16 ms·

An end to all this prostate trouble?

791 points by bondarchuk 2y ago

marvel_boy 2y ago
So there is a cure for BPH?
- cs02rm0 2y ago
  Sounds like it reoccurs, but potentially the procedure is repeatable. I didn't see a frequency. I wonder how many potential answers to such problems are out there, known to a few but not acted on by the masses.
  - cactusplant7374 2y ago
    > In any case, the paper makes no comment as to whether the problem can be solved the same way a second time; obviously in principle it can, but finding all the new bypasses and sclerosing them might be difficult in practice. Multiple surgeries is not sustainable. Too much uncertainty.
    - kevin_thibedeau 2y ago
      > they then have the patient close off the bottom of the vein with finger pressure while they inject a sclerosing agent into the vein It seems highly failure prone. If you don't block the flow are you going to stroke out?
    - Supermancho 1y ago
      > Multiple surgeries is not sustainable. Too much uncertainty I'm not sure where this is coming from. Multiple cardiac bypasses have a ton of uncertainty, but they are effective because efficacy is measured by quality of life * increased lifespan. Multiple surgeries (the time it takes to regrow major veins from capillaries that aren't blocked off) to relatively non-lethal parts of the body seems very sustainable for a human lifespan after 60 or 55 or whatever.
- gavinray 2y ago
  You can use 5-alpha-reductase inhibitors like finasteride. One of the primary causes of BPH is from androgens, specifically the conversion of testosterone -> dihydrotestoerone via the 5-ar enzyme. The prostate is an androgen-sensitive tissue, and DHT causes enlargement. It's not guaranteed to fix it, but it's one option.
  - amelius 2y ago
    I've heard a theory that baldness is related to tension in the scalp, which apparently is more prevalent in men.
  - hamstergene 1y ago
    I wish we all could agree on a terminology where taking a pill daily is management, not a cure. A cure should be a one-off measure after which one stays cured. If not forever then at least for years. Something that needs to be repeated, esp. daily, should have a different word. That’s not a cure.
- ekianjo 2y ago
  Not a cure but Tadalafil works very well as a treatment.
  - fredsmith219 2y ago
    It does. I suffer for almost 20 hours of I miss a dose. I’m very sure that doesn’t happen.
smitty1e 2y ago
> It’s odd for there to be such an easily-removable design flaw in the human body; evolution tends to remove them. I wouldn't say so at all. Poor eyesight carries on smartly. Baldness. I enjoy both. But an old story about the controller code for a surface-to-air missile comes to mind. Someone looking at the memory allocator spots an obvious resource leak: "This code is going to crash." The reply was that, while the point was theoretically valid, it was irrelevant, since the system itself would detonate long before resource exhaustion became an issue. So too prostate cancer back in the day: war, famine and plague were keeping the lifespan well below the threshold of every man's time bomb.
- forinti 2y ago
  There's also your back, your joints, your teeth, GERD. Everything starts getting flimsy in your late forties.
  - Traubenfuchs 2y ago
    It would probably take too long, but a human breeding program centered around the healthiest still fertile old men we can find and young women with spotless genetic heritage would uplift our whole species.
    - lostlogin 2y ago
      Older fathers increase the chance of autism, schizophrenia et al. https://en.m.wikipedia.org/wiki/Paternal_age_effect https://en.m.wikipedia.org/wiki/Paternal_age_effect
      - meindnoch 2y ago
        Obviously you would use sperm harvested while they were still young, and kept frozen for 60 years.
        MyPasswordSucks 1y ago
blainm 2y ago
Issues like these reflects an evolutionary blind spot: selective pressure drops off after reproductive age, allowing defects like prostate dysfunction to persist. It's the same reason late-onset neurological diseases remain prevalent.
- mattigames 2y ago
  We lucked out compared to other species, octopus develop dementia soon after breeding.
  - amelius 1y ago
    Yes, and there are spiders where the female eats the male after breeding. I bet their pr0n movies are a bit more interesting than ours.
    - 7thaccount 1y ago
      Isn't that usually only in captivity where it can't escape?
- card_zero 2y ago
  Hmm. If we engineer late-life reproduction, that might create evolutionary pressure for healthy old age. Hides long list of ethical problems with the concept
  - throwuxiytayq 2y ago
    The main problem is that evolution is just not a thing at our modern civilizational time scale. And I don’t see any problems with late-life reproduction, assuming we can make it reliable and healthy. If anything, some countries desperately need it.
    - literalAardvark 2y ago
      From my reading this is wrong in principle. Evolution is really slow on average, but locally it moves quite quickly and probably explains the large variation between members of a species. Add strong selective pressure to that high local speed and you can change a good part of the genotype within a couple of generations. See: animal husbandry. You can breed a new race of dog within 5-10 generations. Ethics aside we could probably breed people who can sniff out Alzheimer's in less than 250 years. Our current late reproduction style will very likely influence future generations health at older ages.
Traubenfuchs 2y ago
We already have one solution to the problem. Finasteride or dutasteride. They control BPH perfectly, while also treating male pattern baldness. Combine with daily tadalafil to offset any chance of the dubious sexual side effects, while also reducing gynecomastia (it's also an aromatase inhibitor!). Make sure to have regular 5ari-aware PSA screenings to make sure high grade cancers are caught and you are golden. fin/dut + tad are my favorite medications to keep men fresh for many more years than intended by nature. Have your children before you start though, as dut will probably make you sterile eventually.
- formerly_proven 2y ago
  Giving 90% of the gender that looks actually great with hair on their head MPB is easily one of the biggest sleights evolution has committed against our species. I've personally had very little luck with official channels there. Most won't prescribe anything for hair loss, several dermatologists said to just get used to it, one would prescribe fin pills, i.e. systemic - which did eventually give me pain in the breast tissues (so I ceased using it), but not topical, citing that it's too new on the market. I was unable to find anyone who would or even could look at serum DHT. I eventually settled on just paying one of these apparently legal telemedicine vendors 20 bucks per topical fin prescription.
  - Traubenfuchs 2y ago
    > which did eventually give me pain in the breast tissues (so I ceased using it) You already decided to take one hormonal disruptor, so why not go all the way? Find a private andrologist that prescribes you fin/dut + an aromatase inhibitor. Daily tadalafil also acts as aromatase inhibitor by the way. Should be enough to offset the estrogen increase from finasteride. It's worth a try. I personally don't really believe in topical min/fin/dut: You are probably just getting the same effects and side effects you'd get from a lower oral dose. The studies on topical finasteride support this. You just believe it's not in your blood and thus there is no nocebo effect to give you ED but it very much is.
  - seethedeaduu 2y ago
    Serum DHT is not useful at all.
blogabegonija 2y ago
[dead]
elric 2y ago
> Screening for this disorder is simple: use a thermal camera and compare testicular temperature sitting up (or standing) versus lying down, in each case waiting five minutes or so for temperatures to equilibrate, and taping the penis up so that it does not affect the measurement. Interesting. I wonder how many how many other issues we could screen for using such simple, low cost tools. Some scales can already detect reduced blood flow in the feet (which can be a sign of all sorts of nastiness).
- eternauta3k 2y ago
  Stethoscopes are pretty cheap and versatile. Human doctors in general have lots of senses which they (in some medical systems) use for diagnosis before reaching for lab tests and MRTs.
  - bshacklett 2y ago
    If they bother. The vast majority of appointments I’ve had, in recent memory, are the provider typing a bit on their laptop, then sending me to someone else.
    - rendaw 2y ago
      Really? They just tell me it's stress, the prescribe me chinese medicine just in case and send me away.
      - samssf 1y ago
        Damn, they just tell me I’m getting old and wish me luck.
    - malfist 1y ago
      If you don't like your doctor, go to someone else
      - BobbyTables2 1y ago
raffael_de 2y ago
The text brushes over the importance of healthy muscle motion for venous blood flow against gravity. Staying physically active, including pelvic floor exercises into the routine and correct belly breathing utilizing the diaphragm are probably the best options for preventing issues with reduced venous blood flow from the testicles passing by the prostate back to the heart.
- mr90210 2y ago
  Thank you.
- wafflemaker 2y ago
  Please also mention how easy those exercises are: Once per day, when peeing, do it differently. 1. Release the stream during the in-breath. 2. Stop and hold the stream on the outbreath. 3. If not yet bored or tired go back to 1. Else - finish peeing normally. That's it. And note that for most people, a week to few weeks of the exercise give stronger orgasms and ability to delay the ejaculation.
  - anticodon 2y ago
    > And note that for most people, a week to few weeks of the exercise give stronger orgasms and ability to delay the ejaculation. I've experienced all those benefits when I started walking two times a day, 8-10 thousands of steps a day continuously for several weeks. I haven't performed any other exercises. But it's really boring and you need to do it every day. I do it only because I need to walk a dog.
    - beacon294 2y ago
      Walking is considered by einstein and pretty much all thinkers to be critical to deep work. It's also covered in Cal Newport's book "deep work" briefly. Which is a short audiobook worth reading. One such prescription would be to do deep work early in the day then walk after and walk again 2 hours before bed. Another would be split the deep work with a 1 hour walk and do the 2nd walk after the 2nd block. It may be more fulfilling with lots of interesting ideas rattling around. YMMV
jakedata 2y ago
So where's the temperature, pulse/pulseox and orientation monitoring jockstrap with linked smartphone app?
- wafflemaker 2y ago
  Oura ring comes in many sizes. /s
- wkat4242 2y ago
  I'm sure companies like lovense will come up with stuff like that. The problem is really prudeness in society, especially the American one (the main market for many industries). It's holding back things like sex tech.
edem 2y ago
I’ve been reading till…I don’t know 40% of the article? Is there some sort of conclusion besides surgery?
- tickerticker 1y ago
  Not a surgical procedure. It's catheter access to the spermatic veins.
deleted 2y ago
[deleted]
tacon 2y ago
In February I happened to attend a lunch 'n learn presentation at TMCi by a company doing clinical trials based on exactly this venous insufficiency principle. I think I may have been the only one in the audience with gray hair... TMCi is the startup accelerator attached to the Texas Medical Center in Houston. The startup company is Vivifi Medical[1] and they have clinical trials underway with ten men in a Central American country (El Salvador?). They claim that BPH reverses in a few months after their procedure. Their procedure uses a minimally invasive tool of their own invention to snip the vertical blood vessels that are backflowing from age and gravity, and splice them into some existing horizontal blood vessels. On their board of advisors is Dr. Billy Cohn[2], the wildly innovative heart surgeon who is famous for shopping for his medical device components at Home Depot. Dr. Cohn is on the team building the BiVACOR Total Artificial Heart. Vivifi presented their estimated timeline to FDA approval, with proposed general availability in 2028. My personal BPH will be at the head of the line for this procedure. As far as a startup, their TAM is about 500 million men. I had the Urolift procedure for BPH three years ago, and it cost about $15K on the Medicare benefits statement, though Urolift's clips amounted to only a few thousand dollars. Similarly, Vivifi's charges for this procedure are only a few thousand dollars per procedure, but it holds the promise of being a final solution. Currently Urolift is much less disruptive than TURP, which needs a couple of days in the hospital and almost always leads to retrograde ejaculation (into the bladder). [1] https://www.vivifimedical.com/ https://www.vivifimedical.com/ [2] https://www.texasheart.org/people/william-e-cohn/ https://www.texasheart.org/people/william-e-cohn/
- unixhero 2y ago
  Do you end up impotent or with incontinence?
  - tusharsharma09 1y ago
    Not at all. Our device does not go through the penis, doesn’t damage the urethra or resect prostatic tissue. As a result, there is no risk to any sexual or urinary functionalities. There is no post op catheter.
    - 1y ago
raffael_de 2y ago
Based on the simplified sketches and reasoning I'd assume that it made more sense to sclerose the two small vein sections connecting the testicles with the prostate. Does somebody know why that's not the suggested option?
- grok22 1y ago
  That makes sense to me too. Why wouldn't that be an option or is not really just a small vein between the two, but a bunch of "blood vessels"?
- loeg 1y ago
  Based on the proposed mechanism, that would still leave the testicles with low oxygenation blood.
- themantalope 1y ago
  I am an interventional radiologist. I’ve done procedures to embolize the prostate (helps shrink it), and gonadal vein embolization (for varices). The gonadal veins are in a different vascular territory from the prostate. The prostates vascular territory is the anterior division of the internal iliac. The gonadal veins arise directly from the inferior vena cava. I had not come across this research before it’s interesting because as mentioned above, these organs are in different vascular territories but when venous structures begin to reflux the blood may find other collateral routes through other territories. I skeptical that this works, but it is really interesting.
  - q1w2 1y ago
    I'm share some skepticism. While I agree with their belief that prostates suffer from unappreciated "mechanical" issues, I'm less convinced of their method of resolution. For my own worthless anecdote, I've noted that my (usually post-orgasm) prostate pain was significantly improved when I started taking Losartan - a anti-hypertension medication (angiotension II blocker (ARB)). The day after I started taking it, I could feel my prostate like never before (then that initial sensation went away), so there was very clearly an associative mechanism of action.
svilen_dobrev 2y ago
So how the usual otherwise-harmless treatment with extract of Serenoa repens works? Seems even that is not clear - [1] is ~2011, [2] is 2024 it seemed to work for me, took it for few months, 10y+ ago. "Lasted" 8-9 years.. - until recently.. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3175703/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3175703/ [2] https://wjmh.org/DOIx.php?id=10.5534/wjmh.230222 https://wjmh.org/DOIx.php?id=10.5534/wjmh.230222
- inquirerGeneral 2y ago
  There is a reason we are smart enough to develop finasteride and dutasteride that are extremely effective and safe¹ instead of relying on plants & herbs which are just weak versions of taking a drug anyway. ¹ the science is sound, the safety is absolutely a guarantee. There is a group of about 10 individuals who have spent their entire life spreading their neurological issues and obsession with fake reports and exaggerations of the harmful made-up side effects that cannot be repeated in any study whatsoever anywhere.. I actually could not believe the other day that they are still active and have managed to cause the FDA to issue a guidance that there might be higher side effect rates than otherwise were reported . It's actually ridiculous, and every news article and study about it are almost entirely mentioning people who's just start believing in their heads that they have side effects when they actually don't. And yet the news articles took this as evidence of a story that has been hidden or something . I really thought that those 10 or so individuals who you used to be able to read their forum posts back in 2006 when they tried to tell every young guy in the world not to take it for hair loss would have fizzled out by now.
  - 01100011 1y ago
    Finasteride does seem to be able to cause some issues. It seems that DHT has many protective roles in the body and limiting it may cause problems: https://pmc.ncbi.nlm.nih.gov/articles/PMC7308241/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7308241/
    - bawana 1y ago
      Finasteride was discovered because of a tribe in south america with a high frequency of a mutant allele in the gene responsible for protein that converts T to DHT. They had no BPH. This led to the search for a competitive inhibitor of that enzyme.While under patent it was extremely lucrative to big pharma. The incentives of fame and greed will continue to plague our civilization as long as we embrace aggregating structures like corporations, advertising, social media, and instant worldwide communication to amplify human traits that were useful in small scale tribes.
sillyfluke 2y ago
[flagged]
begueradj 2y ago
>In women, breast cancer has a similar death toll, but the breasts have an excuse: they’re much bigger; there are many more cells to go bad. They’re also much more metabolically active, capable of producing enough milk to feed a baby; the prostate’s output is tiny in comparison. Except that you make work your prostate everyday, multiple times, since your adolescence, whereas a woman doesn't breastfeed everyday since adolescence.
- pja 1y ago
  Interestingly, daily masturbation appears to have a protective effect against developing prostate cancer, although no one knows why: https://www.webmd.com/prostate-cancer/ejaculation-prostate-cancer-risk https://www.webmd.com/prostate-cancer/ejaculation-prostate-c...
  - juunpp 1y ago
    From your own link: > There’s no proof that ejaculating more actually lowers the chances of prostate cancer. For now, doctors just know they’re connected. It may be that men who do it more tend to have other healthy habits that are lowering their odds. > Ejaculation doesn’t seem to protect against the most deadly or advanced types of prostate cancer. Experts don’t know why. I'm not the expert but, like all things, exercise, sleep and diet probably goes a long way.
jasonthorsness 2y ago
Why do ideas like this take so long to be tested/adopted? Is it because the alternatives are “good enough”? I would think the evidence would lead to a fast shift; though maybe moving slowly is a good thing when it is surgeries.
- palijer 1y ago
  We require heavy burdens of proof before we subject tens of thousands of people to potentially needless surgeries.
  - wussboy 1y ago
    And this area of human interest has been (and is) prone to abuse from unscrupulous individuals/organizations. Rigorous regulation prevents much of that as well.
- derektank 1y ago
  Research and subsequently clinical testing is expensive so you have to acquire capital, usually from grant providers or working with private industry. Grant providers tend to be conservative and risk-averse so that means individuals with new ideas often won't be able to explore them until later in their career. Private industry is less risk averse but will only fund research if it has the potential to bring a patentable product to market before the parent expires. Even once you have funding secured, the regulatory approval process is long and requires hundreds of pages of documentation, reporting, and compliance. Then you have to get insurance to cover it, which can require a procedural code being generated for it by the AMA and requires convincing insurers it's worth it, particularly Medicare in the US which other insurers take their cues from. And even once a procedure is approved and a patient can get it paid for, you still have inertia from human physicians who have been trained to perform certain kinds of treatments and not others.
  - amelius 1y ago
    If safety regulations are really such a high barrier, then explain why this passed them: https://news.ycombinator.com/item?id=15834006 https://news.ycombinator.com/item?id=15834006
bawana 1y ago
At 50 cents a capsule on amazon , prostamol uno (serenoa repens) is more expensive than finasteride so it will forever remain an unrecognized herb. Also, remember we dont really know how these pills are made. Remember the story of that miracle herb, PC-SPES? Widely regarded as a miracle drug when it started selling over the counter, it did indeed significantly improve voiding symptoms as well as out even advanced prostate cancer into remission. It became so widespread that the California Department of Health Services (CDHS) investigated PC-SPES and discovered that it was adulterated with drugs, including warfarin, alprazolam, and diethylstilbesterol (DES). Each capsule had potent estrogens in it! Then the FDA recalled it. Although the rest of the world benefitted from this research, it was the US that paid for it and did it. I am sad that we are now entering a 'transactional democracy' (you only get as much democracy as you can afford) but then again, that's where the rest of the world has been since WW2. Anecdotal data has driven 'old wives tale medicine' for millenia. I am hoping though that big data, the internet, AI, and the judicious use of Bayes' theorem can distill real knowledge from the vast sea of misinformation that surrounds us.
- xvector 1y ago
  I really do think AI will be key here. It's critical to accelerate towards ASI as quickly as possible.
monkeyelite 1y ago
[flagged]
compiler_queen 1y ago
[flagged]
- n2d4 1y ago
  This is a silly argument. Breast cancer awareness (rightfully) gets a lot of attention; it's also fine to have an article about prostates every once in a while.
  - const_cast 1y ago
    Right, if anything I'd say men's reproductive health is under looked in general. Men rarely go to Urologists and issues with the prostate and penis are very much treated as just a fact of life, as opposed to something to look into it. And, even when we do look at these issues, we do it in such an overly pragmatic sense. Like, how men feel about their penis not working or their muscle atrophying doesn't matter. What matter is does their penis work, literally? We approach it in such a blunt and apathetic manner. We don't really think about the more emotional side of hormonal changes or changes with age.
    - BobbyTables2 1y ago
      [flagged]
- SamBam 1y ago
  Besides the fact that, as others have mentioned, breast cancer gets a ton of attention, I'm not sure what being non-binary has to do with anything. Surely the only question is whether one has a prostate (or breasts) or not?
rurban 1y ago
For more insight into "all" this prostate trouble watch the film "Oslo: Love" currently in some cinemas.
tpoacher 1y ago
I read this with great interest, because about a decade ago, I was convinced I had prostatitis (but NHS screwed the diagnostic process up - the GP didn't do a digital rectal exam because the ultrasound would be more diagnostic anyway, and the ultrasound scan was cancelled because the GP didn't do a digital rectal exam which was part of the criteria for going through with the scan ¯\_(ツ)_/¯ ), and ended up reading quite a bit about it, and how I might try to make things better for myself in the absence of antibiotics. I ended up on this page which I no longer remember (something something prostatitis foundation maybe?), from which I remember two things. The first was this turkish doctor, who against all advice was suggesting a "Brocolli juice therapy" as a prostatitis cure. Fast forward to 2025 and there's lots of studies supporting this. Anecdotally I tried this back then and it really helped the prostate pain I had at the time for months go away within a week. The second, which is more relevant here, was this guy who had a very interesting hypothesis, that a lot of the prostate troubles are actually "musculoskeletal" in origin, and muscle imbalance / weakness of the iliopsoas muscles in particular. And that this imbalance affects venous return which "somehow" causes the condition. But he was just a lay person, and the "somehow" was unclear. So this completes that image perfectly. It's interesting that this article mentions the venous insufficiency link, and that veins rely on valves to direct flow, but doesn't mention the muscular link at all. In any case, this person was saying that in his case, doing lots of iliopsoas stretching and exercises effectively 'fixed' his chronic prostatitis problems. So I've timidly started including a couple of iliopsoas stretching exercises before any workout I do. Anecdotally, I think it helps, but I can't know for sure. But thought I'd mention here in case someone shows interest or can make that link more solid. PS. found the turkish doctor page (or at least a mirror of it): https://www.oocities.org/iastr/ebroc.htm https://www.oocities.org/iastr/ebroc.htm I wish I could find that comment about the iliopsoas ... but alas I think it's probably lost in the sands of time now. UPDATE: Well what do you know. Found it: https://web.archive.org/web/20230203201759/https://prostatitis.org/muscle.html https://web.archive.org/web/20230203201759/https://prostatit... (and https://web.archive.org/web/20230127101206/https://prostatitis.org/physicalcause.html https://web.archive.org/web/20230127101206/https://prostatit... more generally)
- BobbyTables2 1y ago
  It also seems to me that a lot of “prostatis” cases have nothing one to do with bacterial infection but rather pelvic floor issues or is referred pain from spinal issues. Men’s medicine is in the dark ages.
theptip 1y ago
> The theory here is largely mechanical I’ve long felt that the reliance on population-statistics (RCT) rather than individual diagnosis highlights how little we really know about medicine. A mechanic wouldn’t try to fix a car based on a checklist of symptoms interventions that work X% of the time across the population of cars; they would actually inspect the pieces and try to positively identify e.g. a worn/broken component. Of course, this is harder in the human body. I’m hopeful that as diagnostics become cheaper and more democratized (eg you can now get an ultrasound to plug into your iPhone for ~$1k), we’ll be able to make “medicine 3.0” I.e. truly personalized medicine, available as standard rather than a luxury available to the 0.1%.
- potato3732842 1y ago
  What makes professional mechanics fast (and therefore makes them good profit) is knowing from experience when you can shoot from the hip like that. But yeah, you won't find people doing things that way in any setting where it Actually Matters(TM) (e.g. expensive things where you really can't justify not fixing it right the first time)
- thehappypm 1y ago
  This sounds a lot like the pitch for Theranos
  - bear141 1y ago
    Which was a great pitch because it’s what people want. It just has to be based in reality.
  - Robotbeat 1y ago
    So?
- bobthepanda 1y ago
  Diagnostics only really tells you that something is happening but not why; and it is so impractical if not impossible to observe mechanisms of action for much of the body. Heck, we don’t even know the mechanism of action for acetominophen, and that’s one of the most popular, oldest OTC drugs out there.
derefr 1y ago
> The theory here is largely mechanical; and it’s not just psychiatrists like Scott who are weak at mechanical explanations; it’s doctors in general as well as medical researchers and biologists. A tangent here, about not just "mechanical" explanations, but "mechanical" treatments — IMHO, the insistence in modern medicine on treating recurrent bacterial infections purely with antibiotics is wrongheaded, and the cause of a lot of resistant strains of bacteria. Especially for topical/mucosal/epithelial infections, where the infected tissue is accessible without invasive surgery. In a recurrent bacterial infection, the reservoir of the infection is one or more (almost always macro-scale) biofilms or plaques. And antibiotics just don't do much to biofilms/plaques. (If they could, you could spray Lysol on the walls of an under-ventilated shower that's developed "pink slime" biofilms — and all the slime would dissolve, or detach and run down the drain. But it doesn't do that, does it?) Even if you kill most of the bacteria, the biofilm itself — the "fortress" of polymerized sugars which the bacterial cells have secreted to secure their position — is not destroyed by antimicrobal compounds. And the few bacteria that remain have a great position to regrow from. What does work to clean a slimy shower wall? Scrubbing. Scraping. Peeling. Together with targeted chemicals, that 1. get water out of the polymer (because these biofilm surface polymers are often lubricative when wet, and thus resistant to abrasion — but this effect breaks down when dry), and 2. rough up the surface of the biofilm/plaque a bit, to get a better grip on it. Biofilms and plaques adhere to themselves — so, when you can break the biofilm or plaque into chunks, you can then get entire chunks out. (And also, by removing chunks, you create paths for antimicrobials to then get past the biofilm surface polymer. You're breaching the fortress.) If you picture a strep-throat infection — spots on the tonsils and on the throat, etc — those spots aren't a symptom; they are "the enemy" you're trying to fight. Remove them — mechanically! — and you go from using antibiotics (picture tiny cellular infantrymen) to effectively "fight a war of attrition against an enemy with a secure position", to "a defeat in detail of an enemy with nowhere to hide." --- Interestingly, there are certain medical specialties that think mechanically about infection. • Dentists, obviously, know that you must abraid dental plaque away. There's no chemical that you can put in your mouth every day that will keep plaque from forming, or reduce it once it has formed. (In fact, ironically, antimicrobial oral rinses [of e.g. chlorhexidine] accelerate plaque formation, because bacterial cells killed "in place" inside their biofilm fortresses will deposit and enrich the surface polymer layer of the biofilm — much as dead sea creatures deposit and enrich limestone sediment.) • Audiologists know that there's ultimately nothing you can do with drugs or topical treatments to get an ear clear of wax+fat+dust+anything else trapped in there. You have to go digging. Chemicals can soften the wax, to make it easier to remove; but, due to the shape of the ear, and the lack of ability to "come in from behind" (there's an eardrum in the way!), the softened wax will never come out on its own. • Dermatologists know that a cyst can't just be drained + treated with antibiotics. The body forms a defensive pocket around a cyst — but the inside surface of this pocket ironically provides the perfect medium for a biofilm to grow on, and thus for an infection to recur after drainage. Cysts are only considered well-treated if the pocket itself is removed — thus removing the biofilm. ...and yet, when you look at most other disciplines, you see completely the opposite. • An ENT is very much not willing to abraid biofilms out of your sinuses or throat "if they can help it", despite those surfaces being accessible to an endoscope without breaking past any barriers. They will always try first to treat "pharmacodynamically", with e.g. oral antibiotics + an antimicrobial sinus rinse — presumably in the hopes that you'll accidentally do something mechanically in the process of treatment (e.g. snorting really hard to get the remnants of the rinse out) that will dislodge the biofilm. You have to go through years of back-and-forth with an ENT before they'll actually bother to look further up inside your sinuses than they can see with an otoscope/anterior rhinoscope. (And IMHO this is why so many people suffer from idiopathic chronic sinusitis, developing into nasal polyps et al. Nobody's ever been willing to go deep up their nose with an endoscope, find impacted biofilm plaques, and say "alright, let's clear those out.") • Kidney stones, once symptomatic, are treated ultrasonically (lithotripsy); but the thinking on follow-up prevention is entirely about preventing accretion — not in removing the cause. [In many cases, the cause of (struvite or apatite) kidney and/or urinary stones, is very likely a bacterial biofilm within the kidney, spalling off bits of biofilm, which denature into plaques after exposure to the harsh pH of the kidney/uterer/bladder; get caught on some tissue; and then act as nucleation sites for mineralization (stone formation) as dissolved minerals pass through.] Once someone gets one kidney stone, they are generally thought to just be "prone to kidney stones", and will likely get them randomly for the rest of their life. A lot like the old — pre-infectious-origin — thinking that someone can be "prone to peptic ulcers"!
bawana 1y ago
Unmentioned is the significance of dietary modificatioon. In one study, Japanese men had 10% of the incidience of problematic bph as americans. The offspring of the japanese in Hawaii had half the iincidence. The second generation had no difference. The analysis suggested that phytoestrogens in tofu, tempeh,etc are responsible of prostatic involution. Animal fat contains elevated levels of lipid soluble hormones and diets high in fat (meat) are associated w bph as well as elevated risk of prostate ca. Finally, this craze of T replacement is greatly increasing the risk of symptomatic bph (along with other cardiovascular risk factors)
- loeg 1y ago
  > Finally, this craze of T replacement is greatly increasing the risk of symptomatic bph (along with other cardiovascular risk factors) TRT does not increase the risk of BPH; this is discussed in the article, along with a hypothetical mechanism. Nor does TRT seem to have CVD risk.
- qmr 1y ago
  > craze of T replacement Please explain how it's a "craze". T levels and sperm count are tanking. Possibly from micro plastics.
alejohausner 1y ago
This work by Gat and Gornish gives a great explanation for prostate enlargement. There's an article by Donaldson [1] that suggests a connection to vitamin K2: A large study from 2014 by Nimptsch et al found a strong inverse correlation between intake of vitamin K2 and prostate cancer [2]. Dairy foods with K2 had the most effect (K2 is soluble in butterfat). Vitamin K2 helps remove calcium from the elastin in artery and vein walls, reducing their stiffness. Donaldson hypothesizes that K2 improves venous flow, and hence might reduce the varicoceles that lead to too much free testosterone getting to the prostate and causing enlargement. So eat more grass-fed butter, or take a K2 supplement. At worst, you might also improve your bone strength. At best, men might prevent prostate cancer. 1: DOI: 10.1016/j.mehy.2014.12.028 2: DOI: 10.1093/ajcn/87.4.985
- kmbfjr 1y ago
  I had my prostate removed six weeks ago due to Gleason 8 score cancer. The pathology revealed an aggressive cancer. My prostate was not enlarged, my PSA at the end was 4.2. Only because my doctor was overly cautious about the slope of the PSA rise did he send me for an MRI starting the diagnosis. It remains to be seen if it escaped containment. The point here is, I don’t think enlargement and cancer are that intertwined. Cancer happens for any number of reasons, pinning hope that it can be staved off by diet and vitamins seems to ignore tons of other environmental factors.
  - xxbondsxx 1y ago
    I hope you'll be OK!
  - alejohausner 1y ago
    Wow, that sounds scary. I hope it doesn't come back. Weird about the 4.2 PSA; that wouldn't have raised alarms, normally. I guess acceleration is as important as absolute values.
  - brigandish 1y ago
    All the best. I had a check up for prostate cancer recently, and fortunately have been told I don't have it, but until that moment I felt the stress of wondering and worrying, so you have my sympathy. I'm also glad you found a good doctor, the first I found did no checks at all. Told me I'm too young to have any problems (I'm definitely not) and sent me away with some herbal medicine and all that stress I mentioned. The second doctor I found was thorough and reassuring, and shocked by the behaviour of the first.
damnitbuilds 1y ago
TL;DR: Very likely not.
vakde 1y ago
Did no one check the base website (yarchive.net)? He's archived a mindbogglingly large number of usenet posts, each being extremely high signal
ryanobjc 1y ago
This article is literally the definition of TL;DR. It's fairly hard to get thru, I spaced and skipped the conclusion, that the treatment isn't permanent and can be undone.
- SamBam 1y ago
  I was interested through the first 20-25 paragraphs, and then the thing just kept going and going and going. It would have been fine, though, if it had some sub-headings and stuff to help guide one through.
bccdee 1y ago
Good article, but very weird to scroll to the bottom and see "(c) Norman Yarvin" at the bottom. Curtis Yarvin's brother wrote this. I don't have an opinion about that, I just find it strange.
- gwking 1y ago
  I merely saw the domain name 'yarchive' and had a strange inkling that there might be a connection. A quick search yielded this: https://unlimitedhangout.com/2021/08/investigative-reports/the-father-the-son-and-the-mencius-moldbug/ https://unlimitedhangout.com/2021/08/investigative-reports/t.... I have no opinion of unlimitedhangout.com or the veracity of that article. But in response to "I just find it strange", I'm beginning to associate this sort of intensely intellectual inquiry into disparate topics with equally intense political positions. I was first introduced to Urbit as if it was a purely technical, humorous and extremely nerdy lark. It was a joke thing my friend got me to sign up for, to own a slice of an imaginary universe (in a quantity called a "frigate" or whatever it was). When I learned years later about how serious the worldview behind it was, I was quite shocked. Since then, and especially since the NYT outing of Scott Alexander in 2020, I've become more attuned to the pattern. These hyper-analytical blogs often come with a lot of political implications below the surface. Again, I'm not taking sides here. If anything, the takeaway for me is that the world is very complicated. We have these rare polymath personalities who go deep into topics, have a strong voice on the internet, and they end up with all sorts of valid criticisms of the status quo. This in turn can align with extreme political views.
  - bccdee 1y ago
    I say I "just find it strange" because I was hesitant to tar Norman Yarvin with the same brush I'd use for his brother. Curtis Yarvin is a freak, but I figured it would be entirely possible that his brother was just a normal guy on the internet with weird relatives. Judging by the article you posted, though… > When talking about Nigerian Scammers in the online chat room, Norman Yarvin is recorded as making statements like: “I think everyone charged with a crime is entitled to a fair trial and the presumption of innocence, but I also think things would be a lot better if habitual criminals like scammers were executed in a timely manner, say within a week of their trials. Hanging 1% of the population would probably eliminate 99% of the actual crime [...]" > In another piece Norman published on his own website, he blamed Social Security programmes for Germany’s social decline leading up to World War II. [...] Some of Norman’s carefully worded crypto-contrarianism will be familiar to anybody who has read the work of Curtis Yarvin and those observers of Mencius Moldbug will find much of Norman’s take on modern history to be eerily similar. Also apparently he's potentially linked to a terror attack? I guess I'm too prone to giving people the benefit of the doubt. > they end up with all sorts of valid criticisms of the status quo. This in turn can align with extreme political views The thing about the status quo is that it's extremely easy to criticize. Ted Kaczynski made some solid arguments. Mao had some great points. Problems are everywhere—it's not hard to find them. You have to judge people by their solutions, and as a rule, neoreactionaries and their orbiters make flagrantly noxious prescriptions.
irjustin 1y ago
This is incredible.
silexia 1y ago
Fantastically well written article. I read the entire thing in one go with my tiny attention span and learned about an interesting possible procedure.
acyou 1y ago
Here is my pet theory, it's not intended to be political, just thinking about evolutionary biology. There is an optimum lifespan for peak evolutionary population fitness in any group of organisms. Too short a lifespan means not enough time to gather resources and reproduce. Too long a lifespan could mean competing with future generations for scarce resources, which might in theory marginally improve individual fitness, but in the aggregate decreases overall population fitness, and is therefore not selected for. Over billions of years, organisms evolved built-in control mechanisms to ensure that they live/survive for the optimum amount of time. The evolution of these mechanisms is driven in part by the fact that an older organism under stress being eliminated from the environment will probably improve the population fitness of close relatives. I believe this is what cancer is. It's one of many, many built-in mechanisms, reinforced by hundreds of millions of years of evolution, to kill us off when our time has come. So, if there are tons and tons of evolved mechanisms that exist just to knock you out when your time has come. That is the ultimate reason why men die from heart attacks: they have evolved in past generations that if they have extreme exertion at an advanced age, it's an indication that they aren't contributing to population fitness in a useful manner, and that extreme exertion would be more efficiently done by younger individuals. At an old age, they should be at the top of the food chain, guiding and educating and valued and lazy and consuming, and if they are not, better for the tribe for them to die quickly than lingering on. And there is hope. If we can eliminate stress from our lives, we send a signal to our bodies that we will improve population fitness by continuing to exist, and our bodies may reward us. That's a big reason for longer lifespans. Better diet and moderate exercise is great for sure, but less stress makes a big difference. But this is only one of a multitude of dynamics that is happening in the complicated system that is the existence of life, and is not necessarily a dominant dynamic. For prostate cancer, you might get around it temporarily, but something else will get you. Lifestyle changes, medication, placebo and other interventions that reduce stress probably have a better overall shot at increasing your lifespan than any single magic bullet. I suspect that prostate cancer has to do with being old and not having sex, if you're an older male. An older male who doesn't have sex would have lower individual fitness than an older male who does have sex, and would be competing for resources with younger individuals who might have higher evolutionary fitness. So, there's another solution to prostate cancer that doesn't involve surgery (or even necessarily having sex), I think I read another article that mentioned that, I won't spell it out. Given that breast cancer happens more to women who have not breastfed after carrying to full term (citation needed), you can draw a parallel. Females who are decreasing population fitness by not having children, and by extension have lower individual fitness, breast cancer and ovarian cancer are some of the main mechanisms. They also think that breastfeeding reduces the risk of breast cancer. Certainly, even females that don't reproduce, but still breastfeed, probably improve population fitness, even if they don't have good individual fitness.
varjag 1y ago
Fascinating. I wonder what are the consequences of long term zero gravity flight for this.
phront 1y ago
i am curious to know can we plan a better vein system and somehow "implement" it
abhaynayar 1y ago
Love the writing-style. Quite "to-the-point", without any fluff, and with a nice flow and purpose.
deleted 1y ago
[deleted]
someonehere 1y ago
I’m glad we’re starting to talk about the prostate because I feel like for a long time. Men have been reluctant to talk about this more and more in society. I feel like women have their fair share problems as they get older, but men have equal amount of problems too we just don’t like to talk about it.
ycombinator_acc 1y ago
Just take finasteride. As a nice side effect, you won’t go bald.
learningmore 1y ago
Very interesting article. Well-explained.

791 points by bondarchuk 2y ago

marvel_boy 2y ago

So there is a cure for BPH?

cs02rm0 2y ago
Sounds like it reoccurs, but potentially the procedure is repeatable. I didn't see a frequency. I wonder how many potential answers to such problems are out there, known to a few but not acted on by the masses.
- cactusplant7374 2y ago
  > In any case, the paper makes no comment as to whether the problem can be solved the same way a second time; obviously in principle it can, but finding all the new bypasses and sclerosing them might be difficult in practice. Multiple surgeries is not sustainable. Too much uncertainty.
  - kevin_thibedeau 2y ago
    > they then have the patient close off the bottom of the vein with finger pressure while they inject a sclerosing agent into the vein It seems highly failure prone. If you don't block the flow are you going to stroke out?
  - Supermancho 1y ago
    > Multiple surgeries is not sustainable. Too much uncertainty I'm not sure where this is coming from. Multiple cardiac bypasses have a ton of uncertainty, but they are effective because efficacy is measured by quality of life * increased lifespan. Multiple surgeries (the time it takes to regrow major veins from capillaries that aren't blocked off) to relatively non-lethal parts of the body seems very sustainable for a human lifespan after 60 or 55 or whatever.
gavinray 2y ago
You can use 5-alpha-reductase inhibitors like finasteride. One of the primary causes of BPH is from androgens, specifically the conversion of testosterone -> dihydrotestoerone via the 5-ar enzyme. The prostate is an androgen-sensitive tissue, and DHT causes enlargement. It's not guaranteed to fix it, but it's one option.
- amelius 2y ago
  I've heard a theory that baldness is related to tension in the scalp, which apparently is more prevalent in men.
- hamstergene 1y ago
  I wish we all could agree on a terminology where taking a pill daily is management, not a cure. A cure should be a one-off measure after which one stays cured. If not forever then at least for years. Something that needs to be repeated, esp. daily, should have a different word. That’s not a cure.
ekianjo 2y ago
Not a cure but Tadalafil works very well as a treatment.
- fredsmith219 2y ago
  It does. I suffer for almost 20 hours of I miss a dose. I’m very sure that doesn’t happen.

smitty1e 2y ago

> It’s odd for there to be such an easily-removable design flaw in the human body; evolution tends to remove them. I wouldn't say so at all. Poor eyesight carries on smartly. Baldness. I enjoy both. But an old story about the controller code for a surface-to-air missile comes to mind. Someone looking at the memory allocator spots an obvious resource leak: "This code is going to crash." The reply was that, while the point was theoretically valid, it was irrelevant, since the system itself would detonate long before resource exhaustion became an issue. So too prostate cancer back in the day: war, famine and plague were keeping the lifespan well below the threshold of every man's time bomb.

forinti 2y ago
There's also your back, your joints, your teeth, GERD. Everything starts getting flimsy in your late forties.
- Traubenfuchs 2y ago
  It would probably take too long, but a human breeding program centered around the healthiest still fertile old men we can find and young women with spotless genetic heritage would uplift our whole species.
  - lostlogin 2y ago
    Older fathers increase the chance of autism, schizophrenia et al. https://en.m.wikipedia.org/wiki/Paternal_age_effect https://en.m.wikipedia.org/wiki/Paternal_age_effect
    - meindnoch 2y ago
      Obviously you would use sperm harvested while they were still young, and kept frozen for 60 years.
      - MyPasswordSucks 1y ago

blainm 2y ago

Issues like these reflects an evolutionary blind spot: selective pressure drops off after reproductive age, allowing defects like prostate dysfunction to persist. It's the same reason late-onset neurological diseases remain prevalent.

mattigames 2y ago
We lucked out compared to other species, octopus develop dementia soon after breeding.
- amelius 1y ago
  Yes, and there are spiders where the female eats the male after breeding. I bet their pr0n movies are a bit more interesting than ours.
  - 7thaccount 1y ago
    Isn't that usually only in captivity where it can't escape?
card_zero 2y ago
Hmm. If we engineer late-life reproduction, that might create evolutionary pressure for healthy old age. Hides long list of ethical problems with the concept
- throwuxiytayq 2y ago
  The main problem is that evolution is just not a thing at our modern civilizational time scale. And I don’t see any problems with late-life reproduction, assuming we can make it reliable and healthy. If anything, some countries desperately need it.
  - literalAardvark 2y ago
    From my reading this is wrong in principle. Evolution is really slow on average, but locally it moves quite quickly and probably explains the large variation between members of a species. Add strong selective pressure to that high local speed and you can change a good part of the genotype within a couple of generations. See: animal husbandry. You can breed a new race of dog within 5-10 generations. Ethics aside we could probably breed people who can sniff out Alzheimer's in less than 250 years. Our current late reproduction style will very likely influence future generations health at older ages.

Traubenfuchs 2y ago

We already have one solution to the problem. Finasteride or dutasteride. They control BPH perfectly, while also treating male pattern baldness. Combine with daily tadalafil to offset any chance of the dubious sexual side effects, while also reducing gynecomastia (it's also an aromatase inhibitor!). Make sure to have regular 5ari-aware PSA screenings to make sure high grade cancers are caught and you are golden. fin/dut + tad are my favorite medications to keep men fresh for many more years than intended by nature. Have your children before you start though, as dut will probably make you sterile eventually.

formerly_proven 2y ago
Giving 90% of the gender that looks actually great with hair on their head MPB is easily one of the biggest sleights evolution has committed against our species. I've personally had very little luck with official channels there. Most won't prescribe anything for hair loss, several dermatologists said to just get used to it, one would prescribe fin pills, i.e. systemic - which did eventually give me pain in the breast tissues (so I ceased using it), but not topical, citing that it's too new on the market. I was unable to find anyone who would or even could look at serum DHT. I eventually settled on just paying one of these apparently legal telemedicine vendors 20 bucks per topical fin prescription.
- Traubenfuchs 2y ago
  > which did eventually give me pain in the breast tissues (so I ceased using it) You already decided to take one hormonal disruptor, so why not go all the way? Find a private andrologist that prescribes you fin/dut + an aromatase inhibitor. Daily tadalafil also acts as aromatase inhibitor by the way. Should be enough to offset the estrogen increase from finasteride. It's worth a try. I personally don't really believe in topical min/fin/dut: You are probably just getting the same effects and side effects you'd get from a lower oral dose. The studies on topical finasteride support this. You just believe it's not in your blood and thus there is no nocebo effect to give you ED but it very much is.
- seethedeaduu 2y ago
  Serum DHT is not useful at all.

blogabegonija 2y ago

[dead]

elric 2y ago

> Screening for this disorder is simple: use a thermal camera and compare testicular temperature sitting up (or standing) versus lying down, in each case waiting five minutes or so for temperatures to equilibrate, and taping the penis up so that it does not affect the measurement. Interesting. I wonder how many how many other issues we could screen for using such simple, low cost tools. Some scales can already detect reduced blood flow in the feet (which can be a sign of all sorts of nastiness).

eternauta3k 2y ago
Stethoscopes are pretty cheap and versatile. Human doctors in general have lots of senses which they (in some medical systems) use for diagnosis before reaching for lab tests and MRTs.
- bshacklett 2y ago
  If they bother. The vast majority of appointments I’ve had, in recent memory, are the provider typing a bit on their laptop, then sending me to someone else.
  - rendaw 2y ago
    Really? They just tell me it's stress, the prescribe me chinese medicine just in case and send me away.
    - samssf 1y ago
      Damn, they just tell me I’m getting old and wish me luck.
  - malfist 1y ago
    If you don't like your doctor, go to someone else
    - BobbyTables2 1y ago

raffael_de 2y ago

The text brushes over the importance of healthy muscle motion for venous blood flow against gravity. Staying physically active, including pelvic floor exercises into the routine and correct belly breathing utilizing the diaphragm are probably the best options for preventing issues with reduced venous blood flow from the testicles passing by the prostate back to the heart.

mr90210 2y ago
Thank you.
wafflemaker 2y ago
Please also mention how easy those exercises are: Once per day, when peeing, do it differently. 1. Release the stream during the in-breath. 2. Stop and hold the stream on the outbreath. 3. If not yet bored or tired go back to 1. Else - finish peeing normally. That's it. And note that for most people, a week to few weeks of the exercise give stronger orgasms and ability to delay the ejaculation.
- anticodon 2y ago
  > And note that for most people, a week to few weeks of the exercise give stronger orgasms and ability to delay the ejaculation. I've experienced all those benefits when I started walking two times a day, 8-10 thousands of steps a day continuously for several weeks. I haven't performed any other exercises. But it's really boring and you need to do it every day. I do it only because I need to walk a dog.
  - beacon294 2y ago
    Walking is considered by einstein and pretty much all thinkers to be critical to deep work. It's also covered in Cal Newport's book "deep work" briefly. Which is a short audiobook worth reading. One such prescription would be to do deep work early in the day then walk after and walk again 2 hours before bed. Another would be split the deep work with a 1 hour walk and do the 2nd walk after the 2nd block. It may be more fulfilling with lots of interesting ideas rattling around. YMMV

jakedata 2y ago

So where's the temperature, pulse/pulseox and orientation monitoring jockstrap with linked smartphone app?

wafflemaker 2y ago
Oura ring comes in many sizes. /s
wkat4242 2y ago
I'm sure companies like lovense will come up with stuff like that. The problem is really prudeness in society, especially the American one (the main market for many industries). It's holding back things like sex tech.

edem 2y ago

I’ve been reading till…I don’t know 40% of the article? Is there some sort of conclusion besides surgery?

tickerticker 1y ago
Not a surgical procedure. It's catheter access to the spermatic veins.

deleted 2y ago

[deleted]

tacon 2y ago

In February I happened to attend a lunch 'n learn presentation at TMCi by a company doing clinical trials based on exactly this venous insufficiency principle. I think I may have been the only one in the audience with gray hair... TMCi is the startup accelerator attached to the Texas Medical Center in Houston. The startup company is Vivifi Medical[1] and they have clinical trials underway with ten men in a Central American country (El Salvador?). They claim that BPH reverses in a few months after their procedure. Their procedure uses a minimally invasive tool of their own invention to snip the vertical blood vessels that are backflowing from age and gravity, and splice them into some existing horizontal blood vessels. On their board of advisors is Dr. Billy Cohn[2], the wildly innovative heart surgeon who is famous for shopping for his medical device components at Home Depot. Dr. Cohn is on the team building the BiVACOR Total Artificial Heart. Vivifi presented their estimated timeline to FDA approval, with proposed general availability in 2028. My personal BPH will be at the head of the line for this procedure. As far as a startup, their TAM is about 500 million men. I had the Urolift procedure for BPH three years ago, and it cost about $15K on the Medicare benefits statement, though Urolift's clips amounted to only a few thousand dollars. Similarly, Vivifi's charges for this procedure are only a few thousand dollars per procedure, but it holds the promise of being a final solution. Currently Urolift is much less disruptive than TURP, which needs a couple of days in the hospital and almost always leads to retrograde ejaculation (into the bladder). [1] https://www.vivifimedical.com/ https://www.vivifimedical.com/ [2] https://www.texasheart.org/people/william-e-cohn/ https://www.texasheart.org/people/william-e-cohn/

unixhero 2y ago
Do you end up impotent or with incontinence?
- tusharsharma09 1y ago
  Not at all. Our device does not go through the penis, doesn’t damage the urethra or resect prostatic tissue. As a result, there is no risk to any sexual or urinary functionalities. There is no post op catheter.
  - 1y ago

raffael_de 2y ago

Based on the simplified sketches and reasoning I'd assume that it made more sense to sclerose the two small vein sections connecting the testicles with the prostate. Does somebody know why that's not the suggested option?

grok22 1y ago
That makes sense to me too. Why wouldn't that be an option or is not really just a small vein between the two, but a bunch of "blood vessels"?
loeg 1y ago
Based on the proposed mechanism, that would still leave the testicles with low oxygenation blood.
themantalope 1y ago
I am an interventional radiologist. I’ve done procedures to embolize the prostate (helps shrink it), and gonadal vein embolization (for varices). The gonadal veins are in a different vascular territory from the prostate. The prostates vascular territory is the anterior division of the internal iliac. The gonadal veins arise directly from the inferior vena cava. I had not come across this research before it’s interesting because as mentioned above, these organs are in different vascular territories but when venous structures begin to reflux the blood may find other collateral routes through other territories. I skeptical that this works, but it is really interesting.
- q1w2 1y ago
  I'm share some skepticism. While I agree with their belief that prostates suffer from unappreciated "mechanical" issues, I'm less convinced of their method of resolution. For my own worthless anecdote, I've noted that my (usually post-orgasm) prostate pain was significantly improved when I started taking Losartan - a anti-hypertension medication (angiotension II blocker (ARB)). The day after I started taking it, I could feel my prostate like never before (then that initial sensation went away), so there was very clearly an associative mechanism of action.

svilen_dobrev 2y ago

So how the usual otherwise-harmless treatment with extract of Serenoa repens works? Seems even that is not clear - [1] is ~2011, [2] is 2024 it seemed to work for me, took it for few months, 10y+ ago. "Lasted" 8-9 years.. - until recently.. [1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3175703/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3175703/ [2] https://wjmh.org/DOIx.php?id=10.5534/wjmh.230222 https://wjmh.org/DOIx.php?id=10.5534/wjmh.230222

inquirerGeneral 2y ago
There is a reason we are smart enough to develop finasteride and dutasteride that are extremely effective and safe¹ instead of relying on plants & herbs which are just weak versions of taking a drug anyway. ¹ the science is sound, the safety is absolutely a guarantee. There is a group of about 10 individuals who have spent their entire life spreading their neurological issues and obsession with fake reports and exaggerations of the harmful made-up side effects that cannot be repeated in any study whatsoever anywhere.. I actually could not believe the other day that they are still active and have managed to cause the FDA to issue a guidance that there might be higher side effect rates than otherwise were reported . It's actually ridiculous, and every news article and study about it are almost entirely mentioning people who's just start believing in their heads that they have side effects when they actually don't. And yet the news articles took this as evidence of a story that has been hidden or something . I really thought that those 10 or so individuals who you used to be able to read their forum posts back in 2006 when they tried to tell every young guy in the world not to take it for hair loss would have fizzled out by now.
- 01100011 1y ago
  Finasteride does seem to be able to cause some issues. It seems that DHT has many protective roles in the body and limiting it may cause problems: https://pmc.ncbi.nlm.nih.gov/articles/PMC7308241/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7308241/
  - bawana 1y ago
    Finasteride was discovered because of a tribe in south america with a high frequency of a mutant allele in the gene responsible for protein that converts T to DHT. They had no BPH. This led to the search for a competitive inhibitor of that enzyme.While under patent it was extremely lucrative to big pharma. The incentives of fame and greed will continue to plague our civilization as long as we embrace aggregating structures like corporations, advertising, social media, and instant worldwide communication to amplify human traits that were useful in small scale tribes.

sillyfluke 2y ago

[flagged]

begueradj 2y ago

>In women, breast cancer has a similar death toll, but the breasts have an excuse: they’re much bigger; there are many more cells to go bad. They’re also much more metabolically active, capable of producing enough milk to feed a baby; the prostate’s output is tiny in comparison. Except that you make work your prostate everyday, multiple times, since your adolescence, whereas a woman doesn't breastfeed everyday since adolescence.

pja 1y ago
Interestingly, daily masturbation appears to have a protective effect against developing prostate cancer, although no one knows why: https://www.webmd.com/prostate-cancer/ejaculation-prostate-cancer-risk https://www.webmd.com/prostate-cancer/ejaculation-prostate-c...
- juunpp 1y ago
  From your own link: > There’s no proof that ejaculating more actually lowers the chances of prostate cancer. For now, doctors just know they’re connected. It may be that men who do it more tend to have other healthy habits that are lowering their odds. > Ejaculation doesn’t seem to protect against the most deadly or advanced types of prostate cancer. Experts don’t know why. I'm not the expert but, like all things, exercise, sleep and diet probably goes a long way.

jasonthorsness 2y ago

Why do ideas like this take so long to be tested/adopted? Is it because the alternatives are “good enough”? I would think the evidence would lead to a fast shift; though maybe moving slowly is a good thing when it is surgeries.

palijer 1y ago
We require heavy burdens of proof before we subject tens of thousands of people to potentially needless surgeries.
- wussboy 1y ago
  And this area of human interest has been (and is) prone to abuse from unscrupulous individuals/organizations. Rigorous regulation prevents much of that as well.
derektank 1y ago
Research and subsequently clinical testing is expensive so you have to acquire capital, usually from grant providers or working with private industry. Grant providers tend to be conservative and risk-averse so that means individuals with new ideas often won't be able to explore them until later in their career. Private industry is less risk averse but will only fund research if it has the potential to bring a patentable product to market before the parent expires. Even once you have funding secured, the regulatory approval process is long and requires hundreds of pages of documentation, reporting, and compliance. Then you have to get insurance to cover it, which can require a procedural code being generated for it by the AMA and requires convincing insurers it's worth it, particularly Medicare in the US which other insurers take their cues from. And even once a procedure is approved and a patient can get it paid for, you still have inertia from human physicians who have been trained to perform certain kinds of treatments and not others.
- amelius 1y ago
  If safety regulations are really such a high barrier, then explain why this passed them: https://news.ycombinator.com/item?id=15834006 https://news.ycombinator.com/item?id=15834006

bawana 1y ago

At 50 cents a capsule on amazon , prostamol uno (serenoa repens) is more expensive than finasteride so it will forever remain an unrecognized herb. Also, remember we dont really know how these pills are made. Remember the story of that miracle herb, PC-SPES? Widely regarded as a miracle drug when it started selling over the counter, it did indeed significantly improve voiding symptoms as well as out even advanced prostate cancer into remission. It became so widespread that the California Department of Health Services (CDHS) investigated PC-SPES and discovered that it was adulterated with drugs, including warfarin, alprazolam, and diethylstilbesterol (DES). Each capsule had potent estrogens in it! Then the FDA recalled it. Although the rest of the world benefitted from this research, it was the US that paid for it and did it. I am sad that we are now entering a 'transactional democracy' (you only get as much democracy as you can afford) but then again, that's where the rest of the world has been since WW2. Anecdotal data has driven 'old wives tale medicine' for millenia. I am hoping though that big data, the internet, AI, and the judicious use of Bayes' theorem can distill real knowledge from the vast sea of misinformation that surrounds us.

xvector 1y ago
I really do think AI will be key here. It's critical to accelerate towards ASI as quickly as possible.

monkeyelite 1y ago

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compiler_queen 1y ago

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n2d4 1y ago
This is a silly argument. Breast cancer awareness (rightfully) gets a lot of attention; it's also fine to have an article about prostates every once in a while.
- const_cast 1y ago
  Right, if anything I'd say men's reproductive health is under looked in general. Men rarely go to Urologists and issues with the prostate and penis are very much treated as just a fact of life, as opposed to something to look into it. And, even when we do look at these issues, we do it in such an overly pragmatic sense. Like, how men feel about their penis not working or their muscle atrophying doesn't matter. What matter is does their penis work, literally? We approach it in such a blunt and apathetic manner. We don't really think about the more emotional side of hormonal changes or changes with age.
  - BobbyTables2 1y ago
    [flagged]
SamBam 1y ago
Besides the fact that, as others have mentioned, breast cancer gets a ton of attention, I'm not sure what being non-binary has to do with anything. Surely the only question is whether one has a prostate (or breasts) or not?

rurban 1y ago

For more insight into "all" this prostate trouble watch the film "Oslo: Love" currently in some cinemas.

tpoacher 1y ago

I read this with great interest, because about a decade ago, I was convinced I had prostatitis (but NHS screwed the diagnostic process up - the GP didn't do a digital rectal exam because the ultrasound would be more diagnostic anyway, and the ultrasound scan was cancelled because the GP didn't do a digital rectal exam which was part of the criteria for going through with the scan ¯\_(ツ)_/¯ ), and ended up reading quite a bit about it, and how I might try to make things better for myself in the absence of antibiotics. I ended up on this page which I no longer remember (something something prostatitis foundation maybe?), from which I remember two things. The first was this turkish doctor, who against all advice was suggesting a "Brocolli juice therapy" as a prostatitis cure. Fast forward to 2025 and there's lots of studies supporting this. Anecdotally I tried this back then and it really helped the prostate pain I had at the time for months go away within a week. The second, which is more relevant here, was this guy who had a very interesting hypothesis, that a lot of the prostate troubles are actually "musculoskeletal" in origin, and muscle imbalance / weakness of the iliopsoas muscles in particular. And that this imbalance affects venous return which "somehow" causes the condition. But he was just a lay person, and the "somehow" was unclear. So this completes that image perfectly. It's interesting that this article mentions the venous insufficiency link, and that veins rely on valves to direct flow, but doesn't mention the muscular link at all. In any case, this person was saying that in his case, doing lots of iliopsoas stretching and exercises effectively 'fixed' his chronic prostatitis problems. So I've timidly started including a couple of iliopsoas stretching exercises before any workout I do. Anecdotally, I think it helps, but I can't know for sure. But thought I'd mention here in case someone shows interest or can make that link more solid. PS. found the turkish doctor page (or at least a mirror of it): https://www.oocities.org/iastr/ebroc.htm https://www.oocities.org/iastr/ebroc.htm I wish I could find that comment about the iliopsoas ... but alas I think it's probably lost in the sands of time now. UPDATE: Well what do you know. Found it: https://web.archive.org/web/20230203201759/https://prostatitis.org/muscle.html https://web.archive.org/web/20230203201759/https://prostatit... (and https://web.archive.org/web/20230127101206/https://prostatitis.org/physicalcause.html https://web.archive.org/web/20230127101206/https://prostatit... more generally)

BobbyTables2 1y ago
It also seems to me that a lot of “prostatis” cases have nothing one to do with bacterial infection but rather pelvic floor issues or is referred pain from spinal issues. Men’s medicine is in the dark ages.

theptip 1y ago

> The theory here is largely mechanical I’ve long felt that the reliance on population-statistics (RCT) rather than individual diagnosis highlights how little we really know about medicine. A mechanic wouldn’t try to fix a car based on a checklist of symptoms interventions that work X% of the time across the population of cars; they would actually inspect the pieces and try to positively identify e.g. a worn/broken component. Of course, this is harder in the human body. I’m hopeful that as diagnostics become cheaper and more democratized (eg you can now get an ultrasound to plug into your iPhone for ~$1k), we’ll be able to make “medicine 3.0” I.e. truly personalized medicine, available as standard rather than a luxury available to the 0.1%.

potato3732842 1y ago
What makes professional mechanics fast (and therefore makes them good profit) is knowing from experience when you can shoot from the hip like that. But yeah, you won't find people doing things that way in any setting where it Actually Matters(TM) (e.g. expensive things where you really can't justify not fixing it right the first time)
thehappypm 1y ago
This sounds a lot like the pitch for Theranos
- bear141 1y ago
  Which was a great pitch because it’s what people want. It just has to be based in reality.
- Robotbeat 1y ago
  So?
bobthepanda 1y ago
Diagnostics only really tells you that something is happening but not why; and it is so impractical if not impossible to observe mechanisms of action for much of the body. Heck, we don’t even know the mechanism of action for acetominophen, and that’s one of the most popular, oldest OTC drugs out there.

derefr 1y ago

> The theory here is largely mechanical; and it’s not just psychiatrists like Scott who are weak at mechanical explanations; it’s doctors in general as well as medical researchers and biologists. A tangent here, about not just "mechanical" explanations, but "mechanical" treatments — IMHO, the insistence in modern medicine on treating recurrent bacterial infections purely with antibiotics is wrongheaded, and the cause of a lot of resistant strains of bacteria. Especially for topical/mucosal/epithelial infections, where the infected tissue is accessible without invasive surgery. In a recurrent bacterial infection, the reservoir of the infection is one or more (almost always macro-scale) biofilms or plaques. And antibiotics just don't do much to biofilms/plaques. (If they could, you could spray Lysol on the walls of an under-ventilated shower that's developed "pink slime" biofilms — and all the slime would dissolve, or detach and run down the drain. But it doesn't do that, does it?) Even if you kill most of the bacteria, the biofilm itself — the "fortress" of polymerized sugars which the bacterial cells have secreted to secure their position — is not destroyed by antimicrobal compounds. And the few bacteria that remain have a great position to regrow from. What does work to clean a slimy shower wall? Scrubbing. Scraping. Peeling. Together with targeted chemicals, that 1. get water out of the polymer (because these biofilm surface polymers are often lubricative when wet, and thus resistant to abrasion — but this effect breaks down when dry), and 2. rough up the surface of the biofilm/plaque a bit, to get a better grip on it. Biofilms and plaques adhere to themselves — so, when you can break the biofilm or plaque into chunks, you can then get entire chunks out. (And also, by removing chunks, you create paths for antimicrobials to then get past the biofilm surface polymer. You're breaching the fortress.) If you picture a strep-throat infection — spots on the tonsils and on the throat, etc — those spots aren't a symptom; they are "the enemy" you're trying to fight. Remove them — mechanically! — and you go from using antibiotics (picture tiny cellular infantrymen) to effectively "fight a war of attrition against an enemy with a secure position", to "a defeat in detail of an enemy with nowhere to hide." --- Interestingly, there are certain medical specialties that think mechanically about infection. • Dentists, obviously, know that you must abraid dental plaque away. There's no chemical that you can put in your mouth every day that will keep plaque from forming, or reduce it once it has formed. (In fact, ironically, antimicrobial oral rinses [of e.g. chlorhexidine] accelerate plaque formation, because bacterial cells killed "in place" inside their biofilm fortresses will deposit and enrich the surface polymer layer of the biofilm — much as dead sea creatures deposit and enrich limestone sediment.) • Audiologists know that there's ultimately nothing you can do with drugs or topical treatments to get an ear clear of wax+fat+dust+anything else trapped in there. You have to go digging. Chemicals can soften the wax, to make it easier to remove; but, due to the shape of the ear, and the lack of ability to "come in from behind" (there's an eardrum in the way!), the softened wax will never come out on its own. • Dermatologists know that a cyst can't just be drained + treated with antibiotics. The body forms a defensive pocket around a cyst — but the inside surface of this pocket ironically provides the perfect medium for a biofilm to grow on, and thus for an infection to recur after drainage. Cysts are only considered well-treated if the pocket itself is removed — thus removing the biofilm. ...and yet, when you look at most other disciplines, you see completely the opposite. • An ENT is very much not willing to abraid biofilms out of your sinuses or throat "if they can help it", despite those surfaces being accessible to an endoscope without breaking past any barriers. They will always try first to treat "pharmacodynamically", with e.g. oral antibiotics + an antimicrobial sinus rinse — presumably in the hopes that you'll accidentally do something mechanically in the process of treatment (e.g. snorting really hard to get the remnants of the rinse out) that will dislodge the biofilm. You have to go through years of back-and-forth with an ENT before they'll actually bother to look further up inside your sinuses than they can see with an otoscope/anterior rhinoscope. (And IMHO this is why so many people suffer from idiopathic chronic sinusitis, developing into nasal polyps et al. Nobody's ever been willing to go deep up their nose with an endoscope, find impacted biofilm plaques, and say "alright, let's clear those out.") • Kidney stones, once symptomatic, are treated ultrasonically (lithotripsy); but the thinking on follow-up prevention is entirely about preventing accretion — not in removing the cause. [In many cases, the cause of (struvite or apatite) kidney and/or urinary stones, is very likely a bacterial biofilm within the kidney, spalling off bits of biofilm, which denature into plaques after exposure to the harsh pH of the kidney/uterer/bladder; get caught on some tissue; and then act as nucleation sites for mineralization (stone formation) as dissolved minerals pass through.] Once someone gets one kidney stone, they are generally thought to just be "prone to kidney stones", and will likely get them randomly for the rest of their life. A lot like the old — pre-infectious-origin — thinking that someone can be "prone to peptic ulcers"!

bawana 1y ago

Unmentioned is the significance of dietary modificatioon. In one study, Japanese men had 10% of the incidience of problematic bph as americans. The offspring of the japanese in Hawaii had half the iincidence. The second generation had no difference. The analysis suggested that phytoestrogens in tofu, tempeh,etc are responsible of prostatic involution. Animal fat contains elevated levels of lipid soluble hormones and diets high in fat (meat) are associated w bph as well as elevated risk of prostate ca. Finally, this craze of T replacement is greatly increasing the risk of symptomatic bph (along with other cardiovascular risk factors)

loeg 1y ago
> Finally, this craze of T replacement is greatly increasing the risk of symptomatic bph (along with other cardiovascular risk factors) TRT does not increase the risk of BPH; this is discussed in the article, along with a hypothetical mechanism. Nor does TRT seem to have CVD risk.
qmr 1y ago
> craze of T replacement Please explain how it's a "craze". T levels and sperm count are tanking. Possibly from micro plastics.

alejohausner 1y ago

This work by Gat and Gornish gives a great explanation for prostate enlargement. There's an article by Donaldson [1] that suggests a connection to vitamin K2: A large study from 2014 by Nimptsch et al found a strong inverse correlation between intake of vitamin K2 and prostate cancer [2]. Dairy foods with K2 had the most effect (K2 is soluble in butterfat). Vitamin K2 helps remove calcium from the elastin in artery and vein walls, reducing their stiffness. Donaldson hypothesizes that K2 improves venous flow, and hence might reduce the varicoceles that lead to too much free testosterone getting to the prostate and causing enlargement. So eat more grass-fed butter, or take a K2 supplement. At worst, you might also improve your bone strength. At best, men might prevent prostate cancer. 1: DOI: 10.1016/j.mehy.2014.12.028 2: DOI: 10.1093/ajcn/87.4.985

kmbfjr 1y ago
I had my prostate removed six weeks ago due to Gleason 8 score cancer. The pathology revealed an aggressive cancer. My prostate was not enlarged, my PSA at the end was 4.2. Only because my doctor was overly cautious about the slope of the PSA rise did he send me for an MRI starting the diagnosis. It remains to be seen if it escaped containment. The point here is, I don’t think enlargement and cancer are that intertwined. Cancer happens for any number of reasons, pinning hope that it can be staved off by diet and vitamins seems to ignore tons of other environmental factors.
- xxbondsxx 1y ago
  I hope you'll be OK!
- alejohausner 1y ago
  Wow, that sounds scary. I hope it doesn't come back. Weird about the 4.2 PSA; that wouldn't have raised alarms, normally. I guess acceleration is as important as absolute values.
- brigandish 1y ago
  All the best. I had a check up for prostate cancer recently, and fortunately have been told I don't have it, but until that moment I felt the stress of wondering and worrying, so you have my sympathy. I'm also glad you found a good doctor, the first I found did no checks at all. Told me I'm too young to have any problems (I'm definitely not) and sent me away with some herbal medicine and all that stress I mentioned. The second doctor I found was thorough and reassuring, and shocked by the behaviour of the first.

damnitbuilds 1y ago

TL;DR: Very likely not.

vakde 1y ago

Did no one check the base website (yarchive.net)? He's archived a mindbogglingly large number of usenet posts, each being extremely high signal

ryanobjc 1y ago

This article is literally the definition of TL;DR. It's fairly hard to get thru, I spaced and skipped the conclusion, that the treatment isn't permanent and can be undone.

SamBam 1y ago
I was interested through the first 20-25 paragraphs, and then the thing just kept going and going and going. It would have been fine, though, if it had some sub-headings and stuff to help guide one through.

bccdee 1y ago

Good article, but very weird to scroll to the bottom and see "(c) Norman Yarvin" at the bottom. Curtis Yarvin's brother wrote this. I don't have an opinion about that, I just find it strange.

gwking 1y ago
I merely saw the domain name 'yarchive' and had a strange inkling that there might be a connection. A quick search yielded this: https://unlimitedhangout.com/2021/08/investigative-reports/the-father-the-son-and-the-mencius-moldbug/ https://unlimitedhangout.com/2021/08/investigative-reports/t.... I have no opinion of unlimitedhangout.com or the veracity of that article. But in response to "I just find it strange", I'm beginning to associate this sort of intensely intellectual inquiry into disparate topics with equally intense political positions. I was first introduced to Urbit as if it was a purely technical, humorous and extremely nerdy lark. It was a joke thing my friend got me to sign up for, to own a slice of an imaginary universe (in a quantity called a "frigate" or whatever it was). When I learned years later about how serious the worldview behind it was, I was quite shocked. Since then, and especially since the NYT outing of Scott Alexander in 2020, I've become more attuned to the pattern. These hyper-analytical blogs often come with a lot of political implications below the surface. Again, I'm not taking sides here. If anything, the takeaway for me is that the world is very complicated. We have these rare polymath personalities who go deep into topics, have a strong voice on the internet, and they end up with all sorts of valid criticisms of the status quo. This in turn can align with extreme political views.
- bccdee 1y ago
  I say I "just find it strange" because I was hesitant to tar Norman Yarvin with the same brush I'd use for his brother. Curtis Yarvin is a freak, but I figured it would be entirely possible that his brother was just a normal guy on the internet with weird relatives. Judging by the article you posted, though… > When talking about Nigerian Scammers in the online chat room, Norman Yarvin is recorded as making statements like: “I think everyone charged with a crime is entitled to a fair trial and the presumption of innocence, but I also think things would be a lot better if habitual criminals like scammers were executed in a timely manner, say within a week of their trials. Hanging 1% of the population would probably eliminate 99% of the actual crime [...]" > In another piece Norman published on his own website, he blamed Social Security programmes for Germany’s social decline leading up to World War II. [...] Some of Norman’s carefully worded crypto-contrarianism will be familiar to anybody who has read the work of Curtis Yarvin and those observers of Mencius Moldbug will find much of Norman’s take on modern history to be eerily similar. Also apparently he's potentially linked to a terror attack? I guess I'm too prone to giving people the benefit of the doubt. > they end up with all sorts of valid criticisms of the status quo. This in turn can align with extreme political views The thing about the status quo is that it's extremely easy to criticize. Ted Kaczynski made some solid arguments. Mao had some great points. Problems are everywhere—it's not hard to find them. You have to judge people by their solutions, and as a rule, neoreactionaries and their orbiters make flagrantly noxious prescriptions.

irjustin 1y ago

This is incredible.

silexia 1y ago

Fantastically well written article. I read the entire thing in one go with my tiny attention span and learned about an interesting possible procedure.

acyou 1y ago

Here is my pet theory, it's not intended to be political, just thinking about evolutionary biology. There is an optimum lifespan for peak evolutionary population fitness in any group of organisms. Too short a lifespan means not enough time to gather resources and reproduce. Too long a lifespan could mean competing with future generations for scarce resources, which might in theory marginally improve individual fitness, but in the aggregate decreases overall population fitness, and is therefore not selected for. Over billions of years, organisms evolved built-in control mechanisms to ensure that they live/survive for the optimum amount of time. The evolution of these mechanisms is driven in part by the fact that an older organism under stress being eliminated from the environment will probably improve the population fitness of close relatives. I believe this is what cancer is. It's one of many, many built-in mechanisms, reinforced by hundreds of millions of years of evolution, to kill us off when our time has come. So, if there are tons and tons of evolved mechanisms that exist just to knock you out when your time has come. That is the ultimate reason why men die from heart attacks: they have evolved in past generations that if they have extreme exertion at an advanced age, it's an indication that they aren't contributing to population fitness in a useful manner, and that extreme exertion would be more efficiently done by younger individuals. At an old age, they should be at the top of the food chain, guiding and educating and valued and lazy and consuming, and if they are not, better for the tribe for them to die quickly than lingering on. And there is hope. If we can eliminate stress from our lives, we send a signal to our bodies that we will improve population fitness by continuing to exist, and our bodies may reward us. That's a big reason for longer lifespans. Better diet and moderate exercise is great for sure, but less stress makes a big difference. But this is only one of a multitude of dynamics that is happening in the complicated system that is the existence of life, and is not necessarily a dominant dynamic. For prostate cancer, you might get around it temporarily, but something else will get you. Lifestyle changes, medication, placebo and other interventions that reduce stress probably have a better overall shot at increasing your lifespan than any single magic bullet. I suspect that prostate cancer has to do with being old and not having sex, if you're an older male. An older male who doesn't have sex would have lower individual fitness than an older male who does have sex, and would be competing for resources with younger individuals who might have higher evolutionary fitness. So, there's another solution to prostate cancer that doesn't involve surgery (or even necessarily having sex), I think I read another article that mentioned that, I won't spell it out. Given that breast cancer happens more to women who have not breastfed after carrying to full term (citation needed), you can draw a parallel. Females who are decreasing population fitness by not having children, and by extension have lower individual fitness, breast cancer and ovarian cancer are some of the main mechanisms. They also think that breastfeeding reduces the risk of breast cancer. Certainly, even females that don't reproduce, but still breastfeed, probably improve population fitness, even if they don't have good individual fitness.

varjag 1y ago

Fascinating. I wonder what are the consequences of long term zero gravity flight for this.

phront 1y ago

i am curious to know can we plan a better vein system and somehow "implement" it

abhaynayar 1y ago

Love the writing-style. Quite "to-the-point", without any fluff, and with a nice flow and purpose.

deleted 1y ago

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someonehere 1y ago

I’m glad we’re starting to talk about the prostate because I feel like for a long time. Men have been reluctant to talk about this more and more in society. I feel like women have their fair share problems as they get older, but men have equal amount of problems too we just don’t like to talk about it.

ycombinator_acc 1y ago

Just take finasteride. As a nice side effect, you won’t go bald.

learningmore 1y ago

Very interesting article. Well-explained.