DEAR DR. DONOHUE: My 14-year-old son has enlarged breasts. They are so large that he could wear a brassiere. It worries me so much that I feel like crying. He is going to take mandatory gym and must undress in front of other students. They are already teasing him mercilessly. I took him to his doctor, and the doctor confirmed that there is nothing wrong. He said not to worry. I need help now. I want something done. – C.A.

ANSWER: Almost all 14-year-old boys have some breast enlargement. It goes with puberty, when there is an imbalance between male and female hormone production. Usually the growth is not massive, but many times it is noticeable. For most boys, the matter is not one of great concern, and the situation usually resolves itself within three years.

Your son is not the ordinary case. His situation has the potential to do great psychological harm and cause the boy much unhappiness. He should not be made to wait for nature to correct this. He should have the excess breast tissue surgically removed now. It won’t be hard for you to find a general or plastic surgeon willing and capable of doing so. It is not a major procedure.

There are instances when male breast enlargement is not a normal phenomenon. Drugs can do it. Bodybuilders who turn to male hormones to increase muscle size often experience breast growth. Some of the extra male hormone is converted into female hormone. Marijuana is another drug that causes breast growth.

Kidney failure, liver disease, thyroid gland malfunctions, brain tumors and adrenal gland tumors are disorders that can lead to breast enlargement. A doctor’s exam coupled with a few lab tests can generally uncover these causes of gynecomastia (GUY-nuh-coe-MASS-tee-uh), the medical name for this condition.

DEAR DR. DONOHUE: In 2001, I found blood in my urine and was diagnosed with cancer of the bladder. Many tumors were surgically removed. Thirteen months later the cancer had returned and was not operable. My bladder was removed.

I smoked from age 7 to age 52. My cancer was attributed to smoking. I think you would do a service in addressing this condition. – O.L.

ANSWER: In North America, about 60,000 new cases of bladder cancer are diagnosed each year, and it will cause around 13,000 deaths. It is the fourth most common kind of cancer in men and the 10th in women. Four times as many men as women have it.

Cigarette smoke can be blamed for 50 percent or more of bladder cancers.

One warning sign is bloody urine. Another is the need to empty the bladder frequently and urgently.

Early detection and treatment can bring cure. The depth to which the cancer invades the bladder wall provides an estimate of how benign or how deadly the cancer is.

This cancer has a tendency to recur, so constant vigilance after initial treatment is a must. Scope examinations of the bladder during the first year of treatment are generally scheduled every three months. Then they can be spaced more widely.

Your story is an informative warning to all readers. I am sure they appreciate your telling it.

DEAR DR. DONOHUE: My sister’s husband is an insulin-dependent diabetic. He takes a lot of shots each day. During the past couple of years my sister has gained a lot of weight. She has been talking about using insulin to take off some pounds. She says that if her husband can eat anything and then take insulin to counteract the sugar, it might work for her. What can I say to make her see that this is dangerous? – L.L.

ANSWER: Your brother-in-law cannot eat anything he wants and counteract it with insulin. Diet is a bedrock of blood sugar control. He is never going to maintain normal blood sugar without careful attention to what he eats.

Insulin is not a weight-loss medicine. It lowers blood sugar by opening up body cells to sugar. Insulin neither burns sugar nor burns calories. People who take insulin without needing it can lower their blood sugar to dangerous depths, ones that can lead to coma and brain damage.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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