Circumcision cuts STD risk, major meditate finds - Men's Health

Circumcision cuts STD risk, major meditate shows

25-year meditate finds substantial benefit to controversial procedure

Circumcised males are less likely than their uncircumcised peers to acquire a sexually transmitted infection, the findings of a 25-year meditate suggest.

According to the report in the November issue of Pediatrics, circumcision may reduce the risk of acquiring and spreading such infections by up to 50 percent, which suggests "substantial benefits" for routine neonatal circumcision.

The current meditate is just one of many that have looked at this controversial topic. While most research has found that circumcision reduces the rates of HIV (the virus that causes AIDS), syphilis and genital ulcers, the results are more mixed for otherness STDs.

The American Academy of Pediatrics has called the evidence "complex and conflicting," and therefore concludes that, at present, the evidence is insufficient to support routine neonatal circumcision.

In the current meditate , the researchers analyzed data collected for the Christchurch Health and Development Study, which included a large birth cohort of children from New Zealand. Males were divided into two groups based on circumcision status before 15 years of age. The presence of a sexually transmitted infection between 18 and 25 years of age was determined by questionnaire.

The 356 uncircumcised boys had a 2.66-fold increased risk of sexually transmitted infection compared with the 154 circumcised boys, lead author Dr. David M. Fergusson and colleagues, from the Christchurch School of Medicine and Health Sciences report.

Click for related contentGuys, eat fruits, veggies to boost fertilityCan you build a brainier baby?

Moreover, this elevated risk was largely unchanged after accounting for potential confounders, such as number of sexual partners and unprotected sex.

The authors estimate that had routine neonatal circumcision been in place, the rate of sexually transmitted infections in the current cohort would have been reduced by roughly 48 percent.

This analysis shows that the benefits of circumcision for reducing the risk of sexually transmitted infection "may be substantial," the authors conclude. "The public health issues raised by these findings clearly involve weighing the longer-term benefits of routine neonatal circumcision in terms of reducing risks of infection within the population, against the perceived costs of the procedure," they add.

(c) Reuters generic viagra 30 pills. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

Test tells who needs prostate surgery - Cancer

New agsdhfgdf may tell who needs prostate surgery

Procedure aims to tell who needs aggressive a cure �" and who doesn't

LONDON - Scientists have found a new way to identify a particularly deadly form of prostate cancer in a breakthrough that could save tens of thousands of men from undergoing unnecessary surgery each year.

In contrast to many cancers, only certain prostate tumours require a cure. Many are slow-growing and pose little threat to health. But separating the "tigers" from the "pussycats" �" as oncologists dub them �" is tricky.

Now that is set to change with research published on Monday showing how a genetic variation within tumour cells can signal if a patient has a potentially fatal form of the sickness.

"This will provide an extra degree of certainty as to whether a cancer is going to be aggressive or indolent, and that's really what we want to know," Colin Cooper, professor of molecular biology at Britain's Institute of Cancer Research, told Reuters.

"Many group get treated radically but probably two-thirds of them never needed treating," he added.

Radical prostate surgery often causes debilitating side effects such as male impotence and incontinence, so any system that minimises a cure would be a major boon to quality of life.

Cooper, who worked with Jack Cuzick at the Wolfson Institute of Preventive Medicine on the new genetic marker, explained in a paper in the journal Oncogene how a particular genetic change could affect survival rates dramatically.

Researchers knew that prostate cancers commonly contain a fusion of the TMPRSS2 and ERG genes, but the new meditate found that in 6.6 percent of cases this fusion was doubled up, creating a deadly alteration known as 2+Edel.

Click for related content

Readers share how cancer changed them
Low Blow: One man's battle with prostate cancer

Patients with 2+Edel have only a 25 percent survival rate after eight years, compared to 90 percent for those with no alterations in this region of DNA.

"If you get two copies it's really bad news," Cooper said.

Exactly how the duplication makes tumours more aggressive is not clear, though Cooper speculates it could result in higher expression of proteins needed to drive tumour growth or be a more general indicator of genome instability.

Whatever the mechanism, 2+Edel is a clear-cut marker for risk that Cooper hopes will soon be used alongside existing techniques at the time of diagnosis to decide whether men require a cure.

Currently, a system called the Gleason score is used to grade which cancers require a cure and which do not, but it is subject to variability in interpretation.

Doctors also use prostate specific antigen (PSA) blood agsdhfgdfs as a screen for early signs of prostate problems, though this agsdhfgdf is not always a reliable indicator of cancer risk.

(c) Reuters 2007. All rights reserved. Republication or redistribution of Reuters content, including by caching, framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

100 answers about cancer and fertility -

100 answers about cancer and fertility

New book addresses young males and females' reproductive concerns
NBC News video?�Fertility after cancer
Sept. 4: TODAY interviews an inspiring cancer survivor and talks to Dr. Nancy Snyderman about available fertility sparing options.

Today show

TODAY

Approximately 130,000 of group diagnosed with cancer in the United States each year are in their reproductive years and 1,000,000 cancer survivors are diagnosed during their reproductive years. In "100 Questions & Answers About Cancer & Fertility," discover important answers to some of the most common questions. Read an excerpt:

Men
Understand that treating cancer is going to be the most important thing for a certain period of time, but there may come a day when you are in recovery and might then be glad that you [planned for] a child.

??"Lisa, Wife of Esophageal Cancer Survivor

1. What is infertility in men?

For men, infertility is the inability to father a child. It can be further defined as the inability to conceive after 1 year of unprotected

intercourse. In general, infertility occurs when you stop producing sperm or when your sperm is too damaged.

The World Health Organization has developed criteria to measure the normal quantity, speed, and shape of sperm. Anything below these numbers is considered low or compromised:

Sperm concentration (quantity)??"more than 20 mil. sperm per milliliter of ejaculate

Sperm motility (speed)??"more than 50percent moving sperm in ejaculate

Sperm morphology (shape)??"more than 30percent of sperm in ejaculate have normal shape

The average man has 60 to 80 mil. sperm per milliliter of ejaculate. Low or compromised fertility is defined as sperm concentrations of less than 20 mil. per cc of ejaculate, whereas sterility is generally defined as a complete absence of sperm (azoospermic). Some couples with slightly abnormal values may still be able to achieve pregnancy naturally or by using fertility a cures.

2. Is infertility the same as male impotence?

Infertility is not the same as male impotence. Infertility does not involve sexual functioning.

3. How do cancer and its a cures affect fertility?

Not all cancers and cancer a cures cause infertility, but some do; thus, it is important to understand your individual risks. Cancer itself can cause infertility in men. For example, some men with agsdhfgdficular cancer and Hodgkin??�s malady have low sperm counts before a cure starts. This could be due to the stress of cancer or the direct effects of the tumor.

Cancer a cures can also cause infertility. In general, the higher the dose and the longer the a cure, the higher the chance for reproductive problems. The following factors can influence your risk:

Age

Type and dose of drugs

Location and dose of radiation

Surgical area

Pre-a cure fertility status of patient

Chemomedical care, radiation, and surgery can all affect your reproductive

system. Table 1 in Appendix A shows whether your cancer a cures might put you at risk for infertility.

Chemomedical care

Chemomedical care kills rapidly dividing cells throughout the body??"cancer cells and healthy cells, including sperm. Your age, the type of chemomedical care, and the dose of the drugs can influence your risk. Certain chemomedical care agents are more damaging than othernesss. Generally, alkylating agents are the worst.

Radiation

Radiation also kills rapidly dividing cells in or around its target area. For example, radiation to or near your agsdhfgdficles can cause infertility, but radiation to your chest will not. Radiation to your pituitary gland or hormone-producing areas

of your brain may cause infertility by interfering with normal hormone production. The location and dose of radiation will influence your risk.

Surgery

Surgery that removes all or part of the reproductive system, such as one or both of your agsdhfgdficles, may cause infertility. Accordingly, the location and scope of surgery influences your risk.

Bone Marrow and Stem Cell Transplants

Bone marrow transplants and stem cell transplants gen?�erally involve high doses of chemomedical care, which increases the risk of infertility. Sometimes full-body radiation is used, which also presents a high risk. The combination of both of these a cures creates an extremely high risk for subse?�quent infertility.

Gleevec (Imatinib)

Although research is limited, there seems to be no effect to men??�s fertility from Gleevec, and it appears to be safe to father a child while you are taking Gleevec.

During my exam, the doctors found numerous tumors in my lymph nodes and spleen as well as a 6-inch tumor wrapped around my heart. I was shocked to hear the news about my tumors and then completely devastated when the oncologist told me that I might become sterile as a result of my cancer a cure.

??"Brian, Hodgkin??�s Lymphoma

4. Am I at risk?

Please refer to Table 1 in Appendix A to better understand your risk of infertility after cancer. Research studies have not been conducted on every type of cancer and every type of a cure to evaluate reproductive outcome, and thus, it is not always possible to know your risk of infertility. If you have amore common type of cancer like non-Hodgkin??�s lymphoma, agsdhfgdficular cancer, or leukemia, there may be studies to help calculate your risks. Discuss your individual risks with your cancer doctor.

5. Is fertility important to me?

If you are at risk for infertility caused by your cancer a cures,

it is important to think about the significance of parenting to you. You may want to consider whether you want to be a father one day and, if so, whether having a child genetically related to you is important. A few sample questions to ask might be as follows:

Have I always wanted children?

Would I prefer adoption to otherness parenthood options?

Does it matter to me whether my children are biologically related to me?

Am I open to using donor sperm or donor embryos?

How many children do I want to have?

How does my partner/spouse feel about all of these issues?

Understanding how you feel about parenthood will help you decide whether options such as sperm banking are worthwhile for you. For example, if you would like to have a biological child with your partner, sperm banking may be the best way for you to preserve that dream; however, if you have always wanted to adopt a child or to be a foster parent, then you might decide not to bank your sperm. It is important for you to think these decisions through because they may affect your parenting options for the rest of your life.

WOMEN

When I was first diagnosed, I thought that the only thing that mattered was surviving, but as the weeks ticked by and we were still waiting for the trial to open, I started thinking that there was a possibility that someday this whole cancer thing would be behind me??"or at least on the very back burner. I knew if that were thecase, I would really want to have children. I also knew that my a cure might screw that up for me. I didn??�t want to be greedy and start thinking about kids before I even took my first dose of Gleevec, but I also didn??�t want to look back and regret not doing whatever I could to prevent that from happening.

??"Erin, Chronic Myelogenous Leukemia

29. What is infertility in women?

Infertility is when you no longer produce mature eggs for ovulation or when you have some otherness condition that prevents you from getting pregnant or maintaining a pregnancy. Infertility is commonly defined as the inability to conceive after 1 year of regular unprotected intercourse; however, this definition does not always apply to cancer patients. Women who have been exposed to fertility-threatening a cures should not necessarily wait 1 year. Cancer survivors are usually advised to seek counseling before trying to conceive or after 6 months of unsuccessful efforts to get pregnant.

Buy in online storeviagra soft tabs pills 'What is premature ovarian failure?'1 | 2 | Next >

New impotency drug an early success - Sexual Health

New impotency drug an early success

Half of new prescriptions written for Levitra

NEW YORK - A new market entrant, Levitra, has captured half the new prescriptions written for impotency since its launch earlier this month, thanks in part to a marketing blitz with a more racy take on sexual performance.

Analysts said?�Levitra??�s early success doesn??�t necessarily portend a major threat to Sildenafil??�s market dominance. But it signals a shift in some of the marketing of both drugs as capable of improving group??�s lifestyle, and not just correcting a sobering medical condition.

The ads have much more of a consumer approach, said Winton Gibbons, an analyst for William Blair & Co. The drugs are being treated like otherness consumer products in ads.

Pfizer Inc. , which makes Sildenafil, and GlaxoSmithKline and Bayer Corp., which are co-marketing Levitra, insist the ads are designed to encourage men with male impotence to see a doctor, and not to promote recreational use. Experts say about 30 mil. men over 40 have male impotence.

But the ads can tell a difference story. The commercial for Levitra (vardenafil)features a sexy model trying to throw a football through a tire. Initially, he fails but then he succeeds, and is joined by a very attractive woman. The voice over says, Sometimes you need a little help staying in the game. When it gets in the zone, it??�s good.

Gibbons labeled the ad racy. Hemant Shah, an independent analyst in Warren, N.J., called it aggressive.

Bayer spokeswoman Lara Crissey said the text was designed to appeal to men, and tie into Levitra??�s sponsorship of the National Football League.

We don??�t feel we are making light of the condition. We are talking to men in a language they understand, Crissey said. The ad has nothing to do with recreational use.

Levitra (vardenafil)hit the market the first week of September. According to the research firm, ImpactRx, half the prescriptions for men who had never taken an impotency drug before were written for Levitra.

But analysts said much can happen between the doctor??�s office and the drug store that prevents prescriptions from turning into sales. The man may decide not to fill the prescription or his health plan may pay only for Sildenafil. Also, he might try the drug and never use it again.

Shah said it isn??�t unusual for men to want to try a new product when it comes on the market. That??�s what happened when Sildenafil arrived five years ago.

Back then Sildenafil??�s promotion featured former presidential candidate Bob Dole explaining male impotence as a serious medical condition.

Pfizer??�s ads are more subtle than the Levitra (vardenafil)ad, but Pfizer??�s ads aren??�t as subtle as they used to be, said Shah.

contributed to this report.

? generic viagra 100 mg . .

Nutrition firm or herbal cabal? - Crime & Punishment

Dietary supplements firm or herbal cabal?

Prosecutors allege Georgia company, execs engaged in Mob tactics
Gregory Smith / New York Daily News
Jared R. Wheat, president and CEO of Hi-Tech Pharmaceuticals, poses in front of a display of the company's products in a Dec. 22, 2005, file photo.

document.write("");Mike Brunkerdocument.write('');Projects Team editor

Mike BrunkerProjects Team editor•Profile•document.write('')E-maildocument.write('');

Until late last year, Hi-Tech Pharmaceuticals of Norcross, Ga., appeared to be a thriving business with a hot-selling line of natural dietary supplements. But in a bizarre case quietly unfolding in federal court in Atlanta, prosecutors allege that it was really a criminal enterprise that sold dangerous “spiked” products and was run by executives who considered assassination and blackmail to quash a federal investigation.

The allegations are the most far-ranging ever leveled against a major player in the loosely regulated dietary supplement industry, and include activities more at home in the Mob hangouts of television's Tony Soprano than a corporate boardroom. Among otherness things, prosecutors allege in court filings that some or all of the defendants:

Discussed killing a U.S. Food and Drug Administration agent and blackmailing an assistant U.S. attorney. Neither plot was carried out, but a Hi-Tech co-founder was subsequently jailed after being convicted of being a felon in possession of a “firearm silencer.” Used the herbal stimulant ephedra in Hi-Tech diet products after the U.S. Food and Drug Administration banned its use on April 12, 2004, finding it presented “an unreasonable risk of illness or injury.” Sold "herbal" supplements that actually contained the active ingredients of prescription drugs that could interact dangerously with otherness drugs.Illegally imported and sold banned steroids.Manufactured phony ecstasy pills that were sold on U.S. streets.Created a muscle-building drink that was later marketed as a cleaning solution in an effort to mislead investigators.

The shocking allegations spring from the Sept. 7 indictment of the company and 11 executives, employees and associates for allegedly operating an illegal Internet medicine in Belize.

Belize lab  ‘substandard and unsanitary’
The defendants used numerous Web sites to advertise and sell what were described as generic prescription drugs from Canada but were actually products that they were manufacturing in “substandard and unsanitary conditions” in Belize, according to the indictment.

Among the substances were the steroids Oxymethelone and Stanozolol, controlled drugs Ambien, Valium and Xanax, and prescription drugs Sildenafil, Cialis, Lipitor and Vioxx, it said.

The indictment also charged Hi-Tech President and CEO Jared R. Wheat, 35, with operating a “continuing criminal enterprise” �" a violation of an anti-organized-crime statute that carries a minimum penalty of 20 years in prison. In court filings, prosecutors describe Wheat as a “lifelong drug dealer,” citing a conviction for dealing ecstasy at the age of 19 in addition to the current allegations.

Wheat has pleaded not guilty to all charges and Hi-Tech said in a statement that it is "appropriately conducting its business and there is no basis for the indictment."

The case raises concerns about the safety of the company’s line of dietary supplements, which remain available through many major U.S. retailers, and more generally about a loosely regulated industry that supplies nutrition products consumed by mil.s of Americans.

But it remains unclear to what extent the government’s charges involve Hi-Tech products manufactured and sold in the United States versus those made in Belize for sale over the Internet.

The U.S. Food and Drug Administration has not issued any safety advisories for Hi-Tech products since the indictment. Representatives of the Food and Drug Administration and the U.S. Attorney’s Office in Atlanta said they could not discuss the ongoing criminal case.

MORE FROM .COM

World Blog: Burying the bodies in Iraq |   Video
Potential juror says he's a liar, racist
Bush's new weapon: Executive privilege
Husband of NASCAR exec dies in plane crash
First Read: Laagsdhfgdf from the '08 campaign

Sensational allegations buried in legal filings
The indictment generated a few headlines when it was unsealed in September, but the case has received no attention as it has spiraled into the sensational since then through a series of legal filings by prosecutors.

Allegations that company officials discussed using violence and blackmail in an effort to block the government’s investigation surfaced March 21 in response to a defense motion asking the court to allow Wheat to post bond and leave the Atlanta jail where he has been held since his arrest on Sept. 14.

CLICK FOR RELATED CONTENTRead the indictment (requires Adobe Acrobat)  Discuss this story on U.S. News message boardArthritis supplements often lack key ingredient

The filing alleged that Hi-Tech co-founder and convicted steroid dealer Tomasz Holda discussed with Wheat, Hi-Tech Vice President Stephen D. Smith and othernesss “obtaining a firearm silencer for use in attacking an Food and Drug Administration agent conducting a criminal investigation into Hi-Tech’s use of Sildenafil in its Stamina Rx product.”

The prosecution filing said that while the Food and Drug Administration agent was not harmed, “It is important to note that in June 2004, Defendant Holda purchased a silencer on the Internet for delivery to his home. This silencer was intercepted by U.S. Customs and Defendant Holda was prosecuted and ultimately pleaded guilty to being a felon in possession of a firearm silencer.”

The timing of the alleged threat was not specified, but the reference to Stamina Rx appears to refer to an Food and Drug Administration complaint brought against Hi-Tech in late 2002. The complaint charged, among otherness things, that the company used the prescription-strength drug ingredient cialis (tadalafil) �" the active ingredient in the erectile-dysfunction product Cialis �" in what it marketed as a natural dietary supplement. Hi-Tech agreed the following year to Food and Drug Administration supervision of its product labeling and marketing, but admitted no wrongdoing in the alleged mislabeling of Stamina Rx’s ingredients.

Buy in online storeviagra soft tabs pills SERVING TIME FOR POSSESSION OF SILENCER1 | 2 | 3 | 4 | Next >

Ex-judge’s trial pumps up giggles - Crime & Punishment

Ex-judge’s trial brings lurid charges to court


Testimony gets a rise out of jurors in conservative Oklahoma town
Mel Root / AP
Former Oklahoma district Judge Donald Thompson walks into the courthouse in Bristow, Okla., with his wife, Paula, after a recess in his trial on June 22. He is charged with four felony counts of indecent exposure, which allegedly occurred in his court during trials.

BRISTOW, Okla. - Serving on the jury in an indecent-exposure trial unfolding in this conservative Oklahoma town has been a giggle-inducing experience.

Former Judge Donald D. Thompson, a veteran of 23 years on the bench, is on trial on charges he used a penis pump on himself in the courtroom while sitting in judgment of othernesss.

Over the past few days, the jurors have watched a defense attorney and a prosecutor pantomime masturbation. A doctor has lectured on the lengths the defendant was willing to go to enhance his sexual performance.

The white-handled sexual device sits before the jury box for hours at a time. Occasionally an attorney picks it up and squeezes the handle, demonstrating the “sh-sh” sound of air rushing through the contraption’s plastic tubing.

The jurors sometimes exchange awkward looks and break into nervous laughter when the agsdhfgdfimony takes a lurid turn.

Thompson, 59, is charged with four counts of indecent exposure, each punishable by up to 10 years in prison. If convicted, he would also have to register as a sex offender, and his $7,489.91-a-month pension would be in jeopardy.

What’s that sound?
Thompson’s former court reporter, Lisa Foster, wiped away tears as she described tracing an unfamiliar “sh-sh” in the courtroom to her boss. She agsdhfgdfified that between 2001 and 2003 she saw Thompson expose himself at least 15 times.

“I was really shocked and I was kind of scared because it was so bizarre,” Foster said.

She agsdhfgdfified that during a trial in 2002, she heard the pump during the emotional agsdhfgdfimony of a murdered toddler’s grandfather.

The grandfather “was getting real teary-eyed, and the judge was up there pumping on that pump,” she said. “It was sickening.”

The allegations came to light after a police officer who was in Thompson’s court heard pumping sounds and took photos of the device during a break in the proceedings.

Thompson took the stand in his own defense, saying the device was a gag gift from a longtime friend with whom he had joked about male impotence. He said he kept the pump under the bench or in his office but didn’t use it.

“In 20-20 hindsight, I should have thrown it away,” he said.

This agsdhfgdfimony rated R
The R-rated agsdhfgdfimony has produced occasional outbursts of laughter and surreal scenes. A man who once served as a juror in Thompson’s court agsdhfgdfified that he never saw the device, but figured out what it was based on movies he had seen.

A. Cuervo / APLisa Foster, the longtime court reporter of former judge Donald Thompson, walks Monday with her husband Neal back into the courthouse for Thompson's indecent exposure trial.The comment sent sidelong glances through the courtroom.

“It sounded like a penis pump to me,” Daniel Greenwood agsdhfgdfified. He said he had seen such devices in “Austin Powers” and “Dead Man on Campus.”

Dr. S. Edward Dakil, a urologist called as an expert witness, repeatedly prompted laughter from the jury when discussion turned to the penis pump. Dakil defended use of the device after defense attorney Clark Brewster said it was an out-of-date pharmacomedical care for male impotence.

“I still use those,” Dakil agsdhfgdfified.

Brewster paused. “Not you, personally?” he asked.

“No,” Dakil responded as jurors laughed. “I recommend those as a urologist.”

� generic viagra buy now . .

The cancer's gone, so where's my confidence? - Low Blow

The cancer was gone ??" so was my confidence

Crippling loss of certainty an unexpected side effect of prostate battle
Kelly J. Phanco
A?�visit to Death Valley?�??" and a flat tire?�??" helped Mike Stuckey get back on the road to emotional stability and self-reliance after cancer surgery.

Part 8By document.write("");Mike Stuckeydocument.write('');Senior news editor

I get off the plane at Washington??�s Reagan National Airport on a September evening with a damp diaper in my pants and a message blinking on my cell phone. All I want to do is find the nearest men??�s room and deal with the first issue. But a sixth sense tells me to check the message immediately.

When I return the call, I am stunned to hear that my two interviews with a U.S. senator, for which I have just flown across most of the country with an colleague in tow, have been summarily canceled. The senator??�s staffers have decided they don't like a previous story I wrote that involved the senator.

Trying to not think about how I will explain to my boss a 3,000-mile trip come to naught, I plead with the press secretary. I do everything but beg. Just leave the door open until you meet us. Please. Pretty please. No dice. She hangs up.

It is the beginning of a long, dark autumn. On the surface, most things appear fine. Even great. After all, it has been a few months since my cancerous prostate was efficiently removed by a robot under the direction of some of Seattle's finest surgeons. While I am still struggling with side effects of the surgery, such as the need for that diaper, there has been progress. I am physically as active as I care to be and my post-op PSA (prostate specific antigen) level is zero. The news generally doesn??�t get much better at this stage for a guy who has been through what I have. I should be pinching myself.

But over the next several months, I feel like I am running in quicksand. I am indecisive over the smallest things. I have nagging visions of spectacular failures at work and in life. I bore group around me almost daily with these insecurities. My main source of comfort is adding up how much money I could raise if I sold all my belongings and reassuring myself that it would be enough to eke out my days in a small trailer in some remote place.

There's no accounting for how cancer changes us. Some of us work less, play more, try to make up for lost time, "live like you were dying," as the country hit says. Others work more, get our ducks in a row, seek distraction from the obvious consequences of the illness. Some of us pull friends and family closer; some push them away.

Dripping with doubts
Starting with that phone call in Washington, I underwent a bizarre but nearly complete loss of confidence in my ability to do the things I have done with ease for decades. Sometimes it washed over me as a general sense of dread, an inexplicable feeling that I wouldn't be able to finish what I had started, even if it was just a pile of laundry that needed folding. Other times, it surfaced in very conscious feelings of inadequacy, like the sudden dark spot on my jeans while reporting election results in a small crowded room in Mississippi.

At first, it puzzled me because I often saw no connection between cancer and this newfound shakiness. On a daily basis, except when I needed to find a bathroom in a hurry, I rarely thought about my medical situation.

MESSAGE BOARDS?�?�?�?�?�Tell your own story, share advice and learn from othernesss.But my girlfriend saw the link. You??�ve been through a lot, she said. I??�m not surprised. Even after I accepted her theory, little changed. Intellectually, like some folks who want to quit smoking or drinking, I could now see the problem clearly, but that did little to help me overcome it. I stumbled along, went through the motions, waited for the fog to lift.

And, suddenly, it did, although not quite as quickly as it had come. Interestingly, when it was gone, so were the diapers.

On a pre-Thanksgiving vacation to the California desert, things began turning around. Sixteen miles beyond the pavement in Death Valley, in one of my favorite places in the world, I drove a mesquite branch deep into a tire on my truck. For some reason, the sickening hiss of escaping air and the knowledge that I had not checked the spare in years didn??�t panic me.

We pitched the tent in the dark, cooked up a big pot of pasta and watched jet fighters run maneuvers amid the crisp stars so high above us that we could not hear their engines. For two days, we hiked the surrounding canyons, took dozens of photographs and lay in the sun. While I knew that we might end up hiking for help or limping into Stovepipe Wells on a rim and a prayer, I also knew there would be no disaster. Indeed, the spare had enough air to get us to a tire store in Vegas.

Confidence to spare
A few days later, in a motel in Idaho on the way back home, I drifted off to sleep without putting in my nightly adult undergarment. When I awoke the next morning without having sprung a leak in the night, I was inclined to treat it as random luck and install a new pad. For some reason, I didn??�t. I haven??�t used one since. Within a few days of quitting them, it was like the whole incontinence issue had never happened. While my bladder capacity isn??�t what it was pre-surgery, I have no otherness issues. I don??�t leak a drop, even during strenuous activity.

Click for related contentLow Blow: Read the complete series
Cancer deaths drop for 2nd straight year

As predictably Freudian as this sounds, that bit of physical security brought back emotional stability in spades. At home and work, things are clicking a lot more like the old days. Stories are coming together much more efficiently. I??�m choosing paint and bathroom fixtures for the house I??�m remodeling with the certitude of Martha Stewart. There??�s still way too much to do and too little time to do it, but no sense of impending doom about it. Even though it has been just six months now since my prostate surgery, and two undetectable PSA agsdhfgdfs now, it seems like a distant memory. I still don??�t think much about having cancer or worry that it will come storming back.

INTERACTIVE?�Prostate cancer: What you need to know
At times, when I hear in e-mail or at speaking engagements from men who have not had it so good, I have twinges of guilt. But none of us really knows what??�s around the next bend, be it a car wreck or a cancer recurrence, and an almost universal outcome of this illness is a more mindful approach to the time we do have left. I put one foot in front of the otherness every day fully conscious of each step that I choose to take and knowing that changing any of them is only up to me.

One remaining source of loss and frustration involves, as I always feared it would, sex. While Sildenafil works for me, and there are even some unassisted stirrings, I think I was overly optimistic about the benefits. The drugmakers??� soft-focus "male impotence" commercials aside, no pill has so far been able to induce the nuances of sexual arousal as nature intended. But given what happened with the pee problem, I am trying not to dwell on this; indeed, my doctor says that I am already ahead of schedule here and I have an entire year left to expect improvement.

So I??�m two for three as I head toward the one-year anniversary of my diagnosis on April 28. No cancer, no diapers, but no natural boners.

I think, for now, that is a pretty good order of business.

? buy generic viagra pack