Multiple sclerosis is an autoimmune condition that interferes with the flow of information in the central nervous system. It causes a variety of symptoms and can affect women differently than men.

Researchers do not know what triggers multiple sclerosis (MS). Once it develops, the disease causes the immune system to destroy a type of tissue called myelin that insulates nerve fibers. Without enough myelin, it is difficult for the nerves to transmit and receive signals properly. MS randomly affects nerves in the brain, spinal cord, and eyes, meaning that it can cause a wide range of unpredictable physical, mental, and emotional symptoms that vary from person to person.

MS in women

According to the National Multiple Sclerosis Society (NMSS), at least two or three times more women than men receive a diagnosis of MS. Overall, MS seems to affect men and women similarly. However, a doctor cannot predict which symptoms someone with MS will get, the severity of the symptoms, or the progression of the disease. The reason for this is that the disease attacks the myelin randomly, and the nerves that it affects can differ from person to person. Although men and women with MS often experience similar symptoms, certain factors, such as menstruation, pregnancy, and , may influence MS symptoms in women.

Symptoms of MS in women

The symptoms of MS in women are similar to those in men, but they can include additional issues due to hormonal changes.

MS can also affect female sexual health and bladder function differently.

MS symptoms in women include:

1. Vision problems

For many people, a vision problem is the first noticeable symptom of MS.

MS can cause various vision problems, which include:

• blurred vision
• poor color vision or contrast vision
• painful eye movement
• blindness in one eye
• a dark spot in the field of vision

People with MS develop vision problems either because their optic nerves become inflamed or because they have nerve damage in the pathways that control visual coordination and eye movement.

While vision problems due to MS can be scary, most either resolve without treatment or are highly treatable.

2. Numbness

Numbness in the face, body, arms, or legs is another common symptom of MS, and it is often one of the earliest symptoms of the condition.

The numbness can range from mild and barely noticeable to severe enough that it interferes with everyday activities, such as holding objects and walking.

Most periods of numbness from MS resolve without medication and do not become permanently disabling.

3. Fatigue

Fatigue is a common symptom of MS.

About 80 percent of people with MS experience fatigue or unexplained exhaustion.

Sometimes, the cause of fatigue relates to another symptom of MS. For example, people with bladder dysfunction may sleep poorly because they have to wake throughout the night to go to the bathroom.

People with MS who have nocturnal muscle spasms may not sleep well, leaving them feeling tired during the day. MS can also increase the risk of depression, which can cause fatigue.

Another type of fatigue that seems to be unique to MS is called lassitude. A person’s fatigue may be lassitude if it:

• occurs daily
• worsens as the day goes on
• happens in the morning, even after a good sleep
• worsens with heat or humidity
• interferes with daily activity
• is unrelated to physical impairments or depression

4. Bladder problems

Bladder problems affect at least 80 percent of people with MS. These issues occur when scars on the nerves impair nerve signaling that is necessary for the function of the urinary sphincters and bladder.

MS can make it difficult for the bladder to hold urine and may reduce the amount that it can store, causing symptoms such as:

• more frequent or urgent urination
• hesitancy starting urination
• frequent overnight urination
• being unable to empty the bladder
• being unable to hold urine or having urine leaks

5. Bowel problems

Many people with MS experience bowel problems, such as:

• constipation
• diarrhea
• loss of bowel control

Bowel problems can make other MS symptoms worse, especially bladder problems, muscle stiffness, and involuntary muscle spasms.

Researchers think that people with MS have problems controlling their bowels because of the neurological damage that the condition causes. Some people with MS may also have trouble controlling their bowels when they are constipated.

6. Pain

Some research suggests that 55 percent of people with MS experience clinically significant pain, while 48 percent live with chronic pain. Women with MS may be more likely than men to experience pain as a symptom of this condition.

Acute MS pain seems to be due to problems with the nerves that help transmit sensations in the central nervous system.

Some of the acute pain symptoms that have an association with MS include:

• Trigeminal neuralgia, a stabbing pain in the face that people may confuse with dental pain.
• Lhermitte’s sign, a short sensation resembling an electric shock that moves from the back of the head down the neck and spine, usually after bending forward.
• The MS hug, a stabbing, squeezing, painful, or burning sensation around the torso or in the legs, feet, or arms.

Some of the symptoms that people with chronic MS pain may report include:

• burning
• aching
• pins and needles
• prickling

Many people with MS also experience chronic pain as a secondary effect of the condition. For example, it could be due to:

• compensating for gait changes
• muscle stiffness, cramps, and spasms
• incorrect use of mobility aids
• muscle changes from mobility loss

7. Cognitive changes

More than 50 percent of people with MS experience changes in cognition, which means that they may sometimes have trouble:

• processing new information
• learning and remembering new information
• organizing information and problem-solving
• focusing and maintaining attention
• properly perceiving the environment around them
• understanding and using language
• doing calculations

The cognitive symptoms of MS are typically mild to moderate and only affect a few aspects of cognition.

In rare cases, people with MS may experience disabling cognitive problems.

8. Depression

For people with MS, clinical depression is a common symptom.

Clinical depression is one of the most common symptoms of MS. Depression is more common in people with MS than in people with other chronic health conditions.

While almost everyone experiences periods of sadness or grief, clinical depression refers to depressive symptoms that last for a minimum of 2 weeks.

Some of the symptoms of clinical depression include:

• loss of interest in everyday activities
• increase in appetite or appetite loss
• sadness
• irritability
• insomnia or excessive sleep
• fatigue
• feelings of guilt and worthlessness
• difficulty thinking or concentrating
• behavioral changes
• thoughts of death or suicide

Clinical depression can also worsen other MS symptoms, including:

• fatigue
• pain
• cognitive changes

9. Muscle weakness

Many people with MS experience muscle weakness. This symptom is due to damage to the nerve fibers that help control muscles.

People with MS may also experience muscle weakness because a lack of use has led their muscles to become deconditioned over time.

MS-related muscle weakness can affect any part of the body. It can be especially challenging for people with MS to walk and stay mobile when muscle weakness affects their legs, ankles, and feet.

10. Muscle stiffness and spasms

MS can cause spasticity, which is muscle stiffness and involuntary muscle spasms in the extremities, especially the legs.

Some of the signs and symptoms of spasticity include:

• tightness in or around the joints
• painful, uncontrollable spasms in the arms and legs
• lower back pain
• hips and knees that bend and become difficult to straighten
• hips and knees that stiffen while close together or crossed

11. Dizziness and vertigo

Some people with MS experience dizziness and the sensation of being lightheaded, woozy, weak, or faint.

Less commonly, they experience vertigo, which makes it feel as though a person or their surroundings are spinning.

MS may cause vertigo by damaging the pathways that coordinate the spatial, visual, and sensory input that the brain needs to maintain balance in the body.

The symptoms of vertigo include:

• balance problems
• motion sickness
• nausea and vomiting
• being lightheaded
• a spinning sensation

12. Sexual problems

People with MS often experience sexual problems and may find it difficult to get aroused or have an orgasm.

MS may reduce natural vaginal lubrication, potentially making sexual intercourse painful for women.

The disease can also cause sexual problems by damaging nerves in the sexual response pathways that connect the brain and the sexual organs.

People with MS can also experience issues with sex as a result of other MS symptoms, such as:

• muscle spasms and stiffness
• mood or self-esteem changes
• fatigue

13. Emotional changes

MS can cause a wide range of emotional symptoms and changes, including:

• mood swings
• periods of uncontrollable laughter or crying
• irritability
• grief
• worry, fear, and anxiety
• distress, anger, or frustration

The condition is unpredictable, often has fluctuating symptoms, and can become disabling, all of which can be scary for someone.

MS can also cause emotional changes by damaging the nerve fibers in the brain. Some of the medications that people take to manage MS can cause mood changes too.

For example, corticosteroids can have many emotional side effects, including:

• anxiety
• irritability
• agitation
• tearfulness
• restlessness
• fear

14. Difficulty walking

People with MS can develop problems with gait, or how they walk, because of several factors. MS symptoms that affect how a person walks include:

• muscle stiffness and spasms
• numbness or other sensory problems in the hips, legs, ankles, or feet
• fatigue
• muscle weakness
• loss of balance

15. Hormonal effects

There is some evidence to suggest that MS can affect women differently than men due to hormonal changes, including those that occur during:

Menstruation

More research is necessary to draw firm conclusions, but the NMSS state that some studies have found that women with MS have worse symptoms within a week of starting their period. Studies that used an MRI have also shown that MS disease activity may change according to the different hormonal levels during menstruation. 

Pregnancy

Pregnancy can reduce the risk of MS symptom flare-ups, especially during the second and third trimesters. Researchers think that pregnancy has a protective effect against MS by raising the levels of compounds that help reduce inflammation and the effects of the disease. Women who are pregnant also have naturally higher levels of circulating corticosteroids, another type of immunosuppressant.

Although pregnancy can temporarily reduce some MS symptoms, flare-ups tend to return in the first 3 to 6 months postpartum. However, in the long term, there is no proven link between pregnancy and a higher risk of disability.

While being pregnant can temporarily reduce the risk of flare-ups, pregnancy also puts a lot of physical stress on the body, which can make certain symptoms of MS worse.

In addition, some of the medications that people use for MS are not safe to take during pregnancy and can worsen symptoms.

Anyone with MS who is pregnant or planning to become pregnant should discuss their medications with their doctor.

Some MS symptoms that pregnancy often exacerbates include:

• fatigue
• gait problems
• bladder and bowel problems

Menopause

MS symptoms may worsen after menopause, possibly because declining estrogen levels adversely affect disease progression. However, it is difficult to tell whether MS symptoms worsen because of menopause or just as a natural result of aging or the progression of the condition. Much more research is necessary to understand the relationship between menopause and MS symptoms.

Rarer symptoms

While the symptoms above are the most common, MS affects everyone differently. Less common symptoms of MS include:

• speech problems
• seizures
• hearing loss
• swallowing problems
• tremor
• breathing problems
• itching
• headaches

Outlook

MS is an autoimmune disease that randomly affects parts of the central nervous system, resulting in unpredictable physical, cognitive, and emotional symptoms.

Although MS tends to affect more women than men, it usually causes similar symptoms. However, women may experience variations in their symptoms due to hormonal changes, such as those that take place during menstruation or menopause.

Vision problems and random localized numbness are often the first symptoms of the condition. Depression, bladder problems, cognitive changes, and pain are also among the most common symptoms of MS.

There is no cure for MS, but different drugs and complementary therapies can typically help manage symptoms or even slow the progression of the condition.

Anyone experiencing concerning symptoms should see a doctor for a proper diagnosis.

What is Alzheimer’s disease?

Alzheimer’s disease is a progressive form of dementia. Dementia is a broader term for conditions caused by brain injuries or diseases that negatively affect memory, thinking, and behavior. These changes interfere with daily living.

According to the Alzheimer’s Association, Alzheimer’s disease accounts for 60 to 80 percent of dementia cases. Most people with the disease get a diagnosis after age 65. If it’s diagnosed before then, it’s generally referred to as early onset Alzheimer’s disease.

There’s no cure for Alzheimer’s, but there are treatments that can slow the progression of the disease. Learn more about the basics of Alzheimer’s disease.

Alzheimer’s facts

Although many people have heard of Alzheimer’s disease, some aren’t sure exactly what it is. Here are some facts about this condition:

• Alzheimer’s disease is a chronic ongoing condition.
• Its symptoms come on gradually and the effects on the brain are degenerative, meaning they cause slow decline.
• There’s no cure for Alzheimer’s but treatment can help slow the progression of the disease and may improve quality of life.
• Anyone can get Alzheimer’s disease but certain people are at higher risk for it. This includes people over age 65 and those with a family history of the condition.
• Alzheimer’s and dementia aren’t the same thing. Alzheimer’s disease is a type of dementia.
• There’s no single expected outcome for people with Alzheimer’s. Some people live a long time with mild cognitive damage, while others experience a more rapid onset of symptoms and quicker disease progression.

Each person’s journey with Alzheimer’s disease is different. Find out more details about how Alzheimer’s can affect people.

Dementia vs. Alzheimer’s

The terms “dementia” and “Alzheimer’s” are sometimes used interchangeably. However, these two conditions aren’t the same. Alzheimer’s is a type of dementia.

Dementia is a broader term for conditions with symptoms relating to memory loss such as forgetfulness and confusion. Dementia includes more specific conditions, such as Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, and others, which can cause these symptoms.

Causes, symptoms, and treatments can be different for these diseases. Learn more about how dementia and Alzheimer’s disease differ.

Alzheimer’s disease causes and risk factors

Experts haven’t determined a single cause of Alzheimer’s disease but they have identified certain risk factors, including:

• Age. Most people who develop Alzheimer’s disease are 65 years of age or older.
• Family history. If you have an immediate family member who has developed the condition, you’re more likely to get it.
• Genetics. Certain genes have been linked to Alzheimer’s disease.

Having one or more of these risk factors doesn’t mean that you’ll develop Alzheimer’s disease. It simply raises your risk level.

To learn more about your personal risk of developing the condition, talk with your doctor. 

Alzheimer’s and genetics

While there’s no one identifiable cause of Alzheimer’s, genetics may play a key role. One gene in particular is of interest to researchers. Apolipoprotein E (APOE) is a gene that’s been linked to the onset of Alzheimer’s symptoms in older adults.

Blood tests can determine if you have this gene, which increases your risk of developing Alzheimer’s. Keep in mind that even if someone has this gene, they may not get Alzheimer’s.

The opposite is also true: Someone may still get Alzheimer’s even if they don’t have the gene. There’s no way to tell for sure whether someone will develop Alzheimer’s.

Other genes could also increase risk of Alzheimer’s and early onset Alzheimer’s.

Symptoms of Alzheimer’s disease

Everyone has episodes of forgetfulness from time to time. But people with Alzheimer’s disease display certain ongoing behaviors and symptoms that worsen over time. These can include:

• memory loss affecting daily activities, such as an ability to keep appointments
• trouble with familiar tasks, such as using a microwave
• difficulties with problem-solving
• trouble with speech or writing
• becoming disoriented about times or places
• decreased judgment
• decreased personal hygiene
• mood and personality changes
• withdrawal from friends, family, and community

Symptoms change according to the stage of the disease. 

Alzheimer’s stages

Alzheimer’s is a progressive disease, which means the symptoms will gradually worsen over time. Alzheimer’s is broken down into seven stages:

• Stage 1. There are no symptoms at this stage but there might be an early diagnosis based on family history.
• Stage 2. The earliest symptoms appear, such as forgetfulness.
• Stage 3. Mild physical and mental impairments appear, such as reduced memory and concentration. These may only be noticeable by someone very close to the person.
• Stage 4. Alzheimer’s is often diagnosed at this stage, but it’s still considered mild. Memory loss and the inability to perform everyday tasks is evident.
• Stage 5. Moderate to severe symptoms require help from loved ones or caregivers.
• Stage 6. At this stage, a person with Alzheimer’s may need help with basic tasks, such as eating and putting on clothes.
• Stage 7. This is the most severe and final stage of Alzheimer’s. There may be a loss of speech and facial expressions.

As a person progresses through these stages, they’ll need increasing support from a caregiver. 

Early onset Alzheimer’s

Alzheimer’s typically affects people ages 65 years and older. However, it can occur in people as early as their 40s or 50s. This is called early onset, or younger onset, Alzheimer’s. This type of Alzheimer’s affects about 5 percent of all people with the condition.

Symptoms of early onset Alzheimer’s can include mild memory loss and trouble concentrating or finishing everyday tasks. It can be hard to find the right words, and you may lose track of time. Mild vision problems, such as trouble telling distances, can also occur.

Certain people are at greater risk of developing this condition. 

The only definitive way to diagnose someone with Alzheimer’s disease is to examine their brain tissue after death. But your doctor can use other examinations and tests to assess your mental abilities, diagnose dementia, and rule out other conditions.

They’ll likely start by taking a medical history. They may ask about your:

• symptoms
• family medical history
• other current or past health conditions
• current or past medications
• diet, alcohol intake, or other lifestyle habits

From there, your doctor will likely do several tests to help determine if you have Alzheimer’s disease.

Alzheimer’s tests

There’s no definitive test for Alzheimer’s disease. However, your doctor will likely do several tests to determine your diagnosis. These can be mental, physical, neurological, and imaging tests.

Your doctor may start with a mental status test. This can help them assess your short-term memory, long-term memory, and orientation to place and time. For example, they may ask you:

• what day it is
• who the president is
• to remember and recall a short list of words

Next, they’ll likely conduct a physical exam. For example, they may check your blood pressure, assess your heart rate, and take your temperature. In some cases, they may collect urine or blood samples for testing in a laboratory.

Your doctor may also conduct a neurological exam to rule out other possible diagnoses, such as an acute medical issue, such as infection or stroke. During this exam, they will check your reflexes, muscle tone, and speech.

Your doctor may also order brain-imaging studies. These studies, which will create pictures of your brain, can include:

• Magnetic resonance imaging (MRI). MRIs can help pick up key markers, such as inflammation, bleeding, and structural issues.
• Computed tomography (CT) scan. CT scans take X-ray images which can help your doctor look for abnormal characteristics in your brain.
• Positron emission tomography (PET) scan. PET scan images can help your doctor detect plaque buildup. Plaque is a protein substance related to Alzheimer’s symptoms.

Other tests your doctor may do include blood tests to check for genes that may indicate you have a higher risk of Alzheimer’s disease. 

Alzheimer’s medication

There’s no known cure for Alzheimer’s disease. However, your doctor can recommend medications and other treatments to help ease your symptoms and delay the progression of the disease for as long as possible.

For early to moderate Alzheimer’s, your doctor may prescribe medications such as donepezil (Aricept) or rivastigmine (Exelon). These drugs can help maintain high levels of acetylcholine in your brain. This is a type of neurotransmitter that can help aid your memory.

To treat moderate to severe Alzheimer’s, your doctor may prescribe donepezil (Aricept) or memantine (Namenda). Memantine can help block the effects of excess glutamate. Glutamate is a brain chemical that’s released in higher amounts in Alzheimer’s disease and damages brain cells.

Your doctor may also recommend antidepressants, antianxiety medications, or antipsychotics to help treat symptoms related to Alzheimer’s. These symptoms include:

• depression
• restlessness
• aggression
• agitation
• hallucinations

Other Alzheimer’s treatments

In addition to medication, lifestyle changes may help you manage your condition. For example, your doctor might develop strategies to help you or your loved one:

• focus on tasks
• limit confusion
• avoid confrontation
• get enough rest every day
• stay calm

Some people believe that vitamin E can help prevent decline in mental abilities, but studies indicate that more research is needed. Be sure to ask your doctor before taking vitamin E or any other supplements. It can interfere with some of the medications used to treat Alzheimer’s disease.

In addition to lifestyle changes, there are several alternative options you can ask your doctor about. 

Preventing Alzheimer’s

Just as there’s no known cure for Alzheimer’s, there are no foolproof preventive measures. However, researchers are focusing on overall healthy lifestyle habits as ways of preventing cognitive decline.

The following measures may help:

• Quit smoking.
• Exercise regularly.
• Try cognitive training exercises.
• Eat a plant-based diet.
• Consume more antioxidants.
• Maintain an active social life.

Be sure to talk with your doctor before making any big changes in your lifestyle.

Alzheimer’s care

If you have a loved one with Alzheimer’s, you may consider becoming a caregiver. This is a full-time job that’s typically not easy but can be very rewarding.

Being a caregiver takes many skills. These include patience perhaps above all, as well as creativity, stamina, and the ability to see joy in the role of helping someone you care about live the most comfortable life they can.

As a caregiver, it’s important to take care of yourself as well as your loved one. With the responsibilities of the role can come an increased risk of stress, poor nutrition, and lack of exercise.

If you choose to assume the role of caregiver, you may need to enlist the help of professional caregivers as well as family members to help. 

The statistics surrounding Alzheimer’s disease are daunting.

• According to the Centers for Disease Control and Prevention (CDC), Alzheimer’s is the sixth most common cause of death among U.S. adults. It ranks fifth among causes of death for people 65 years and older.
• A study found that 4.7 million Americans over the age of 65 years had Alzheimer’s disease in 2010. Those researchers projected that by 2050, there will be 13.8 million Americans with Alzheimer’s.
• The CDC estimates that over 90 percent of people with Alzheimer’s don’t see any symptoms until they’re over 60 years old.
• Alzheimer’s is an expensive disease. According to the CDC, about $259 billion was spent on Alzheimer’s and dementia care costs in the United States in 2017.

The takeaway

Alzheimer’s is a complicated disease in which there are many unknowns. What is known is that the condition worsens over time, but treatment can help delay symptoms and improve your quality of life.

If you think you or a loved one may have Alzheimer’s, your first step is to talk with your doctor. They can help make a diagnosis, discuss what you can expect, and help connect you with services and support. If you’re interested, they can also give you information about taking part in clinical trials.

Prostate cancer affects the prostate gland, the gland that produces some of the fluid in semen and plays a role in urine control in men.

The prostate gland is located below the bladder and in front of the rectum.

In the United States, it is the most common cancer in men, but it is also treatable if found in the early stages.

In 2017, the American Cancer Society predicts that there will be around 161,360 new diagnoses of prostate cancer, and that around 26,730 fatalities will occur because of it.

Regular testing is crucial as the cancer needs to be diagnosed before metastasis.

Fast facts on prostate cancer:

Here are some key points about the prostate cancer. More detail is in the main article.

The prostate gland is part of the male reproductive system.

Prostate cancer is the most common cancer in men.

It is treatable if diagnosed early, before it spreads.

If symptoms appear, they include problems with urination.

Regular screening Is the best way to detect it in good time.

Symptoms

There are usually no symptoms during the early stages of prostate cancer. However, if symptoms do appear, they usually involve one or more of the following:

• frequent urges to urinate, including at night
• difficulty commencing and maintaining urination
• blood in the urine
• painful urination and, less commonly, ejaculation
• difficulty achieving or maintaining an erection may be difficult

Advanced prostate cancer can involve the following symptoms:

• bone pain, often in the spine, femur, pelvis, or ribs
• bone fractures

If the cancer spreads to the spine and compresses the spinal cord, there may be:

• leg weakness
• urinary incontinence
• fecal incontinence

Treatment

Treatment is different for early and advanced prostate cancers.

Early stage prostate cancer

If the cancer is small and localized, it is usually managed by one of the following treatments:

Watchful waiting or monitoring: PSA blood levels are regularly checked, but there is no immediate action. The risk of side-effects sometimes outweighs the need for immediate treatment for this slow-developing cancer.

Radical prostatectomy: The prostate is surgically removed. Traditional surgery requires a hospital stay of up to 10 days, with a recovery time of up to 3 months. Robotic keyhole surgery involves a shorter hospitalization and recovery period, but it can be more expensive. Patients should speak to their insurer about coverage.

Brachytherapy: Radioactive seeds are implanted into the prostate to deliver targeted radiation treatment.

Conformal radiation therapy: Radiation beams are shaped so that the region where they overlap is as close to the same shape as the organ or region that requires treatment. This minimizes healthy tissue exposure to radiation.

Intensity modulated radiation therapy: Beams with variable intensity are used. This is an advanced form of conformal radiation therapy.

In the early stages, patients may receive radiation therapy combined with hormone therapy for 4 to 6 months.

Treatment recommendations depend on individual cases. The patient should discuss all available options with their urologist or oncologist.

Advanced prostate cancer

Advanced cancer is more aggressive and will have spread further throughout the body.

Chemotherapy may be recommended, as it can kill cancer cells around the body.

Androgen deprivation therapy (ADT), or androgen suppression therapy, is a hormone treatment that reduces the effect of androgen. Androgens are male hormones that can stimulate cancer growth. ADT can slow down and even stop cancer growth by reducing androgen levels.

The patient will likely need long-term hormone therapy.

Even if the hormone therapy stops working after a while, there may be other options. Participation in clinical trials is one option that a patient may wish to discuss with the doctor.

Radical prostatectomy is not currently an option for advanced cases, as it does not treat the cancer that has spread to other parts of the body.

Fertility

As the prostate is directly involved with sexual reproduction, removing it affects semen production and fertility.

Radiation therapy affects the prostate tissue and often reduces the ability to father children. The sperm can be damaged and the semen insufficient for transporting sperm.

Non-surgical options, too, can severely inhibit a man’s reproductive capacity.

Options for preserving these functions can include donating to a sperm bank before surgery, or having sperm extracted directly from the testicles for artificial insemination into an egg. However, the success of these options is never guaranteed.

Patients with prostate cancer can speak to a fertility doctor if they still intend to father children.

What causes prostate cancer?

The prostate is a walnut-sized exocrine gland. This means that it’s fluids and secretions are intended for use outside of the body.

The prostate produces the fluid that nourishes and transports sperm on their journey to fuse with a female ovum, or egg, and produce human life. The prostate contracts and forces these fluids out during orgasm.

The protein excreted by the prostate, prostate-specific antigen (PSA), helps semen retain its liquid state. An excess of this protein in the blood is one of the first signs of prostate cancer.

The urethra is tube through which sperm and urine exit the body. It also passes through the prostate.

As such, the prostate is also responsible for urine control. It can tighten and restrict the flow of urine through the urethra using thousands of tiny muscle fibers.

How does it start?

It usually starts in the glandular cells. This is known as adenocarcinoma. Tiny changes occur in the shape and size of the prostate gland cells, known as prostatic intraepithelial neoplasia (PIN). This tends to happen slowly and does not show symptoms until further into the progression.

Nearly 50 percent of all men over the age of 50 years have PIN. High-grade PIN is considered pre-cancerous, and it requires further investigation. Low-grade PIN is not a cause for concern.

Prostate cancer can be successfully treated if it is diagnosed before metastasis, but if it spreads, it is more dangerous. It most commonly spreads to the bones.

Stages

Staging takes into account the size and extent of the tumor and the scale of the metastasis (whether it has traveled to other organs and tissues).

At Stage 0, the tumor has neither spread from the prostate gland nor invaded deeply into it. At Stage 4, the cancer has spread to distant sites and organs.

Diagnosis

A doctor will carry out a physical examination and enquire about any ongoing medical history. If the patient has symptoms, or if a routine blood test shows abnormally high PSA levels, further examinations may be requested.

Tests may include:

• a digital rectal examination (DRE), in which a doctor will manually check for any abnormalities of the prostate with their finger
• a biomarker test checking the blood, urine, or body tissues of a person with cancer for chemicals unique to individuals with cancer

If these tests show abnormal results, further tests will include:

• a PCA3 test examining the urine for the PCA3 gene only found in prostate cancer cells
• a transrectal ultrasound scan providing imaging of the affected region using a probe that emits sounds
• a biopsy, or the removal of 12 to 14 small pieces of tissue from several areas of the prostate for examination under a microscope

These will help confirm the stage of the cancer, whether it has spread, and what treatment is appropriate.

To track any spread, or metastasis, doctors may use a bone, CT scan, or MRI scan.

Outlook

If the disease is found before it spreads to other organs in a process known as metastasis, the 5-year survival rate is 99 percent. After fifteen years, this decreases to 96 percent. Once the cancer metastasizes, or spreads, the 5-year survival rate is 29 percent.

Regular screening can help detect prostate cancer while it is still treatable.

Risk factors

The exact cause of prostate cancer is unclear, but there are many possible risk factors.

Age

Prostate cancer is rare among men under the age of 45 years, but more common after the age of 50 years.

Geography

Prostate cancer occurs most frequently in North America, northwestern Europe, on the Caribbean islands, and in Australia. The reasons remain unclear.

Genetic factors

Certain genetic and ethnic groups have an increased risk of prostate cancer.

In the U.S., prostate cancer is at least 60 percent more common and 2 to 3 times more deadly among black men than non-Hispanic white men.

A man also has a much higher risk of developing cancer if his identical twin has it, and a man whose brother or father had prostate cancer has twice the risk of developing it compared to other men. Having a brother who has or has had prostate cancer is more of a genetic risk than having a father with the disease.

Diet

Studies have suggested that a diet high in red meat or high-fat dairy products may increase a person’s chances of developing prostate cancer, but the link is neither confirmed nor clear.

Medication

Some research has suggested that non-steroidal anti-inflammatory drug (NSAID) use may reduce the risk of prostate cancer. Others have linked NSAID use with a higher risk of death from the disease. This is a controversial area, and results have not been confirmed.

There has also been some investigation into whether statins might slow the progression of prostate cancer. One 2016 study concluded that results were “weak and inconsistent.”

Obesity

It is often believed that obesity is linked to the development of prostate cancer, but the American Cancer Society maintains that there is no clear link.

Some studies have found that obesity increases the risk of death in advanced cancers. Studies have also concluded that obesity decreases the risk that a cancer will be low-grade if it does occur.

Agent Orange

Exposure to Agent Orange, a chemical weapon used in the Vietnam war, may possibly be linked to the development of more aggressive types of cancer, but the extent of this has not been confirmed.

“The largest and longest feeding study to test the ‘carbohydrate-insulin model, concludes that a lower carb intake burns more calories, which may help people maintain weight loss over a longer period of time.

Eating a high-quality, low-carb diet may help us stave off weight gain for longer.

when we lose weight, the body adapts by lowering its energy expenditure. In other words, it burns fewer calories.

This way, the metabolism protects itself against long-term weight changes.

However, when the weight loss is intentional, this adaptive response can be frustrating for dieters, as it leads to weight regain.

Although weight gain after dieting is a well-known phenomenon, researchers do not know much about how different diets affect the way the metabolism responds to them.

The so-called carbohydrate-insulin model, however, suggests one such mechanism. It posits that highly processed foods high in sugar drive hormonal changes that increase the appetite and lead to weight gain.

“According to this model, the processed carbohydrates that flooded our diets during the low-fat era have raised insulin levels, driving fat cells to store excessive calories. With fewer calories available to the rest of the body, hunger increases and metabolism slows — a recipe for weight gain.”

In this context, we decided to investigate the effects that different diets had on the metabolism. Specifically, we looked at the carb-to-fat ratio in varying diets over a 20-week period.

Studying carb intake, weight, and calories

The researchers examined the effect of different diets on 234 adults aged 18–65 whose body mass index (BMI) was at least 25. As part of the study, the participants had also adhered to a weight loss plan for 10 weeks.

By the end of the trial, 164 participants had achieved their weight loss goal of around 12 percent of their total weight. Then, they adhered to either a high-, moderate-, or low-carb diet for 20 weeks, allowing the researchers to examine if they managed to maintain the weight loss.

The high-carb diet was composed of 60 percent high-quality carbs, the moderate-carb one had 40 percent carbs, and the low-carb diet had 20 percent carbs. The diets also minimized sugar intake and used whole grains.

During this time, the scientists measured the participants’ weight and tracked the number of calories they burned. They also examined the participants’ insulin secretion and metabolic hormones.

‘A 20-pound weight loss after 3 years’

At the end of the study period, people in the low-carb group burned significantly more calories than those who had been on a high-carb diet.

Specifically, participants who were on a low-carb diet burned around 250 kilocalories more per day than those who were on a high-carb diet.

“If this difference persists — and we saw no drop-off during the 20 weeks of our study — the effect would translate into about a 20-pound weight loss after 3 years, with no change in calorie intake.”

The results also indicated that for participants who had the highest insulin secretion, the impact of a low-carb diet was even more significant: low-carb dieters burned 400 calories more per day than high-carb dieters.

“A low glycemic load, high-fat diet,” explain the authors, “might facilitate weight loss maintenance beyond the conventional focus on restricting energy intake and encouraging physical activity.”

 “Our observations challenge the belief that all calories are the same to the body.”

“This is the largest and longest feeding study to test the ‘carbohydrate-insulin model,’ which provides a new way to think about and treat obesity.”