Saturday, February 20, 2010

Circumcision Makes Comeback in Australia

Once upon a time, boys in Australia were as clean-cut as their American cousins. Then the national nannies stepped in to discourage and not pay for this important neonatal procedure. But even during the "bad times" a number of Australian parents opted to circumcise their sons. Now, the growing evidence of the medical benefits of circumcision are reaching parents, despite the reluctance of some in the Australian medical bureaucracy.

Under the headline -- "More boys go under knife as parents opt for kind cut" -- the Sydney Morning Herald reports a resurgence in newborn circumcision in New South Wales. It's still a long ways from American standards, but the good news is that trend is upward. One doctor predicts it will grow quickly to 30% over the next decade.

The headline is also a sign of the change in times. After some used to call circumcision "an unkind cut," how refreshing to see this simple health-giving procedure call what it is: a "kind cut" -- in fact, it's the kindest cut of all a parent can do for a newborn baby boy.

Here's the full story below:

CIRCUMCISION is making a comeback as a new generation of parents arm themselves with medical research to justify their decision.

The rate of circumcision for baby boys in NSW rose from 13 per cent in 1999 to 18 per cent last year, according to Medicare figures.

It's a long way from the 1950s when boys were routinely circumcised but Sydney paediatric surgeon Dr Anthony Dilley predicts the rate will keep rising. This is despite NSW Health banning circumcisions from public hospitals in 2006, except in cases of medical emergency.

"By the time today's baby boys are in kindergarten, it will be 30 per cent," Dr Dilley said.

Dr Dilley said parents were asking for circumcision because they thought it would benefit their child – "to look like dad", be more hygienic and reduce risk of disease – rather than for cultural or religious reasons."My own gut feeling is that there are parents who didn't get it done 20 or 30 years ago because they were bullied out of it," Dr Dilley said. "Most parents now don't stand for being told: 'Don't do it.' They will do their own research."

Proponents of circumcision such as Professor Brian Morris from the University of Sydney school of medical sciences say it is a kind of "surgical vaccine", pointing to studies showing it reduces the incidence of urinary tract infections, sexually transmitted diseases, penile cancer and penile inflammatory disorders, as well as being more hygienic.

It has also been shown to reduce the incidence of cervical cancer in female partners.
"At birth it's a very simple, safe procedure that gives immediate benefit through infancy and continues through life," he said.

The Royal Australian College of Physicians recently softened its opposition towards circumcision. Its 2004 position statement said there was no medical indication for routine neonatal circumcision and that benefits needed to be weighed against a complication rate of 1 to 5 per cent but its interim statement released last year was more nuanced, saying parental choice should be respected.

The college's paediatric and child health policy committee chairman Professor David Forbes said: "We have stepped back and said: 'Yes, there are ethical issues around circumcision but ultimately we have to have a policy that fits with society's practice and acknowledging parents' role in the decision-making process, while recognising the potential benefits and risks'."

But the statement recommends parents should wait until their boys are old enough to make their own decision on circumcision – the subject of a petition by pro-circumcision clinicians led by Professor Morris, who say infancy is best for the procedure.

Royal Australian College of General Practitioners national spokesman Dr Ronald McCoy said he didn't believe there was any reason to circumcise except for a handful of medical indications but agreed the debate was not going away.

"It certainly is a real issue. Parents want to find out what's best for their kids," Dr McCoy said.
General Practice NSW chairman Dr Ken Mackey said circumcision was generally safe but there were still slight risks of infection or deformity of the penis. "As always, fully informed consent is important," he said.

Sunday, February 7, 2010

Tim Tebow, Superbowl, Abortion & Circumcision

Tim Tebow, the awesome quarterback for the University of Florida 'Gators, is getting a lot of flack because he and his mom are "out front" in the anti-abortion campaign. That will be highlighted in a Superbowl ad produced by Focus on the Family that has the pro-choice crowd up in arms.

Perhaps Tim might have gotten a better reception if he had used his notoriety to promote the universal circumcision of all males.

Now I want to be clear. The abortion issue really has nothing to do with circumcision. Those who "respect life" should obviously value circumcision for its life-giving medical advantages. Those who are "pro choice" should obviously value a parent's right to circumcise a child as that is in the best interests of everyone.

I'm just saying Tim Tebow should be the national spokesman for universal circumcision.

A lot of people may not know that, while other kids were carousing on the beach, Tim made an important missionary trip to the Phillipines during the 2008 spring break. During that trip, Tim took part in circumcising Filipino boys who almost all get circumcised in that country.

Circumcision is a rite of passage in a country that is about 95% foreskin-free. To be uncircumcised is to be "supot" or "pisot." Both words carry a negative connotation far beyond the simple expression "uncircumcised," the literal translation. If you call another dude supot, it's like saying he's unclean, a baby, and unworthy to be a man.

While some college kids go on drunken debaucheries during spring break, Tim was helping out his father on a mission trip. Here was the account at the time:

"In an impoverished village outside General Santos City in the Philippines, Tebow helped circumcise impoverished children. On the Friday of a weeklong trip to the orphanage his father's ministry runs in Southeast Asia, Tebow assisted with the care of locals who had walked miles to the temporary clinic that the ministry helped organize. More than 250 people underwent medical and dental procedures, some of them from "Dr. Tebow," who has no formal surgical training."

"The first time, it was nerve-racking," he said. "Hands were shaking a little bit. I mean, I'm cutting somebody. You can't do those kinds of things in the United States. But those people really needed the surgeries. We needed to help them."

"Tebow didn't plan on operating that day in the Philippines -- his job was to preach to the hundreds of people before they had teeth pulled or cysts removed. But as the day rolled on, he grew curious about the three Filipino doctors and his friend, UF graduate and aspiring doctor Richard "R.B." Moleno, in the bus-sized vehicle that served as a mobile hospital.

"Tebow started as a helper and gofer, holding tools and running errands for the medics. By afternoon, he was asking questions and looking for more active ways to help. And by the end of an exhausting day, he was wearing gloves and a mask, wielding surgical scissors, finishing off stitches with a snip."

In my view, Tim Tebow's public service circumcision of Filipino boys is something to praise, and it's a sign of his commitment to this life-saving procedure. I just hope as he enters the NFL, he'll remember how important it is to promote a clean-cut, foreskin-free country both here in America and in Asia, too.

I nominate Tim Tebow to be the national poster boy for universal circumcision. Is there a second?

Wednesday, February 3, 2010

Foreskin Dangerous on Males But Could Help Others

The foreskin is obviously a source of dirt and danger to the normal male, but it apparently does have some scientific value that is likely to grow in the decades ahead.

Have you ever wondered what happened to your foreskin? Probably not. But it is nice to think that this worthless piece of tissue when disfiguring (and harming) the male penis may have some positive benefits in collagen and skin repairs.

Here's what the alternative San Diego CityBeat wrote about this topic:

The $140-million foreskin
How San Diego biotech benefits from circumcision
By Dave Maass

In the bio-tech industry, the term “neonatal fibroblast” is often code for “baby foreskin,” or at least the cells derived from one.

Much like embryonic stem cells may revolutionize treatments for a wide range of chronic and genetic disorders, the neonatal fibroblast has changed how medical and cosmetic doctors heal the skin.

San Diego doctors have appreciated the potential of the foreskin as far back as the 19th century.
As Dr. Peter Charles Remondino wrote in 1891 in The History of Circumcision, “for skin-transplanting there is nothing superior to the plants offered by the prepuce of a boy.”

What Remondino couldn’t have foreseen is how San Diego County’s bio-science industry would develop foreskin technology. For example, Invitrogen Corp., a subsidiary of Carlsbad-based Life Technologies Corp., offers neonatal fibroblasts for $339 per 500,000-cell vial.

Asked where the foreskins come from, spokesperson Tim Ingersoll responded via e-mail: “Life Technologies produces research-use only products using neonatal foreskins discarded from circumcisions with full, informed consent.”

Foreskin research is more closely associated with La Jolla-based Advanced Tissue Sciences. In the early ’90s, the company invented a way to grow and use the fibroblast cells in a skin overlay that could produce collagen and other biological elements to heal wounds.

ATS eventually became financially insolvent and spent the past decade liquidating its assets. Co-founder Dr. Gail Naughton is now dean of the SDSU School of Business Administration.

The foreskin formula also stayed local. Advanced BioHealing, a Connecticut-based company with a 70,000-square-foot manufacturing facility in La Jolla, currently uses ATS’s “Dermagraft” treatment, which is applied primarily to diabetic foot ulcers. Carlsbad-based SkinMedica also employs ATS’s fibroblast process but discards the cells and uses only the protein-rich culture in its skin-cream products.

According to the corporate-analysis firm Hoovers, SkinMedica has a staff of 160 employees and reports $60 million annually in sales. Advanced BioHealing estimates that it pulled in $80 million in sales in 2009 and grew its workforce to 250 employees.

Neither company has acquired a prepuce in nearly 20 years: Advanced BioHealing and SkinMedica’s cells lines are both derived from a single foreskin.

Technically, a fibroblast can be made from any skin tissue, old or young, but the healing properties of infant skin are superior. The fibroblast can come from the skin of any body part, but circumcision means there’s already a surplus of infant skin that would otherwise be destroyed.

“It comes down to the availability of tissue,” Charlie Hart, chief scientific officer for Advanced BioHealing, says. “Collecting tissue from a different site would be an abnormal surgical procedure and there would be a lot of ethical issues with that.”

SkinMedica has been questioned for using the foreskin culture in its Oprah-endorsed anti-aging products.

“Initially, there was a misunderstanding and people thought we were actually grinding up the foreskin,” SkinMedica founder Dr. Richard Fitzpatrick says. “So, there was a lot of snickering and laughing about people putting this foreskin product on their face.”

How did SkinMedica put the urban legend to rest?

“We stopped mentioning it,” Fitzpatrick says.