Drunk Driving Awareness

This is the 35th anniversary of the Mothers Against Drunk Driving (MADD) "Tie One On for Safety Holiday Campaign".  During the holiday season from Thanksgiving through New Year's Day, MADD encourages everyone to tie a red ribbon, or place red ribbon magnets, on their car as a reminder to always designate a non-drinking driver. 

What is MADD?

Mothers Against Drunk Driving was founded in 1980 by a mother whose daughter was killed by a drunk driver.  It is the largest nonprofit organization in the US working to fight drunk driving, drugged driving, and support the victims of these crimes.  The organization is credited with helping to reduce drunk driving deaths by 50% since it was founded.

Here are some statistics around drunk driving:

• Drunk driving is still the number 1 cause of death on roadways in the US.
• Adults drink too much and drive about 121 million times a year, which averages to more than 300,000 incidents per day of drinking and driving.
• 10,142 people were killed in 2019 due to drunk driving, which is 29 people killed every day.
• 300,000 people per year are injured by drunk driving.
• The National Highway Traffic Safety Administration (NHTSA) traffic fatality estimates show that crashes have skyrocketed during the pandemic, largely due to impaired driving, speeding, and not wearing seatbelts.  An estimated 20,160 people died in traffic crashes in the first half of 2021, the largest number of projected traffic fatalities in that time frame since 2006.  
• Other NHTSA information indicates a significant increase in the presence of alcohol or other drugs (or a combination of more than one impairing substance) in seriously and fatally injured patients at five trauma centers since March 2020. 

What is the Tie One On for Safety Holiday Campaign?

The campaign encourages everyone to put a red ribbon on their car during the holiday season to help remind people to always designate a non-drinking driver.  This time of year, more people are on the roads due to holiday travel, parties, and family gatherings.  The holidays are also traditionally more dangerous on America's roads.  This makes it especially important to try to keep drunk drivers off the roads.

What can you do to help decrease drunk driving?

• Designated Drivers - If you are going out with friends, plan for one of you to be a non-drinking driver.  If you are hosting friends or family at your home, confirm that your guests have a non-drinking driver.
• If you are hosting a party, be sure to have non-alcoholic drinks, including some "mocktails" for any guests who may be a designated driver or who just choose not to drink alcohol.
• Ride-Sharing Services or Cabs - There are several ride-sharing options now available.  
  • If you are out alone and have been drinking, use one to get you safely home.  
  • If you are with someone who is impaired and does not have a designated driver, arrange a ride for them.  
  • If you know you will be drinking, use a service to get to your destination so you won't worry about leaving your car at the end of the night.
Talk to your kids - Have meaningful conversations with your middle school and high school age children about the dangers of using impairing substances, including the dangers of driving if they have used an impairing substance like alcohol or marijuana.  Kids' brains work differently than adult brains.  No matter how mature they may seem, they can make some pretty bad decisions sometimes.  
• Make sure they have a ride-sharing app installed on their phone so that if they are in a situation where they are impaired, they can use it.  You can deal with other consequences for their actions later, but in the moment, you want them to be as safe as possible if they do become impaired and should not be driving.
• Never ride with a driver who is impaired - And make sure your kids know that they should never get in the car with a driver who is impaired.
  

For more information, visit the MADD website at:

https://www.madd.org/the-solution/drunk-driving/tie-one-on-for-safety/

If you have any questions about drunk driving, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Testicular Cancer

We will continue our men's health series with a discussion of testicular cancer. While it is a highly treatable cancer, men in the affected age group should be aware of it to recognize the signs and seek appropriate treatment.

What is testicular cancer?

The testicles are responsible for making male hormones, such as testosterone, as well as making sperm.  They are made up of many different types of cells, and each type of cell can potentially develop into a different type of cancer.  The type of cell in which the cancer starts determines how the cancer is treated and how serious the cancer is.

How common is testicular cancer?

When compared with other types of cancer, testicular cancer is rare, but it is the most common cancer in American men between the ages of 15 and 35.  About 1 of every 250 males will develop testicular cancer at some point during their lifetime.  

In most cases, it is not clear what causes testicular cancer.  There is ongoing research trying to determine the cause.  The rate of testicular cancer has been increasing in the US for several decades.  We don't yet know why the incidence is increasing.  

What are the risk factors for developing testicular cancer?

Any man can develop testicular cancer.  These factors can increase your risk of developing it:

• Undescended testicle - The testicles develop in the abdominal area of the fetus.  They usually descend into the scrotum before birth.  Sometimes one of the testicles does not descend into the scrotum.  This can be treated by surgically relocating the affected testicle into the scrotum.  Men who have a testicle that did not descend into the scrotum are at higher risk of testicular cancer, regardless of whether they had the testicle relocated surgically.  This increased risk includes the testicle that descended normally.  However, most men who develop testicular cancer do not have a history of undescended testicles.
• Abnormal development of the testicle - This can be caused by various genetic conditions.
• Family history of testicular cancer in a father or brother - However, most men with testicular cancer do not have a family history of it.
• Age - Usually affects men between the ages of 15 and 35 but can occur at any age.
• Race - More common in white men than in black men.

What are the symptoms of testicular cancer?

• A lump or enlargement in either testicle - This is usually the first symptom.
• Dull aching in the abdomen or groin
• A heavy feeling in the scrotum
• Sudden collection of fluid in the scrotum
• Pain in the scrotum or testicle
• Back pain

Can testicular cancer be prevented?

No.  There is no known way to prevent testicular cancer.

Can testicular cancer be found early?

Yes.  Most testicular cancers can be found at an early stage, when they are small and haven't spread beyond the testicle.  Most doctors agree that examining a man's testicles should be part of a routine physical exam.  Men can also do monthly self-exams of the testicles after puberty, which are important to notice changes in the testicles.  Most testicular cancers are found by men, or their partners.

I will include a link below that explains how to do the exam on yourself.

Testicular cancer is very treatable, especially if found early.  Educate yourself and encourage the men in your life to learn more about testicular cancer.   Knowledge is power.  

For more information about testicular cancer, use these links.

https://testicularcancersociety.org/pages/self-exam-how-to

https://www.cancer.org/ More Info

If you have any questions about testicular cancer, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Prostate Cancer Part II - Diagnosis and Treatment

We are continuing our discussion of prostate cancer today, focusing on diagnosis and treatment.  Over the next few weeks, we will continue to spotlight men’s health issues, including testicular cancer and mental health.

Is there routine screening for prostate cancer?

Screening for prostate cancer is controversial.  Part of the reason for this is that prostate cancer screening finds both the slow growing kind that might never cause any problems along with the aggressive kinds.  That makes the research harder to sort out and determine if the benefits of testing outweigh the potential risks involved.  

Most medical organizations encourage men in their 50s to discuss the risks and potential benefits of prostate cancer screening with their doctors.  This will include your own specific circumstances including race, family history, personal preferences, etc.  

Black men or men with a family history of prostate cancer may want to have this discussion earlier.

What are the screening tests?

• Digital rectal exam - The prostate can be felt by your doctor on a rectal exam because the prostate is directly adjacent to the rectum.  Your doctor feels for any abnormalities in the size or shape of the prostate, as well as feeling for any lumps or change in texture.
• Prostate-specific antigen test (PSA) - This is a blood test that checks the level of a substance produced by the prostate.  If the level is higher than expected, this may indicate prostate cancer.  The level can also be high due to noncancerous conditions such as an enlarged prostate or inflammation, so the PSA test cannot diagnose prostate cancer.  Sometimes the test is repeated later to see if the elevation was just temporary.
  

What if the screening test is abnormal?  How is the diagnosis made?

There are several tests that can be done to make a definitive diagnosis.

• Ultrasound - An ultrasound uses sound waves to create a picture of the prostate.
• MRI - This can create a more detailed picture of the prostate, as well as the surrounding tissues such as lymph nodes.
• Biopsy - Collecting a tissue sample that can be analyzed to look for cancer cells.

How can you tell if the cancer is aggressive or not?

• Cancer Grading - Once the cancer cells are seen on the biopsy, the pathologist will determine the “grade” of the cancer, which is a level of the aggressiveness determined by how different the cells are from normal cells.  The scale used to evaluate the grade is called the Gleason score.  Most scores range from 6-10.  A score of 6 is low-grade, 7 is medium-grade, and 8 through 10 are considered high-grade cancers.
• Cancer Staging - There are several imaging tests that can be done to determine if prostate cancer has spread and the extent of the spread.  Your doctor will help determine which test is right for you.  These results are used to assign a “stage”, using Roman numerals I through IV.  Stage I is confined to the prostate.  Stage IV is the widest spread to other areas of the body.

How is prostate cancer treated?

Treatment depends on many things, including the grade and stage of your cancer, your underlying health status, and the potential benefits and risks or side effects of treatment.

• Active Surveillance - If your cancer appears to be slow growing and confined to a small area of the prostate, you may not require any treatment.  Your doctor may instead recommend what is called “active surveillance”.  This involves regular follow-up tests to monitor your cancer.  If the tests show progression of cancer, your doctor may recommend treatment.  This option may also be considered for a man of advanced age, or one who has serious medical conditions that may make treatment more difficult or who might have more risk than benefit from treatment.
• Surgery - Prostate cancer surgery involves removing the entire prostate gland, some of the surrounding tissue, and a few lymph nodes.  Surgery may be used for cancer confined to the prostate or in combination with other treatments in more advanced cancer.
• Radiation Therapy - Radiation treatments can be used instead of surgery in some cases, or after surgery to kill any potential remaining cancer cells.  It can also be used to treat cancer spread to other areas, such as the bones.  
• Hormone Therapy - Because prostate cancer cells rely on testosterone to grow, cutting off the supply of testosterone can cause cancer cells to die or to grow more slowly.  There are several hormone therapy options available.  
• Chemotherapy - This is sometimes used for prostate cancer that has spread to other areas of the body or if the cancer does not respond to hormone therapy.
• Immunotherapy - One of the most recent treatment options for prostate cancer is immunotherapy.  This type of therapy helps your immune system to see the cancer as foreign and start attacking those cancer cells.

We will continue to focus on the men’s health issues spotlighted by The Movember Foundation over the next couple of weeks. 

If you have any questions about prostate cancer, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor