Doctor's Advice - Do I have prostate cancer?

Q I am a 19-year-old guy who has been having a problem for about a year now. While passing my stool, I sometimes notice there is some blood. It started in April last year, when I was away in Trinidad. The food I was given there was not good for me, as it was totally different to what I was used to at home. The bleeding recurred last August. Each time it lasted about a week. It only happens when I am defecating. Now it is happening again, so I'm somewhat worried about my health. Do you think it could be prostate cancer?

A No, I do not. First, prostate issues cause problems with the urinary system, not the bowels. Second, prostate cancer does not occur at age 19. According to the Jamaica Cancer Society, nearly all cases occur among the over-45s.

So why are you bleeding?

Well, statistically speaking, the likeliest reason for a young guy to bleed from the bottom is piles.

Piles (also known as haemorrhoids) are varicose veins in the rectum. This means that the veins are 'bulging' and are liable to bleed when under pressure.

Piles are extremely common. Experts think they are at least partly caused by a poor diet.

If you do have piles, don't be scared. Most people who get this condition do not have to undergo surgery. Very often, the disorder can be controlled by medication and diet.

I must stress that there could be other reasons why you have been bleeding. See a doc now. Good luck.

Q I am a 20-year-old woman. About two weeks ago, I had sex with my boyfriend. The condom fell off. He decided that he wanted to go ahead without the condom, but I disagreed. So he stayed inside for only about a minute or less. My period came a couple of days after that. Now I have an awful smelly discharge. What do you think I should do? Is it serious?

A On the night the condom fell off, you were absolutely right to insist that your boyfriend stop. However, it is a pity that he continued for around a minute.

Nevertheless, it does seem you are not pregnant, because you say that your menses arrived.

Now you have an offensive discharge. The first thing that occurs to me is this: When the condom came off, did it by any chance remain inside you? A 'retained' condom is a well-known cause of a smelly discharge.

However, let us assume that you had both found the condom. In that case, the likeliest reason for that offensive discharge is a vaginal infection.

You may well have caught the infection during that brief minute of unprotected sex.

It is absolutely essential that you consult a doctor. She can examine you internally, take test samples from the region of your cervix, and reach a diagnosis.

Until you have seen the doc and been diagnosed, do not have sex.

Q I am a man in my early 20s. Around nine months ago, I was in a relationship with another man. I am not gay, but did it for financial reasons, which I know was wrong. What I am worried about is that I have recently failed a blood examination. So I am now wondering if I have contracted HIV. Do you think it was HIV which caused me to fail? But if I had HIV, would I have been seeing signs of it by now?

A Sorry to hear about your problems. But what I do not understand is this. What do you mean when you say that you 'failed' a blood test?

What blood test was it? And why did you have it done? If it was for HIV, I would have thought that whoever did the test would have told you so.

It seems clear that you should now go back to whoever conducted that blood examination and ask them to explain what sort of test it was. It may just have been a blood count for anaemia. Or possibly it was a 'sickling' test.

In the part of your email which I have not published, you told me precisely what you did with this other guy. I regret to say that this particular activity could have been enough to give you HIV if the other man was infected.

You should take an HIV test. The fact that you have not had any symptoms does not mean you are OK. Get this matter sorted out right away.

Q I'm a 19-year-old female who has had two miscarriages, both at five months. I have a problem with my weight, which is 190 pounds. I want to lose about 30 pounds, but I'm really depressed about everything, including the two miscarriages, and being unemployed. I really need advice on how to start losing weight without getting depressed.

A You have obviously had a bad time lately. Many people do not realise how stressful a miscarriage can be for a woman. To have two in succession is extremely distressing. You don't say whether you are in a sexual relationship at the moment. But if you are, I would suggest that you use a good contraceptive method for a year or so, so that you are not exposed to the strain of a further pregnancy, plus the worry of wondering whether you might miscarry again. It is clear that you are quite depressed, so I urge you to see a doctor as soon as possible. It is likely that she will put you on an antidepressant to help you get through this difficult time. On the point of losing weight, do not attempt to lose it quickly! Very strict dieting would probably make you even more depressed. Instead, a reasonable target would be to lose the 30 pounds over, say, the next two and a half years! That is a target of only one pound per month, which is achievable without making yourself miserable. A sensible free diet sheet is available at www.health24.com/dietnfood/weight.

Q Can one die from a heart attack during sex, as I have heard?

A Such things do occasionally happen in elderly people, particularly if they already have heart trouble. But if you are a young person, you really need not fret about this.

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