My husband left me for an older woman

I refuse to be the stereotypical bitter single mum. Her age makes it easier. She has middle-aged spread and a lived-in face and he will probably end up caring for her in a few years

Perhaps I should find it harder knowing that my husband would prefer to be with a woman more than 10 years older than me. A woman who is not far off her 60th birthday. A woman still reaching forthe henna hair dye despite her advancing years.

She is old enough to be my daughters grandmother, never mind potential stepmother. How insulting, right? And what an outrage! Im younger, a toned size 10 and I look after my appearance. The humiliation should be devastating.

But, perhaps surprisingly, it makes things a whole lot easier.

There is absolutely nothing for me to be jealous about. No stereotypical younger woman with a pre-baby bodyand not a grey hair in sight. My husbands mistress has middle-aged spread and a lived-in face. When friends first spotted them together, they reassured me that he must be telling the truth when he said nothing was happening between them. There was no way they could be romantically together as she was so old. How wrong we all were.

He still denies an affair even now, despite the overwhelming evidence tothe contrary, claiming they formed arelationship after we had split up. But the signs of an affair were there long before the sickening suspicion and then, finally, the confirmation.

I can pretty much pinpoint when itstarted. From being my husbands everything, it was as if a switch had flicked off overnight. Cold and distant, he took up golf and disappeared forhours at a time. His phone was permanently clamped in his hand, and he would need to make private work calls at weekends and when we were on family trips. All affection was withdrawn and his hair-trigger temper became apocalyptic as he clearly resented every second he spent in mycompany.

With hindsight, it doesnt take apsychologist to work it out. He felt trapped in our marriage: we had two preschool-age daughters and he wanted his carefree life back. His mistresss children are grown up, so she and he are free of responsibility or restrictions. A holiday touring around south-east Asia? No problem. A music festival in New Orleans? Lets book it. Midlife crisis complete he has even started dressing like he did 25 years ago.

I dont blame his mistress one bit. She must have thought it was her luckyday when a handsome, younger man showed an interest. Maybe she thought she was destined for a life alone, or to be stuck with men of herown generation with prostate problems and a cosy pair ofslippers.

If it hadnt been her, it would have been someone else. It is not as if he met the love of his life and had to betrue to himself. She was just an escape route out of a life he viewed as mundane and humdrum until he didnt have it any more and realised the grass isnt always greener. Of course, life with two small children is hard throw in a long daily commute and it isdownright tough. But you deal with it and know that, for a short time, you might have to come a bit further down the priority list. Instead of which, he threw it all away for a woman he will probably end up caring for in a few years.

There were weeks of him sobbing and begging to come back, calling it the biggest mistake of his life but, by then, I had begun to experience how life could be, should be fun, light-hearted and not living in fear of someone elsesmood swings. The cloud of doomhad left the building and I was not going to let it back in.

Now things have calmed down andwe are a few years down the line, Iam glad he is with an older woman. He andI arent right together, and my daughters seem to like her. Because she is a mum herself, I trust her with my children and am happy there is someone else looking out for them when they visit their dad. Better they are staying in her beautiful home than a depressing bedsit.

Granted, this wasnt the life I had imagined. The Richard Curtis world ofhappy ever after with a mum and adad in a rambling house hosting big parties filled with children running in and out. We had talked about moving out to the countryside one day dreams that were all whipped away pretty much overnight, leaving a void of uncertainty. But one thing I know is how unhappy the girls and I would be if their dad and I still shared a home.

Yes, things such as parents evenings, sports days and school shows can be hard when you are surrounded by other parents with their partners. Orwhen one of the girls has done something particularly funny or clever and you long to be able to exchange that proud look with someone who loves them just as much as you.

But the reality is, even if we were still together, those situations would not happen like that. He would be scowling and surly at parents evening, or he would refuse to talk ormake eye contact with me at sports day. It would not have been the normal interaction I see with other couples. And, anyway, the older I get, the more I realise that quite often the happy facade many couples present is very different from the reality when the front door is closed.

I refuse to be the stereotypical bitter single mum: I am a professional fortysomething mother with a very busy, joy-filled life who just happens to be parenting alone. I dont sit around swigging chardonnay and slagging off men. I love men I have three brothers and lots of male friends. One bad marriage doesnt mean its game over. Perhaps surprisingly, I dont regret my choice of husband. We were deeply in love once and shared many special times. We also created two perfect little people. One day, I hope that I will find love again, but perhaps this time Iwill choose someone who has put their midlife crisis far behind them.

Read more: https://www.theguardian.com/lifeandstyle/2017/nov/25/my-husband-left-me-for-an-older-woman

This Is How To Calm Your Bladder And Pee Less Often

Do you often feel the urge to pee and feel like you just can’t hold it? Do you head to the bathroom far more than you think is normal? You may have overactive bladder (OAB), a condition that affects about 33 million Americans. With OAB, people experience sudden urges to urinate that they can’t control, as well as the need to urinate frequently. People with OAB may also leak when they experience the urge to urinate.

Who Gets OAB?

According to the American Urological Association, up to 30 percent of men and 40 percent of women in the U.S. experience OAB symptoms. Women who have gone through menopause and men who have had prostate problems have a greater risk for OAB. And risk increases with age. In addition, some medications may cause or worsen urinary symptoms. These include blood pressure drugsdiuretics and a class called alpha blockers (Cardura, Minipress)antidepressants and sleeping medications.

Doctors diagnose OAB based on a physical exam, symptoms of frequency and urgency, and other test results. Urinary frequency is defined as urinating at least eight times in a 24-hour period. You may also wake up to urinate two or three times a night. In about 40 percent of patients, OAB resolves on its own within a year, but most people suffer from symptoms for years.

Luckily there is much you can do to alleviate symptoms and overcome overactive bladder.  

OAB Treatments

Lifestyle changes are a first step in overcoming overactive bladder. What you eat, how you exercise, and how well you take care of yourself all factor in your overall bladder health and your success at alleviating overactive bladder symptoms, says Karen Sebastian, M.S.P.T., a physical therapist in Honolulu, HI, who specializes in bladder control issues. Here, a primer on lifestyle practices that can help: 

1. Change your diet 

What you eat and dont eat can affect your symptoms.

Reduce: 

  • Diuretics, such as alcohol and caffeine, which stimulate muscles in the bladder, increasing urgency. Limit caffeine to 100 mg a day (about half a cup of coffee). 
  • Irritants, including acidic fruits and juices, carbonated beverages, spicy foods and artificial sweeteners like saccharine and aspartame

Eat more: 

  •  Fiber. Because the bladder and rectum are in close proximity, being constipated puts constant pressure on the bladder, says Sebastian. In fact women with OAB have higher rates of constipation than those without the condition. Load up on fruits, vegetables and whole grains.

2. Exercise 

While Kegels are the best exercise for urinary health (See how to do them below), having a strong back and core are also important. Were finding more and more in research that our muscles work together in groups, says Sebastian. Your abs and adductorship musclesattach directly to the pubic bone. And muscle fibers in the hip feed into the pelvic floor. They all help each other activate. To ease bladder symptoms, try three moves once a day, while lying down on your back:

  • Inner thigh squeeze. With your knees bent and feet on the floor, place a pillow between your knees and lightly squeeze to work your adductors. Inhale, and as you exhale, clench your stomach muscles to tilt your pelvis up, while keeping your tailbone on the floor. (It should feel like you’re pulling your pelvis towards your belly button.) Hold for 10 seconds while breathing normally. Relax completely. Repeat 10 times.   
  • Hip flexors. Position yourself as you did for the “inner thigh squeeze” exercise, but without the pillow. Inhale, and as you exhale, clench your stomach muscles to tilt your pelvis up, while keeping your tailbone on the floor. Then lift up your hips to create a bridge, and slowly open and close your knees 10 times. Lower your hips and relax completely. Repeat 2 or 3 times for a total of 20 to 30 hip rotations. 

3. Meditate 

Some women find their bladder symptoms are eased when they tap into the mind-body connection. Women who listened to a 15-minute audio recording using deep breathing and visualization exercises twice a day for two weeks cut the average number of their urge incontinence episodes from 42 to 16 per week, Loyola University researchers have reported. The women also boosted their continuous dry time from 32 to 100 hours per week.

Try this deep-breathing exercise:

Lie down and get comfortable. Allow yourself 10 undisturbed minutes. Take a few slow, deep breaths, allowing your belly to rise and fall. With each exhale let your muscles go, allowing yourself to melt into your supporting surface.

Concentrate on your breath. Inhale to a silent count of 3, allowing your stomach to rise, hold for a second at the top of your inhale, then slowly exhale to a silent count of 3. Repeat this pattern five times.  Next, continue breathing slowly and deeply, but now to a count of 4. Progress to a count of 5, then 6.

Re-focus on your surroundings. Slowly bring your attention back to the here and now. 

4. Do Kegel Exercises

Your pelvic floor muscles support your urethra and bladder, so keeping them strong is crucial to preventing leaks. Research shows that Kegel exercises, which involve contracting and releasing the pelvic floor muscles, can be very helpful.  Kegels are a good starting point for anyone with a bladder problem, says Lauri Romanzi, MD, a uro-gynecologist in New York City. Try this Kegel routine recommended by the American Urogynecologic Society (AUS), three times a day:  

  • Start by pulling in and holding a pelvic muscle squeeze (as if you were trying to stop yourself from urinating) for 3 seconds then relax for an equal amount of time (3 seconds). Do this for 10 repetitions.
  • Increase your contraction hold by 1 second each week until you are contracting for a 10-second squeeze.
  • Remember to rest and breathe between contractions.
  • When you start, do the exercises while lying down. As you get stronger; do an exercise set sitting and standing.

If self-help tactics arent enough to get symptoms under control, your doctor may suggest bladder training, which involves scheduling times for urinating instead of waiting for the urge, for instance, and other behavioral measures. A medication that relaxes the bladder may also be prescribed. Together these measures often improve the problemand your quality of life. 

Read more from Grandparents.com:

6 Look-Younger Tips That Don’t Work

10 Best Drugstore Beauty Buys Under $10

7 Biggest Cellulite MythsAnd What You Can Do About It

Read more: http://www.huffingtonpost.com/2015/11/12/this-is-how-to-calm-your-bladder-and-pee-less-often_n_8547116.html

Horrifying Things Caused By Shockingly Naive Charities

It’s said that the road to hell is paved with good intentions. That may be true, but it’s also lined with giant signs reading CAUTION: THIS IS THE ROAD TO HELL. It’s up to you to put your goddamn phone away and read them. But not everybody does, and that’s why some of the most charitable gestures went straight to shit after folks overlooked some glaring problems that were apparent right from the jump.

#5. Providing Water To Rural Africa With Inadvertent Child Labor

Rural Africans spend nearly 40 billion hours fetching water from old-fashioned hand pumps every single year. To put it in perspective, that’s about the same amount of time the world collectively spent in front of Netflix in 2015. That’s why borehole driller, engineer, and habitual well-meaner Ronnie Stuiver devised a contraption to significantly lessen this burden. The PlayPump was a merry-go-round connected to an underground water pump, thereby allowing a utility to literally run on the power of children’s laughter, a la Monsters, Inc. The invention was awarded the World Bank Development Marketplace Award for its ingenuity, and donations soon poured in from the U.S. government, two major foundations, and, um, Jay-Z.

With the funding (and street cred) secured, the project pledged to install 4,000 PlayPumps by 2010, providing clean drinking water to 10 million Africans.

“Step 8: Repeat steps 1-7 to get those kids some water too.”

What Could Possibly Go Wrong?

In order to meet the projected numbers, children would have had to “play” on the merry-go-rounds non-stop for 27 hours a day. Which you may recognize as A.) Impossible and B.) Some pretty messed up foreshadowing. Adults assigned kids strict play schedules, paid them meager wages to “play,” or simply threw their hands up and spun the goddamned things themselves. And that’s when the PlayPump’s true weakness came to light: Remove childhood exuberance from the equation, and the device was just plain exhausting to operate. Spinning it like a madman produced the sad stream of a 70-year-old with prostate problems:

Also not helping: PlayPumps were ridiculously expensive to build, the infrastructure to repair their (frequent) breakdowns was nonexistent, and they were installed without so much as asking the locals if they wanted to replace their (working) hand pumps with a toy that required enslaving their young ones for impossible hours a day.

#4. The DoD Packaged Food Aid Like Unexploded Cluster Bombs

The US Department of Defense developed Humanitarian Daily Rations — a culturally sensitive vegetarian meal capable of providing exactly one day’s worth of nourishment to exactly one human. Bearing the pleasant message “A Food Gift From the People of the United States of America” which approximately 100 percent of its recipients couldn’t read, the package was bright yellow for easy spotting and could be air-dropped en masse, in full accordance with the DoD philosophy that any international crisis worth solving is best solved by dropping shit out of airplanes.

“The only flavor is freedom.”

What Could Possibly Go Wrong?

This crucial, life-saving product had a somewhat difficult market introduction due to aggressive competition from another heavily marketed U.S. export: explosions. You see, the HDR packages were the same color and about the same size as unexploded cluster munitions.

One contains enough food to sustain you for a day.
The other blasts you into a fine mist. Good Luck!

Back in the early 2000s, the U.S. was cluster-bombing the crap out of Afghanistan while simultaneously filling its skies with millions of HDR packages to aid refugees. Cluster bombs contain up to 200 bomblets, which scatter in midair to turn a sizable area into a wailing lake of fire. Up to 30 percent of them fail to detonate on impact, leaving behind a maiming-in-a-can just waiting for some unlucky bastard to unwittingly pop its tab.

To their credit, the DoD changed the color of the packages once this was pointed out. But since they had a significant stock of yellow HDRs to use up first, they taught recipients how to differentiate between the two in the best way they knew how: by dropping instructive flyers out of airplanes.

“Make the least favorite in the family test it first.”

#3. The Worst Person Possible Wins An Anti-Rape Benefit Lottery

In 2009, Lucky Times Pull Tabs ran a statewide lottery in Alaska to help raise funds for the Anchorage nonprofit group STAR (Standing Together Against Rape). With a cool half-million-dollar jackpot (the largest in the state’s history) and a good cause behind it, the organizers had everything going for them.

What Could Possibly Go Wrong?

Here’s the thing about lotteries: There’s absolutely no way to know who’s going to win. And so it came to pass that the winning ticket for the $500,000 anti-rape jackpot went to three-time convicted sex offender Alec Ahsoak.

“Alright, now do Popeye.”

The day after the winning ticket was drawn, Ahsoak flagged down a group of reporters to make his good fortune known to the world. When his checkered past came to light, Ahsoak claimed to be a changed man who was currently undergoing treatment, and even pledged to donate $100,000 of his winnings to STAR. Ahsoak’s (predictably empty) promise did little to assuage his victims, however, two of whom came out to publicly announce their utter disgust for the circumstances.

Nor did it do much to assuage the tire iron of one Brandon J. Hughes, who took it upon himself to track down Ahsoak and “beat his ass” in the street like a low-budget Batman. When all was said and done, the final tally was $350,000 (after taxes) and an abundance of stitches for Ahsoak, three years in prison for his assailant, and a newfound lack of faith in humanity for STAR.

The tire iron received 10 years due to outstanding warrants.

#2. A Charity Triathlon Nearly Drowned Hundreds

Close to 900 people gathered near Annapolis, Maryland one Sunday morning in January of 1991 to raise money for the American Diabetes Association by swimming 4.4 miles across the Chesapeake Bay, followed by a 13-mile run and a 76-mile bike ride. Some people consider that “fun.” Those people are insane. But together, those beautiful maniacs intended on conquering land, sea, and then … well, land again, to demonstrate to Mother Nature just where she could stuff her shitty disease.

What Could Possibly Go Wrong?

Swimmers began hitting the water shortly after 8:00 a.m. By 9:30, several hundred of them were being flushed off course down the bay, in very real danger of horrifically drowning — or worse, ending up in Virginia. That’s because Fletcher Hanks, the event’s organizer, had scheduled the swim to perfectly coincide with the ebbing tide, meaning that the participants found themselves swimming against a two-knot current. To compound the problem, the only safety net provided was a ragtag group of 55 private boats assembled by Hanks — the absolute minimum required to get the event approved, and “woefully inadequate” to contain a veritable flood of flailing people.

“What? We gave them all orange caps so we could find them in the unforgiving sea.”

A fleet made up of the Coast Guard, Coast Guard Auxiliary, the Department of Natural Resources, and a state police medevac helicopter swooped in to yank 720 people out of the drink. Miraculously, no one drowned, though a handful suffered hypothermia and one especially unlucky paddler was found three full miles down the bay. Hanks was arrested later that day for trying to continue the event without having a permit for the running and cycling stages, because you can’t make a triathlon without nearly drowning a few eggs.

#1. Western “Charities” Keep “Rescuing” Disaster-Stricken “Orphans”

People are inherently good, and there are plenty of them willing to do whatever it takes, personal consequences be damned, to provide a safe environment for children in need. People like volunteer firefighter and renowned 4X4 enthusiast Eric Breteau, founder of the French nonprofit Zoe’s Ark, whose mission was to rescue children orphaned by the war in Darfur. Or Laura Silsby, founder of the Idaho-based New Life Children’s Refuge, which aimed to provide a safe haven for orphans in the wake of the 2010 Haiti earthquake.

What Could Possibly Go Wrong?

Both organizations were wildly successful at saving unwanted, abandoned orphans … from their loving families.

“But could their families have given them the chance to become someone’s new Facebook profile photo?”

In the case of New Life Children’s Refuge, that meant telling desperate and terrified parents that their children would be kept safe in a brand-spanking-new Dominican Republic orphanage until the chaos from the quake died down. To be fair, this wasn’t the initial plan: Silsby first tried to stir up a sufficient orphan supply by going door to door at existing orphanages and asking if they had any leftover kids. Only when that failed did she resort to persuading shell-shocked parents to hand over their children with promises of a life filled with soccer fields and swimming pools. The group managed to round up 33 kids — all of whom had either loving parents or immediate family — before being arrested at the Haitian border.

Eric Breteau’s professed mission was to rescue Sudanese orphans from refugee camps in Chad and whisk them to France, where a number of couples had already put down deposits and were anxiously awaiting delivery of their shiny new war orphans. French authorities warned the group that their plan was likely super duper illegal, and Chadian authorities were duly notified. Breteau and Co. responded by registering the charity under a new name, donning freshly-printed “Children Rescue” T-shirts, and proceeding to convince Chadian parents that they were opening a nearby refuge where their children would receive top-notch care and a free education. Zoe’s Ark managed to bullshit their way into 103 kids who were neither orphans nor from Sudan, but were definitely children, probably.

“Here’s the son you ordered.”

Cargo secured, the group went to the airport, disguised the kids as war casualties, and told the flight crew that they were being transported to France for medical attention. Thankfully, the criminal do-gooders were apprehended before the flight left the ground, bringing their ill-conceived vigilante adoption scheme to an end. To their credit, both Zoe’s Ark and New Life Children’s Refuge eventually succeeded in their goal of finding the children loving homes — the exact same homes they were “rescued” from in the first place.

For more people who should’ve thought twice about their altruism, check out 5 Popular Forms of Charity (That Aren’t Helping) and 5 Famous Charity Songs That Were Insanely Harmful.

Read more: http://www.cracked.com/article_23796_5-charities-that-failed-in-worst-way-imaginable.html

Man who killed abortion doctor gets more lenient sentence

Scott Roeder, 51-year-old Kansas City-area man charged with murder of Kansas abortion doctor George Tiller, is seen in this undated booking photograph  (Reuters)

The man who seven years ago ambushed and fatally shot one of the few U.S. doctors performing late-term abortions was given a more lenient sentence Wednesday of at least 25 years in prison before becoming eligible for parole.

At a surprise resentencing hearing, prosecutors withdrew their request that Scott Roeder serve at least 50 years before parole eligibility. Roeder also was sentenced to an additional two years for aggravated assault for threatening two church ushers as he fled.

“I was really shocked about today,” Roeder said in a jailhouse phone call to The Associated Press after the hearing. “I was glad obviously to hear the sentence reduced, but I was looking forward to being another voice for the unborn so I was disappointed in that respect.”

He said he knew the consequences of his actions going in and has “no regrets” because children have been saved because of him.

Roeder was convicted in January 2010 of premeditated first-degree murder for the shooting death of Dr. George Tiller as he was serving as an usher in the foyer of the doctor’s church in Wichita on May 31, 2009.

Tiller’s murder was among the most notorious acts of violence since the U.S. Supreme Court legalized the procedure nationwide in 1973. It alarmed the abortion rights community and came as numerous conservative states, including Kansas, passed restrictions making it harder for women to obtain abortions.

The hearing Wednesday came just days before Roeder was set to go before a jury on Monday for what had been anticipated to be a two-week sentencing hearing. Roeder’s original life sentence with no chance of parole for 50 years was among many vacated after the U.S. Supreme Court ruled in 2013 that juries, not judges, must decide whether to increase punishment.

Roeder, who suffers from prostate problems, looked much thinner than at his initial sentencing in 2010 and was subdued throughout the proceeding. He chose not make a courtroom statement before the judge pronounced his sentence.

That was in contrast to the previous sentencing hearing that Roeder used as a forum to espouse at length on his anti-abortion views in an effort to justify his killing the doctor to save unborn babies.

Sedgwick County District Attorney Marc Bennett said that the decision not to seek the added time was reached by prosecutors after examining Roeder’s health, his expected life span and the likelihood of whether he would ever be released from prison alive. Tiller’s family was also consulted, he said.

Bennett told reporters after the hearing that “rather than putting the community and the victim’s family and witnesses through another contested hearing” in order to extend a 58-year-old defendant’s parole eligibility from 25 to 50 years, the state decided to withdraw the request.

He cited the 58-year-old defendant’s declining health and the unlikelihood of him living long enough to ever get out of prison. Bennett said the decision was made “in the best interest” of the community and Tiller’s family.

Bennett also read a statement from Tiller’s family saying nothing will change the fact Tiller was assassinated, and the family continues to grieve his loss. The family cited the “very difficult and emotionally draining trial” in which Roeder was found guilty, and thanked people involved with ensuring it was a fair trial.

Tiller’s family said they had decided to support the sentence of a minimum 25 years in prison without parole.

“With this legal closure, the Dr. George Tiller family will continue to heal and thrive and live fully in our communities,” their statement said.

The abortion rights group Trust Women, which opened a clinic in 2013 in the same facility where Tiller once practiced, said in a statement its staff is grateful the doctor’s family has some measure of closure and healing. Its founder, Julie Burkhart, said Roeder deserves the maximum sentence allowed by law.

“Dr. Tiller’s assassination most certainly left a hole in the reproductive rights movement, but we remain committed to this critical work in his honor and memory,” Burkhart said.

Defense attorney Mark Rudy said after the hearing that he thinks his client is relieved it is over, and no appeal is planned. The defense has already lost on every other appeal issue and this is the minimum sentence Roeder could hope to receive, he said.

“We are glad we can put this to rest,” Rudy said.

Read more: http://www.foxnews.com/us/2016/11/23/man-who-killed-abortion-doctor-gets-more-lenient-sentence.html

Experts reverse themselves on prostate cancer screenings

(CNN)Men younger than 70 with no signs of prostate cancer may no longer be discouraged from checking their PSA levels, according to guidelines proposed today by the US Preventive Services Task Force.

But experts say that a positive test may leave some confused about what to do next.
In 2012, the task force recommended against routinely checking the levels of prostate-specific antigen, or PSA, in the blood, saying that the risks outweighed the rewards. But the latest draft loosens the reins for men 55 to 69 with no symptoms or history of prostate cancer: The former D rating, which discourages screening, has been upgraded to a C, which leaves the decision up to “a man’s values and preferences,” the task force said in a statement.
    The D rating remains for men 70 and older.
    According to the task force, many prostate cancers grow slowly or not at all, so some men will not experience any symptoms, nor will they die from the cancer.
    “We were very concerned in 2012 that many, many men were being treated for prostate cancer,” said Dr. Kirsten Bibbins-Domingo, chairwoman of the task force, an independent panel of medical experts.
    “The balance has shifted,” she added, “and now we can recommend that men have a conversation with their doctors about screening.”
    Bibbins-Domingo said that several studies have reinforced not only the benefits of PSA tests but also ways to lessen the harms of screening, which include unnecessary biopsies and treatments. Because radiation and surgery may lead to impotence, bowel injury and problems with urination, some men may be uncertain about what to do with a positive test result.
    One of the studies that influenced the committee’s decision came in October, when researchers showed that doctors could safely monitor a patient’s prostate cancer — largely through repeated PSA checks — without rushing to treat it.
    In the study, only about 1% of men died of prostate cancer over 10 years, with no significant differences between those who were treated and those who simply kept a watchful eye. The authors calculated that a surgeon would need to perform 27 prostate removals in order to prevent just one case of the cancer spreading to other areas.
    “Men who have low-risk prostate cancer, they don’t have to go right away to aggressive treatment,” Bibbins-Domingo said.

    An imperfect test

    Not everyone fully agrees with the proposed changes, which are open to public comment through May 8.
    “Prostate screening has been a contentious issue ever since the prostate specific antigen test became available more than three decades ago,” Dr. Otis Brawley, chief medical officer of the American Cancer Society, wrote today in a CNN op-ed.
    Prostate cancer is one of the most common types among men in the US; nearly 13% will be diagnosed with it over the course of their lifetimes, according to the National Cancer Institute. The latest data show that over 180,000 men were diagnosed with prostate cancer in 2016, but there were only 26,000 deaths from it. Prostate cancer accounted for 4.4% of all cancer deathsin the United States last year.
    Prostate cancer can raise levels of PSA, a protein produced by the prostate gland — but this doesn’t happen in all cases. PSA can also go up for other reasons, such as infections or benign enlargement of the prostate. Because the test is imperfect, Brawley said, there are a number of missed cancers and false alarms.
    “It literally misses as many prostate cancers as it finds,” Brawley said.
    About 70% of men with elevated PSA do not have prostate cancer when they are biopsied, according to research.
    “The PSA test is not a great test. We all acknowledge that. We need better tests,” Bibbins-Domingo said.
    “We encourage men to be informed, and that is the basis of this recommendation,” she added.
    A number of celebrities and politicians have become advocates of PSA testing after being diagnosed, Brawley said, raising awareness and fueling what he described as a “screening frenzy” that was also driven by early research, health fairs and doctors themselves. Prostate cancer treatments also led to considerable profits for hospitals, he added.
    Last year, actor Ben Stiller announced that he had had his prostate surgically removed in 2014, after testing revealed that he had developed prostate cancer in his 40s.
    “Taking the PSA test saved my life. Literally,” he wrote in a blog post.

    Patients first

    Dr. John Meigs, president of the American Academy of Family Physicians, often thinks of two former patients who were screened when the PSA test was used more liberally. Both had high PSA levels and were eventually diagnosed with prostate cancer.
    “They could not live with the fact that they had cancer. It had to come out,” Meigs recalled.
    But his patients died of something else entirely and spent their final years “incontinent and miserable,” he said.
    “We did them no favors by telling them they had cancer and giving them surgery,” he added.
    But now that there is more evidence about the pros and cons of screening and treatment, Meigs said, a “primary care physician is probably the best one to have that conversation, someone who knows them and their entire situation.”
    The American Academy of Family Physicians will conduct its own review of the evidence. However, Meigs said that he and other family doctors have come to depend on the task force’s recommendations, which are known for sticking closely to the available evidence.
    The proposed guidelines do not specify how often men might want to screen their PSA levels, if they choose to do so. Bibbins-Domingo said the largest European studies have generally screened every two to four years.
    “A discussion to send a PSA test shouldn’t happen annually,” she said.
    The new suggestions do not single out men who have an increased risk of prostate cancer, such as African-American men, who are roughly twice as likely to die of prostate cancer as the general population. Men with a family history of prostate cancer would also fall into this category.
    Bibbins-Domingo said that more research is needed to figure out whether to screen these men more aggressively than the general population.
    The task force updates their guidelines every five years. Bibbins-Domingo said that the final draft may come toward the end of the year, once the task force considers all the public comments it receives.

    See the latest news and share your comments with CNN Health on Facebook and Twitter.

    Brawley said that, despite the possible harms, patient preference comes first.
    “Some men who are very concerned about prostate cancer will elect to be screened, and others who are less concerned will elect not to be screened; either decision should be supported,” he wrote.
    “Once diagnosed, hopefully patients and their physicians will not rush into treatment,” he added.

    Read more: http://www.cnn.com/2017/04/11/health/prostate-cancer-screening-guidelines-draft/index.html

    This Is How To Calm Your Bladder And Pee Less Often

    Do you often feel the urge to pee and feel like you just can’t hold it? Do you head to the bathroom far more than you think is normal? You may have overactive bladder (OAB), a condition that affects about 33 million Americans. With OAB, people experience sudden urges to urinate that they can’t control, as well as the need to urinate frequently. People with OAB may also leak when they experience the urge to urinate.

    Who Gets OAB?

    According to the American Urological Association, up to 30 percent of men and 40 percent of women in the U.S. experience OAB symptoms. Women who have gone through menopause and men who have had prostate problems have a greater risk for OAB. And risk increases with age. In addition, some medications may cause or worsen urinary symptoms. These include blood pressure drugsdiuretics and a class called alpha blockers (Cardura, Minipress)antidepressants and sleeping medications.

    Doctors diagnose OAB based on a physical exam, symptoms of frequency and urgency, and other test results. Urinary frequency is defined as urinating at least eight times in a 24-hour period. You may also wake up to urinate two or three times a night. In about 40 percent of patients, OAB resolves on its own within a year, but most people suffer from symptoms for years.

    Luckily there is much you can do to alleviate symptoms and overcome overactive bladder.  

    OAB Treatments

    Lifestyle changes are a first step in overcoming overactive bladder. What you eat, how you exercise, and how well you take care of yourself all factor in your overall bladder health and your success at alleviating overactive bladder symptoms, says Karen Sebastian, M.S.P.T., a physical therapist in Honolulu, HI, who specializes in bladder control issues. Here, a primer on lifestyle practices that can help: 

    1. Change your diet 

    What you eat and dont eat can affect your symptoms.

    Reduce: 

    • Diuretics, such as alcohol and caffeine, which stimulate muscles in the bladder, increasing urgency. Limit caffeine to 100 mg a day (about half a cup of coffee). 
    • Irritants, including acidic fruits and juices, carbonated beverages, spicy foods and artificial sweeteners like saccharine and aspartame

    Eat more: 

    •  Fiber. Because the bladder and rectum are in close proximity, being constipated puts constant pressure on the bladder, says Sebastian. In fact women with OAB have higher rates of constipation than those without the condition. Load up on fruits, vegetables and whole grains.

    2. Exercise 

    While Kegels are the best exercise for urinary health (See how to do them below), having a strong back and core are also important. Were finding more and more in research that our muscles work together in groups, says Sebastian. Your abs and adductorship musclesattach directly to the pubic bone. And muscle fibers in the hip feed into the pelvic floor. They all help each other activate. To ease bladder symptoms, try three moves once a day, while lying down on your back:

    • Inner thigh squeeze. With your knees bent and feet on the floor, place a pillow between your knees and lightly squeeze to work your adductors. Inhale, and as you exhale, clench your stomach muscles to tilt your pelvis up, while keeping your tailbone on the floor. (It should feel like you’re pulling your pelvis towards your belly button.) Hold for 10 seconds while breathing normally. Relax completely. Repeat 10 times.   
    • Hip flexors. Position yourself as you did for the “inner thigh squeeze” exercise, but without the pillow. Inhale, and as you exhale, clench your stomach muscles to tilt your pelvis up, while keeping your tailbone on the floor. Then lift up your hips to create a bridge, and slowly open and close your knees 10 times. Lower your hips and relax completely. Repeat 2 or 3 times for a total of 20 to 30 hip rotations. 

    3. Meditate 

    Some women find their bladder symptoms are eased when they tap into the mind-body connection. Women who listened to a 15-minute audio recording using deep breathing and visualization exercises twice a day for two weeks cut the average number of their urge incontinence episodes from 42 to 16 per week, Loyola University researchers have reported. The women also boosted their continuous dry time from 32 to 100 hours per week.

    Try this deep-breathing exercise:

    Lie down and get comfortable. Allow yourself 10 undisturbed minutes. Take a few slow, deep breaths, allowing your belly to rise and fall. With each exhale let your muscles go, allowing yourself to melt into your supporting surface.

    Concentrate on your breath. Inhale to a silent count of 3, allowing your stomach to rise, hold for a second at the top of your inhale, then slowly exhale to a silent count of 3. Repeat this pattern five times.  Next, continue breathing slowly and deeply, but now to a count of 4. Progress to a count of 5, then 6.

    Re-focus on your surroundings. Slowly bring your attention back to the here and now. 

    4. Do Kegel Exercises

    Your pelvic floor muscles support your urethra and bladder, so keeping them strong is crucial to preventing leaks. Research shows that Kegel exercises, which involve contracting and releasing the pelvic floor muscles, can be very helpful.  Kegels are a good starting point for anyone with a bladder problem, says Lauri Romanzi, MD, a uro-gynecologist in New York City. Try this Kegel routine recommended by the American Urogynecologic Society (AUS), three times a day:  

    • Start by pulling in and holding a pelvic muscle squeeze (as if you were trying to stop yourself from urinating) for 3 seconds then relax for an equal amount of time (3 seconds). Do this for 10 repetitions.
    • Increase your contraction hold by 1 second each week until you are contracting for a 10-second squeeze.
    • Remember to rest and breathe between contractions.
    • When you start, do the exercises while lying down. As you get stronger; do an exercise set sitting and standing.

    If self-help tactics arent enough to get symptoms under control, your doctor may suggest bladder training, which involves scheduling times for urinating instead of waiting for the urge, for instance, and other behavioral measures. A medication that relaxes the bladder may also be prescribed. Together these measures often improve the problemand your quality of life. 

    Read more from Grandparents.com:

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    Read more: http://www.huffingtonpost.com/2015/11/12/this-is-how-to-calm-your-bladder-and-pee-less-often_n_8547116.html

    Horrifying Things Caused By Shockingly Naive Charities

    It’s said that the road to hell is paved with good intentions. That may be true, but it’s also lined with giant signs reading CAUTION: THIS IS THE ROAD TO HELL. It’s up to you to put your goddamn phone away and read them. But not everybody does, and that’s why some of the most charitable gestures went straight to shit after folks overlooked some glaring problems that were apparent right from the jump.

    #5. Providing Water To Rural Africa With Inadvertent Child Labor

    Rural Africans spend nearly 40 billion hours fetching water from old-fashioned hand pumps every single year. To put it in perspective, that’s about the same amount of time the world collectively spent in front of Netflix in 2015. That’s why borehole driller, engineer, and habitual well-meaner Ronnie Stuiver devised a contraption to significantly lessen this burden. The PlayPump was a merry-go-round connected to an underground water pump, thereby allowing a utility to literally run on the power of children’s laughter, a la Monsters, Inc. The invention was awarded the World Bank Development Marketplace Award for its ingenuity, and donations soon poured in from the U.S. government, two major foundations, and, um, Jay-Z.

    With the funding (and street cred) secured, the project pledged to install 4,000 PlayPumps by 2010, providing clean drinking water to 10 million Africans.

    “Step 8: Repeat steps 1-7 to get those kids some water too.”

    What Could Possibly Go Wrong?

    In order to meet the projected numbers, children would have had to “play” on the merry-go-rounds non-stop for 27 hours a day. Which you may recognize as A.) Impossible and B.) Some pretty messed up foreshadowing. Adults assigned kids strict play schedules, paid them meager wages to “play,” or simply threw their hands up and spun the goddamned things themselves. And that’s when the PlayPump’s true weakness came to light: Remove childhood exuberance from the equation, and the device was just plain exhausting to operate. Spinning it like a madman produced the sad stream of a 70-year-old with prostate problems:

    Also not helping: PlayPumps were ridiculously expensive to build, the infrastructure to repair their (frequent) breakdowns was nonexistent, and they were installed without so much as asking the locals if they wanted to replace their (working) hand pumps with a toy that required enslaving their young ones for impossible hours a day.

    #4. The DoD Packaged Food Aid Like Unexploded Cluster Bombs

    The US Department of Defense developed Humanitarian Daily Rations — a culturally sensitive vegetarian meal capable of providing exactly one day’s worth of nourishment to exactly one human. Bearing the pleasant message “A Food Gift From the People of the United States of America” which approximately 100 percent of its recipients couldn’t read, the package was bright yellow for easy spotting and could be air-dropped en masse, in full accordance with the DoD philosophy that any international crisis worth solving is best solved by dropping shit out of airplanes.

    “The only flavor is freedom.”

    What Could Possibly Go Wrong?

    This crucial, life-saving product had a somewhat difficult market introduction due to aggressive competition from another heavily marketed U.S. export: explosions. You see, the HDR packages were the same color and about the same size as unexploded cluster munitions.

    One contains enough food to sustain you for a day.
    The other blasts you into a fine mist. Good Luck!

    Back in the early 2000s, the U.S. was cluster-bombing the crap out of Afghanistan while simultaneously filling its skies with millions of HDR packages to aid refugees. Cluster bombs contain up to 200 bomblets, which scatter in midair to turn a sizable area into a wailing lake of fire. Up to 30 percent of them fail to detonate on impact, leaving behind a maiming-in-a-can just waiting for some unlucky bastard to unwittingly pop its tab.

    To their credit, the DoD changed the color of the packages once this was pointed out. But since they had a significant stock of yellow HDRs to use up first, they taught recipients how to differentiate between the two in the best way they knew how: by dropping instructive flyers out of airplanes.

    “Make the least favorite in the family test it first.”

    #3. The Worst Person Possible Wins An Anti-Rape Benefit Lottery

    In 2009, Lucky Times Pull Tabs ran a statewide lottery in Alaska to help raise funds for the Anchorage nonprofit group STAR (Standing Together Against Rape). With a cool half-million-dollar jackpot (the largest in the state’s history) and a good cause behind it, the organizers had everything going for them.

    What Could Possibly Go Wrong?

    Here’s the thing about lotteries: There’s absolutely no way to know who’s going to win. And so it came to pass that the winning ticket for the $500,000 anti-rape jackpot went to three-time convicted sex offender Alec Ahsoak.

    “Alright, now do Popeye.”

    The day after the winning ticket was drawn, Ahsoak flagged down a group of reporters to make his good fortune known to the world. When his checkered past came to light, Ahsoak claimed to be a changed man who was currently undergoing treatment, and even pledged to donate $100,000 of his winnings to STAR. Ahsoak’s (predictably empty) promise did little to assuage his victims, however, two of whom came out to publicly announce their utter disgust for the circumstances.

    Nor did it do much to assuage the tire iron of one Brandon J. Hughes, who took it upon himself to track down Ahsoak and “beat his ass” in the street like a low-budget Batman. When all was said and done, the final tally was $350,000 (after taxes) and an abundance of stitches for Ahsoak, three years in prison for his assailant, and a newfound lack of faith in humanity for STAR.

    The tire iron received 10 years due to outstanding warrants.

    #2. A Charity Triathlon Nearly Drowned Hundreds

    Close to 900 people gathered near Annapolis, Maryland one Sunday morning in January of 1991 to raise money for the American Diabetes Association by swimming 4.4 miles across the Chesapeake Bay, followed by a 13-mile run and a 76-mile bike ride. Some people consider that “fun.” Those people are insane. But together, those beautiful maniacs intended on conquering land, sea, and then … well, land again, to demonstrate to Mother Nature just where she could stuff her shitty disease.

    What Could Possibly Go Wrong?

    Swimmers began hitting the water shortly after 8:00 a.m. By 9:30, several hundred of them were being flushed off course down the bay, in very real danger of horrifically drowning — or worse, ending up in Virginia. That’s because Fletcher Hanks, the event’s organizer, had scheduled the swim to perfectly coincide with the ebbing tide, meaning that the participants found themselves swimming against a two-knot current. To compound the problem, the only safety net provided was a ragtag group of 55 private boats assembled by Hanks — the absolute minimum required to get the event approved, and “woefully inadequate” to contain a veritable flood of flailing people.

    “What? We gave them all orange caps so we could find them in the unforgiving sea.”

    A fleet made up of the Coast Guard, Coast Guard Auxiliary, the Department of Natural Resources, and a state police medevac helicopter swooped in to yank 720 people out of the drink. Miraculously, no one drowned, though a handful suffered hypothermia and one especially unlucky paddler was found three full miles down the bay. Hanks was arrested later that day for trying to continue the event without having a permit for the running and cycling stages, because you can’t make a triathlon without nearly drowning a few eggs.

    #1. Western “Charities” Keep “Rescuing” Disaster-Stricken “Orphans”

    People are inherently good, and there are plenty of them willing to do whatever it takes, personal consequences be damned, to provide a safe environment for children in need. People like volunteer firefighter and renowned 4X4 enthusiast Eric Breteau, founder of the French nonprofit Zoe’s Ark, whose mission was to rescue children orphaned by the war in Darfur. Or Laura Silsby, founder of the Idaho-based New Life Children’s Refuge, which aimed to provide a safe haven for orphans in the wake of the 2010 Haiti earthquake.

    What Could Possibly Go Wrong?

    Both organizations were wildly successful at saving unwanted, abandoned orphans … from their loving families.

    “But could their families have given them the chance to become someone’s new Facebook profile photo?”

    In the case of New Life Children’s Refuge, that meant telling desperate and terrified parents that their children would be kept safe in a brand-spanking-new Dominican Republic orphanage until the chaos from the quake died down. To be fair, this wasn’t the initial plan: Silsby first tried to stir up a sufficient orphan supply by going door to door at existing orphanages and asking if they had any leftover kids. Only when that failed did she resort to persuading shell-shocked parents to hand over their children with promises of a life filled with soccer fields and swimming pools. The group managed to round up 33 kids — all of whom had either loving parents or immediate family — before being arrested at the Haitian border.

    Eric Breteau’s professed mission was to rescue Sudanese orphans from refugee camps in Chad and whisk them to France, where a number of couples had already put down deposits and were anxiously awaiting delivery of their shiny new war orphans. French authorities warned the group that their plan was likely super duper illegal, and Chadian authorities were duly notified. Breteau and Co. responded by registering the charity under a new name, donning freshly-printed “Children Rescue” T-shirts, and proceeding to convince Chadian parents that they were opening a nearby refuge where their children would receive top-notch care and a free education. Zoe’s Ark managed to bullshit their way into 103 kids who were neither orphans nor from Sudan, but were definitely children, probably.

    “Here’s the son you ordered.”

    Cargo secured, the group went to the airport, disguised the kids as war casualties, and told the flight crew that they were being transported to France for medical attention. Thankfully, the criminal do-gooders were apprehended before the flight left the ground, bringing their ill-conceived vigilante adoption scheme to an end. To their credit, both Zoe’s Ark and New Life Children’s Refuge eventually succeeded in their goal of finding the children loving homes — the exact same homes they were “rescued” from in the first place.

    For more people who should’ve thought twice about their altruism, check out 5 Popular Forms of Charity (That Aren’t Helping) and 5 Famous Charity Songs That Were Insanely Harmful.

    Read more: http://www.cracked.com/article_23796_5-charities-that-failed-in-worst-way-imaginable.html

    Man who killed abortion doctor gets more lenient sentence

    Scott Roeder, 51-year-old Kansas City-area man charged with murder of Kansas abortion doctor George Tiller, is seen in this undated booking photograph  (Reuters)

    The man who seven years ago ambushed and fatally shot one of the few U.S. doctors performing late-term abortions was given a more lenient sentence Wednesday of at least 25 years in prison before becoming eligible for parole.

    At a surprise resentencing hearing, prosecutors withdrew their request that Scott Roeder serve at least 50 years before parole eligibility. Roeder also was sentenced to an additional two years for aggravated assault for threatening two church ushers as he fled.

    “I was really shocked about today,” Roeder said in a jailhouse phone call to The Associated Press after the hearing. “I was glad obviously to hear the sentence reduced, but I was looking forward to being another voice for the unborn so I was disappointed in that respect.”

    He said he knew the consequences of his actions going in and has “no regrets” because children have been saved because of him.

    Roeder was convicted in January 2010 of premeditated first-degree murder for the shooting death of Dr. George Tiller as he was serving as an usher in the foyer of the doctor’s church in Wichita on May 31, 2009.

    Tiller’s murder was among the most notorious acts of violence since the U.S. Supreme Court legalized the procedure nationwide in 1973. It alarmed the abortion rights community and came as numerous conservative states, including Kansas, passed restrictions making it harder for women to obtain abortions.

    The hearing Wednesday came just days before Roeder was set to go before a jury on Monday for what had been anticipated to be a two-week sentencing hearing. Roeder’s original life sentence with no chance of parole for 50 years was among many vacated after the U.S. Supreme Court ruled in 2013 that juries, not judges, must decide whether to increase punishment.

    Roeder, who suffers from prostate problems, looked much thinner than at his initial sentencing in 2010 and was subdued throughout the proceeding. He chose not make a courtroom statement before the judge pronounced his sentence.

    That was in contrast to the previous sentencing hearing that Roeder used as a forum to espouse at length on his anti-abortion views in an effort to justify his killing the doctor to save unborn babies.

    Sedgwick County District Attorney Marc Bennett said that the decision not to seek the added time was reached by prosecutors after examining Roeder’s health, his expected life span and the likelihood of whether he would ever be released from prison alive. Tiller’s family was also consulted, he said.

    Bennett told reporters after the hearing that “rather than putting the community and the victim’s family and witnesses through another contested hearing” in order to extend a 58-year-old defendant’s parole eligibility from 25 to 50 years, the state decided to withdraw the request.

    He cited the 58-year-old defendant’s declining health and the unlikelihood of him living long enough to ever get out of prison. Bennett said the decision was made “in the best interest” of the community and Tiller’s family.

    Bennett also read a statement from Tiller’s family saying nothing will change the fact Tiller was assassinated, and the family continues to grieve his loss. The family cited the “very difficult and emotionally draining trial” in which Roeder was found guilty, and thanked people involved with ensuring it was a fair trial.

    Tiller’s family said they had decided to support the sentence of a minimum 25 years in prison without parole.

    “With this legal closure, the Dr. George Tiller family will continue to heal and thrive and live fully in our communities,” their statement said.

    The abortion rights group Trust Women, which opened a clinic in 2013 in the same facility where Tiller once practiced, said in a statement its staff is grateful the doctor’s family has some measure of closure and healing. Its founder, Julie Burkhart, said Roeder deserves the maximum sentence allowed by law.

    “Dr. Tiller’s assassination most certainly left a hole in the reproductive rights movement, but we remain committed to this critical work in his honor and memory,” Burkhart said.

    Defense attorney Mark Rudy said after the hearing that he thinks his client is relieved it is over, and no appeal is planned. The defense has already lost on every other appeal issue and this is the minimum sentence Roeder could hope to receive, he said.

    “We are glad we can put this to rest,” Rudy said.

    Read more: http://www.foxnews.com/us/2016/11/23/man-who-killed-abortion-doctor-gets-more-lenient-sentence.html

    Experts reverse themselves on prostate cancer screenings

    (CNN)Men younger than 70 with no signs of prostate cancer may no longer be discouraged from checking their PSA levels, according to guidelines proposed today by the US Preventive Services Task Force.

    But experts say that a positive test may leave some confused about what to do next.
    In 2012, the task force recommended against routinely checking the levels of prostate-specific antigen, or PSA, in the blood, saying that the risks outweighed the rewards. But the latest draft loosens the reins for men 55 to 69 with no symptoms or history of prostate cancer: The former D rating, which discourages screening, has been upgraded to a C, which leaves the decision up to “a man’s values and preferences,” the task force said in a statement.
      The D rating remains for men 70 and older.
      According to the task force, many prostate cancers grow slowly or not at all, so some men will not experience any symptoms, nor will they die from the cancer.
      “We were very concerned in 2012 that many, many men were being treated for prostate cancer,” said Dr. Kirsten Bibbins-Domingo, chairwoman of the task force, an independent panel of medical experts.
      “The balance has shifted,” she added, “and now we can recommend that men have a conversation with their doctors about screening.”
      Bibbins-Domingo said that several studies have reinforced not only the benefits of PSA tests but also ways to lessen the harms of screening, which include unnecessary biopsies and treatments. Because radiation and surgery may lead to impotence, bowel injury and problems with urination, some men may be uncertain about what to do with a positive test result.
      One of the studies that influenced the committee’s decision came in October, when researchers showed that doctors could safely monitor a patient’s prostate cancer — largely through repeated PSA checks — without rushing to treat it.
      In the study, only about 1% of men died of prostate cancer over 10 years, with no significant differences between those who were treated and those who simply kept a watchful eye. The authors calculated that a surgeon would need to perform 27 prostate removals in order to prevent just one case of the cancer spreading to other areas.
      “Men who have low-risk prostate cancer, they don’t have to go right away to aggressive treatment,” Bibbins-Domingo said.

      An imperfect test

      Not everyone fully agrees with the proposed changes, which are open to public comment through May 8.
      “Prostate screening has been a contentious issue ever since the prostate specific antigen test became available more than three decades ago,” Dr. Otis Brawley, chief medical officer of the American Cancer Society, wrote today in a CNN op-ed.
      Prostate cancer is one of the most common types among men in the US; nearly 13% will be diagnosed with it over the course of their lifetimes, according to the National Cancer Institute. The latest data show that over 180,000 men were diagnosed with prostate cancer in 2016, but there were only 26,000 deaths from it. Prostate cancer accounted for 4.4% of all cancer deathsin the United States last year.
      Prostate cancer can raise levels of PSA, a protein produced by the prostate gland — but this doesn’t happen in all cases. PSA can also go up for other reasons, such as infections or benign enlargement of the prostate. Because the test is imperfect, Brawley said, there are a number of missed cancers and false alarms.
      “It literally misses as many prostate cancers as it finds,” Brawley said.
      About 70% of men with elevated PSA do not have prostate cancer when they are biopsied, according to research.
      “The PSA test is not a great test. We all acknowledge that. We need better tests,” Bibbins-Domingo said.
      “We encourage men to be informed, and that is the basis of this recommendation,” she added.
      A number of celebrities and politicians have become advocates of PSA testing after being diagnosed, Brawley said, raising awareness and fueling what he described as a “screening frenzy” that was also driven by early research, health fairs and doctors themselves. Prostate cancer treatments also led to considerable profits for hospitals, he added.
      Last year, actor Ben Stiller announced that he had had his prostate surgically removed in 2014, after testing revealed that he had developed prostate cancer in his 40s.
      “Taking the PSA test saved my life. Literally,” he wrote in a blog post.

      Patients first

      Dr. John Meigs, president of the American Academy of Family Physicians, often thinks of two former patients who were screened when the PSA test was used more liberally. Both had high PSA levels and were eventually diagnosed with prostate cancer.
      “They could not live with the fact that they had cancer. It had to come out,” Meigs recalled.
      But his patients died of something else entirely and spent their final years “incontinent and miserable,” he said.
      “We did them no favors by telling them they had cancer and giving them surgery,” he added.
      But now that there is more evidence about the pros and cons of screening and treatment, Meigs said, a “primary care physician is probably the best one to have that conversation, someone who knows them and their entire situation.”
      The American Academy of Family Physicians will conduct its own review of the evidence. However, Meigs said that he and other family doctors have come to depend on the task force’s recommendations, which are known for sticking closely to the available evidence.
      The proposed guidelines do not specify how often men might want to screen their PSA levels, if they choose to do so. Bibbins-Domingo said the largest European studies have generally screened every two to four years.
      “A discussion to send a PSA test shouldn’t happen annually,” she said.
      The new suggestions do not single out men who have an increased risk of prostate cancer, such as African-American men, who are roughly twice as likely to die of prostate cancer as the general population. Men with a family history of prostate cancer would also fall into this category.
      Bibbins-Domingo said that more research is needed to figure out whether to screen these men more aggressively than the general population.
      The task force updates their guidelines every five years. Bibbins-Domingo said that the final draft may come toward the end of the year, once the task force considers all the public comments it receives.

      See the latest news and share your comments with CNN Health on Facebook and Twitter.

      Brawley said that, despite the possible harms, patient preference comes first.
      “Some men who are very concerned about prostate cancer will elect to be screened, and others who are less concerned will elect not to be screened; either decision should be supported,” he wrote.
      “Once diagnosed, hopefully patients and their physicians will not rush into treatment,” he added.

      Read more: http://www.cnn.com/2017/04/11/health/prostate-cancer-screening-guidelines-draft/index.html

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