Q: I quit smoking cigarettes about two years ago and started vaping nicotine instead. I've heard that a lot less people are smoking cigarettes. Could vaping account for the decrease in smoking? - Ned T., Arlington, Texas
A: Bravo for getting off cigarettes, but ... we'll get to vaping nicotine in a minute.
According to the Centers for Disease Control and Prevention, smoking declined from around 21 percent of adults in 2005 to about 18 percent in 2013 and preliminary data show that it hit 16.8 percent in 2015. And it's certainly possible that the numbers indicate a lot of folks, like you, have switched from cigarettes to vaping. Some folks are even doing both.
As for your nicotine vaping: While you may be dodging the tar and chemical additives in cigarettes - that's a good thing - vaping isn't harmless. One study found that using an e-cigarette for 10 minutes raised airway resistance significantly (breathing became more difficult). Reduced respiration taxes your heart and your brain, which makes your RealAge older!
The National Institutes of Health also points out nicotine is highly addictive, and testing of some e-cigarette products found that the vapor contained carcinogens and toxic chemicals such as formaldehyde and acetaldehyde, as well as potentially toxic metal nanoparticles from the vaporizing mechanism.
Ned, we still don't know vaping's long-term effects, and you're still addicted to nicotine. So put down the vape and try a smoking-cessation program that uses nicotine aids, such as nicotine gum or a patch, in ever-reduced doses to help you breathe free. And for help quitting, check out www.sharecare.com/health/quit-smoking.
Q: New info on prostate cancer screening and "active surveillance" is confusing. Do I get a PSA test every year or not? And what do I do if I have an elevated PSA score? - Lamar P., Baltimore
A: This complex topic has no easy answers. The smart choices will change when (we predict) a radically new, highly specific prostate cancer test becomes available in late 2016. But for now, let's examine the effect of the 2012 recommendation against PSA testing, and look at the results of a new study on the risks and benefits of active surveillance if you're diagnosed with low- and very-low-risk prostate cancer.
First, since the no-PSA-test recommendation came out, PSA tests have dropped by about 20 percent and the number of early prostate cancer diagnoses has declined 23 percent. That means some men who would have been diagnosed with early-stage prostate cancer aren't getting that life-saving diagnosis, and it's estimated by some researchers that the one-year drop in testing will lead to more than 1,200 additional deaths from prostate cancer down the road.
However, because of fewer PSA tests, fewer men went under the knife. That spared some who didn't have prostate cancer and some who had slow-moving, low-risk prostate cancer that didn't call for immediate treatment.
Our advice to you: Talk with your doc about your risk factors for prostate cancer; then go ahead and have the PSA test. But if you get a significantly elevated reading, repeat the test at least once before you start thinking about next steps. Then, if you're diagnosed with low-risk or very-low-risk prostate cancer, consider AS.
The latest study out of Johns Hopkins University finds that, for low-risk prostate cancer, regular monitoring via the current PSA test, digital rectal examination and repeat prostate biopsy, is safe and effective. Tracking almost 1,300 men (mean age of 61) who did AS for 10 years, the survival rate was 99.9 percent; metastasis survival rate, 99.4 percent.
IMPORTANT: Late in 2016, every guy should ask his doc about the new prostate cancer test. In preliminary trials, it has demonstrated "100 percent sensitivity with no false negatives and approximately 80 percent specificity." Read about it on the Cleveland Clinic Innovation site (go to myclevelandclinic.org and search for Protein Biomarker Analysis). You'll see it under "Top 10 clinical innovations predicted for 2016."
Distributed by King Features Syndicate, Inc.
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