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Newsletter 6 - September 30, 2012
Dear Patients,
I hope you're enjoying the fall weather. Thank you to so many of you who gave me such great feedback on my summer newsletter. In this newsletter, I'd like to address 3 issues: calcium supplements, PSA testing, and flu shots.
Use of Calcium Supplements for Women
Recently, a research study suggested that post-menopausal women should not take calcium supplements. This large study found a higher incidence of cardiovascular disease in women who took supplemental calcium. Heart disease is the number one cause of death for both men and women. Below are two links that discuss this issue; the first link discusses the recent study and the NCBI link describes the first large meta-analysis suggesting the connection. http://www.medicalnewstoday.com/articles/245811.php http://www.ncbi.nlm.nih.gov/pubmed/20671013
In my opinion, these studies are compelling and I am therefore recommending discontinuation of all calcium supplements for bone health. Nevertheless, adequate calcium is important in maintaining healthy bones. At menopause, there is an acceleration of bone loss which can be limited by weight-bearing exercise, adequate calcium intake, and Vitamin D. Postmenopausal women should get at least 1200 mg of calcium per day, however, you should try to get this from your diet. Here is a link to calcium rich foods:
I also recommend for women, as well as men, Vitamin D-3 supplements, at least 1000 units per day. Vitamin D-3 allows for efficient absorption of calcium and also has some positive effects on the immune system. This is becoming more important since most Americans limit their exposure to the sun.
PSA Testing for Men
Recently, the United States Preventative Care Task force recommended that we no longer obtain PSAs as a screening test for prostate cancer. The PSA test is a crude but nonetheless useful tool to help follow men over the age of 40, so I continue to recommend it as a screening tool in conjunction with an annual rectal exam. Prostate cancer is usually detected by either an elevated PSA or a nodule found during a rectal exam, both of which lead to a biopsy. If the biopsy is positive, now more than ever, men are followed by "watchful waiting" rather than having surgery or radiation. On occasion, we discover a very high PSA; if a biopsy confirms a high grade cancer, an early intervention can be life-saving.
Unfortunately, we currently lack a non-invasive test that is sensitive and specific for the diagnosis and, more importantly, lack a test that definitively directs us who should be treated and who should be followed. I am optimistic that in the near future such a test will be available. For now, I continue to use the PSA test annually and, should a problem be detected, I am involved every step of the way to determine whether treatment or surveillance is the best course of action. I follow the literature closely as well as work with my Urology colleagues. Please take the time to read the pros and cons in this excellent article published in the Wall Street Journal: http://online.wsj.com/article/SB10000872396390444301704577631431570809256.html
Please Consider Getting your Influenza Vaccine
Stop by my office any weekday from 8:30 AM to noon, or obtain it at an upcoming appointment. Take a look at the link below for more information about influenza. Yup -- that's me on Columbia Matters! http://www.youtube.com/watch?v=kzDgpBi4hHk&list=PLBD67029A34F53273&index=9&feature=plpp_video
Re-enrollment for 2013 This year has flown by quickly. I feel so fortunate and grateful to have the privilege of taking care of you, my patients. I am hopeful we have met or exceeded your expectations for your care in the office, after hours, in the emergency room and, if needed, in the hospital. Re-enrollment information will be sent out by mail the first week of November. Please note there will be no changes in the fees for 2013.
Wishing you good health, Harry A. Oken, MD |
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