Radiotherapy is a cancer treatment that uses high-intensity radiation to shrink the tumor cells. In ordinary circumstances, radiation is used in the form of an x-ray to get images of human bones.

The high-intensity radiation alters the cancer cell DNA. This alteration leads to the death of cancer cells after a while and then the body removes those cells.
The removal of cancer cells through radiation therapy is not an instantaneous process. It takes days or even months for the body to change the DNA of the cancer cell and to remove those cells from the body.
In this article, we will answer the following frequently asked questions about radiotherapy:

  1. What are the types of radiotherapy?
  2. Is radiation therapy painful?
  3. What are the side effects of radiotherapy?
  4. How does radiation kill cancer?
  5. Is radiation worse than chemo?
  6. Is radiotherapy effective?

What are the types of radiotherapy?

There are three basic types of radiotherapy:

  1. External beam radiotherapy- It uses a machine to emit a high-intensity radio beam to kill cancer cells.
  2. Internal radiotherapy or brachytherapy- In this type of radiotherapy, a radioactive source in either solid or liquid form is implanted at the cancer site that emits radiation to kill the cancer cells.
  3. Systemic radiotherapy- In this type of therapy a radioactive source is either given orally or intravenously to destroy cancer cells.

Is radiation therapy painful?

A patient may not feel any pain during the process of radiotherapy. There’s no burning or stinging sensation when a high beam of radiation is passed through the cells. However, days after the radiotherapy can be uncomfortable due to the skin changes or irritation one feels. It may have an effect on the healthy cells while killing the cancer cells which can be a painful experience.

What are the side effects of radiotherapy?

Radiotherapy can have different side effects depending upon the site of treatment. In the case of radiation near the neck, it may cause mouth sores, limited production of saliva, or even tooth decay. 

Skin changes such as peeling, stinging sensation, or blisters may appear. If the skin condition worsens, the health care provider may reconsider the decision of radiotherapy for a patient.

Loss of appetite, nausea, vomiting, and fatigue are some other side effects of radiotherapy sessions that occur after continuous therapy.

How does radiation kill cancer?

The radio beam throws concentrated radioactive rays at the cancer cells that puncture the cells’ DNA. As a result, the cancer cells stop growing and multiplying. The only problem with this treatment is the damage it does to the healthy cells.

Is radiation worse than chemo?

Radiotherapy has side effects that can be hard to manage, but as a treatment option, it is better than chemo because chemotherapy destroys a lot of healthy cells in the body and deteriorates their growth such as hair, nail, and bone marrow cells.
In contrast, radiotherapy may affect the healthy cells only near the site of treatment.

Is radiotherapy effective?

Radiotherapy is 90% effective if the cancer is at the initial stages.

Tooth decay occurs when the enamel of the teeth is damaged by the plaque turning sugars into acids. If the plaque is not taken care of at the right time, it can cause loosening of the gums, cavities in the teeth, and even tooth loss.

This article will cover the following questions regarding tooth decay:

  • What are the causes of tooth decay?
  • What are the symptoms of tooth decay?
  • When to see a dentist?
  • What are the treatment options for tooth decay?
  • How to prevent tooth decay?
  1. What are the causes of tooth decay?
  • Inadequate brushing of the teeth and not taking proper care of oral hygiene may cause tooth decay.
  • Tartar, if not taken seriously, turns into plaque that causes sugars to turn into acids that attack the outer layer and enamel of the teeth causing them to have cavities. This can ultimately lead to tooth decay.
  • Limited quantities of saliva in the mouth may cause tooth decay.
  • If the food particles such as sugars are not cleaned properly they may cause tooth decay.
  • The oral bacteria can also act against the teeth causing them to decay by turning the sugars into acids.
  • Some medical treatments can also lead to tooth decay such as radiation therapy for cancer can affect the teeth.
  1. What are the symptoms of tooth decay?

Tooth decay may not come with obvious symptoms every time. However, in the later stages, it may cause -symptoms such as:

  1. Frequent toothache that doesn’t get away without a pain medication.
  2. The sensitivity of the teeth and gums.
  3. Sharp pain that occurs on eating or chewing something.
  4. Cavities that are visible to the eye.
  5. White, brown, or black stains on the teeth that don’t go away by brushing.

3. When to see a dentist?

If you are not regular on dental check-ups, you should consult a dentist whenever you experience pain, swelling, or sensitivity in the teeth that is not usual. Tooth decay goes unnoticed by normal people, and it can occur even after maintaining proper oral hygiene, so it is crucial to get your teeth checked regularly by a dentist.

4. What are the treatment options for tooth decay?

If you have visited the dentist on the onset of tooth decay, he may suggest scaling to clean the plaque. However, if your teeth has started having cavities, they may require fluoride treatment that can restore the enamel of the teeth, fillings that can fill the holes, crowning in case of a loss of teeth, root canals when the teeth are damaged till the inside and the last resort of tooth extraction when there is no other option left to prevent to treat a decayed tooth.

5. How to prevent tooth decay?

Tooth decay can be prevented by practicing the following things:

  • Brushing your teeth twice a day.
  • Using a fluoride-based mouthwash.
  • Using dental floss to remove residual food from the oral cavity.
  • Seeing your dentist to discuss tooth decay prevention techniques.

Hair fall is a problem that may occur due to aging, a hereditary pattern, hormonal changes in the body, or as a side effect of an illness. People may experience hair loss in different ways and they also react to it differently.

A receding hairline may be a cause of shame to some which they tend to hide through wigs or scarves while many may flaunt it as an emblem of pride(cancer survivors may experience a complete loss of hair).

Men are more prone to hair loss when they are aging. The patterns of hair loss can be in the middle of the head, a receding hairline from the forehead, bald patches on the head, and sometimes the hair loss can be from the whole body.

In this article we will discuss the following aspects of hair fall:

  1. What are the causes of hair fall?
  2. What are the treatments for hair fall?
  3. Who is at the risk of hair fall?
  4. How to prevent hair fall?

What are the causes of hair fall?

As stated earlier, hair fall can occur due to reasons such as:

  • Hereditary- Hereditary hair fall is known as alopecia in medical terms and it can occur in both men and women.
  • Hormonal changes- This type of hair fall is usually seen in women when they go through phases such as pregnancy, childbirth, or breastfeeding.
  • Aging- Hair fall can come in the package of an aging body.
  • Medication- Cancer medicines or radiotherapy can cause extreme hair fall and sometimes permanent hair loss.
  • Heavy usage of hair treatments- Chemical treatments such as hair dyes or heat treatments can cause hair damage that causes hair fall.
  • Stress or trauma- A high-stress level or an emotional trauma such as death of a near one can trigger hair loss in some individuals.

What are the treatments for hair fall?

The hair fall treatment can involve over-the-counter medications that are only suitable for treating male-pattern baldness. These medications are only limited to topical non-prescription androgenic alopecia (male pattern baldness) drugs containing minoxidil in concentrations such as 2% or 5%.
Only these medicines are FDA approved and for other medicines, you need to see a dermatologist.
Many people rely on herbal treatments for hair fall such as herbal oils or organic products such as aloe vera or onion juice. Although there’s no clinical evidence for the effectiveness of such things, they are frequently used.

Who is at the risk of hair fall?

Aging people are most likely to experience hair fall. Other than old people, people in their 30’s may experience hair fall due to nutrient deficiencies that occur as a result of strict dieting, and hormonal changes in women such as the times of pregnancy, childbirth, or menopause.

How to prevent hair fall?

Inherited hair fall may not be prevented, but other than that following preventive measures can help:

  • Taking a protein-rich diet
  • Taking vitamin supplements
  • Avoiding hair damaging treatments such as heat treatments and chemical dyes.
  • Regular hair washes with a mild shampoo.

Ear infections occur when the middle ear gets infected with a virus or bacteria. The middle ear is the air-filled space that contains the vibrating tiny bones of the ear.

Middle ear is the part of the ear behind the eardrum.

The ear infections may also occur due to the blockade of Eustachian tubes (start from the middle ear and end at the back of the throat) that are responsible for the clearing of the ear fluid. The blockade of Eustachian tubes causes the fluid to get stuck in the ear that catches infection.

The infection of the middle ear is known as otitis media. Usually the ear repairs this infection itself, but if it doesn’t there may be a need for an antibiotic.

In this article we will discuss the following things regarding ear infections:

  1. What are the types of ear infections?
  2. What are the causes of ear infection?
  3. How to treat ear infections?
  4. How to prevent ear infections?

What are the types of ear infections?

The ear infections can be of these three main types:

  • Acute Otitis media- It is the most common type of ear infection in which fluid traps behind the eardrum. It can also cause fever.
  • Otitis media with effusion- it is the proceeding stage of otitis media when after the course of the infection, a little fluid remains in the middle ear. This may not cause any symptoms, but a medical practitioner may spot out a lingering infection.
  • Chronic Otitis media with effusion- It is the type of ear infection in which the fluid buildup keeps recurring. It is a more serious type of ear infection that can eventually lead to hearing loss.

What are the causes of ear infection?

The main reason for an ear infection is the blockage of Eustachian tubes. This may be caused due to cold, flu, excessive mucus production, infection of adenoids, smoking or changes in the air pressure due to altitude.

How to treat ear infections?

A usual ear infection may not require medical intervention. If the ear infection persists longer than a day, it may require medical attention.

Usual practices for curing an ear infection involve application of a warm cloth at the ear.

Other than antibiotics as the final line of action, over the counter non-steroidal ear drops can be a cure.

If the pain is unmanageable, you can alleviate it by an over the counter pain killer such as ibuprofen.

How to prevent ear infections?

An ear infection occurs usually as a result of cold and allergies. In winters,it is important to take preventive measures against catching cold.

Dietary changes such as taking warm liquids can help prevent cold.

Nasal irrigation is another method to prevent ear infection, but before practicing it consult a doctor.

Smoking increases the risk of ear infections, and if you are prone to ear infections, choose not to smoke.

Clean your ears after shower using your finger or a tissue.

A cotton bud is not recommended for cleaning an ear because it pushes the earwax deeper.

Arthritis or joint inflammation is a medical condition where a patient feels swelling or tenderness in one or more joints. This joint disorder or disease is common usually in aged persons as their joints become weak as their age increases.

Are you suffering from arthritis and nothing is working for you? Well stop worrying as in this article we are going to throw light on certain aspects of disease and its treatment as well. Here are the points that you will get to know:



Types of Arthritis:

There are various types of arthritis but here we will discuss only some common types:

  1. Osteoarthritis (weakening of joints due to overuse).
  2. Rheumatoid arthritis (immune system attacks joints and causes severe pain or damage).
  3. Psoriatic arthritis (condition caused by inflammation of skin and may swell fingers and toes by raising patchy red areas on skin of joints).
  4. Lupus (an autoimmune form which affects joints and other body organs).


  • Dysfunction of immune system
  • Abnormal metabolism
  • An injury to a joint leading to arthritis
  • Genetic disorder


Arthritis mostly has its roots in small joints of hands and feet and then it slowly starts affecting other joints of the whole body as well. It may start mildly and then get severe if not diagnosed in the beginning.

Arthritis carries following symptoms:

  • Weak muscles
  • Warm red skin over joints.
  • Difficulty in movement.
  • Inflammation around joints.
  • Swelling
  • Tenderness
  • Stiffness
  • Joint pain

The symptoms usually appear on any side of the body and then get worse with time.


It is a conception that arthritis can’t be treated or there’s no cure available for this disease or medical condition. No doubt that it becomes difficult to diagnose arthritis when it’s in severe or worse form as patients with arthritis may also have chronic pain.

In this case a number of treatments or therapies are there to deal with the condition. Your doctor may recommend you the best treatment after analyzing your condition and response to the treatment.


A number of medications are there which relieves pain and stiffness but the disease may continue to progress. But various high quality medications can even slow down or stop the progress of arthritis in many cases. An expert health care taker would direct you the exact medicine after observing the nature of your disease.

Golimumab, hydroxychloroquine, amjevita etanercept, leflunomide etc are the drugs which may prove good against arthritis.


Several forms of surgeries may be essential in some cases to reduce discomfort and stiffness in joints. When arthritis pain becomes intolerable then surgery is only the option that can actually do something for the patient. Spinal surgery is sometimes performed against neck or lower spine arthritis.

Occupational therapy (arthritis treatment):

This treatment is all about protecting your joints. You may be able to do normal activities easily with the help of this therapy by learning simple ways to do your daily tasks.

You should try to adjust or use stronger healthy muscles with affected ones. Use canes or walkers which may help you do your work properly. In addition to above mentioned treatments some home remedies or tonics also prove helpful in normal cases.

Eye problem or eye disorder is the most common medical condition these days that is affecting the vision of a number of people across the world. About more than half of the world’s population is facing this problem that can however easily be treated.

There are different various kinds of eye disorder but our concern in this particular article is short sightedness. We are supposed to convey here basic information about this disorder. Let us first list out different key points that we have to discuss.



What is short sightedness?

Short sightedness also called nearsightedness is an eye condition where the eye can’t see distant objects normally or the appearance of distant objects is blurred but close objects appear normal.

Doctors call this disorder myopia. In this condition light doesn’t focus on the retina but in front of the retina. It is a common condition where eyes are unable to produce clear images of distant objects or things.

Short sightedness v/s long sightedness:

Mostly people mix up both short and long sightedness but the two disorders are totally opposite. Short sightedness doesn’t affect close vision whereas long sightedness does so.

Short sightedness is an eye disorder where patients can’t see distant objects properly and in long sightedness close vision is affected and distant things appear clearly.


There are several causes of short sightedness. Some prominent causes may include:

  • Inherited condition
  • Imperfection in eye
  • Excessive close work

Genetic disorder of any type affects children’s health greatly. If a child’s parents have short sightedness there are sure chances that child too will have this disorder.

Myopia may be caused by an imperfection in the eye such as a problem in the shape of eyeballs, cornea, retina, optic nerve can cause sudden blurred vision.

Excessive close work on computer, laptop or mobile phone can also affect your sight and cause short sightedness. 

Symptoms of short sightedness:

Common symptoms of short sightedness may include:

  • Blurred far vision
  • Inability to recognize distant faces.
  • Inability to drive safely.
  • Problem in studying in class when one is sitting back in the class.
  • Difficulty in watching television from a distance.
  • Headache
  • Tired eyes
  • Eye pain
  • Squinting at night.
  • In severe cases close vision may be affected.


As mentioned before, short sightedness or myopia is caused by retinal problems or eye imperfection (by the shape of eyeballs). So this thing is clear that it isn’t easily curable but you don’t need to get worried as we are not saying that there is nothing that can be done about it.

However medicines, herbal remedies or exercises can’t give you the least benefit in this case. But glasses, contact lenses & laser eye surgery (that include LASIK, LASEK & PRK) can undoubtedly be beneficial. Laser treatment only takes 30 or more minutes to get completed.

Your doctor would obviously be in a better position to tell you which procedure or treatment would work best for you after observing your condition.

Night blindness is the inability to adapt to low light situations such as night time or dark. It is an eye condition which is the result of eye disorder. It doesn’t cause complete blindness though a person can’t see properly in dim or low light.

In this article we will discuss what are causes and symptoms of night blindness and how it can be treated.


Night blindness is the result of several causes and most of them are easily curable in a short time period. But some of these causes are complex, especially retinitis pigmentosa is still not curable. Let’s here throw light on different reasons that cause night blindness:

Deficiency of vitamin A is the most common cause of night blindness and it’s treatable too. Vitamin A is an essential vitamin for vision or sight sense and its deficiency can leave serious side effects on vision or sight.

Retinitis pigmentosa is an eye condition or disease that damages retina and affects vision negatively.

Cataracts appear when the eye lens becomes cloudy or breaks down due to aging or other factors. It can impair sight.

Glaucoma can also impair or weaken vision. It is an eye condition that damages the optic nerve which connects the eye to the brain.


Serious or worth noticing symptoms of night blindness may include:

  • Excessive squinting at night.
  • Blurred vision while driving during night or darkness.
  • Difficulty adjusting from light to dark areas.
  • Trouble seeing in places with low or dim light.
  • Tricky to recognize faces in dim light.

Night blindness may have other symptoms as well which usually depend on the nature of the issue or condition.

Common symptoms of night blindness are following:

  • Blurred or cloudy vision
  • Eye pain
  • Nausea
  • Vomiting
  • Difficulty seeing in the dark.
  • Sensitivity to light


Treatment for night blindness varies from person to person depending on cause or reason. It may sometimes prove simple and may be complex if the condition of the victim is serious.

Night blindness that is caused by deficiency of vitamin A, cataracts, nearsightedness is easily curable with short term simple treatment and an eyeglass can be helpful for you. Eyeglasses can improve nearsighted vision both in day and night.

As we discussed before, treatment of night blindness depends on the cause so medication or the recovery process would be according to the cause of defect or inability.

Wearing glasses: Wearing glasses can save one’s eyes from ultraviolet light or rays and it can improve one’s vision. So eyeglasses or certain lenses can be a treatment when there is only a mild issue.

Surgery: Surgery may be an option when other treatments don’t work. It is in fact essential in severe cases. Surgeries usually aim to remove glaucoma or to remove cataracts from the eye. LASIK is a type of eye surgery which changes the shape of the cornea to improve vision.

Good portion of Vitamin A in diet: If night blindness is caused by deficiency of vitamin A then a healthy diet with proper amount of vitamin A can treat the problem.

Foods which contain vitamin A in heavy amount include:

  • Green vegetables
  • Eggs
  • Orange and yellow vegetables and fruits
  • Fortified milk
  • Fortified cereals
  • Cod liver oil

Hepatic statuses commonly known as fatty liver disease is a condition in which fat builds up in the liver. In normal conditions, the liver can have small amounts of fat, but too much fat on the liver can be dangerous.
It can damage the liver and can cause problems such as scarring of the liver tissues. In severe conditions, it can even cause liver failure.
The fatty liver disease is generally classified into two categories:

  1. Alcoholic fatty liver disease– Occurs in people who consume too much alcohol that causes fat deposit on the liver
  2. Non-alcoholic fatty liver disease- As the name suggests, this type occurs in the people who do not abuse alcohol. Still 25-30% of the total patients belong to this category of the disease.

Now that we are done with a brief introduction of the disease, let’s move on to answering some common questions regarding the disease such as:

  1. What are the causes of fatty liver disease?
  2. What are the symptoms?
  3. Is fatty liver disease a serious condition?
  4. How can fatty liver disease be cured?
  5. What foods help cure a fatty liver?

What are the causes of fatty liver disease?

Fatty liver disease occurs in either alcoholics or people who are obese. The risk of the disease increases in obese people because their bodies aren’t able to process fat that leads to an accumulation in the liver cells.
High blood sugar also puts people at risk of fatty liver disease. Other than that, sometimes infection such as hepatitis C can also lead to fatty liver disease.
In some cases, it can be hereditary as well.

What are the symptoms?

The symptoms of fatty liver disease are similar to any other liver related issue. It causes the patient to lose appetite, feel nauseous, skin and whites of the eye turning pale, pain in the upper right side of the abdomen and weakness.

Is fatty liver disease a serious condition?

Fatty liver disease is not a serious health condition until it starts damaging the liver that happens in severe conditions only. The disease progresses in three stages where the first stage is of a swelling of the liver, the second one is scar tissue formation and the third one is replacement of healthy tissues with scar tissues.

If timely medical intervention is proceeding, this disease doesn’t cause too much harm.

The good part with this disease is that it can be cured by adopting lifestyle changes.

How can fatty liver disease be cured?

As explained earlier, fatty liver disease occurs in obese people. The first step towards curing the disease is to reduce the weight to a healthy limit. This involves lifestyle changes and dietary alterations. The easiest way is to keep a check on the calories taken versus the calories consumed.

What foods help cure a fatty liver?

Healthy fats, complex carbohydrates and detoxifying foods are the best bet when it comes to reducing weight. In this condition, sea food, nuts and vegetables are the best foods to consume.

Diarrhea is the persistence of watery stool at least thrice a day. It can affect a child or an adult for two to three days in normal circumstances. A prolonged diarrhea can indicate an underlying condition that may need medical attention.
Irritable bowel syndrome is one condition that can cause prolonged diarrhea and needs proper medical attention. Other than diseases, many medicines can also cause diarrhea as a side effect.

Diarrhea can be of three types- Acute diarrhea is the diarrhea that persists for two to three days and then subsides.

Persistent diarrhea lasts longer than acute diarrhea. It takes 3 to four weeks’ time to settle down. The third type is chronic diarrhea that lasts for more than a month and doesn’t ease up for months.

Now that we know what diarrhea is, the next part of the article will include:

  1. What are the causes of diarrhea?
  2. What are the symptoms of diarrhea?
  3. Who can have diarrhea?
  4. When to see a doctor in case of diarrhea?
  5. What are the treatment options for diarrhea?

What are the causes of diarrhea?

Diarrhea can either be viral or bacterial. If it is not caused by a pathogen, substance abuse can be a reason behind it such as heavy use of alcohol or misuse of medicines such as laxatives. Dietary alterations in some cases may also cause diarrhea such as intake of heavy, oily food can lead to an upset stomach. Sometimes, diarrhea is caused by conditions such as ulcers or irritable bowel syndrome.
Other than these causes, an intolerance or allergy to certain food elements can also cause diarrhea in some people.

What are the symptoms of diarrhea?

Diarrhea causes stomach cramps, bloating, watery stools that are more frequent than the usual bowel pattern of a child or an adult. Nausea and an urgent feeling of passing stool are some other symptoms.
In worse situations, diarrhea can have symptoms of blood and mucus in the stool.

Who can have diarrhea?

Anyone can have diarrhea. It is a common condition in infants, adults and old people alike. The only difference comes in the treatment of the disease.

When to see a doctor in case of diarrhea?

Diarrhea usually doesn’t require immediate medical attention and can be cured by maintaining the fluid intake. However, if you see stool that has blood or black tarry material in it, immediately see your doctor.
A fever higher than 101 degree Fahrenheit along with diarrhea needs immediate medical intervention.
In case of severe dehydration, the patient may not be able to eat or drink and in that condition, seeing a doctor is important.

What are the treatment options for diarrhea?

Before medical intervention, going on a semi-solid diet such as having yogurt or low fiber food can help. It is very important to maintain the mineral level during diarrhea so having liquids such as juices and water with every episode of watery stools prevents dehydration.

Avoiding dairy products and foods that have high spice levels can also help the stomach get back to normal.

Female sexual dysfunction is a condition in which a woman finds it hard to get sexual due to lack of sexual desire or pain during intercourse.

It can also include the lack of orgasm. Overall it is a condition in which sex drive is lowered due to one reason or another.

These reasons may include a lack of arousal, a lack of reaching orgasm or pain that does not allow one to get sexual.

Sexuality depends on many factors including physical aspects  as well as psychological factors. Even beliefs or apprehensions can play an adverse role in maintaining a sexual desire.

For many women, it may not be an issue until their relationships start getting affected due to it. The only way out is to consult a doctor which itself is uncomfortable due to the nature of the problem.

This article will be based on some questions regarding female sexual dysfunction such as:

  1. What are the causes of sexual dysfunction in women?
  2. What are the treatment options?
  3. Who is more prone to female sexual dysfunction?

What are the causes of female sexual dysfunction?

As discussed earlier, sexual dysfunction in women can either be due to physical reasons, hormonal reasons or psychological reasons.

The physical reasons include:

  • Diseases such as heart disease,renal problems or multiple sclerosis can adversely affect sexual desire in women.
  • Certain medicines can alter the sexual desire in women such as antihistamines or antidepressants.

The hormonal aspects that affect female sexual desire include:

  • Lower levels of estrogen after menopause can cause the vaginal tissues to become thin and inelastic.
  • Women can face vaginal dryness after giving birth or during breastfeeding that leads to lowered sexual desire.

The psychological causes include:

  • Sexual disharmony with the partner can lower down the sexual desire.
  • Untreated anxiety or depression can also lead to lowered sexual desire in women.
  • An unresolved sexual trauma from the past can also limit sex drive in women.

What are the treatment options?

The treatment options can include psychological techniques or medicines in case of a physical/hormonal underlying cause of sexual dysfunction.

  • For psychological issues, a therapist who counsels and provides an environment for stimulating sexual desire through stimulators such as music and videos can be consulted.
  • If the sexual dysfunction occurs due to depression and anxiety disorders, a thorough course of treatment regarding the issue can be helpful.
  • For pain management during sexual intercourse, women can take non-steroidal pain killers before intercourse.
  • Lubricants can help in curing the dry vagina issue.
  • Hormone replacement therapy can play a vital role in treating women with low sexual desire due to menopause.

Who is more prone to female sexual dysfunction?

Although men can also face sexual dysfunction, we are discussing female sexual dysfunction here, the women who are aging are more prone to sexual dysfunction.

In younger women, psychological barriers or sometimes infections can be a cause of low sexual desire. There’s no hard and fast rule for sexual dysfunction in women and it can be managed by treatment options.