Dr. Keith Roach

DEAR DR. ROACH: I’m an 80-year-old man in generally good health, but I have trouble urinating. It comes out in dribs and drabs, and frequently, I cannot completely clear my bladder. But immediately after having an orgasm, things are completely different. I whiz like a teenage boy. What’s happening? — B.L.M.
ANSWER: Like most 80-year-old men, you have an enlarged prostate. The prostate makes less than half of ejaculatory fluid (most comes from the seminal vesicles), but an ejaculation does reduce the size of the prostate somewhat. Regular ejaculation (and prostate massage, which is not often performed now as a treatment) can improve urinary symptoms, but this rarely happens to the degree you describe. (A study showed about a 15% improvement among young men.) Still, I am pretty sure that the benefit is coming from a reduced prostate size.
While regular ejaculation might be an effective treatment for you, most men benefit from a medication called an alpha blocker. You might ask your regular doctor or a urologist about it.
DEAR DR. ROACH: I hope you can give me an answer to this. The minute I go outside on a sunny day, I start to sneeze and won’t stop until I get out of the sun. Is there a reason for this? — J.S.
ANSWER: At least 15% of the population has a reflex sneeze when looking at bright light like the sun. It’s more common in white women, but anyone can have it. There is sometimes a family history if you ask. One group with a sense of humor in 1978 proposed the name “autosomal dominant compelling helioophthalmic outburst” (ACHOO syndrome). Ninety percent of people had three or fewer sneezes, so you are in the select few of people who have persistent sneezing.
A pair of dark glasses might be more effective than medicine.
DEAR DR. ROACH: Do negative people and worriers have a higher risk of getting cancer than happy, positive people? Has a study been done? — G.W.B.
ANSWER: Studies have been done, and although people with generalized anxiety disorder are at a higher risk for being diagnosed with cancer, the studies need to be interpreted with caution. As you might imagine, people with anxiety disorders (an anxiety disorder is defined as “clearly excessive,” persisting for six months or more and accompanied by physical or cognitive symptoms) tend to see doctors more often than the general population. They often have concerns that can lead to diagnostic testing. This may be why cancer is diagnosed more frequently.
Another study looking at people with major depression and generalized anxiety disorder didn’t find any increase in the risk of cancer, except for smoking-related cancers (especially lung cancer).
You didn’t suggest it, but I have frequently heard people with cancer tell me they have been told that the cancer is somehow their fault for not having a “good attitude.” I am exceptionally careful not to suggest this to any person with cancer. Most cancer is literally bad luck, but a person’s genetics, occupational and environmental exposures, and lifestyle all have impacts on their risk of cancer.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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