Dear doctor

Prostate surgery fears

Q: I am 53 and was recently diagnosed with prostate cancer. I am due to have major surgery, which I understand may make me impotent and incontinent. My wife heard about a treatment called gene therapy that sounds much less drastic. Would it be suitable for me and how can I find out about it?

A: As you say, current prostate cancer treatments have risks, so there is lots of work on less aggressive methods. Researchers at the Queen Elizabeth hospital in Birmingham are set to inject a genetically modified form of the common cold virus (adenovirus) into prostate cancer cells. It enters the cancer cells then makes a chemical that activates a drug which kills cancer cells. It is hoped that this method will be used in frail men for whom surgery may be dangerous or when radiotherapy has not worked. It seems unlikely that it will replace surgery for younger men such as you and it remains to be seen how safe and effective it is.

Pigment problem

Q: About four months ago I had a skin graft to my lower leg. I have been told the graft and donor areas will eventually fade but there will always be a difference in skin colour between the damaged and undamaged areas. Can anything be done to improve the appearance, for example using lasers?

A: The graft will lose its shiny, pink look and look less obvious than it does now. Lasers can't reliably restore pigment to a skin graft. Camouflage make-up or fake tan may be your best bets. The Red Cross offers a wonderful service to show you how to apply camouflage creams matched to your skin colour. They're waterproof and can stay on for two to three days. You need to be referred by a consultant or GP and the service is free, though you will be asked to make a donation. For details of your nearest Red Cross skin camouflage service, look in the phone book or visit

Menstrual tension

Q: For my last four menstrual cycles, the blood has been very dark red/brown. The period only lasts about three days (it used to be five) and isn't painful. I don't have any bleeding outside my periods. I recently had a normal smear test and feel healthy, but this worries me. What could be the problem?

A: There is no problem. When you bleed fairly heavily, it tends to drain out of the uterus quickly and you see fresh red blood. If the bleeding is less heavy, it sits in the uterus for longer; by the time you see it the blood's red pigment has started to break down and it looks brownish. Your periods are short, light and painless - thank heaven for small mercies and don't worry at all!

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