TO YOUR GOOD HEALTH
By KEITH ROACH, M.D.
DEAR DR. ROACH: I’m 87 and have an enlarged prostate. When I get the urge to urinate, which is often, I have to go at once. Do you think that taking a bladder-control medicine would interfere with the Cardura (doxazosin) I’m taking to keep my urine duct (urethra) open? It’s getting to be a big problem. Hope you can help me. – CB
ANSWER: Both men and women can have urinary urgency (the sensation of needing to go right away), and sometimes this can lead to accidents. In women, the problem usually is attributed to bladder spasm, and in men it may be attributed erroneously to the prostate. Of course, it is possible to have both prostate problems like benign enlargement of the gland and bladder spasm, but oftentimes the problem in men is solely the bladder.
Some people need treatment for both, and there are no interactions I could find between doxazosin and bladder spasm agents like Detrol (tolterodine) or Ditropan (oxybutynin).
The booklet on men’s health discusses prostate gland enlargement. Readers can obtain a copy by writing: Dr. Roach – No. 1001W, 628 Virginia Drive, Orlando, FL 32803. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. ROACH: I read and hear of great health benefits attributed to eating nuts. I have a very healthy heart, but no one can consider himself beyond the specter of cancer. Also, possibly my neurological or other systems that deteriorate with age could benefit from eating nuts. Unfortunately, eating nuts or peanuts results in constipation that can last for days. Foods with dairy or egg components give me the same problem. Do I do myself a disservice by not eating nuts? Should I consider episodes of constipation worth the benefits? – J.M.
ANSWER: I have carefully read the new studies on nuts, and they confirm previous studies showing that nut consumption is associated with a lower risk of heart disease and overall death and, as you note, reduced cancer risk as well. However, this doesn’t prove that eating nuts reduces those risks. It is possible that people who eat nuts have other behaviors that are really responsible for their lower risk of disease.
However, the authors of the study did as good a job as possible to reduce that possibility.
In your case, I would think of nuts as a medicine. You have to consider the benefits (possibly lower risk of cancer and other diseases) against the side effects (constipation, which can be very unpleasant and reduce quality of life). One estimate is that nut consumption may increase lifespan by as much as a year.
You may have less benefit than other people from nut consumption because of your healthy heart. That would make me less likely to recommend nut consumption for you. If your constipation were more than mildly annoying, I probably wouldn’t “prescribe” nuts. Similarly, people with nut allergies, which are increasingly common, cannot enjoy the health benefits of nuts. Only you can determine if the modest improvement in (possible) life expectancy is worth the symptoms.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to P.O. Box 536475, Orlando, FL 32853-6475.
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