Question 1

I've had a surgery and circumcision when I was 9, and there's always been this tiny bump near the stitch under the skin of my penis shaft. Lately, it's swollen, and sometimes there's this white fluid coming out. It's painful if I touch it. I'm kind of worried it might be an infection or something. I'm trying to avoid going to a hospital right now, so I thought I'd ask for advice online first. Any idea what's going on?

Accepted Answer

Even though you're trying to avoid going to a hospital, if the situation doesn't improve or worsens, it may be necessary to see a healthcare provider. In some cases, an incision and drainage might be needed if there's an abscess or infected cyst.
Please monitor the area closely, and if symptoms worsen, do not hesitate to seek medical attention.

Question 2

My uncle is 55 years old and his biopsy results show moderately differentiated adenocarcinoma of the prostate with a Gleason score of 347 and ISUP grade 2. There's no perineural invasion, but 60 tissues showed tumor presence. The urologist suggested either surgery or injections every three months costing 12000. He's not financially strong, so what should we do? Is the operation life-threatening? Also, who performs this surgery a urologist, surgeon, or some other specialist? We're really worried and need guidance.

Accepted Answer

Okay, it sounds like your uncle is facing a difficult situation, but there are definitely options and things to consider. It's understandable that you're worried, but it's important to get accurate information. Let's break this down:
 1. Understanding the Results:
 
  Adenocarcinoma:
  This is the most common type of prostate cancer. 
 
 Moderately Differentiated:
 This means the cancer cells, while not normal, don't look extremely abnormal under the microscope. 
 Gleason Score 3+4=7 (ISUP Grade 2):
 A Gleason score of 7 (3+4) indicates intermediate-risk prostate cancer. ISUP grade 2 is also associated with intermediate risk. This is a good starting point, but other factors matter. 
 No Perineural Invasion:
 This is a positive sign, as perineural invasion is associated with poorer outcomes. 
 60/60 cores positive:
 This indicates the cancer is present in all or most of the biopsy samples. This is a sign of a significant amount of cancer. 
 
 2. Treatment Options:
 
  Surgery (Radical Prostatectomy):
  This involves removing the prostate gland and some surrounding tissue. It is a common and effective treatment for prostate cancer. 
 
  Not generally life-threatening: While there are risks with any surgery (bleeding, infection, etc.), prostate removal itself isn't typically life-threatening. 
 
 Performed by a Urologist: A urologist is a specialist in the urinary and reproductive system and performs prostatectomies. 
 Long-term outlook: Studies show that most people who have prostate removal surgery early in the course of their cancer are alive 15 years later. 
 
 Hormone Therapy (Injections):
 These injections can help slow down or stop the growth of prostate cancer cells by reducing testosterone levels. 
 
  Cost: The cost of these injections every three months at Rs. 12,000 is significant. 
 
 Not a cure: Hormone therapy is not a cure for prostate cancer, but it can be an effective way to manage it. 
 
 3. What to do now:
 
  Second Opinion:
  It is very important to get a second opinion from another urologist or oncologist (cancer specialist). This is especially important given the financial concerns. 
 
 Discuss all options:
 Explore all treatment options with the doctors and discuss the pros and cons of each, especially considering the financial implications. 
 Consider a clinical trial:
 Some clinical trials might offer treatment options that are less expensive or provide new approaches. 
 Seek Financial Assistance:
 Look into financial assistance programs offered by cancer organizations or hospitals. 
 Discuss with your urologist:
 Talk to the urologist about the specific type of surgery being considered and the potential risks and benefits. 
 Focus on long-term outlook:
 While it's natural to be worried, remember that with appropriate treatment, many men with prostate cancer have a good long-term prognosis. 
 
 4. Important considerations:
 
  Gleason score is just one factor:
  While the Gleason score is an important indicator, it's not the only factor in determining the best course of treatment. 
 
 Individualized treatment plan:
 Treatment plans should be tailored to the individual's specific circumstances, considering their age, overall health, and the characteristics of the cancer. 
 
 It's crucial to gather as much information as possible, discuss all options with healthcare professionals, and make an informed decision that is right for your uncle.

Question 3

I'm experiencing something strange and I'm a bit confused about it. Lately, I've noticed that every time I sit down to eat a meal, like lunch or dinner, I end up with a pretty intense erection. I can't figure out why this is happening. Could this be normal or is there something I should be concerned about?

Accepted Answer

Chronic headaches can be debilitating. To determine the cause, let's break it down:

*Possible Causes*

1. *Tension Headaches*: Tight muscles in the neck and scalp can cause headaches.
2. *Migraines*: A neurological condition characterized by intense, throbbing headaches, often accompanied by sensitivity to light, sound, and nausea.
3. *Sinusitis*: Inflammation or infection of the sinuses can cause headaches.
4. *Eye Strain*: Prolonged use of computers, smartphones, or other digital devices can cause eye strain, leading to headaches.
5. *Dehydration*: Inadequate hydration can cause headaches.
6. *Sleep Disorders*: Poor sleep quality, insomnia, or sleep apnea can contribute to headaches.
7. *Nutritional Deficiencies*: Lack of essential nutrients like magnesium, vitamin B2, or coenzyme Q10 can cause headaches.
8. *Hormonal Changes*: Hormonal fluctuations during menstruation, menopause, or pregnancy can lead to headaches.
9. *Medication Overuse*: Frequent use of pain-relieving medications can cause rebound headaches.
10. *Underlying Medical Conditions*: Certain conditions like hypothyroidism, anemia, or temporomandibular joint (TMJ) disorders can cause headaches.

*Next Steps*

1. *Consult a Doctor*: Schedule an appointment with your primary care physician or a neurologist to discuss your headaches.
2. *Keep a Headache Diary*: Track your headaches, including when they occur, how long they last, and any potential triggers.

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