Mass screening for prostate of little value?

Mass screening for prostate brings few benefits

PARIS: Mass screening of men for prostate cancer has little impact on the toll from the disease and carries a risk of over-treatment, according to a review published by the British Medical Journal (BMJ) on Wednesday.

University of Florida professor Philipp Dahm looked at the outcome of six trials in which populations of men were tested either using a digital rectal examination or a blood test for an antigen linked to prostate cancer, or were untested.

Screening had negligible effect on the death toll from this disease or indeed on overall mortality.

"Our findings suggest that the expected impact in absolute terms would be modest at best," according to the paper.

Prostate cancer is the commonest non-skin cancer among men worldwide and, after lung tumours, is the second biggest cause of death from cancer among men in the United States. Most cases occur among men aged in their sixties.

Many countries have routine screening programmes for men in their middle age, but this policy is controversial.

One of the problems is that the so-called PSA antigen test, now 20 years old, cannot distinguish between low-risk tumours and aggressive lesions that are often fatal.

Antigen levels can also fluctuate according to the individual and may be skewed by prostate inflammation.

As a result, experts looking at systematic screening have squabbled over whether the benefit of detecting men in danger outweighs the potential harm of over-diagnosing and over-treating men who are healthy.

In a separate study published by the BMJ, researchers found that the level of antigen, as found among men at the age of 60, strongly identified those most at risk.

This would curb the need for repetitive PSA testing among those who were least vulnerable, say its authors.

Others who should be closely monitored are young men with a family history of prostate cancer or who have a relatively high level of PSA in their initial test.

- AFP/de


From ChannelNewsAsia.com; source article is below: Mass screening for prostate brings few benefits
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Bedtime worries

Are you getting enough sleep?
by Eveline Gan 

Updated 05:15 PM Mar 16, 2010

IT WAS almost midnight when I started my research for this story.

Along the way, I got distracted by a friend's MSN message. We chatted for a while before I returned to my work.

By the time I decided to go to bed, I was simply too wired up to sleep, so I fiddled with my mobile phone and played my favourite game. I finally willed myself into a fitful sleep after 3am.

Needless to say, I was a wreck when my daughter woke me up at 9am the next morning.

A good number of people may find the above scenario familiar.

Inadequate sleep may sometimes be due to sleep disorders. However, in many cases, people often do not have enough sleep because they voluntarily choose to forgo sleep for other activities, said sleep experts.

While there are no formal statistics, Dr Lim Li Ling, president of the Singapore Sleep Society, reckoned that many adult Singaporeans do not get the daily six to eight hours of sleep that is needed for optimal well-being.

"Lack of sleep is a common and largely under-recognised cause of daytime sleepiness and other health problems in countries such as Singapore, where the lifestyle is hectic and round-the-clock activities (such as online shopping and games) are available," said Dr Lim, who is also the medical director and consultant neurologist at the Singapore Neurology and Sleep Centre at Gleneagles Medical Centre.

According to her, most people who have problems falling asleep generally have bad habits that are not conducive to healthy sleep.

"For example, it is common to see people work till late at night, and thus do not have enough of a wind-down period. This can make falling asleep difficult because the mind is not relaxed enough."

Dr Lim added that she noticed that most people do not get enough physical exercise and use stimulants such as caffeine to stay alert, habits which can affect one's quality of sleep. Long daytime naps, stress and eating late can also interfere with sleep.

To encourage Singaporeans to sleep more, the Singapore Sleep Society is introducing the Sleep An Hour More Movement when its Singapore Sleep Awareness Week (SSAW) launches this Friday.

The society is urging Singaporeans to "switch off your mobile phone, computer or TV, tuck in early, sleep in later or take a nap in the day", in order to sleep an extra hour each day (bosses, are you reading this?) during the 10-day campaign to feel the physical differences.

For obvious reasons, chronic sleep deprivation can cause excessive daytime sleepiness, fatigue and weariness, lack of concentration, irritability, a lousy mood, as well as affect cognitive function such as problem solving, learning and memory, said Dr Jenny Tang, medical director of SBCC Asthma Lung Sleep and Allergy Centre at Gleneagles Medical Centre. It can also affect one's immunity.

Lesser known negative effects include risking a bigger waistline.

Explained Dr Tang: "When people are sleep deprived, there is a chance that there will be a change in the balance of their appetite hormones, which results in a bigger appetite and desire to eat more."

She added that heart palpitation could also occur when people overuse stimulant substances such as caffeinated beverages to counter sleepiness.

"Through raising awareness of the many serious health issues which can arise from long term lack of good quality sleep, we hope to encourage more people to make sleep a priority for the sake of their emotional and physical wellbeing," said Dr Lim.

Good night, and good luck

Sleep tight with these tips from sleep expert Dr Lim Li Ling.

- Work out a sweat. Exercise helps one feel relaxed and less stressed, but don't exercise for at least four hours before bedtime.

- Avoid alcohol near to bedtime. And don't drink caffeinated beverages such as coffee and colas eight to 10 hours before bedtime.

- Have a bedtime routine that can help you unwind. Don't think about work before you sleep! Also, steer clear of stimulating activities such as online games before bedtime.

- Ditch heavy suppers. Eating close to bedtime can cause symptoms such as heartburn, which can disturb sleep.

- Go to bed and get up at about the same time every night and day respectively, including weekends. This will help anchor your circadian (biological) clock and establish a consistent rhythm of sleep.

- Use the bed mainly for sleeping and sex, not other activities. Can't get to sleep after 20 mins? Get out of bed and engage in a relaxing activity like light reading and go back to bed when you feel sleepy.


Does what you sleep on matter?

According to Dr Lim, most " average" mattresses and pillows are good enough for normal sleepers.

"Of course, a lousy sleeping surface can affect normal sleepers, such as a cold hard concrete floor or a mattress that is lumpy and causing back pain - but most people do not have to contend with such challenging situations," she said.

She added that people who suffer from sleep problems may need to make more effort to make the bedroom environment more conducive to sleep. "This could include air-conditioning, soft or firm pillows ... whatever the patient prefers."

From TODAYOnline.com; see the source article here.

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