WEDNESDAY, Jan. 30 (HealthDay News) -- For men with prostate cancer who are trying to decide between surgery or radiation therapy, new research shows that declines in sexual, urinary and bowel function do differ with each treatment in the short-term, but those declines tend to even out in the long run.
The study included more than 1,600 men treated for early stage prostate cancer. Researchers asked them about their urinary, sexual and bowel health following either surgery to remove the prostate or radiation therapy.
Although the rates of health decline in these areas differed at two and five years after treatment, men reported similar declines regardless of their treatment after 15 years.
While men who underwent surgery experienced higher rates of urinary incontinence and erectile dysfunction two and five years later, men who received radiation therapy had higher rates of bowel urgency, or feeling like they had to pass stool but not being able to do so.
The study was published in the Jan. 31 issue of the New England Journal of Medicine.
"Our hope was that measuring patient-reported outcomes at a 15-year time point would provide patients and their physicians with a realistic picture of the prostate cancer survivorship experience," said study author Dr. Matthew Resnick, an instructor of urologic surgery at Vanderbilt University Medical Center in Nashville, Tenn.
Urinary, sexual and bowel problems are among the most common side effects of treatment for prostate cancer, Resnick added. Declines are probably due to a combination of the treatment and aging in general, and the side effects even out after 15 years.
However, the shorter-term differences could be enough to steer some men toward one treatment or the other.
"There isn't a one-size-fits-all approach. Different men feel differently about the possibility of benefits and risks of treatment," Resnick said. For example, men who were already experiencing urinary incontinence might want to choose a treatment like radiation therapy because it was associated with lower rates of urinary problems in the short-term.
Surgery to remove the entire prostate, called radical prostatectomy, and radiation therapy are both recommended treatments for low- and medium-risk prostate cancer, according to the National Comprehensive Cancer Network guidelines.
However, these guidelines state that, for men with low-risk prostate cancer, watchful waiting -- closely monitoring the disease and treating it only if it changes -- is the best option.
It remains to be seen how men who opt for watchful waiting will fare in terms of their urinary, sexual and bowel health, especially in the long-term, Resnick noted.
Previous research has found doing watchful waiting for one year after diagnosis was associated with lower rates of urinary incontinence and sexual dysfunction, but higher rates of urinary blockage seven years later, compared to men who were treated immediately.
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Is Your Child Spoiled? Tips From Child Development Experts Skip to content Enter Search Keywords. Use the arrow keys to navigate suggestions. Health A-Z
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Every parent has probably heard it at one time or another: "You're going to spoil that child!" Yet what do we really mean by spoiled child? How do you know if your child is spoiled, and what can you do to avoid spoiling him or her if you haven't done so already?
No Such Thing as Spoiled Children?
Most child development experts cringe at the use of the term "spoiled child."
David Elkind, a professor of child development at Tufts University and author of The Hurried Child: Growing Up Too Fast Too Soon, says, "That's really a term from a different era. Parents who 'spoil,' often out of the best of intentions, really want to give their children everything without their having to work for it. But the world doesn't work that way."
Why You Can't Spoil a Baby
You cannot "spoil" an infant, Elkind says. "Infants cry when they need something, and it's hard to spoil them because they're not trying to manipulate or maneuver. In infancy, you really need to build the feeling that the world's a safe place."
Later on, he says, it's certainly possible to spoil your child by giving him or her too much, not setting boundaries, and not expecting your child to do what's healthy. But there's no spoiling a 6-month-old.
Peter A. Gorski, MD, director of the Lawton and Rhea Chiles Center for Healthy Mothers and Babies, says, "There is so much questionable parenting literature out there that still talks about spoiling babies. This is a myth that really needs to be addressed."
Research shows that infants whose parents respond quicker to their needs, including their cries, are happier and more independent by their first birthday, Gorski says. They learn to trust that you'll be there when they need you.
What about toddler temper tantrums? Are these children spoiled? No, Elkind says. Tantrums are simply a part of normal development. "This is a time kids are differentiating themselves, and they do that by saying no," he says. "That's normal." It doesn't mean you don't need to set limits for your toddler or that you should always give in. But saying "No no no no no!" every time you want him or her to get dressed or eat lunch doesn't mean the child's spoiled. It just means he's 2.
3 Signs You're Spoiling Your Child
So if an often-cuddled infant and a toddler with tantrums are not spoiled -- how do you tell if your child is?
The cafeteria dining plan. "You serve dinner, and the child doesn't want to eat what's on the table, so you always have to go out of your way to make a special meal," Elkind says. Once or twice is one thing, and of course children with special dietary needs must always be accommodated. But a child who insists on special orders every night could be on the way to being spoiled. "If a 5-year-old misses a meal it won't hurt him," Elkind says. Tantrums. They're normal in toddlers. But when a 5- or 6-year-old throws a fit because she doesn't get what she wants, that's age-inappropriate. "For little ones, it may be the only way they can express their feelings, but in older children, tantrums are manipulative," Elkind says. Extreme dependence on parents. If your child can't go to sleep unless you're there, won't ever let you leave him with grandma or a babysitter, and throws fits when it's time to go to school or day care, that's a problem, Elkind says. "Your child depends on you, yes, but as they get older, children have to learn to be comfortable with other people and with being on their own.”
Instead of "spoiled child," Gorski prefers to use the term "overindulged" or "overprotected." These children may indeed "run the house" -- but it's because parents treat them like they're much younger than they are. "A key warning sign," he says, "is any child much older than the toddler years who continues to act like a baby or toddler -- kicking and screaming, biting other children, not using age-appropriate ways of communicating thoughts and feelings. This is a sign that they're not very secure about themselves."
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