DEAR DR. DONOHUE: I got a call from my mother that my grandfather was in the hospital and was suffering from a malignancy of his ear canal. I asked around, and no one has heard of such a thing. Did my mother misunderstand the doctor? Or is there really such a thing as ear-canal cancer? If there is, what are the chances for survival? Should I make a trip back home? — L.C.

ANSWER: Your grandfather has an aggressive and serious infection of the ear canal. The name of this condition is malignant otitis externa. “Malignant” here indicates a raging infection, not a malignancy, a cancer. Your mother made an honest mistake by focusing on “malignant.”

The organism responsible for this infection is Pseudomonas (SUED-oh-MOAN-us), a bacterium found in many, many places, including water. It is difficult to treat. Once it has invaded the ear canal, it can advance through the canal to the bones of the skull. From there, it can infect the brain by forming an abscess or by bringing on meningitis, an infection of the brain coverings.

How your grandfather contracted the organism most likely will never be discovered. This sort of infection most often happens to older people, especially to older people who have diabetes.

Severe ear pain and often copious drainage from the canal are signs and symptoms of the infection. The pain worsens at night. Chewing intensifies the pain.

Before there were antibiotics that reliably worked against Pseudomonas, the mortality rate from malignant otitis external was 50 percent.

Now with antibiotics that can eliminate this germ, the cure rate is 90 percent.

I don’t know what to tell you about taking the trip to your home. I don’t anticipate your grandfather’s death.

DEAR DR. DONOHUE: I have a problem with my medicine, Flomax. My doctor took a painful look into my bladder, checked my prostate gland and took a biopsy of it. No cancer. Since the procedure, I can perform sexually, but I don’t ejaculate. Even though I am 80, I enjoyed my sex life. Now it’s not the same as it was. The doctor thinks it’s due to Flomax. If I quit it, will my sex life return? I wouldn’t quit for good, but just to see if the medicine is the cause. — T.S.

ANSWER: Flomax (tamsulosin) is a medicine for enlarged prostate glands. Gland enlargement makes it impossible for a man to completely empty his bladder. Nighttime, therefore, becomes a series of trips to the bathroom. Flomax relaxes the muscles that keep the bladder shut tight. It makes bladder emptying more complete. Flomax can cause problems with ejaculation. It wouldn’t hurt to stay off it for a week or so to see if your sex life returns to normal. Don’t stop it completely unless you tell your doctor.

The booklet on the prostate gland explains the many difficulties men have with it. To obtain a copy, write: Dr. Donohue — No. 1001, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I was advised to take aspirin, 81 mg, by my eye doctor because he saw changes in the arteries in my eyes. A friend was told by her doctor that 81 mg of aspirin doesn’t work for women, but does for men. Have you heard this? — A.R.

ANSWER: Aspirin, 81 mg, protects men at risk of having a heart attack from having one. It doesn’t protect women as well. The reason why isn’t clear. However, it does protect women from having a stroke. Aspirin does protect both men and women who have had a heart attack from having a second one.

I’d go along with your doctor if I were you.

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. Readers may also order health newsletters from www.rbmamall.com.

Copy the Story Link