Written by Dr. Andrew Siegel
Some urological medical myths are perpetuated by the general (non-medical) community, consisting of erroneous beliefs and inaccurate presumptions. These falsehoods often require a great deal of physician time in an effort to disabuse patients of them.
Myth 1: A vaccine caused my child’s autism.
(This is a non-urological myth, but nonetheless needs to be addressed.)
Myth: Vaccines, particularly MMR (measles, mumps, rubella) cause neurological injuries including autism spectrum disorder.
Reality: Scientific evidence overwhelmingly shows no correlation between vaccines in general, MMR vaccine in specific, and thimerosal (a mercury-based preservative) in vaccines with autism spectrum disorders or other neuro-developmental issues.
We have come a long way on the immunization and vaccination front, wiping out a significant number of diseases completely. In children, vaccines have been among our most effective interventions to protect individual as well as public health. What a great means of reducing risk for certain infections that are potentially lethal, if not capable of incurring significant morbidity. Vaccinations are now available for hepatitis A and B, diphtheria, tetanus, pertusis, polio, hemophilus, measles, mumps, rubella, varicella, meningitis, cervical cancer/human papilloma virus, influenza and pneumococcal pneumonia and herpes zoster (shingles).
Myth 2: Doing a prostate biopsy will spread any cancer that may be present.
Myth: Using a needle to obtain tissue samples of the prostate allows cancer cells to seed and implant along the needle track, or alternatively, into blood or lymphatic vessels.
Reality: Although this is a theoretical consideration, the truth of the matter is that based upon millions of prostate biopsies performed annually in the USA, the incidence of seeding is virtually non-existent and the potential risk can be thought of as being negligible at best.
Myth 3: Cancer spreads when exposed to oxygen.
Myth: When a body is opened up and exposed to oxygen any cancer present can readily spread.
Reality: There is no scientific evidence that supports cancer advancing because of exposure to air/oxygen. At times, upon doing an exploratory surgery, more cancer is discovered than was anticipated based upon imaging studies. This has nothing to do with the surgical incision nor exposure to air/oxygen, but is simply on the basis of cancer that did not show up on the diagnostic evaluation.
Myth 4: All prostate cancer is slow growing and can be ignored.
Myth: Prostate cancer grows so slowly that it can be disregarded.
Reality: Every case of prostate cancer is unique and has a variable biological behavior.
Yes, some cancers are so unaggressive that no cure is necessary and can be managed with surveillance. However, others are so aggressive that no treatment is curative, and many are in between these two extremes, being moderately aggressive and highly curable. A major advance in the last few decades is the vast improvement in the ability to predict which prostate cancers need to be actively treated and which can be watched, a nuanced and individualized approach.
Those who feel that prostate cancer should not be sought out and treated should be attentive to the fact that prostate cancer is the second leading cause of cancer death, with an estimated 30,000 deaths in 2018, and furthermore, that death from prostate cancer is typically an unpleasant one.
Myth 5: Drink lots of fluids to flush out kidney stones.
Myth: Drinking copiously will help promote passage of kidney and ureteral stones. The rationale of this advice is that by hydrating massively, a head of pressure will be created to help passage of a stone present in the kidney or ureter.
Reality: The presence of a stone often causes urinary tract obstruction. Over-hydration in the presence of obstruction will further distend the already bloated and inflated portion of the urinary collecting system located above the stone. This increased distension can exacerbate pain and nausea that are often symptoms of colic. The collecting system of the kidney and the ureter have natural peristalsis—similar to that of the intestine—and over-hydration has no physiological basis in terms of helping this process along, being pointless and perhaps even dangerous. Drinking moderately in the face of a kidney or ureteral stone is sound advice.
Myth 6: Everyone must drink 8-12 glasses of water a day.
Myth: Many sources of information (mostly non-medical and of dubious reliability) dogmatically assert that humans need 8-12 glasses of water daily to stay well hydrated and thrive.
Reality: Many people take the 8-12 glass/day rule literally and as a result end up in urologists’ offices with urinary urgency, frequency and often urinary leakage. The truth of the matter is that although some urinary issues are brought on or worsened by insufficient fluid intake–including kidney stones and urinary infections–other urinary woes are brought on or worsened by excessive fluid intake, including the aforementioned “overactive bladder” symptoms. Water requirements are based upon ambient temperature and activity level. If you are sedentary and in a cool environment, your water requirements are significantly less than when exercising vigorously in 90-degree temperatures.
Humans are extraordinarily sophisticated and well-engineered “machines” and your body lets you know when you are hungry, ill, sleepy, thirsty, etc. Heeding your thirst is one of the best ways of maintaining good hydration status, in other words, drinking when thirsty and not otherwise. Another method of maintaining good hydration status is to pay attention to your urine color. Urine color can vary from deep amber to as clear as water. If your urine is dark amber, you need to drink more as a lighter color is ideal and indicative of satisfactory hydration.
Bottom Line: General and even medical populations are subject to medical myths—mistaken beliefs that are often passed down like memes with little to no basis in fact. These myths have no place in the art and craft of medicine and need to be challenged with real science.