January 2009 Mayo Clinic Health Letter Highlights Improved PSA Tests, Dry Eyes and Colds
Improved PSA Tests a Better Gauge of Prostate Cancer Risk
A prostate-specific antigen (PSA) test can’t diagnose prostate cancer, but results indicate the risk of cancer. According to the January issue of Mayo Clinic Health Letter, recent fine-tuning of this test gives doctors better information to help determine cancer risk.
PSA is a substance produced in the prostate gland. Normally, a small amount of PSA enters the bloodstream. A higher amount or an abrupt rise in PSA levels can indicate a problem, possibly cancer.
However, PSA results aren’t specific; that is, a high PSA indicates increased risk of cancer, but not the presence of cancer. Nor does the risk information indicate how quickly a potential cancer might be growing. Most prostate cancers are slow growing. For older men, a slow-growing cancer may not cause symptoms and may never need treatment.
While not perfect, annual PSA testing, along with a digital rectal exam, remains the best option to detect prostate cancer early. Ask your physician about these recent refinements in PSA testing:
PSA velocity: This charts the change in PSA levels over time. PSA levels tend to increase more quickly in men who have prostate cancer than those with other prostate conditions. For example, an enlarged prostate, a benign condition, also can be indicated by increased PSA levels. Velocity testing is a reason why annual or more frequent PSA measures are important, because it shows subtle changes that can lead to early intervention and better outcomes.
PSA doubling time: Similar to PSA velocity, this test looks at how quickly PSA levels double. The risk of prostate cancer is particularly acute when PSA levels double within 18 months.
PSA density: Using ultrasound imaging, the physician determines the size of the prostate gland. With this data, the physician can evaluate the PSA number based on the gland’s size. For example, larger prostate glands produce more PSA.
Free versus total PSA: This test separates PSA in the bloodstream into two types. Bound or total PSA is attached to certain blood proteins, and free PSA isn’t. Prostate cancer is more likely to result from bound PSA. So, a lower percentage of free PSA compared to bound indicates an increased likelihood of cancer.
No More Dry Eyes — Tips to Get the Grit Out
Dry eyes can be a nuisance. But when severe cases are not treated, the condition becomes more than an irritation. The surface of the eye is susceptible to infection and scarring. The January issue of Mayo Clinic Health Letter covers the causes of dry eyes and treatment options.
Healthy eyes are continuously covered by layers of fluids. The outermost layer includes fatty acids that smooth the tear surface and slow evaporation of the thicker, middle layer, which is mostly water. Mucus makes up the innermost layer, which allows tears to be evenly spread over the eye surface. Dry eyes happen when any of these three components is out of balance.
For example, dry eyes occur when tear glands don’t produce enough fluids or when problems with blinking hamper tear distribution. Also, several commonly used medications, including diuretics, pain relievers, sleep medications and antidepressants, can cause dry eyes.
Most people with dry eyes don’t develop long-term complications, but they can happen. Treatments are designed to both increase comfort and reduce the possibility of complications. The best treatment depends on what is causing dry eyes.
If the irritant is lack of tears, using nonprescription artificial tears is the mainstay treatment. Generally, it’s best to avoid drops such as Clear Eyes and Visine, which reduce redness but may aggravate dry eyes. Some products have a thicker consistency, and their effects last longer, but they can blur vision. Others such as Refresh Dry Eye Therapy use an oil-based component to help prevent evaporation. Another option, Optive, lubricates the eye surface and keeps the eye healthy.
For severe dry eyes, a physician may recommend tear conservation methods such as blocking tear drainage with tiny silicone plugs or cauterizing the tissues of the tear drainage area so scarring closes the tear ducts.
Other options are prescription cyclosporine (Restasis) drops and corticosteroid drops or contact lenses that cover the white of the eye to help retain moisture. For impaired blinking, surgery may be needed.
At home, using eyedrops before eyes become irritated is helpful. Protecting eyes from blowing air, for example with wraparound sunglasses, can reduce eye irritation. So can avoiding smoke and not rubbing the eyes. A humidifier can help when the air inside the home is dry.
More Than a Week of Misery Could Mean More Than a Cold
When a cold lasts longer than seven to 10 days, or when symptoms seem to improve, then suddenly worsen, chances are good an acute sinus infection is the cause.
The body can usually fight off infection if symptoms are mild. But, according to the January issue of Mayo Clinic Health Letter, when symptoms last more than seven to 10 days, a secondary bacterial infection may be present. Antibiotics often can help.
The sinuses are a maze of air-filled chambers in the bones around the nose. They make mucus, which drains and moisturizes the nasal passages. When sinus openings become blocked due to the inflammation and swelling triggered by the cold virus, drainage is hindered and mucus builds. Bacteria thrive in this moist environment. A sinus infection can cause:
- Nasal congestion and facial pain and pressure
- A thick yellow or greenish discharge that drains from the nose or down the back of the throat
- Headache, pain in the upper teeth and jaw, or ear pain that comes on abruptly, usually following a cold
Most cases of acute sinusitis come and go within a month. If symptoms linger, a physician may recommend tests to determine the cause and an appropriate treatment plan. The common cold isn’t the only culprit that causes acute sinusitis. Other factors can include allergies, fungal infections, polyps in the nasal passage, and environmental pollution.
Testing might include nasal endoscopy, which involves inserting a thin, flexible scope with an attached light in the nose to visualize the drainage from the sinuses. This test helps identify abnormalities within the nose. Imaging tests of the sinuses or allergy skin testing also may be recommended.
Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today’s health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit www.HealthLetter.MayoClinic.com.
SOURCE Mayo Clinic