Cancer

Prostate cancer is the second leading type of cancer in men behind skin cancer and is one of the primary causes of death among men of all races. It is estimated that approximately twenty-seven thousand nine hundred and seventy men will die from prostate cancer in the United States alone. Despite these numbers, prostate cancer is highly treatable if it is caught during the early stages of the disease. Here are the visual signs to look out for.

Frequent Urination 

Although there are no real warning signs of early prostate cancer, frequent urination may be an indication of swelling or pressure on the prostate gland. This occurs when a tumor has formed and puts pressure on the prostate gland, resulting in the urge to urinate more often than normal, especially at night. In some cases, frequent urination is a sign that the tumor has spread beyond the prostate or may entirely encompass the gland. 

Difficulty Urinating 

Difficulty urinating may be caused when the prostate gland grows large enough to press against the urethra, making it harder for urine to be comfortably evacuated from the body. This is known as a condition called benign prostate hyperplasia. However, a man may also experience difficulty urinating when a tumor is pressing against the urethra. Other symptoms may include a burning sensation or pain while urinating or during ejaculation. A doctor should be notified at the first sign of these symptoms to rule out prostate cancer. 

The diagnosis of prostate cancer is something no man wants to hear from his doctor. If there is a chance the disease will occur, there are proactive measures men can take to lower the odds. If a diagnosis has already been confirmed, options exist to help fight the disease and ease symptoms to improve the quality of life for the patient. The choices, whether natural or traditional medicinal methods are determined by each patient and his in-depth discussion with his doctor. Explore the best possible options for beating prostate cancer now. 

Interrupted Urine Flow 

Along with difficulty urinating, a man with prostate cancer may experience an interrupted urine flow that starts and often stops before the bladder feels empty. This may be caused by a tumor growth pressing on the urethra. Enlargement or inflammation of the prostate gland are also symptoms of prostate cancer and may cause an interrupted urine stream. A frequently interrupted urine stream may be an indication of a tumor and should be discussed with a doctor. 

Blood 

The presence of blood in the semen or urine may be a sign of prostate cancer. It is important to seek medical treatment to rule out other conditions as blood in the urine may be related to a urinary tract infection or kidney disease. Cancer may block the urethra tube, resulting in painful inflammation and bleeding of the prostate gland. Blood in the urine is usually a sign of advanced cancer and needs to be looked after immediately. 

Enlarged Prostate 

Although a man’s prostate will naturally grow as he ages, abnormally large growth advancements may be a sign of cancer. Several tests can be performed by a medical doctor to determine if cancer is present. A digital rectal exam involves a medical professional using an index finger to check the gland for abnormalities. An enlarged gland will feel smooth and firm while cancer will feel hard and lumpy. An ultrasound may also be done to determine the health of the prostate gland. 

Burning Or Pain When Urinating 

When a tumor presses on and constricts the urethra, it may inhibit the flow of urine which can cause the patient to feel a burning sensation or pain when urinating along with other symptoms related to urination. 

Those at risk of prostate cancer include those who have a family history of the disease, consume a diet high in saturated fat, have high testosterone levels, genome changes, or a condition known as prostatic intraepithelial neoplasia (PIN). The American Cancer Society recommends that men begin getting tested for prostate cancer when they reach the age of fifty. 

Urges To Urinate At Night 

One of the symptoms of prostate cancer is for the patient to have more frequent urges to urinate during the night. This is also a symptom of the prostate is enlarged, which begins to happen as men age. However, this symptom may be confused with many other illnesses classified under the medical term, nocturia, which is the need to urinate excessively at night. 

Some other causes of nocturia include infections, an overactive bladder, anxiety, edema, diabetes, obstructive sleep apnea, and neurological disorders like Parkinson’s disease or Multiple sclerosis (MS). Nocturia can also be common amongst patients with organ failure. 

If there are extreme urges to urinate at night, speak to a licensed physician.

Gilead Sciences will begin human trials for an inhaled version of its antiviral drug remdesivir in August, the biotech company said Monday.

Remdesivir, which was granted an emergency use authorization (EUA) from the Food and Drug Administration to treat patients hospitalized with Covid-19, is administered intravenously. The company told investors in April that it was looking to develop easier-to-administer versions of the drug, including an inhaled version. The drug can’t be administered in pill form because its chemical makeup would impact the liver, the company noted.

Gilead said it will administer the drug through a nebulizer, a delivery device that can turn liquid medicines into mist.

An inhaled version “could potentially allow for easier administration outside the hospital, at earlier stages of disease,” Gilead Chairman and CEO Daniel O’Day said in an open letter Monday. “That could have significant implications in helping to stem the tide of the pandemic.”

Gilead will screen healthy volunteers for the early-stage trial and hope to begin studies in patients with Covid-19 in August.

The company said it will also conduct trials using intravenous infusions in outpatient settings such as infusion centers and nursing homes. It is also exploring whether it can improve patient outcomes by combining remdesivir with other therapies.

“Our best hope of beating Covid-19 is with a set of tools at our disposal: complementary therapeutics, effective vaccines and widespread testing,” O’Day said. “Having already seen that science can deliver answers, we can be hopeful of continued progress. Gilead will do all it can to help drive that progress by exploring the full potential of remdesivir.”

There are no FDA-approved drugs to treat Covid-19, which has infected nearly 9 million people worldwide and killed at least 468,589, according to data compiled by Johns Hopkins University. 

Remdesivir was granted a EUA by the FDA in May. Hydroxychloroquine, a malaria drug touted by President Donald Trump, had also been granted a EUA for the coronavirus, but the designation was revoked after the FDA found it was unlikely to be effective.

In April, the National Institute of Allergy and Infectious Diseases released results from its study showing a modest benefit for patients who took remdesivir. It showed Covid-19 patients who took the drug usually recovered after 11 days, four days faster than those who didn’t take the drug.

The company has said it can produce “several million” rounds of its antiviral drug next year to help patients fight the coronavirus.

Scientists hail dexamethasone as ‘major breakthrough’ in treating coronavirus

Published Tue, Jun 16 20208:56 AM EDTUpdated Tue, Jun 16 20205:06 PM EDT

Dexamethasone, a cheap and widely used steroid, has become the first drug shown to be able to save lives among Covid-19 patients in what scientists hailed as a “major breakthrough”.


Results of trials announced on Tuesday showed dexamethasone, which is used to reduce inflammation in other diseases, reduced death rates by around a third among the most severely ill Covid-19 patients admitted to hospital.

The results suggest the drug should immediately become standard care in patients with severe cases of the pandemic disease, said the researchers who led the trials.


“This is a result that shows that if patients who have Covid-19 and are on ventilators or are on oxygen are given dexamethasone, it will save lives, and it will do so at a remarkably low cost,” said Martin Landray, an Oxford University professor co-leading the trial, known as the RECOVERY trial.

“It’s going to be very hard for any drug really to replace this, given that for less than 50 pounds ($63.26), you can treat eight patients and save a life,” he told reporters in an online briefing.


His co-lead investigator, Peter Horby, said dexamethasone was “the only drug that’s so far shown to reduce mortality - and it reduces it significantly.”


“It is a major breakthrough,” he said. “Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”

There are currently no approved treatments or vaccines for Covid-19, the disease caused by the new coronavirus which has killed more than 431,000 globally.

Saving ‘countless lives’

The RECOVERY trial compared outcomes of around 2,100 patients who were randomly assigned to get the steroid, with those of around 4,300 patients who did not get it.

The results suggest that one death would be prevented by treatment with dexamethasone among every eight ventilated Covid-19 patients, Landray said, and one death would be prevented among every 25 Covid-19 patients that received the drug and are on oxygen.

Among patients with Covid-19 who did not require respiratory support, there was no benefit from treatment with dexamethasone.

“The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients,” Horby said.

” Nick Cammack, an expert on Covid-19 at the Wellcome Trust global health charity, said the findings would “transform the impact of the Covid-19 pandemic on lives and economies across the world”.

“Countless lives will be saved globally,” he said in a statement responding to the results.

The RECOVERY trial was launched in April as a randomised clinical trial to test a range of potential treatments for Covid-19, including low-dose dexamethasone and the malaria drug hydoxycholoroquine.

The hydroxychloroquine arm was halted earlier this month after Horby and Landray said results showed it was “useless” at treating Covid-19 patients.

Global cases of infection with the novel coronavirus have reached over 8 million, according to a Reuters tally, and more than 434,000 people have died after contracting the virus, the first case of which was reported in China in early January, 2020.

WHO welcomes preliminary results about dexamethasone use in treating critically ill COVID-19 patients

16 June 2020

News release

The World Health Organization (WHO) welcomes the initial clinical trial results from the United Kingdom (UK) that show dexamethasone, a corticosteroid, can be lifesaving for patients who are critically ill with COVID-19. For patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth, according to preliminary findings shared with WHO.

The benefit was only seen in patients seriously ill with COVID-19, and was not observed in patients with milder disease. 

“This is the first treatment to be shown to reduce mortality in patients with COVID-19 requiring oxygen or ventilator support,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This is great news and I congratulate the Government of the UK, the University of Oxford, and the many hospitals and patients in the UK who have contributed to this lifesaving scientific breakthrough.”

Dexamethasone is a steroid that has been used since the 1960s to reduce inflammation in a range of conditions, including inflammatory disorders and certain cancers. It has been listed on the WHO Model List of Essential Medicines since 1977 in multiple formulations, and is currently off-patent and affordably available in most countries.

The researchers shared initial insights about the results of the trial with WHO, and we are looking forward to the full data analysis in the coming days. WHO will coordinate a meta-analysis to increase our overall understanding of this intervention. WHO clinical guidance will be updated to reflect how and when the drug should be used in COVID-19.

Today’s news builds off the WHO Research & Development Blueprint meeting, which took place in Geneva in mid-February to accelerate health technologies for COVID-19, where further research into the use of steroids was highlighted as a priority. The findings reinforce the importance of large randomized control trials that produce actionable evidence. WHO will continue to work together with all partners to further develop lifesaving therapeutics and vaccines to tackle COVID-19 including under the umbrella of the Access to COVID-19 Tools Accelerator. 

Seasonal Affective Disorder

Overview

Seasonal Affective Disorder (SAD) is a type of depression that comes and goes with the seasons, typically starting in the late fall and early winter and going away during the spring and summer. Depressive episodes linked to the summer can occur, but are much less common than winter episodes of SAD.

Signs and Symptoms

Seasonal Affective Disorder (SAD) is not considered as a separate disorder. It is a type of depression displaying a recurring seasonal pattern. To be diagnosed with SAD, people must meet full criteria for major depression coinciding with specific seasons (appearing in the winter or summer months) for at least 2 years. Seasonal depressions must be much more frequent than any non-seasonal depressions.

Symptoms of Major Depression

• Feeling depressed most of the day, nearly every day
• Feeling hopeless or worthless
• Having low energy
• Losing interest in activities you once enjoyed
• Having problems with sleep
• Experiencing changes in your appetite or weight
• Feeling sluggish or agitated
• Having difficulty concentrating
• Having frequent thoughts of death or suicide.

Symptoms of the Winter Pattern of SAD include:

• Having low energy
• Hypersomnia
• Overeating
• Weight gain
• Craving for carbohydrates
• Social withdrawal (feel like “hibernating”)

Symptoms of the less frequently occurring summer seasonal affective disorder include:

• Poor appetite with associated weight loss
• Insomnia
• Agitation
• Restlessness
• Anxiety
• Episodes of violent behavior

Risk Factors

Attributes that may increase your risk of SAD include:

• Being female. SAD is diagnosed four times more often in women than men.
• Living far from the equator. SAD is more frequent in people who live far north or south of the equator. For example, 1 percent of those who live in Florida and 9 percent of those who live in New England or Alaska suffer from SAD.
• Family history. People with a family history of other types of depression are more likely to develop SAD than people who do not have a family history of depression.
• Having depression or bipolar disorder. The symptoms of depression may worsen with the seasons if you have one of these conditions (but SAD is diagnosed only if seasonal depressions are the most common).
• Younger Age. Younger adults have a higher risk of SAD than older adults. SAD has been reported even in children and teens.

The causes of SAD are unknown, but research has found some biological clues: 

• People with SAD may have trouble regulating one of the key neurotransmitters involved in mood, serotonin. One study found that people with SAD have 5 percent more serotonin transporter protein in winter months than summer months. Higher serotonin transporter protein leaves less serotonin available at the synapse because the function of the transporter is to recycle neurotransmitter back into the pre-synaptic neuron.
• People with SAD may overproduce the hormone melatonin. Darkness increases production of melatonin, which regulates sleep. As winter days become shorter, melatonin production increases, leaving people with SAD to feel sleepier and more lethargic, often with delayed circadian rhythms.
• People with SAD also may produce less Vitamin D.Vitamin D is believed to play a role in serotonin activity. Vitamin D insufficiency may be associated with clinically significant depression symptoms.

Treatments and Therapies

There are four major types of treatment for SAD:

• Medication
• Light therapy
• Psychotherapy
• Vitamin D

 These may be used alone or in combination.

Medication

Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat SAD. The FDA has also approved the use of bupropion, another type of antidepressant, for treating SAD.

As with other medications, there are side effects to SSRIs. Talk to your doctor about the possible risks of using this medication for your condition. You may need to try several different antidepressant medications before finding the one that improves your symptoms without causing problematic side effects. For basic information about SSRIs and other mental health medications, visit NIMH’s Medications webpage. Check the FDA’s website for the latest information on warnings, patient medication guides, or newly approved medications.

Light Therapy

Light therapy has been a mainstay of treatment for SAD since the 1980s. The idea behind light therapy is to replace the diminished sunshine of the fall and winter months using daily exposure to bright, artificial light. Symptoms of SAD may be relieved by sitting in front of a light box first thing in the morning, on a daily basis from the early fall until spring. Most typically, light boxes filter out the ultraviolet rays and require 20-60 minutes of exposure to 10,000 lux of cool-white fluorescent light, an amount that is about 20 times greater than ordinary indoor lighting.

Psychotherapy

Cognitive behavioral therapy (CBT) is type of psychotherapy that is effective for SAD. Traditional cognitive behavioral therapy has been adapted for use with SAD (CBT-SAD). CBT-SAD relies on basic techniques of CBT such as identifying negative thoughts and replacing them with more positive thoughts along with a technique called behavioral activation. Behavioral activation seeks to help the person identify activities that are engaging and pleasurable, whether indoors or outdoors, to improve coping with winter.

Vitamin D

At present, vitamin D supplementation by itself is not regarded as an effective SAD treatment. The reason behind its use is that low blood levels of vitamin D were found in people with SAD. The low levels are usually due to insufficient dietary intake or insufficient exposure to sunshine. However, the evidence for its use has been mixed. While some studies suggest vitamin D supplementation may be as effective as light therapy, others found vitamin D had no effect.

Join a Study

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including seasonal affective disorder. During clinical trials, treatments might be new drugs or new combinations of drugs, new psychotherapies or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Please Note: Decisions about whether to apply for a clinical trial and which ones are best suited for a given individual are best made in collaboration with your licensed health professional.

Clinical Trials at NIMH/NIH

Scientists at the NIMH campus conduct research on numerous areas of study, including cognition, genetics, epidemiology, and psychiatry. The studies take place at the NIH Clinical Center in Bethesda, Maryland and usually require regular visits. After an initial phone interview to see if any of the clinical trials recruiting subjects are a good match for you, you will come to an appointment at the clinic and meet with a clinician. Visit the NIMH Clinical Trials — Participants or Join a Study for more information.

How Do I Find a Clinical Trial Near Me?

To find a clinical trial near you, you can visit ClinicalTrials.gov. This is a searchable registry and results database of federally and privately supported clinical trials conducted in the United States and around the world. ClinicalTrials.gov gives you information about a trial's purpose, who may participate, locations, and contact information for more details. This information should be used in conjunction with advice from your health provider.

Hãy thay đổi cách nói về bệnh tiểu đường

Theo một nghiên cứu mới đây cho thấy việc thay đổi cách nói và ngôn từ thường dùng khi nói về bệnh tiểu đường có thể đem lại một tác động hết sức bất ngờ cho chính sức khỏe của người bệnh

Những từ ngữ như “ đường huyết” và “ tiểu đường” có thể gây hại đến  việc chăm sóc sức khỏe cho người bị tiểu đường type 2

Theo bác sỹ Justin Laube, những lời nói về bệnh tiểu đường đẩy rẫy những từ gây khó chịu , bực bội nào là kiểm tra đường huyểt, kiêng ăn, tự lừa dối mình, béo phì .... toàn là những cảm xúc sợ hãi, đau đớn và xấu hổ

 By Ilene Raymond Rush

John Zrebiec, một nhà hoạt động xã hội phục vụ tại bệnh viện và là giám đốc trung tâm chăm sóc sức khỏe người bệnh tiểu đường ở Boston đã có một ý tưởng 

Zrebiec cho biết người bị bệnh tiểu đường thường nói chuyện với nhau hoặc đọc về “ các chế độ ăn kiêng”. Khi nói đến những kế hoạch chuẩn bị cho từng bữa ăn hoặc phải ăn uống ra sao cho bổ dưỡng. “ chẳng ai có thể duy trì mãi những chế độ ăn kiêng ấy” Zrebiec nói tiếp “ mà ngược lại là chỉ cần có một kế hoặch ăn uống bổ dưỡng “ thì mới bền lâu

Những từ khác có vẻ ít ảnh hưởng hơn như lấy máu để thử . Lại thử máu rồi lại thất vọng?

“ kết quả có thể tốt, xấu, đúng hay sai” “ thay vì một điều cho thấy làm sao để trị được bệnh tiểu đường, nó đã trở nên một nỗi ám ảnh 

Ông cho rằng ý tưởng nguyên thủy về thử đường huyết có vẻ giúp cho các người bị tiểu đường biết được tình trạng bệnh của họ, ý tưởng này đã nhanh chóng được chấp nhận hoặc không

Quan điểm sử dụng xét nghiệm đường huyết giúp cho người bệnh biết sẽ phải làm gì sau đó:  tăng hay giảm liều thuốc đang uống, bớt ăn các chất có chứa tinh bột, -đều không phải là cách giải quyết tối ưu

Thế ngôn từ sẽ tác động ra sao ?

Ngoài việc khiến cho người bệnh tiểu đường cảm thấy xấu hổ hay tìm cách đổ lỗi cho nguyên nhân này  nguyên nhân khác, thì ngôn từ mà họ hay nhân viên chăm sóc y tế thường dùng có thể tác động đến tình trạng bệnh tật của họ

Tuỳ vào việc chọn từ hay cụm từ, ngôn ngữ có thể làm “mất hứng thú, hay thậm chí còn có tác động tai hại nữa không chừng” một bài báo được đăng trên tạp chí nghiên cứu về bệnh tiểu đường vào tháng 9 năm 2012 đã viết nhừ trên. Bài báo này do hội tiểu đường Úc đã xác định được một số từ mà các nhân viên chăm sóc y tế và người bệnh tiểu đường thường sử dụng có tác hại ra sao đến việc chăm sóc

Ở Mỹ, bác sỹ và điều dưỡng đang khuyến khích động viên các nhân viên chăm sóc y tế hãy cẩn thận chọn lựa từ ngữ khi giao tiếp với bệnh nhân bị tiểu đường của họ. Như vậy chính bác sỹ và y tá phải là những người tiên phong cho việc sử dụng “ những biện pháp tập trung vào bệnh nhân” về phương diện ngôn từ, họ cần tránh những nhận xét mang tính tiêu cực mà phải cố gắng gởi đến bệnh nhân của họ những Thông điệp chứa đựng sự cảm thông

“Chúng ta háy cố gắng giúp cho mọi người hiểu rằng chúng ta đang cùng hành động để chiến đấu với căn bệnh tiểu đường qua từng ngày” tiến sỹ Jane K Dickinson, nhà tư vấn về bệnh tiểu đường, giám đốc chương trình quãn lý và chăm sóc bệnh tiểu đường thuộc viện đại học Columbia, thành phố New York cho biết như trên.

Hãy thay đổi ngôn từ nói về bệnh tiểu đường của các bạn

Trong khi các từ ngữ nói về bệnh tiểu đường xem ra như một vấn đề đành phải cảm chịu, thì đã có một tin tốt lành: một khi bạn đã có ý thức rằng ngôn từ có khã năng gây tác hại âm thầm đến việc chăm lo bệnh tật của các bạn, thì các bạn nên cố gắng thay đổi cách nói đi.

Sau đây là một vải từ và cụm từ thường dùng để nói về bệnh tiểu đường, cùng với cách thay đổi để cho chúng mang yếu nghĩa tích cực và động viên , chính xác và mang tính hỗ trợ nhiều hơn

Đường huyết nặng quá, hay thay chữ “ nặng” bằng chữ “ cao hay thấp” vì chữ nặng ám chỉ một tình huống không thể thay đổi được, mà thực tế kết quả đó cũng chỉ diễn tả ở một thời điểm nào đó mà thôi

“Thử máu” nên thay bằng từ “ kiểm tra” “ theo dõi” hay “ tự theo dõi” có vẻ phù hợp hơn từ “ thử máu” vì xét nghiệm thường ám chỉ đến một kết quả tốt hay xấu, trong khi người bệnh tiểu đường cần được theo dõi suốt cuộc đời còn lại của họ

”Kiểm soát” thường dùng trong các cụm từ như “ kiểm soát được bệnh tiểu đường” hay “ kiểm soát được đường huyết” nên thay bằng từ “ xứ lý” hay “ có tác dụng” vì từ “ kiểm soát có yếu nghĩa rõ ràng, trong khi người bệnh tiểu đường thật sự không thể biết điều gì đang xã ra bên trong cơ thể họ

“ người bệnh tiểu đường” có ý nói đến một đặc điểm về bệnh tật ở một người, nên thay bằng cụm từ “ người đang sống chung với tiểu đường “ nghe nhẹ nhàng hơn

“Thất bại” thầm hiểu toàn là nguy cơ dẫn đến không thành công, nên thay bằng từ “ không” hay chưa” thí dụ :” bạn chưa kiểm tra đường huyết của bạn đấy, ngảy mai hãy bắt đẩu ngay nhé”

“ béo phì” vả “ cân nặng bình thường” hội tiểu đường Úc đề nghị bạn nên thay hẳn bằng từ “ trọng lượng không lành mạnh hay lành mạnh” thế thôi. Đây Chính là các từ diễn tả sự khác biệt về dáng vẻ và tình trạng cơ thể. Béo phì là từ mô tả về dáng vẻ xem ra mang tính cố hữu và không thể thay đổi, còn trạng thái cơ thể có thể lảnh mạnh hay không lành mạnh, hàm ý đến những gì còn có thể thay đôi được

“Không nên” “ phải” và “ không thể” tránh sử dụng những từ này vì nó chẳng cho bạn một sự chọn lựa nào cả. Thí dụ “khi bạn nói với ai đó hãy vứt nó vào thùng rác, thì cơ hội vẫn còn đấy, họ vẫn còn có cảm giác mình còn có sự chọn lựa” Kim Olson giải thích thêm như vậy

Nói chuyện với tư cách như một người bị tiểu đường không phải dễ, một số người trong chúng ta quen sử dụng những từ mang tính tiêu cực, việc làm này sẽ có những tác hại tiềm ẩn đến tâm lý cũng như thể lý của người bệnh tiểu đường. Hãy cố gắng thay đổi từ ngữ và cách nói về bệnh tiểu đường nếu như bạn là người đang mắc bệnh tiểu đường hay thậm chí là nhân viên y tế chăm sóc sức khỏe cho họ

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Diabetes Survival Guide
Don't throw away those Halloween pumpkins! The seeds are a delicious, diabetes-friendly snack. You can have 1/2 cup of shell-on roasted pumpkin seeds for fewer than 200 calories. Punch up the flavor by sprinkling on creole seasoning, cayenne pepper, curry powder, or your favorite spice blend. #ItsNotEasyButItsWor

the biggest leap in diagnosing prostate cancer

The biggest leap in diagnosing prostate cancer "in decades" has been made using new scanning equipment, say doctors and campaigners.
Using advanced MRI nearly doubles the number of aggressive tumours that are caught.
And the trial on 576 men, published in the Lancet, showed more than a quarter could be spared invasive biopsies, which can lead to severe side-effects.
The NHS is already reviewing whether the scans can be introduced widely.
Prostate cancer is the most common cancer in British men, and yet testing for it is far from perfect.
If men have high prostate specific antigen (PSA) levels in the blood, they go for a biopsy.
Twelve needles then take random samples from the whole of the prostate.
It can miss a cancer that is there, fail to spot whether it is aggressive, and cause side-effects including bleeding, serious infections and erectile dysfunction.
"Taking a random biopsy from the breast would not be accepted, but we accept that in prostate," said Dr Hashim Ahmed, a consultant and one of the researchers.
Around 100,000 to 120,000 men go through this every year in the UK.
Scanning
The trial, at 11 hospitals in the UK, used multi-parametric MRI on men with high PSA levels.
It showed 27% of the men did not need a biopsy at all.
And 93% of aggressive cancers were detected by using the MRI scan to guide the biopsy compared with just 48% when the biopsy was done at random.
Dr Ahmed, who works at University College London Hospitals, told the BBC News website: "This is a significant step-change in the way we diagnose prostate cancer.
"We have to look at the long-term survival, but in my opinion by improving the detection of important cancers that are currently missed we could see a considerable impact.
"But that will need to be evaluated in future studies, and we may have to wait 10 to 15 years."
Chris, 70, from Hassocks, West Sussex
Chris first noticed the symptoms at the theatre a decade ago, when he needed to go to the toilet repeatedly.
Doctors found his prostate was enlarged.
In May last year, Chris needed to see his doctor again, as he was feeling tired a lot of the time.
Prostate cancer was suspected, and he was offered an MRI scan as part of the trial.
He says: "I'd heard from a friend that a prostate biopsy could be extremely painful and uncomfortable, so was pleased to know that I wouldn't be sent for one unless the doctors were confident I needed it."
In the end, he still needed a biopsy, and he was diagnosed with a cancer that had not spread out of the tumour.
He is now considering what to do about treatment.
Angela Culhane, the chief executive at Prostate Cancer UK, described the current system of testing as "notoriously imperfect".
She added: "This is the biggest leap forward in prostate cancer diagnosis in decades."
The study, led by the Medical Research Council Clinical Trials Unit, is already being considered by the National Institute for Health and Care Excellence.
It will decide whether the NHS can afford multi-parametric MRI for prostate cancer.
Each scan costs between £350 and £450 pounds per patient - so introducing them for all patients across the UK would have a bill around the £40m mark.
But each biopsy costs the NHS £450 so reducing the number would deliver savings. Catching aggressive cancers earlier could also deliver savings as could not treating patients with very low-risk cancers.
A full cost-effectiveness analysis is being carried out.
Prof Ros Eeles, from the Institute of Cancer Research in London, said the study was "very important" and "provides ground breaking data".
The chairman of the British Society of Urogenital Radiology, Dr Philip Haslam, said: "Today's findings represent a huge leap forward in prostate cancer diagnosis."
However, he warned the biggest issue could be the number of scanners and training people to interpret the results.
Follow James on Twitter.
Have you been affected by prostate cancer? What is your reaction to the test advance? You can share your experience by emailing haveyoursay@bbc.co.uk.
Please include a contact number if you are willing to speak to a BBC journalist. You can also contact us in the following ways:
■   WhatsApp: +44 7525 900971
■   Send pictures/video to yourpics@bbc.co.uk
■   Upload your pictures / video here
■   Tweet: @BBC_HaveYourSay
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9 Types of Medication That Help Control Type 2 Diabetes

By Margaret O'Malley

Reviewed by Bhargavi Patham, MD

Although lifestyle changes are essential for people with type 2 diabetes, your doctor may prescribe one or more medications as well.

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Managing Type 2 Diabetes

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Sometimes people with type 2 diabetes are able to bring their blood glucose levels under control through a combination of weight loss, diet, and exercise, but many people with diabetes take medication to manage their condition. For some, a single medication is effective, while in other cases a combination of medications works better.

There are many drugs available to treat type 2 diabetes. Your diabetes care team can help you understand the differences among the medications on this long list, and will explain how you take them, what they do, and what side effects they may cause. Your doctor will discuss your specific situation and your options for adding one or more medications to your treatment.

Types of Medication

The various type 2 diabetes medicines work in different ways to lower blood glucose levels. Below is an overview of the types of medication now available and how they work. Note that these drugs have many different names depending on what company manufactures them. Researchers continue to look for new and effective medications.

The most commonly prescribed oral medication for type 2 diabetes is metformin, which belongs to a family of drugs called biguanides. It works by decreasing the amount of sugar your liver releases, and by helping your body to use its own insulin more efficiently. Metformin is prescribed frequently because it has been found to help prevent many of the long-term complications of diabetes.

Here are the other types of oral medication your doctor may choose to prescribe to treat type 2 diabetes:

• Alpha-glucosidase inhibitors These drugs work by slowing the absorption of carbohydrates into the blood after meals. While they don't cause weight gain, side effects may include stomach pain, gas, and diarrhea.
• Biguanides These decrease the amount of glucose released from the liver and help improve your body's sensitivity to insulin. While this type of drug may promote modest weight loss and a slight decline in "bad" cholesterol, side effects may include nausea, diarrhea, and (rarely) the harmful buildup of lactic acid.
• DPP-4 inhibitors These drugs stimulate the release of insulin and inhibit the release of glucose from the liver. Known side effects include upper respiratory tract infections, sore throat, headache, and inflammation of the pancreas.
• Meglitinides These medications work quickly to stimulate the release of insulin. Possible side effects include severe low blood sugar, weight gain, nausea, back pain, and headache.
• Sulfonylureas These drugs stimulate the release of insulin from the pancreas. While the medication does work quickly, it may cause severe low blood sugar, weight gain, nausea, and skin rashes.
• TZD Otherwise known as or thiazolidinedione, this helps improve the body’s sensitivity to insulin and may slightly increase "good" cholesterol levels. Side effects can be serious, including heart failure, heart attack, stroke, and liver disease.

Injectible medications include:

• Amylin mimetic This type of medication stimulates the release of insulin, and is used along with insulin injections. It may also help suppress hunger and promote weight loss. Side effects can include low blood sugar, nausea, vomiting, headache, and redness and irritation at the injection site.
• Incretin mimetic These drugs also stimulate the release of insulin, and are used in conjunction with biguanides and sulfonylureas. They may suppress hunger and promote modest weight loss, but can cause nausea, vomiting, headache, dizziness, and kidney damage or failure. 

Some of the medications above are available in combination form. Combination medications can be highly effective and may make it easier for you to stick to your diabetes treatment plan. But if you do experience side effects, it can be tougher to figure out which medication is to blame.

A Multipronged Care Plan

Remember that a healthy diet, regular exercise, and the right medication are all critical to managing type 2 diabetes. You’ll be working closely with your care team to determine which medication or combination of medications works best for you.

Next step: Using Insulin to Control Your Diabetes

Last Updated: 6/13/2016

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