#Middlebury
DEAR DR. ROACH: There is a question that has intrigued me for years: What is the purpose of underarm and pubic hair? I guess, for that matter, what is the purpose of any body hair and hair on your head? – B.H.
ANSWER: Hair provides protection from the sun and helps regulate body temperature. Many evolutionary biologists believe our distant ancestors began losing most body hair when we began walking upright.
Axillary (underarm) and pubic hair are thought to be conserved because they reduce friction, wick moisture away from the skin, provide a small degree of protection and as part of sexual selection, possibly due to pheromones, hormones that act outside the body to attract others.
DEAR DR. ROACH: I’m confused. While it may be true that the majority of men having prostate cancer may never be bothered by it, what about the minority whose lives will be threatened by it? If they aren’t screened and treated, many will die. – G.F.
ANSWER: I had a professor in medical school, Dr. Larry Wood, who used to say, “If I have confused you, you’re probably paying attention.” You have identified a major issue with prostate cancer screening (and screening in general): If screening harms some but saves the lives of a few, is it worth doing? That answer may be different if you are coming from a public policy perspective versus an individual perspective.
Although we don’t know the exact numbers, it is estimated that about 47 men need to be treated for prostate cancer in order to save one life. Put another way, 46 out of 47 men are treated for prostate cancer, with its attendant risk of side effects, such as loss of sexual function and incontinence, without reducing their likelihood of dying of prostate cancer. We can’t predict with certainty whose prostate cancer is destined to kill them and whose is destined to be more indolent and slow-growing. The Gleason score, a measure of pathologic appearance of the cancer, helps, but is not completely accurate.
Ninety percent of men with screening-detected prostate cancer elect to get it treated. Based on the many letters I get, all of them feel like they were the lucky ones to have had their lethal cancer removed – even if, statistically, most of them were not destined to die from prostate cancer.
Because it is likely that the harms of screening outweigh the benefits, the U.S. Preventive Service Task Force has recommended against prostate cancer screening in general. However, there are certainly cases in which I feel prostate cancer screening (remember that “screening” means there are no symptoms or signs of cancer) is appropriate, which is why it’s important to have an individualized discussion of the risks and benefits of screening.
The booklet on the prostate gland discusses enlargement and cancer. Readers can obtain a copy by writing: Dr. Roach – No. 1001W, 628 Virginia Dr., 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.
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 Good Health, 628 Virginia Drive, Orlando, FL 32803.
(c) 2017 North America Synd. Inc.
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