Dear Doctor: My husband was recently diagnosed with Huntington’s chorea. Is this the same thing as Huntington’s disease? We would like to know what we can expect in the future with this condition. Are there any new treatments yet? What does this mean for our children?

Dear Reader: Yes, Huntington’s chorea and Huntington’s disease refer to the same condition. It’s a neurological disease in which ongoing damage to nerve cells in the brain leads to the steady deterioration of the individual’s motor skills, speech and memory. The changes that occur in the brain can also affect emotions, judgment and cognition.

Huntington’s disease is an inherited condition. It’s caused by a faulty gene that produces an abnormally long segment of a protein that is essential to brain function. These elongated segments get cut into smaller fragments that cluster together and accumulate on nerve cells in certain regions of the brain. This leads to a gradual and ongoing disruption of brain function.

Huntington’s is a progressive disease. Once the symptoms appear, they continue and worsen over time. In most cases, they become noticeable between the ages of 30 and 50 and typically begin gradually. Although their onset and progression can vary from person to person, they fall into three basic categories. Changes to movement can include increasing clumsiness; difficulty with posture, balance and gait, involuntary muscle spasms that result in jerky movement, abnormally slow eye movement, and difficulty with speaking or swallowing. Cognitive changes can include difficulty concentrating, increasing forgetfulness, memory lapses, and difficulty with logic and reasoning. The disease can also take a toll on an individual’s emotions and their personality. Some patients find that they begin to experience sudden mood swings, irritability or anger, frustration, anxiety and depression.

As the symptoms manifest and become more severe, the person eventually becomes unable to work or to manage the tasks of daily life. Someone with advanced disease will require full-time care. Because of the loss of motor function, people with advanced Huntington’s disease become susceptible to pneumonia, which is one of the primary causes of death in these patients.

Unfortunately, at this time there is no cure or treatment for the disease. Instead, a range of medications are used to manage the physical and emotional symptoms, as well as therapies to help the patient deal with them.

The children of someone who develops Huntington’s disease have a 50% chance of having inherited the mutated gene, and thus developing the condition. People with a history of the disease in their family can choose to meet with a genetic counselor to discuss whether they want to be tested for the presence of the mutation that causes the disease. It’s a difficult and deeply personal decision. Some children of Huntington’s patients choose not to know. Others, who plan to have families or want time to prepare should they test positive, decide to move forward.

For more information about all aspects of the disease, as well as support and advocacy, visit the Huntington Disease Society of America, at hdsa.org. It’s a very good resource for patients and their families.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: In fitness circles, one often hears the saying, “No pain, no gain.” But isn’t pain the body’s way of warning one to back off? Do you really need to push yourself to the point of pain for a good workout?

Dear Reader: You’re correct on both points. The idea of ”No pain, no gain,” which actually dates back to the second century, became widely accepted as an exercise mantra at the start of the 1980s. That’s when Jane Fonda’s exercise video empire brought aerobics to the masses. (People of a certain age may also remember “Feel the burn,” another popular phrase of the era.) And yes, the sensation of pain is part of the body’s alert system. It instantly lets us know that something, somewhere, is amiss.

Elite athletes and hardcore fitness enthusiasts may continue to adhere to the “No pain, no gain” way of training. However, when the goal isn’t breaking records or winning medals but rather the pursuit of good health, we think that a more moderate approach works best for the rest of us. When having this conversation with our own patients, we always refer to the part of the Hippocratic oath that states, “Do no harm.”

Note that when people talk about pain in relation to exercise, they’re actually referring to discomfort. It makes itself known in the burning sensation you feel in the muscles or lungs during exertion, and the fatigue that sets in when you push your limits. The burning occurs because your muscles’ need for oxygen exceeds the supply delivered in the blood; when that’s the case, they switch from aerobic to anaerobic activity, which doesn’t require oxygen. This leads to the formation of lactic acid, a byproduct of anaerobic respiration. The longer and harder you work while generating energy anaerobically, the greater the lactic acid buildup, and the greater the burn.

Discomfort might also mean the stiffness and aches in muscles and joints that many people experience a day or two after a particularly vigorous or sustained workout. The delayed soreness is the result of microscopic tears in the muscles and nearby connective tissues.

The gain part of that discomfort is two-fold. The accumulation of lactic acid plays a role in increased blood flow to the muscles, which helps with increased strength and endurance. Delayed soreness is believed to be a side effect of the healing process. It occurs as muscles repair themselves, and emerge stronger than before.

Outright pain should never be part of your exercise routine. If you ever feel a sensation that goes beyond discomfort and firmly into the realm of pain -- anything that’s sharp, stabbing or sudden -- it’s a sign that something’s wrong. Stop what you’re doing so you don’t cause more damage. The same goes for post-exercise soreness or pain that becomes extreme enough that you are unable to lift or use a limb. You need to stop that activity until you’ve fully recovered, or else risk injury.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I just had a scare with prostate cancer. The tests turned out negative, but it shook me up. Now I just want to make sure things stay that way. What should I be doing -- and what can my two sons do -- to reduce their risk? I’m 67, and they’re in their mid-40s.

Dear Reader: Prostate cancer is the most common cancer in men. Only the various types of skin cancers, when bundled together into a single category, get diagnosed more often. The majority of prostate cancers are found in men 65 and older, so at 67, you fall into that demographic.

It is estimated that 1 in every 8 men will be diagnosed with prostate cancer. More than 250,000 new cases are expected to be diagnosed this year, and the cancer is predicted to cause 35,000 deaths. Although your sons are a generation younger, the risk factors and lifestyle changes that we’re going to discuss apply to them as well.

To understand how to reduce the risk of developing prostate cancer, let’s first take a look at the risk factors. These include age, race, tobacco use, being sedentary, eating a diet high in red meat and saturated fat, and family history. There’s nothing you can do to change your age, race or family history. However, the risks associated with all of these can play a role in decisions men make around when to begin screening for prostate cancer.

Men of average risk should talk to their doctor about screening at age 50. Men at higher risk, which includes those with a father or brother diagnosed with prostate cancer before age 65, should have the screening conversation at age 45. Because the mortality rate is highest in men of African and Afro-Caribbean descent, they should also discuss early screening with their health care provider.

Studies have shown that changes to the factors you have some control over can help reduce risk. This includes reaching and maintaining a healthy weight, getting regular exercise, and limiting red meat and saturated fats. Instead, shift to a diet with proteins such as fresh fish, chicken, turkey and healthful oils. Round things out with plenty of leafy greens, an assortment of fresh vegetables and fruit, whole grains, nuts and legumes. Steer clear of highly processed foods, which are loaded with salt, fat and added sugar, and have little to no nutritional value.

If you smoke, try to quit. Tobacco products of all kinds play a role in numerous diseases and conditions, including prostate cancer. They put the people around the smoker at risk as well. There’s no question that quitting is difficult, but smokers don’t have to go it alone -- don’t be afraid to ask for help from your doctor.

Prostate cancers grow slowly and are slow to spread, so survival rates are quite good. The five-year survival rate is close to 100%. The 15-year survival rate is 95%. Cancers that are caught early are more easily treated, which makes being vigilant about screening all the more important. Thanks to new understanding about the prognosis of older men with slow-growing tumors, many doctors now counsel watchful waiting rather than immediate surgery.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)