Better Health 13 ENG

W e l c o m e
04
W
elcome to Better Health, the magazine
for patients and friends of Bumrungrad
International.
There are countless differences between men
and women, and issues of health and medical care
are no exception. In this issue, we're devoting special
attention to the important health topics affecting men.
For decades the term menopause has been used
to describe the unique changes women experience
beginning around the age of 40. Our cover story
beginning on page four explores andropause a
more recent and lesser known concept that describes
the changes that occur in men age 40 and above.
We examine the nature of these changes, and how
the medical community is bringing greater knowledge
and advances in treating age-related problems in men.
Prostate problems such as cancer, prostatitis
and prostate enlargement are among the most common
ailments in men over 40. Our story beginning on
page 12 provides an overview of their causes and
treatment options, while our feature on page 15 reports
on an exciting new treatment called HDR Brachytherapy,
which has already brought many patients at
Bumrungrad and around the world successful
treatment outcomes for prostate problems.
Finally, we devote our Q & A feature on page 10
to the subject of erectile dysfunction (ED). We turned
to a leading ED expert to answer the important
questions men have about dealing with this
sensitive and treatable problem.
As always, we welcome your feedback, ideas
and comments about Better Health. Please feel free
to e-mail us at betterhealth@bumrungrad.com.
We look forward to hearing from you, and
here's wishing you better health.
Oranuch Nilpradit
Contributing Editor
Contact Bumrungrad International
Telephone: 66 (0) 2667 1000
Facsimile: 66 (0) 2667 2525
Out-patient
appointment: 66 (0) 2667 1555
Website: www.bumrungrad.com
BetterHealth
Better Health magazine is published quarterly by Bumrungrad
Hospital Public Company Limited and is produced for Bumrungrad
Hospital Public Company Limited by Oakins and Stone Limited,
Suite 2-A, Asoke Court, 16 Sukhumvit 21 Road (Asoke), Klongtoey-nua,
Wattana, Bangkok 10110 Tel: +66 (0) 2261 1211 Fax: +66 (0) 2261 1213.
No part of this magazine may be reproduced without the written
permission of Bumrungrad Hospital Public Company Limited.
All rights reserved. c 2008 by Bumrungrad Hospital Public
Company Limited.
C o n t e n t s
04 Andropause: Understanding and Treating
Men’s Mid-life Health Problems
10 Q & A: Erectile Dysfunction
12 A Protective Approach to Prostate Health
15 HDR Brachytherapy _ An Effective Alternative
for Treating Prostate Cancer
16 Health Briefs
18 News from Bumrungrad International
12 15 18

A N D R O P A U S E
Andropause: Understanding
and Treating Men’s Mid-life
Health Problems
For men over 40, getting older doesn’t have to mean living with
declining health. Thanks to extensive research and new treatment
advances, male andropause can be diagnosed and treated
successfully.
T
here’s a ring of truth to the old saying that “Life begins
at 40.” Entering the middle part of life is supposed
to be a positive experience, and a time to feel more
settled, established and comfortable.
But for a great number of men, life beyond the age of
40 can feel more like the end of good health, with
unexplained fatigue, insomnia, depressed feelings and a
general lack of enthusiasm for living not unlike the
difficulties many women encounter during menopause. For
some middle-aged men, the physical and mental toll of
everyday living means a profound decline in quality of life.
Given the similarities to the symptoms of female
menopause, this condition has been referred to as “male
menopause” or “mid-life crisis.” Some used to believe it was
just a normal part of the male aging process. Others
questioned whether it was all just a state of mind.
So what exactly is it that these men are experiencing?
And what is the best way to deal with it? For answers,
Better Health turned to Dr. Pansak
Sugkraruek, an endocrinologist and fertility
expert with vast experience treating men
for what is now called andropause.
WHAT IS ANDROPAUSE?
Years ago many doctors believed that male
‘menopause’ symptoms were merely an unavoidable part of
the aging process; consequently, relatively little research effort
was made to understand what exactly was causing the condition.
Thanks to intensive research in recent years, science now has a
clear understanding that andropause results from declining levels
of several male hormones.
“People used to equate these symptoms in men with those
that occur during female menopause, and so the term ‘male
menopause’ was coined,” says Dr. Pansak. “Extensive research in
recent years has shown that the term doesn’t properly describe the
male condition. While the symptoms are similar in both men and
women, the causes are very different.”
For women, menopause begins when the ovaries stop
functioning and no longer produce hormones. “In men, hormone
production continues,” Dr. Pansak explains, “but certain bodily
conditions impair a man’s hormone production to such an extent
that this hormone deficiency begins to have a noticeable effect on
some important body functions.”
“The correct term to describe this process is testosterone
deficiency syndrome or androgen deficiency of the aging male,”
says Dr. Pansak. “In simple terms, this is andropause.”
ANDROPAUSE AND HORMONE DEFICIENCY
The impact of hormone deficiency in men is usually
gradual and often goes unnoticed at least initially. “As the
condition progresses it can lead to a significant impact in both
4

physical and psychological
terms on a man’s quality
of life,” Dr. Pansak
explains. “Andropause
affects a man’s self-esteem
and how he relates to
others. Men with hormone
deficiency often feel
frustrated, irritable,
subdued and pessimistic.
Their muscles contract
while body fat increases.
They often experience
insomnia, emotional
turbulence, less-sharp
thinking, a decreased
sex drive and erectile
dysfunction. Serious cases
can eventually lead to
clinical depression.”
Andropause affects
more than just testosterone. “All hormones experience a decline,”
Dr. Pansak continues. “One of the first to decline is melatonin,
the so-called ‘hormone of the night.’ Melatonin is normally
secreted after sundown and helps a person feel sleepy as bedtime
approaches, allowing y man, the pituitary gland produces a
variety of hormones during deep sleep. The first of these is the
growth hormone which preserves one’s youthfulness and
counters the aging process.”
"The thyroid gland then produces a hormone that converts
food into energy,” explains Dr. Pansak. “A healthy thyroid
hormone function gives a man energy to enthusiastically engage
in activities. The adrenal gland produces the antioxidant
hormone DHEA that slows the aging process.”
The male sexual hormone testosterone is the last hormone
produced. “This hormone helps one think decisively, reasonably
and positively as a healthy man should,” says Dr. Pansak. “It
also supports bone and muscle strength and regulates body fat
and body contour. That’s why men with normal hormone levels
usually don’t have a ‘beer belly.’ Their bodies are strong and
their mood is good.”
THE DANGERS OF MALE HORMONE
DEFICIENCY
If left untreated, male hormone deficiency poses a number
of potentially serious health risks, including fragile bones, weak
muscles, erectile dysfunction, hypertension,
heart disease and stroke.
“With decreased hormone levels,
body fat increases and accumulates
around the waistline,” notes Dr.
Pansak. “The ‘beer belly’ is one
sign of male hormone
deficiency. The criterion is a
waistline in excess of 94
centimeters for westerners
and 90 centimeters for
easterners.”
BEER BELLY
DANGERS
While most of us are
aware of the health risks
that come with being
overweight, the specific
dangers for men with
excessive fat accumulation
around the waist are less
well understood, but no less serious.
“Think about it: When a man has a ‘spare tire’

around his waist, he’s unlikely to have the energy or the desire to
stay active,”
Dr. Pansak explains. “This lack of activity means he’s not using
enough energy to burn his daily calorie intake, and that leads to
even more fat buildup. This increased fat clogs blood vessels and
leads to hypertension. It can also cause dyslipidemia, the condition
of having too much ‘bad’ cholesterol and not enough ‘good’
cholesterol. This can significantly raise a man’s risk for stroke,
a potentially deadly condition.”
This unhealthy state can also affect a man’s sexual health.
“Clogged blood vessels affect the supply of blood to the genitals,”
says Dr. Pansak. “This can cause erectile dysfunction. Excess fat
accumulates in the genital muscles, further worsening the
symptoms. This is a prime example of how the body’s many
systems are interconnected.”
Dr. Pansak stresses the importance of consulting a doctor at
the first sign of difficulty in achieving a normal erection. “Your
doctor may recommend a hormone level test to check for possible
deficiencies,” he explains. “Your doctor can recommend a
treatment strategy for sexual impotency as well as other steps
to address one’s overall health situation.”
TREATING HORMONE DEFICIENCY
Hormone Supplement Therapy
The old saying “Getting old is natural, feeling old is
optional” certainly applies to male hormone deficiency. Today’s
modern lifestyles are far different from earlier generations.
People tend to spend more time working and less time sleeping,
and most of us endure greater stress from everyday living. Our
fast-paced world leads to eating on-the-run and sleeping just a
few hours a night, while leaving less time for exercise and
relaxation. These factors all contribute to premature hormone
deficiency.
6
Dr. Pansak shares his experience: “I see more and more
men in their 30s who come to me because of loss of sexual
desire and erectile dysfunction, hair loss or obesity. Dealing with
their problems requires a holistic approach, to diagnose and treat
the full range of health issues to produce a successful treatment
outcome.”
“Sexual impotency is an important indicator of male health
problems, so we have to check blood sugar and body fat levels,
hormone levels, the health of the prostate gland, and understand
a patient’s lifestyle and family history to see what changes may
be needed,” says Dr. Pansak. “Hormone supplement therapy is
often recommended as part of the treatment plan. After a period
of taking hormone supplements, patients usually experience
noticeable improvements to their health and wellness, which are
often accompanied by weight loss and improved sexual function.
A patient’s mood and overall happiness usually also improves.”

Hormone supplement
therapy has an impressive
record of safety for
effectively treating
men suffering from
andropause. All medical
treatments and
procedures involve
some level of risk
and may not be
suitable for everyone.
Your doctor will
explain the risks
involved and
recommend the
course of treatment
that’s right for your
individual situation.
Lifestyle Modification
Dr. Pansak emphasizes the hormone-related differences
between men and women. “The female body stops producing
female hormones during menopause,” he explains. “Replacement
therapy is usually recommended to mitigate the negative effects.
On the contrary, the male body never stops producing male
hormones. The levels of hormones decline, but they can be
restored. Doctors will advise their patients on specific lifestyle
changes that can help increase hormone production. For some
patients usually older men with greater hormone deficiency
doctors will also prescribe male hormone supplements to be
taken on a regular basis.”
There are simple guidelines that all men can follow to
improve their overall health and limit the effects of hormone
deficiency. Dr. Pansak recommends:
going to bed early enough to ensure that you fall into deep
sleep by midnight;
exercising most days for 45 minutes per workout (or 300
total minutes each week) as opposed to the 30 minutes-perworkout
guideline for the general population;
eating a healthier diet;
adopting a positive attitude in order to avoid depression
and insomnia.
According to Dr. Pansak, unhealthy living is often the
biggest single factor in causing male hormone deficiency. So
making healthy lifestyle changes under the supervision of a
medical specialist can prove highly effective in returning to
better health. Middle age really can be the beginning of a
happier, healthier life. As the famous comedian George Burns
said, “You can’t help getting older, but you don’t have to
get old.”
Do you have hormone
deficiency? Find out by
taking this quiz.
Are you experiencing these symptoms?
Sexual health:
Yes
1. Decreased sex drive
2. Difficulty achieving and/or
maintaining an erection
General health:
3. Decreased strength and stamina
4. Fatigue or lack of energy
5. Depression
6. 'Shrinking' or having a hunched back
7. Difficulty concentrating at work
8. Feeling unhappy or pessimistic about life
9. Decreased athletic capabilities
10. Falling asleep or nodding off
during the day
If you answered YES to questions 1 or 2, or if you
answered YES to at least 3 of the general health questions,
you may be experiencing male hormone deficiency. Consult
your doctor for a physical examination and a hormone level
test.
No
8

Q & A
In survey after survey, men report that
declining sexual performance is one of their
greatest fears about getting older. As part
of our focus on men’s health issues, Better Health
answers some important questions from readers
about erectile dysfunction (ED).
Q: What are the most common myths and misconceptions
about ED?
A: One common misconception is that emotional and
psychological problems are the
main causes. In truth, it’s just the
opposite; research has shown that
physical causes account for over
80% of ED cases.
Another popular myth is that
ED is an unavoidable part of the
aging process. Yes, a man’s hormone
levels diminish with age, and he
may need more stimulation to
achieve a healthy erection. But age alone does not cause ED.
Q: What are the most common causes of ED? What are the
key risk factors?
A: Difficulty achieving an erection can be caused by any number
of factors, either physical, psychological, or a combination of the
two. A number of medical conditions are known to cause ED,
including some arterosclerosis, heart and vascular diseases,
diabetes, prostate conditions including enlargement and cancer,
diseases affecting the nerves and brain (e.g. multiple sclerosis,
Parkinson’s disease, Alzheimer’s disease), and vascular conditions
that affect blood vessels and circulation.
Unhealthy living excessive stress, obesity and poor
nutrition, lack of exercise, tobacco use, excessive alcohol
consumption and drug use, among others can lead to ED. It’s
also a potential side effect resulting from a number of prescription
medications, medical procedures and surgeries.
Age also plays a role; studies show ED affects about one
out of 20 men aged 40, but about one out of four men aged 65.
ED can also be a symptom of a potential undiagnosed
medical condition; which is one of many reasons why it is
important for men to talk to their doctor about ED.
Q: What treatment options are most effective?
A: There has been tremendous progress in the number and
effectiveness of treatments for ED. The best treatments include
medications (taken orally), penile implants, and penile pumps.
Doctors often recommend lifestyle modifications such as exercise,
smoking cessation, and stress reduction, all of which help
improve erectile function and overall health.
Q: What advice should be
given to men who may be
suffering from ED but are
reluctant to seek help?
A: Men should know that
it’s normal to feel anxious
about talking to your doctor
about ED. Men have always
been less likely than women
to make regular doctor visits, and there’s a stigma in almost
every society that men should be able to handle their problems
by themselves, and that feeling vulnerable or seeking help is a
sign of weakness.
Doctors have been successfully treating men with ED for
many years. With even more effective treatment options available
now, whatever anxiety men may feel about seeking help always
pales in comparison to the anxiety and potentially serious
medical problems that can result from not seeking help.
10
Have a question? You can submit your question for possible inclusion in future issues of Better Health, by e-mail
betterhealth@bumrungrad.com or by mail to Editor, Better Health Magazine, Bumrungrad International, 33 Sukhumvit 3,
Wattana, Bangkok 10110 Thailand.
In the next issue: The next issue of Better Health will be published in October. Be sure to submit any questions
>>for possible inclusion no later than September 25, 2008.

P R O S T A T E H E A L T H
A Proactive Approach
to Prostate Health
As a man enters middle age, his risk of developing prostate problems increases significantly.
Following is a look at what every man should know about potentially serious prostate conditions,
and the proactive steps that can be taken to reduce your own risk.
M
en and women are different when it comes to matters
of health. Though the aging process increases the risk
of health problems for both men and women, male
life expectancy remains several years shorter, and men remain
less likely to see a doctor for regular check-ups or when health
problems arise.
With the help of Dr. Apichart Kongkanan, a board-certified
urologist with vast experience treating men with prostate conditions,
Better Health looks at the important issues every man should
understand about prostate health.
THE PROSTATE’S IMPORTANT ROLE
The prostate is the walnut-size reproductive gland located
below a man’s bladder that plays an important role in sexual
health and reproduction. During ejaculation, the prostate gland
produces whitish seminal fluid that protects sperm produced by
the testicles. Unlike other organs and glands, the prostate doesn’t
stop growing in early adulthood.
“Normally, body organs reach full size after a man’s
transition from adolescence to adulthood around his early 20s,”
Dr. Apichart explains. “However, the prostate continues to grow.”
Just how much it
Beginning at age 40,
men should have
regular annual
prostate check-ups
grows depends
on the level of
testosterone, the
male sex hormone
which usually
declines as a man
ages.
Declining
testosterone levels
can lead to an unhealthy enlargement of the prostate gland the
less testosterone sent to the prostate, the more the enzymes in
the prostate convert testosterone to Dihydrotestosterone (DHT),
which is the hormone responsible for prostate enlargement and
cause one or more prostate diseases.
CANCER AND OTHER PROSTATE DISEASES
When the prostate becomes enlarged, it may begin pressing
against the urethra, leading to urinary control problems, painful
or uncomfortable urination, and/or the presence of blood during
urination. In serious cases, cancerous tumors may begin to form
in the prostate, and if left untreated, the cancer may spread to
12
other areas of the body. In most parts of the world, prostate
cancer is the leading type of cancer among men.
Men should see their doctor at the first sign of abnormal
urinary function as this may be a symptom of one or more of
the following prostate conditions:
Prostatitis
The term prostatitis means inflammation of the prostate
gland. It is often found in men between the ages of 30 to 50 and
can result from both bacterial and non-bacterial causes. Prostatitis
is not considered contagious.
Bacterial prostatitis is usually the result of bacteria entering
the prostate through the urinary tract. Typical symptoms include

fever, chills, muscle aches, pain in the penis and/or testicles, and
abnormal urination.
The symptoms of non-bacterial prostatitis are similar to
those of bacterial prostatitis but the source of the infection may
be difficult to identify.
Prostate Enlargement (Benign Prostate Hypertrophy)
This condition typically affects men beyond the age of 40
who have reduced levels of testosterone. Patients usually fall into
one of two groups based on whether they show obstructive or
irritative symptoms. Obstructive symptoms include weak or
intermittent urinary stream, hesitation before urine flow begins,
or a feeling that the bladder has not emptied completely. Irritative
symptoms include an increased frequency of urination, urgent
need to urinate, and bladder pain or irritation while urinating.
Prostate enlargement is usually not life threatening, but its
symptoms can have a major impact on a man’s quality of life.
Prostate enlargement may lead to kidney problems including
kidney stones and further loss of bladder control.
Patients with mild
symptoms are usually
treated through
a combination of
lifestyle changes and
medication. Doctors
often recommend
reducing liquid
consumption
in the evening
hours, cutting
back on alcoholic
and caffeinated
beverages, and
avoiding medications
such as decongestants
which can increase the desire to urinate. A number of prescription
medications have been proven safe and effective in treating
overactive bladders.
Prostate Cancer
Prostate cancer occurs when cancerous cells within the
prostate grow and divide abnormally to form malignant tumors.
Age and family history are key risk factors in developing prostate
cancer; a man’s risk increases significantly after the age of 40,
and having a father or brother who has had prostate cancer
increases a man’s own prostate cancer risk.
Prostate cancer especially when detected early is
treatable and curable. As the cancer cells grow and press against
the urethra, they typically produce symptoms such as frequent
urination, difficulty or pain during urination, or the presence of
blood in the urine. In serious cases, the cancer eventually spreads
to the lymph nodes, bones or other organs where it becomes
difficult to treat and impossible to cure.
PREVENTING
PROSTATE PROBLEMS
As with so many other
medical problems, prevention
and early detection are the
most important steps a man
can take to avoid prostate
problems. “Beginning at the
age of 40, men should have
regular annual prostate
check-ups, because prostate
cancer in its early stage is
highly treatable, but it may
not cause any symptoms,”
Dr. Apichart says. “Moreover,
men should see their doctor
immediately if they encounter any
urinary problems don’t wait until your next check-up!”
Good nutrition habits can lower one’s risk of developing
prostate problems. “Cooking with oils like olive oil and peanut
oil, which are high in monounsaturated fats, can promote prostate
health,” Dr. Apichart says. “Other healthy choices include eating
fish like mackerel and salmon that are rich in cancer-fighting
omega-3 fatty acids. Vegetables containing Allyn Sulfur,
including garlic, onions, chive and soy protein, have been found
to have cancer-fighting properties. And avoid high fat foods as
they can increase one’s risk of prostate cancer and other serious
conditions.”
“The key to good prostate health is to maintain good overall
health, and pay attention to signs of potential prostate problems,
especially urinary tract symptoms,” Dr. Apichart recommends.
“And get in the habit of regular doctor visits, because preventing
illness is always easier than treating it.”
How is prostate cancer
diagnosed?
Digital Rectal Exam (DRE) the doctor places a finger
inside the rectum to check for changes to the size and
surface of the prostate.
PSA (prostate-specific antigen) Test this blood test
measures the level of a naturally-occurring protein
produced by the prostate. High or increasing levels can
indicate the presence of prostate cancer.
Ultrasound the prostate can be examined through a
type of ultrasound called transrectal ultrasonography. A
tube inserted into the rectum transmits sound waves to
the nearby prostate, producing a computerized image.
Biopsy if diagnostic tests and symptoms suggest
prostate cancer, the doctor will perform a prostate
biopsy, a technique in which a small sample of tissue is
removed through a tiny needle and examined under a
microscope to check if the cells are malignant.
13

PET CT
New Innovation = Earlier, More Precise Cancer Detection
very year, cancer claims the lives of millions of
people. It continues to be a leading cause of death
among Thais. But it doesn’t have to be that way. Many
types of cancer are treatable and curable if detected early.
Recent advances in
technology are helping detect
cancerous cells earlier and
with greater precision and
accuracy, making it possible
to save potentially millions of
lives. One of the most exciting
innovations in cancer detection
is PET/CT (Positron Emission
Tomography / Computed
Tomography) technology. In
the few short years since its
introduction, PET/CT has
become one of the most highly
effective tools for early detection
of cancerous cells.
PET/CT provides an
anatomical map of the body
with 64 slices per revolution in
only 0.33 seconds. It produces
high resolution 2-dimensional
and 3-dimensional images
capable of revealing even tiny
traces of cancerous tissue - as
small as 3 millimeters in size. Its effectiveness helps doctors
to plan medical treatments and schedule suitable to each
patient individually.
Dr. Narongsak Kiatikajornthada, Hematology and
Oncology specialist at Bumrungrad International Hospital,
explains how PET/CT technology is used to pinpoint the
exact location and size of tumors and to quickly determine
the exact stage of cancer. “The procedure begins with an
injection of FDG, an analog
of glucose that is tagged
to the radionuclide F18,”
Dr. Narongsak says. “Tumors
trap more FDG than other
organs, so PET/CT can identify
gamma rays in the rapidly
growing tumors. This helps
doctors to detect and diagnose
cancer faster and easier.”
The scanner pinpoints the
exact location of tumors that
may have gone unnoticed by
other CT or MRI diagnostic
tools. Besides cancer, PET/
CT can also detect some
brain diseases such as
Alzheimer’s disease and
epilepsy.
With early detection being
among the most important
factors for successful cancer
treatment, Bumrungrad
patients are already reaping significant benefits through
more successful and less traumatic treatment regimens.
14

H D R B R A C H Y T H E R A P Y
HDR Brachytherapy –
An Effective Alternative
for Treating Prostate Cancer
Learn more about this revolutionary way of utilizing
radioactive materials to combat localized cancer.
P
rostate cancer is the most common cancer among men
worldwide, and according to Thailand’s National Cancer
Institute, it is the ninth leading cause of death among
Thai men. There are several ways to treat prostate cancer,
depending on the stage of the disease and the patient’s symptoms.
Widely-used treatments include surgery, chemotherapy and
external-beam radiation therapy. Among the newer and most
exciting treatment advances is High Dose Rate (HDR)
Brachytherapy, which uses radioactive seed implants to shrink
prostate cancer tumors with better treatment outcomes and fewer
complications than earlier generation radiation treatments.
RADIOACTIVE SEED IMPLANTS
Radioactive seed implantation is an increasingly popular
choice for treating and curing prostate and other types of cancer.
“Implanting radioactive seeds is one of the minimally-invasive
techniques that is suitable for patients whose cancer is still
localized within the prostate gland,” says Radiotherapist
Dr. Apichart Panichchivaluck.
During the implantation procedure, the doctor first
measures the volume of the patient’s prostate gland to properly
calculate the necessary radiation dosage. Tiny radioactive seeds
are then inserted through catheter tubes into the prostate gland,
where they emit radiation that destroys the cancerous cells. There
are two main methods of prostate brachytherapy: permanent seed
implantation and high dose rate (HDR) temporary brachytherapy.
“Permanent seed implantation is typically used when the
prostate cancer is the low-risk localized type,” Dr. Apichart
explains. “Permanent seed implants involve injecting radioactive
seeds which give off radiation at a low dose rate to kill cancer
cells over several weeks or months, while the seeds remain in
the prostate gland permanently.”
HIGH DOSE RATE (HDR) TEMPORARY
BRACHYTHERAPY
For patients with an intermediate or high risk localized
prostate cancer, doctors usually choose high dose rate radioactive
seeds (High Dose Rate Brachytherapy, also known as temporary
brachytherapy). “The HDR implant employs different radiation
sources than permanent seed implantation,” says Dr. Apichart.
“There is also the probability for patients with prostate cancer at
this stage that the cancer has spread beyond the capsule of the
prostate gland. HDR temporary brachytherapy involves placing
very small plastic catheters into the prostate gland. A series of
radiation treatments is performed by pushing radioactive seeds
into the catheter using a computer-controlled machine under
Transrectal Ultrasound Guidance (TRUS). This helps control the
radiation dose in different regions of the prostate. After the catheter
is removed, no radioactive material is left in the prostate gland.”
The ability to modify the radiation dose after the catheters
are in place is one of the main advantages of temporary brachytherapy
compared to permanent seed implants. HDR brachytherapy is
highly effective in the treatment of intermediate to high risk
localized prostate cancer, and is also useful in the control of localized
recurrence. It has also been reported that HDR brachytherapy
can achieve survival rates above 90% in prostate cancer patients,
while the side effects such as urgency to urinate, frequent urination,
and erectile dysfunction have been shown to be much lower
than with other types of treatments.
15

H E A L T H B R I E F S
Men Still Reluctant to Get Tested
for Colon Cancer
Even when it’s free, men are still less likely to have a colon
cancer screening test that could ultimately prove life-saving. That’s
the finding of a Swedish research study whose results were
reported in the International Journal of Cancer.
Researchers offered free sigmoidoscopy screening tests to
nearly 2,000 adults between the ages of 59 to 61 [Sigmoidoscopy is
one of several screening tests that help detect the presence of colon
cancer and pre-cancerous polyps]. Routine screening for colon
cancer is generally recommended for adults starting at age 50, and
sooner for people considered at higher risk for the disease.
Men were nearly 30% more likely than women to decline the
test. Differences were also found between single and married
adults; unmarried or divorced men and women were much less
likely to be tested compared to married adults.
The results of the Swedish study were consistent with other
research that also found men to be more reluctant than women to
have health screening tests; men tend to be less knowledgeable
about health and less likely to take preventive measures like
screening tests.
Exercise May be
the True ‘Fountain
of Youth’
Aging ungracefully can
mean wrinkles, weak bones and
muscles, and a losing struggle to
keep off unwanted extra weight.
According to Dr. Pravee Sirithientas, sports medicine
specialist at Vitallife Wellness Center, aging results from
a decline in the body’s production of human growth
hormone the naturally-occurring substance that promotes
healthy cell growth. The hormone promotes smoother skin,
fights body fat, and helps build muscle mass. However, the
jury is still out on growth hormone therapy due to potential
side effects and high cost.
Exercise may be the best choice to safely slow the aging
process. And even moderate exercise walking or gardening
for 30 minutes can deliver impressive health benefits.
Adding vitamins and nutrition supplements can further
stimulate the production of human growth hormone,
providing an additional boost to an anti-aging regimen.
Exercise is also a great way to enhance brain function
well into old age. Be sure to talk to your doctor before
starting any new exercise or vitamin program.
Battle of the Bulge: Number of Fat Cells may be
Set Early in Life
As the old saying goes, “The only thing harder than losing weight is keeping it off.” A new
study on fat cells may help explain why that sentiment rings true. Scientists in Sweden studying
how the number of fat cells change over time reported that the number is set during adolescence
and then remains unchanged throughout adult life even after drastic weight loss.
At the beginning of the study, researchers measured the number of fat cells in groups of
children, adolescents and adults. They found that fat cell numbers increased throughout childhood
and adolescence, but by the beginning of adulthood, the number reached its peak and remained
constant.
The next phase of the study measured the number of fat cells in people before and after
undergoing major weight loss through a procedure called gastric banding. While the procedure
can lead to weight loss in excess of 100 kilos, the study showed the number of fat cells hardly
changed.
The findings, first reported in the journal Nature, aren’t good news for people struggling
to lose unhealthy excess weight; rather, they further reinforce the importance of developing and
sticking to healthy diet and exercise habits beginning early in life.
16

N E W S F R O M B U M R U N G R A D I N T E R N A T I O N A L
A New Era of Care Begins at the
Newly-Opened Bumrungrad
International Clinic
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F
ollowing its July 31 grand opening, the brand new
53,000-square meter Bumrungrad International Clinic is
now delivering an unrivaled patient experience in a warm,
comfortable and friendly environment.
The 22-storey building was designed to be the ideal place
for patients and doctors to meet for consultations and medical
services. The clinic is equipped with world-class medical
technology and equipment and offers a full range of facilities,
including spacious lobby and seating areas, an international food
center, retail shops, and a lounge for Bumrungrad patients and
Healthy Living Club members.
The Bumrungrad International Clinic delivers on its
promise of a one-stop, one-location service with ease and
convenience from start to finish. New technology delivers more
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1. Spacious lobby
2. Clinic reception area
3. The new 22-storey Bumrunrad International Clinic
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streamlined patient registration and online medical records
availability. More convenience is offered with diagnostic imaging
services available right inside patient consultation rooms, and
expanded laboratory automation to provide faster and more
accurate test results. Patients can even pay their bills and pickup
prescribed medicine on the same floor.
With the opening of the new outpatient building,
Bumrungrad International is Thailand’s largest private hospital,
with 250 outpatient consultation rooms and the capacity to
welcome up to 6,000 patients each day.

N E W S F R O M B U M R U N G R A D I N T E R N A T I O N A L
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4. Comfortable seating area
5, 6. International food center
7. View from the Sky Lobby
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The Bumrungrad International Clinic incorporates many
medical services and specialist centers, including:
Medical Coordination Center
Health Screening Center
Respiratory Efficiency Testing
Rehabilitation Center
Surgical Clinic
Men Center
Endocrinology services
Nutrition therapy
Diagnostic radiology
Heart Center
Dialysis
Specialists in infectious disease, lung disease, internal
medicine, allergies, orthopedics and rheumatism, hematology,
urology, neurology, neurosurgery and breast surgery.
Bumrungrad International now serves more than 1.2 million
Thai and international patients each year from 190 countries all
over the world and is acknowledged as a pioneer in Medical
Tourism. More recently, The Wall Street Journal Asia named
Bumrungrad one of the best companies in Thailand.
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N E W S F R O M B U M R U N G R A D I N T E R N A T I O N A L
Healthy Living Club
A Health and Wellness
Member Program
L
iving a healthy life doesn’t just mean eating
healthy foods and getting some regular exercise;
it’s also about having access to health experts and
useful advice to stay in good health at any age. And
that’s what being a Healthy Living Club member is all about.
Bumrungrad International Hospital is pleased to
introduce you to the Healthy Living Club the first
membership program designed especially for Thai citizens
and expats who live in Thailand. The Healthy Living Club
provides a three-year membership with many valuable
privileges, including:
30% discount for inpatient room charges (effective
7 days after membership acceptance)
15% discount for outpatient medication and medical
supplies (chemotherapy and special medical supplies
not included), laboratory fees (not applicable to special
laboratory procedures) and X-rays (effective immediately
upon membership acceptance).
Club members also enjoy free Wi-Fi Internet service,
Sky Lounge access, and a free home delivery subscription
to Better Health magazine. Healthy Living Club members
are also entitled to pre-book seats for health seminars
and events, along with receiving discounts from hospital
retail shops.
All these privileges are included in the one-time
membership fee of Baht 6,300. For the primary member
card, you will instantly receive a voucher for an Executive
Program Health Check valued at Baht 6,300. Supplementary
memberships for spouse and family members are Baht
3,000, and each supplementary member will receive
a voucher redeemable for Baht 3,000 discount for
an Executive Program Health Check.
A healthier lifestyle and many more privileges
await you at Bumrungrad International.
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For more information, please call 0 2667 1000 or visit www.bumrungrad.com