Monday, July 9, 2018

Dear doc, can prostate cancer come back?

 

Dear Doc,

Due to urination complications, my prostate was removed 16 years ago. Recently, the problem returned and another doctor says I have prostate cancer. How is this possible?

A prostate is a sexual gland that produces about 30 per cent of seminal fluid that carries sperms and because it surrounds the upper part of the urethra, it may interfere with urine passage when it grows bigger as happens when men get older.

When the urinary flow is obstructed, a man will find it difficult to pass urine requiring surgery as a relief and to prevent other urinary tract complications, especially those affecting the kidneys.

Surgery may then be done to remove all (if it is due to cancer) or part (if it is BPH) of the prostate gland in what is called prostatectomy.

Removing part of the prostate rather than the whole of it helps in preservation of urinary and sexual function and minimises the side effects of removing the whole prostate.

So, the doctor was right to treat your prostate enlargement, the reason you could urinate well after the operation and most likely your sexual function was preserved.

Unfortunately, as you grew older, you got cancer in the part that was left after the operation because it was previously not diseased.

Dear Doc,

I am 23 and my right breast produces milk when pressed. I gave birth in 2014 and stopped breastfeeding in 2016. Both breasts were producing milk when pressed long after I stopped breastfeeding; now it is just the right one. Is this normal?

It is possible to induce production of milk through repeated stimulation, either with the hands, by sucking or by using a breast pump, even without pregnancy or normal lactation and even in someone who has never been pregnant.

For someone who has been pregnant, as long as you keep stimulating the breasts, by pressing or sucking, milk will be produced.

About six weeks after breastfeeding stops, most people stop producing milk. In a few people this does not happen, but as long as there are no additional issues like pain or breast lump, there is no need to worry.

To avoid milk production, avoid breast stimulation (pulling, pinching, and sucking) and do not wear clothes that have a lot of friction between your nipples and the fabric.

Visit a doctor for a physical breast exam. You may have tests done to find out if you have high prolactin levels (the hormone that causes milk production), and if you have other disorders.

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