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One of the most confusing things about being diagnosed with early stage prostate cancer is choosing if and how to treat it. Unlike other cancers that have one or two standard treatment options, acceptable approaches for prostate cancer are more numerous. Each has different pros and cons and the decision about how to proceed needs to be customized to each man, depending on his age, his general health, and the severity of his early prostate cancer. Treatment options · Radical prostatectomy is the surgical procedure that removes the prostate gland. The operation is traditionally performed through a vertical incision made in the pelvis. The man needs to be admitted to the hospital and recover for several days. The most worrisome potential long term side effects are urinary incontinence and impotence. A new technology is available: robotic laparoscopic prostatectomy. This method entails making five small incisions instead of one larger one. The recovery is expected to be faster and easier than with the traditional procedure. · Radiation therapy has a cure rate comparable to that of surgery. The two forms of radiation therapy are external beam and brachytherapy, pronounced bray-kee-ther-uh-pee. o External Beam Radiation Therapy entails the use of a radiation treatment machine, most commonly, a linear accelerator. Using sophisticated treatment planning computers and devices built into the linear accelerator, the radiation beams deliver a very precise dose of radiation to the intended area while sparing the normal surrounding structures, such as the rectum and bladder. By using 3-D conformal radiation therapy, the radiation beams conform to, or match the shape of the tumor. Intensity modulated radiation therapy, also known as IMRT, is a refinement of 3-D conformal radiation therapy. It uses multiple, tiny beamlets, instead of a single radiation beam. IMRT beamlets can be understood by visualizing it as multiple, tiny mosaic tiles of different hues of blue; the tumor receives the dark blue beamlets, whereas the tissue near the rectum and bladder receives the beamlets of the palest shade of blue. This way, the intensity of each tiny beamlet is modulated. IMRT has enabled radiation oncologists to deliver much higher doses of radiation therapy to the prostate with fewer complications to the rectum, resulting in higher cure rates. Temporary and early side effects include the need to urinate frequently, diarrhea, abdominal cramping, and fatigue, which is usually not severe. Side effects that can develop months to years later include urinary incontinence and erectile dysfunction, albeit a significantly lower incidence than with surgery. With the advent of IMRT, the risk of rectal injury that can cause rectal bleeding is uncommon. o Prostate Seed Implants introduce multiple radioactive pellets smaller than grains of rice into the prostate gland. The prostate gland then receives a substantial dose of radiation, but the surrounding tissues receive virtually none. This option is very attractive to men who are concerned about maintaining potency. Also, for men who do not have a significant risk of the cancer penetrating through the capsule that envelopes the prostate, a prostate seed implant can serve as the only form of therapy. However, men whose tumors fall into a higher risk category cannot be treated solely with a prostate seed implant, and need to supplement it with external beam radiation therapy, albeit a briefer course of treatment than in men who receive only external beam radiation therapy. The disadvantages of brachytherapy include the fact that the radioactive seeds take several weeks to decay to the level of background radiation; during this time, men need to refrain from getting close to pregnant women and small children. Also, there is a low risk of rectal irritation in the short and long run. Infrequently, the need to urinate frequently can persist. Incontinence and impotence are relatively rare. The risk of a channel forming between the urinary tract and the rectum, also known as a rectal fistula, can cause urine to leak through the rectum. This complication is rare, fortunately, and can be repaired surgically. · Cryosurgery involves freezing the prostate tissue with liquid nitrogen. Via the guidance of an ultrasound probe inserted in the rectum, needles are guided into the prostate, by piercing the skin between the scrotum and the anus. Short term side effects include blood in the urine for several days, soreness of the surgical area, swelling of the penis and scrotum, urinary burning, and frequency of urine and bowel movements. Late complications include nerve damage that can result in impotence and rarely, the formation of a fistula. Also, the long-term success rate is not well known. · Hormone Therapy is also known as androgen deprivation therapy (ADT). Prostate cancer thrives on testosterone. By depleting testosterone, prostate cancer cells die. ADT has never been demonstrated to be a curative modality, but it is useful in holding the disease at bay for some time. Its other role is in shrinking the prostate prior to surgery or radiation therapy. Side effects are those of “male menopause”, such as hot flashes, weight gain, decreased mental acuity and depression. Other potential adverse effects include osteoporosis, anemia, breast enlargement, fatigue, diminished good cholesterol and loss of muscle mass. · Watchful waiting is a reasonable choice for men who have a short life expectancy, as well as for those men who have very slowly growing prostate cancer and will most likely not die from prostate cancer but rather, from some other more life threatening problem. The down side of watchful waiting is the psychological implication that the man’s mortality is looming ahead of him. Although no active treatment is given, men are still followed with digital rectal exams, PSA levels and possibly, transrectal ultrasounds of the prostate. However, with low risk prostate cancer in an elderly man, this might be a fine option. Apparently the spectrum of treatment options is vast, and ranges from doing nothing to undergoing radical surgery. To make the best decision for himself, a man should know his treatment options based on his individual situation and lifestyle. Then, he will be empowered by knowledge as he embarks on his journey into the world of medical opinions. Finally, he should choose an experienced specialist to ultimately treat and follow him. For more information about radiation therapy, check out http://www.ASTRO.org, the official website of ASTRO, The American Society for Therapeutic Radiology and Oncology. Copyright 2006 by Carol L. Kornmehl. All rights reserved. buy penis enlargment pills penile enlargment cream does vimax work penis enlargement excercises penis enlarement excercises pnis enlargement surgery photo penis enlagement surgery cost truth about penis enargement

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Until recently, the very mention of erectile dysfunction or impotence could bring about a blush to even the most manly of men. Embarrassing as it may be, erectile dysfunction affects more than 18 million men in America. It can vary in severity from an inability to achieve, maintain and sustain an erection, to an inability to achieve an orgasm, even though a healthy sexual desire exists. Because of the sensitive nature of this disorder, it often goes unreported. Achieving a normal erection is a complex process. It involves psychological impulses from the brain, adequate levels of testosterone (male sex hormone), a functioning nervous system, and healthy vascular tissue of the penis. Electrical impulses from the brain, when stimulated, cause the nerves in the penis to release nitric oxide. This, in turn, increases the production of guanylate MonoPhosphate (cGMP) in the muscle cells of the corpora cavernosa (the tissue of the penis, consisting of smooth muscles, fibrous tissues, spaces, veins and arteries). The cGMP triggers the muscles of the corpora cavernosa to relax and fill with blood, which causes the penis to expand. Because of the intricate nature of the physiological processes involved, a number of different factors can interfere with a man’s ability to achieve a normal and healthy erection. The most common of these is aging. As a man gets older, his ability to produce nitric oxide decreases, thus affecting the proper functioning of the corpora cavernosa. A number of health issues can also underscore this disorder. The most frequently seen are diabetes mellitus and hypertension. Diabetes, for example, can damage the sensory nerves in the body. In turn, individuals who suffer from hypertension exhibit low nitric oxide production. Other factors that can contribute to erectile dysfunction include cardiovascular disease, nerve or spinal cord damage, cigarette smoking, low testosterone levels, prescription medications, depression, stress and anxiety. Until recently, it was believed that little could be done to help a man who is suffering from erectile dysfunction, but there are a number of natural alternative health remedies that can be tried before having to rely on the “little blue pill”. Recommendations For Wellness If you think your stress, anxiety or depression is affecting you physically, perhaps psychological counseling, meditation, bio-feedback or hypnotherapy can help. If you are taking prescription medications such as MAO inhibitors or anti-hypertensives, talk to your doctor about their possible side effects. Have your hormone levels checked. You might be suffering from low testosterone levels. In some men, low levels of the hormone dehydroepiandrosterone (DHEA) have also been reported. DHEA is essential for the production of testosterone. Quit smoking. Try supplementing with the amino acid L-arginine. Nitric oxide formation depends on sufficient levels of L-arginine in the body and has been found particularly effective for men with abnormal nitric oxide metabolism. Yohimbe bark has a history of helping men with erectile dysfunction. Yohimbe dilates blood vessels and may help regardless of the underlying cause. If you are on prescription medications, talk to your doctor before taking yohimbe. Muria puama can be used to increase the libido and erectile strength. It works best when combined with yohimbe bark. This combination can be found in Nature’s Sunshine’s X-Action for Men. In Mexico, the herb damiana is used as a male aphrodisiac and is an herb traditionally recommended for men with erectile dysfunction. In Peru, maca is known as a potent aphrodisiac. Maca is often called the herbal “Viagra” and does not alter circulation. Instead it works to regulate hormones and bring the body back into balance. Asian (panax) ginseng is an herb that has long been used to support male potency. Sarsaparilla has a history of being used as a tonic for male sexual potency and is thought to assist in the production of testosterone. Some men find relief when taking ginkgo biloba. Ginkgo biloba supports blood circulation and may help by increasing blood flow to the penis. This supplement is not recommended if you are taking any kind of prescription blood thinner. Traditionally used to lessen the symptoms of an enlarged prostate, saw palmetto stimulates a low libido and increases sexual energy. herbal natural penis enlargement penile enlargement surgery cost free penis elargement penis enlagement excercises penis enlarement surgery picture vimax homemade penis enlargement penis enhancement pills product manual penis enlagement penis enlagement cream

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From our deconstruction of hundreds of Hollywood blockbusters at at www.managing-creativity.com The Hero's Journey is the template upon which the vast majority of successful stories and Hollywood blockbusters are based upon. In fact, ALL of the Hollywood movies we have deconstructed are based on this template. Understanding this template is a priority for story or screenwriters. The Hero's Journey: a) Attempts to tap into unconscious expectations the audience has regarding what a story is and how it should be told. b) Gives the writer more structural elements than simply three or four acts, plot points, mid point and so on. c) Interpreted metaphorically, laterally and symbolically, allows an infinite number of varied stories to be created. and more... Transamerica (2005) deconstructed FADE IN: the voice range; this is the voice I want to use. Meeting the Hero: Bree getting dressed. Hero in her Ordinary World: walking out of the house; waiting for the bus. Developing the Hero: the doctor asks questions about her. Motivation / the Elixir: you can sign that consent form. Refusing the Elixir: the doctor is resistant. Hero's Backstory / Foreshadow of the Transformation: my family is dead. Developing the Hero / Elixir: Bree pushes her penis back. Devolved State: Bree is a busboy in the restaurant. Hero's Capabilities / Ordinary World: Bree telemarketing. Call to Adventure: Toby calls. Refusal: Bree tries to ignore the call. Meeting the Mentor: the therapist, Margaret. Pushed toward the First Threshold: Margaret won't give her permission. Resisting: he's probably a scam artist. Time Pressure: I can't delay my operation, the waiting list is a year long. Preparing for the Journey to the First Threshold: thinking about it in her room. First Threshold from Afar: outside the police station. Threshold Guardian: the officer. Backstory of Hero 2: Toby is into drugs and a prostitute. Meeting Hero 2: Toby brought out. Outer Cave: at the restaurant. Middle Cave: inside Toby's room. Foreshadow of the Transformation: maybe I'll be a blonde. Resisting the Inner Cave: Bree calls and lies to Margaret. Inner Cave: Bree agrees to take Toby home. Consciously agreeing to the Transformation: Toby refuses the drugs. Physical Separation: on the road. Journey to the Belly of the Whale: in the car. Resisting the Belly of the Whale: Toby doesn't want to go home. Developing Characters and Relationships: Filling up at the gas station; Toby hides his money. Developing Characters and Relationships: arriving at a hotel; Toby lying naked. Resisting the Belly of the Whale: Toby repeats he doesn't want to go home. Developing Characters and Relationships: waking up in the morning. Developing Characters and Relationships: driving in the car; talking Lord of the Rings. Push to the Belly of the Whale: Turning off to Calcun. Resisting the Belly of the Whale: Toby runs away. Forced to the Belly of the Whale: Grandma gives Toby a hug. Developing Characters and Relationships: grandma plucks out Bree's nasal hair. Pushed to the Belly of the Whale: Bree fetches Toby's step dad. Belly of the Whale: Toby and his Dad have a fight; Dad's been abusing him. Polarization: Bree apologises. Polarization: Toby camps outside. Push to the Physical Separation: Grandma tells Bree that Toby's Ma killed herself. Physical Separation: Toby hitchhiking; Toby getting in the car. Polarization: in the car; Toby won't talk to Bree; Toby insists on the drugs. Polarization: in the café; I'm not his mother; sitting on the other side. Creatures of the World of the Transformation: filling up at the gas station; the men watching. Trial 1: Outer Cave: Toby is camping out. Preparing for the Outer Cave: Bree shopping for camping gear. Outer Cave: Bree cooking. Middle Cave: Going to the ladies room; do you think there are snakes around here. Inner Cave: Toby talking about his dad by the campfire; Bree takes her pills. Transformation 1: Waking up; the bright idea; Bree will set him up in the telemarketing field. In the car; working in a pet store is not very ambitious. Trial 2: In the café / store; Toby meets the girl. The child reads Bree. Bree phones Margaret. The girl kisses Toby. Transformation: (Bree acting as a mother) Bree wants to be introduced to Toby's new friend. Resisting the Transformation: "..Margaret, I don't think I'm cut out to be a mother…" Trial 3: Forced to the Transformation: Bree forced to pray at the table. Acting like Mother: eat your vegetables; a condition for buying the hat is not to do drugs. Resisting the Transformation: Toby does drugs. Transforming: Toby gives Bree the hat. Celebration: Toby hanging out of the window of the car. Journey to a (glimpse of ) the New World: why are we going to Dallas? Warning: I hope you'll be on your best behaviour. Threshold Guardian: Marianne welcomes them. Outer Cave: New World: Bree surprised to be at the Gender Pride meeting. Initiates: Marianne passes the word that Toby doesn't know. Middle Cave: Creatures of the New World: the characters at the party. Inner Cave: Toby almost sees Bree undressed, not ready to reveal herself. Regression: Driving; what did you study? Proximity: Blowing bubbles. Deception Revealed: Toby sees that Bree has a penis. Polarization: Toby ignores Bree; continues smoking. Polarization: Toby doesn't speak to Bree in the car. Journey to the Communion: Toby wants to go to Sammy's Wigwam. Foreshadow of the Oracle: seeing the hitcher. Communion: Toby tells that she has a Dick. Communion: Bree walks away. Communion: Arguing in the car; Bree tells Toby about the operation she wants. Meeting the Oracle: Picking up the hitcher. Meeting the Oracle: The hitcher endears himself. Communion: The hitcher and Toby get undressed and swim in the pool. Developing Characters and Relationships: talking while swimming. Communion: Toby doesn't think Bree is a freak, just a liar. Oracle Reveals: The hitcher steals the car. Pushed to the Sword: walking and hitching the ride. World of the Sword: on the back of the truck. Seizing the Sword [Toby]: Toby picks up someone in the toilet and gets some money. Seizing the Sword [Bree]: Bree meets Calvin Manygoats and gets a ride and a place to stay. Developing Characters and Relationships: Bree sits with Calvin on the porch; "..keeps the dogs off the porch…" Developing Characters and Relationships: Bree has the hots for Calvin. Developing Characters and Relationships: the hat keeps the sun off my face better than a headband and a couple of eagle feathers. Threshold Guardian: Bree goes to the powder room; Toby tries to tell Calvin that there's more to her than she's letting on. Seizing the Sword: Calvin gives Bree his phone number and Toby a hat. Near Death Experience: Toby asks for Sidney at the door; Elisabeth closes the door on him. Resisting the Atonement: On the grass. Atonement with the Father: Bree knocks on the door; Mom and Dad it's me. Apotheosis: with her Dad; it's Subrina! we love you but we don't respect you; meeting Sidney; he's your grandson. Ultimate Boon: the parents treat Toby really well. Journey to / Foreshadow of the Elixir: Bree needs to borrow $1000 for the airfare. Transforming: Bree gets ready and steals the tablets. Transformation (New Clothes): Bree in her dress; Elizabeth combs Toby's hair. Resisting the Transformation: arriving at dinner; Bree has to pull out Elizabeth's chair. Transformation: the joint photo; Toby pulls out Bree's chair. Journey to / Foreshadow of the Elixir: Bree asks to borrow $1000 for the airfare. Guardain of the Elixir: Elizabeth tries to dissuade Bree from the operation. Guardain of the Elixir: Elizabeth offers the money on condition that Toby stays. Guardain of the Elixir: Elizabeth running after Toby. Foreshadow of the Elixir: Bree wishes that they could just look at her and see her; Bree agrees to let Toby come and live with her. Disgust / Refusal: Toby tries to sleep with Bree; Bree tells him she's his father. Magic Flight: Bree pursues Toby. Bree recovers from the punch. Toby disappears; putting out an APB. Crossing the Return Threshold: Bree returns to the hospital and gets the operation. Obstacle: after the operation; Bree unhappy that Toby has disappeared. Obstacle: Toby in LA on the beach, taking drugs. Master of Two Worlds: Bree a woman now. Transformed: Bree a waitress, not a busboy now; learning Spanish. Transformed: Toby doing porn as a blonde. Freedom to Live: Toby turns up at Bree's door. You can also receive a regular, free newsletter by entering your email address at this site. Kal Bishop ********************************** You are free to reproduce this article as long as no changes are made and the author's name and site URL are retained. vigrx enhancement pennis enlargement tool enhancement forum free matter penis size penis enlargement pump get vigrx top penis enlargment pills prosolution pnis enlargement pills penis enlargement result penis enlagement cream

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