Cardiac calcium score is a screening

Dear Dr. Roach: A friend suggested I get a cardiac calcium score test to measure the amount of plaque in my heart. What is your opinion of this test? — R.I.

The coronary calcium score is a screening test for coronary artery disease. It is not appropriate for everyone, but it is a useful test for men and women at higher risk. Doctors often order it when they are uncertain whether to recommend treatment to combat risk factors for blockages in the arteries.

People with a calcium score of zero are at very low risk for developing a heart attack in the three years after the test. However, it is possible to have blockages in the arteries without calcium.

If a blockage is still suspected despite a normal calcium score, it may be diagnosed by cardiac catheterization and angiography. A CT scan with dye can find blockages even without calcium. Finally, if the blockage is large enough, a stress test will be abnormal.

Dear Dr. Roach: My husband successfully completed 45 days of radiation for prostate cancer. His last PSA was non-detectable. He has to take medication for two years as part of the cure. However, it is causing him to have horrible hot flashes and night sweats. Would you suggest something designed for a male? — P.B.

The first effective treatment for prostate cancer was depriving the cancer cells of androgens. It is done now with medications. Their continued use causes lower levels of testosterone.

Hot flashes occur in 80% of men and can be very disruptive. The best-studied and most effective treatments in men were medroxyprogesterone and cyproterone. It reduced hot flashes by 84% to 95% in men. Venlafaxine reduced symptoms by 50%, and gabapentin reduced symptoms by about 45%.