Prostate tests may cause more harm than good?

Q: I’ve just read this article titled ‘Prostate tests may cause more harm than good’. What’s your opinion on this? Thanks.

A: Good question. 

To test or not to test, it is up to the patient to decide. If a male patient wants PSA , digital rectal exam, transrectal ultrasound or a prastate biopsy(if the first 3 are abnormal), any normal professional doctor would comply with an added caveat that no lab test or tests is/are 100% accurate.
Dr Neil Fleshner’s opinion is that of the current Canadian MD thinking:
“Canadians physicians know screening for prostate cancer saves lives, he said. The preferred approach in Canada is to find the cancer but not necessarily treat it, an approach called “active surveillance,” 
It is the treatment like radical prostatectomy, orchidectomy (surgical castration), or estrogen therapy (chemical castration) which can do more harm than good.
If the doctor explains the test results and options to the patient well, it is highly unlikely that the patient would be harmed.
As the saying goes: “Ignorance is the worst cardinal sin!”
Here is additional reading for those who might be interested: .  As well  search under “Prostate”
or Stay Active to Reduce Your Risk of Prostate Cancer in the same Johns Hopkins’ website.

Enlarged Heart

Q: A recent Xray (chest) shows that my heart is larger than normal. Pl give possible explanation and what practical steps to take. I am in Hong Kong and wonder if any wynites is a heart specialist here that I could see. I am retired and 76 years old. Thank you

A: A heart is enlarged because it has to do more work.  This is akin to body building.  Muscles “enlarge” when body builders pump iron.
Without knowing your background training & past medical history, I’ll try to list some general etiologies using as many laymen’s terms as possible.
What might be the causes?
1.  High blood pressure.
2.  Structural damage: leaking heart valves,(rheumatic heart disease, calcification/stiffness), damage by infections/poisons/medications, etc.
3.  Anemia.
4.  Hormonal: eg. hypothyroidism.
5.  Rarely, hereditary (cardiomyopathy).
You can also check internet search engines for: cardiomegaly” , “cardiac hypertrophy” or simply “enlarged heart”.
I don’t know any cardiologist in HK, but I’ll check with Mr. Anthony Ho & see if he knows any WYK alumni who are practicing cardiologist in HK.