DEAR DR. ROACH: I have been treated for prostate cancer and stopped my semiannual Eligard injections three years ago. I’m 75 years old and about 5 feet, 9 inches tall. Before treatment, I weighed 227 pounds; I currently weigh 209 pounds. My testosterone level is 49.6 ng/dL. My breasts have become somewhat feminine.

My question is: Will they regain their normal appearance? I’m losing weight slowly, and I’m trying to build muscle with weights. — Anon.

ANSWER: Gynecomastia is the growth of male breast tissue, specifically when not due to breast cancer. It can happen during puberty in healthy males, but it is a common side effect of androgen deprivation therapy for prostate cancer. Up to 75% of men treated with antiandrogen therapy like leuprolide (Lupron or Eligard) will develop breast tissue.

It isn’t likely that the breast tissue will go away on its own. For men who want treatment due to the appearance or tenderness of the breast tissue, there are radiation, medication and surgical treatments available. Radiation therapy is the most effective for men who develop breast tissue with androgen-depletion treatment.

Tamoxifen is the usual medical treatment, and you may ask the physician treating your prostate cancer about these choices. Men who can’t take or choose not to take either of these treatments can be referred for surgical treatment, which can be liposuction or a mastectomy.

DEAR DR. ROACH: I am a 74-year-old active male currently taking a daily 81-mg aspirin due to a periodic heart arrythmia. I have elective sinus surgery scheduled, requiring that I be under a general anesthetic for 90 minutes and that I be off aspirin for the two weeks preceding the procedure.

I’m beginning to have second thoughts about the surgery as I wonder if I’m risking a stroke. Would you please share your thoughts on this? Thank you. — R.B.

ANSWER: Aspirin is used in some people with atrial fibrillation (the likely heart arrythmia you would be put on aspirin for) when they are at a low risk for a stroke.

There is a score called the CHA2DS2-VASc that is used to estimate risk. People at a higher risk are recommended anticoagulants, such as apixaban (Eliquis). Since you are 74, you get at least one point for your age, and unless you have another risk factor that I don’t know about, you have an estimated risk of stroke without treatment of approximately 0.6% per year.

While it is true that being off aspirin for a period of time around a surgery increases your stroke risk, your risk is already so low that the absolute risk of being off aspirin for two weeks is quite small. You should always consider the risks of any surgery against the benefits, but the risk of stroke in your case is small compared to the risks anyone has with sinus surgery (such as bleeding or infection).

I am a little surprised about it being two weeks; normally when a person comes off aspirin before surgery, it’s for five to seven days. Also, not all surgeons require aspirin to be stopped before sinus surgery.

Since your reason to be on aspirin is to prevent a stroke due to your arrythmia, and this risk appears to be very small, it may be the surgeon determined that since the risk of stopping aspirin was so small, it wasn’t worth the possible increased risk of bleeding from the sinus surgery if you’re still taking aspirin.

If you haven’t talked to your regular doctor or cardiologist about this, I recommend doing so since I don’t have your full medical history.