variety of health-care institutions have developed services specifically for women — now, with Obsidian Men's Health, Drs.
However, this is the first study to determine the drug’s success as a preventative measure. The remaining 37% received brachytherapy—where radioactive seeds are placed within the prostate. In the 1980s, a technique was developed using ultrasound to guide the placement of tiny radioactive "seeds" into the prostate. The seeds are temporarily radioactive as the radiation is given off gradually over a period of several weeks to months. The information obtained from the TRUS can also be used to generate a road map for seed implantation. As the needles penetrate the prostate they are seen on a monitor and can be accurately guided to their predetermined position. A remote control device is used to move the radioactive material, which rests for a calculated period of time at various positions within each catheter.
The radiation given off is weak and does not penetrate very far into surrounding tissues and organs.

Within one or two months following completion of treatment, most men notice that symptoms disappear.
Typically, 40 to 100 of these radioactive seeds are placed and left in the prostate until the radioactive material has been completely dissolved. A fitted plastic mold will be created to ensure you are in the same position for each treatment session. The Mayo Clinic and the Radiation Therapy Oncology Group joined forces to conduct the study, observing 242 male participants with prostate cancer.
This second form is thought to have less of a chance of causing ED as it affects surrounding tissue less severely. 72% who had received the drug during radiation had proper functioning, compared to 71% of placebo recipients. Proton beam therapy is another form of EBRT that is used in a few centers in the country to treat prostate cancer. Ultrasound imaging is typically used to define the prostate although newer approaches using CT scan or MRI may be used. Once the position of the needle in the prostate matches the intended position, the needle is withdrawn leaving the seeds behind in the prostate.
A computerized treatment-planning program is used to determine the required time the radioactive material must stay at each position and the sequential positioning of the radioactive material at each location needed to achieve coverage of the prostate with the prescribed radiation dose. A single injection is given in the doctor's office after which the patient may return home. Since the radioactive seeds are placed directly into the prostate, short-term bowel side effects are also relatively uncommon. Temporary Brachytherapy (high dose rate) delivers radioactive iridium-192 or cesium-137 through catheters and are kept in place for 5 to 15 minutes. Intensity modulated radiation therapy (IMRT) uses a machine that moves around the patient while it targets and delivers radiation.
Just as with a diagnostic X-ray, there is a brief exposure to the radiation, typically lasting several minutes.
HDR brachytherapy involves the temporary placement of a highly radioactive source into the prostate. The radioactivity of the seeds slowly decays during several weeks to months after the procedure, and there are few long-term risks associated with this treatment. Additional injections may be given after a period of a few months once the effects of the prior injection have diminished. About 20 percent of men, however, do experience more significant long-term bowel irritability. However, as the front part of the rectum lies close to the prostate, over time bowel side effects similar to those of EBRT may occur. The radioactive pellets are removed after each treatment and the catheters are removed after the final treatment.
Recent clinical trials have shown that increasing the dose of radiation, either with photons or protons, can be done safely and leads to improved cancer control. The radiation treatment is given off over a period of minutes and typically repeated two or three times over the course of several days. Relatively rare complications include significant rectal bleeding, bladder irritability and urethral stricture. New computer-driven radiation machines have imaging scanners and this form of treatment is called image-guided radiation therapy (IGRT). The treatment is completely non-invasive, so there is no discomfort to the patient during the delivery of the radiation.
Both LDR and HDR brachytherapy are usually used alone, but occasionally they may also be combined with EBRT.
However, the risk of erectile dysfunction (ED) following radiation varies widely, depending on use of other treatments such as hormonal therapies and the presence of other medical conditions that may affect sexual function. Primary treatment for localized prostate cancer usually requires about eight weeks of treatment.

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