Should older men (75 and up) get the PSA test for prostate cancer?

exam table (Photo credit: Lynn Kelley Author)

Over the life of this blog, I have shared my experience with prostate cancer. I was diagnosed with the disease a few years ago. The cancer was found at an earlier stage, so I elected to have radiation treatment. So far, my PSA levels have been low, and that’s a good thing. HOWEVER, I respect the fact that cancer is a tough and sneaky foe, so I will continue with my PSA tests.

There is a study that came out in the October 16th issue of the Journal of the American Medical Association that suggests that many doctors order PSA tests for men 75 and older. Current guidelines, according to HealthDay.com, advise against PSA tests for elderly men. HealthDay reporter Steven Reinberg has the lastest information.

As I have stated many times in this blog, I am not a doctor or a health care professional. I’m simply a baby boomer trying to inspire other men to see the doctor. I certainly do not have the authority to suggest whether older men need these tests.

I do feel a guy needs to meet with his doctor to discuss prostate cancer screening, and the earlier the better. While many prostate cancers are slow growing, men 75 and older have a perfect right to discuss prostate cancer screening with their physicians.  At the end of the day, a decision needs to satisfy the doctor, the patient and the patient’s family.

Early stage prostate cancer: Do you need surgery?

Throughout this blog, I have kept you up to date on my prostate cancer. I was diagnosed with an early-stage cancer and, after a period of active surveillance, decided to be treated with radiation. So far, so good.  Post-treatment blood tests show my PSA at normal levels. Yet, I need to keep up with regular screenings, to make sure the cancer doesn’t progress.

I understand many men prefer surgery, so they know their cancerous prostate has been removed.  It makes a great deal of sense.  But what is a guy to do? Recent news reports are throwing out many conflicting messages.  Do I wait and monitor my cancer?  Do I opt for surgical removal?  Do I decide on radiation treatment? It’s confusing stuff for any guy.

The following article by Tara Parker-Pope, in the New York Times, explores whether surgery is a good choice for early-stage cancer.

I am not a doctor, but here is my suggestion. Talk with your doctor about prostate cancer. Bring up the subject, even if you’re a younger man. Start taking prostate exams at the appropriate age (after consulting with the doctor). Some men are at higher risk and need to be screened at a younger age.  If you’re eventually diagnosed with the disease, you don’t need to panic. Do research, talk with your family and spend a lot of time with your urologist (and perhaps a radiation oncologist) to determine the best treatment option. A lot will be determined by the clinical grade of the cancer.  It’s a fact guys don’t like to see the doctor. It’s a main theme throughout my blog.

So guys, don’t avoid the doctor during your baby boomer years.

Note: Since posting this piece, I came across the latest from HealthDay.com

New options put a permanent end to post-prostatectomy urinary incontinence — guest post by Dr. Kurt McCammon

For many men, stress urinary incontinence (SUI) is a common side effect of prostate cancer treatments^1a. Unfortunately, amidst the flurry of questions and concerns surrounding the cancer diagnosis, many men don’t even recall hearing this part of the conversation when they discuss treatments with their doctor. Let’s face it, most everyone’s ability to process new information shuts down as soon as they hear the word “cancer,” and understandably so.

Fortunately, prostate cancer is entirely treatable in the vast majority of cases. However, the treatment is not without potential side effects, and stress urinary incontinence is one of the most common^1a. For most men, it’s a temporary problem. But for some, the leakage can become a permanent, life-altering issue.

Many men resolve themselves to thinking they must just learn to live with incontinence. After all, the prostate surgery likely saved their life, so how could they complain about leaking urine once in a while?

The fact is that SUI isn’t just a nuisance. It can actually cause other health-related issues and can completely destroy a man’s self-confidence and social life¹. For example, the constant worry about odor and leakage can cause a man to withdraw from activities he once loved,including exercise and intimacy with his partner¹. Another problem can result with long-term use of absorbent pads, which can cause skin breakdown that can lead to troublesome and painful skin infections². The problem can negatively impact not only a man’s relationships but also his health—lack of exercise can lead to weight gain and other health problems.

Fortunately, there are permanent solutions to post-prostatectomy SUI that can put an end to these troublesome symptoms and help prostate cancer survivors reclaim the active, vibrant life they once knew.

A male urinary sling can permanently restore continence for most men with mild to moderate

Image via Wikipedia

stress urinary incontinence (SUI). The sling is made of sterile surgical mesh (the same type that is used to repair hernias), which works like a hammock to lift and support the urethra, restoring their natural position and their ability to maintain continence. The sling is completely concealed within the body and seems to be well-tolerated by most men³. Sling placement takes less than an hour and, in most cases, can even be performed as an out-patient procedure^1b.

For men with more severe SUI, an artificial urinary sphincter offers a greater level of control in a permanent solution^1c. Also concealed entirely within the body, the artificial sphincter consists of a small cuff placed around the urethra that, when inflated, applies pressure to prevent urine from escaping. The device is discreet and simple to use, restoring continence with very little impact on your normal restroom routine.

The artificial urinary sphincter implantation procedure also takes about an hour and can be performed as an outpatient procedure^1d. The system is an effective long-term treatment for incontinence, having been used for almost 40 years to permanently restore continence for thousands of men worldwide ^4,1

If you have been dealing with post-op SUI for more than 12 months, it’s time to talk to your doctor about the minimally-invasive treatment options available to you. You may even want to involve your significant other in the conversation, as SUI no doubt has an effect on your close relationships. The truth is that SUI is often quite problematic for wives in traditional households—in many cases, she’s the one buying the absorbent products and doing the laundry. Partners can often provide valuable insight for the doctor into the severity of the problem.

I recommend making an appointment with your urologist,primary care doctor or family physician to talk specifically about your UI problem. Perhaps out of embarrassment, or not wanting to “disappoint” their doctor with a complaint about an unwelcome side effect of a life-saving procedure, many patients fail to mention this problem on follow-up visits. You, as the patient, need to be your own advocate. Physicians who’ve never experienced the problem of SUI often don’t realize just how life altering it can be.

Once you’ve evaluated the options and chosen the one that’s best for your unique situation, you will be amazed with the difference it makes in your everyday life. I’ve seen an extraordinary number of patients for whom these procedures have made a tremendous impact in their quality of life. With the wide availability of treatments, there’s no reason to suffer in silence any longer.

Kurt A. McCammon, M.D., FACS, is a practicing urologist specializing in male incontinence and voiding dysfunction and chairman and program director of the Urology Residency Program at the Eastern Virginia Medical School in Norfolk, Va. Earning his medical degree from the Medical College of Ohio in Toledo, followed with residency training in urology at Eastern Virginia Medical School and a fellowship in adult and pediatric genitourinary reconstructive surgery.

 

This article was written with assistance from American Medical Systems to provide general information about male urinary incontinence and treatment options. For more information about male urinaryincontinence and treatment options available through AMS please visit www.malecontinence.com.

1a.   Claim 349

1b.   Claim 367

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1d.   Claim 369

1e.   Claim 370

1. Hunskaar S., Sandvik H. One hundered and fifty men with urinary incontinence. Scand J Prim Health Care 1993; 11: 193-196
2. Rackley R., MD. et al. Nonsurgical Treatment of Urinary Incontinence. http://emedicine.medscape.com/article/452289-overview; downloaded May 31, 2011.
3. Klingler H.C., Marberger M. Incontinence after radical prostatectomy: surgical treatment options. Current Opinion in Urology 2006; 16: 60-64
4. Venn S.N., Greenwell T.J., Mundy A.R. The Long-Term Outcome of Artificial Urinary Sphincters. Jol. of Urol. 2000; 164: 702-707.

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Four popular prostate cancer myths — busted. Guest post by Bernice Spradlin

Telling fact from fiction is your first defense when it comes to prostate cancer.

Sure, you are growing your Mo (or mustache in support of November’s Prostate Cancer Awareness month) but do you know that prostate cancer is not just a disease that affects old dudes? No, most men afflicted are in their 50s. Did you also know that prostate cancer is the second most common type of cancer among men in the U.S.?

You might believe that you know enough about prostate cancer in order to recognize the signs and symptoms if they affected you or someone you love. However, doctors and cancer experts worry about the popular prostate cancer myths might negatively impact your awareness or decisions about taking pro-active decisions about your health. For instance:

Myth #1. Prostate cancer treatment causes impotence

Although it is a fact that 50% of all men who undergo prostate cancer treatment will experience problems with erectile dysfunction, it can be only temporary. A talk with your doctor will inform you on the risks and shed light on popular erectile dysfunction medications, like Cialis, Viagra and Levitra. These drugs don’t come cheap so purchasing Canadian drugs online at heavily discounted rates may be an option. Men that undergo surgery or radiation have experienced potency issues due to the damage to nerves and blood vessels (the same nerves and blood vessels that control erection), as well as lower sex drive due to hormone therapy. However the side effects of surgery, radiation and hormone therapy, typically subside within a year following treatment. Erectile-stimulating drugs can also be prescribed by your doctor until normal erectile function returns.

The risk: If a man believes he will have to live impotent as a result of prostate cancer, he may refuse treatment altogether and increase his risk of death when in actuality only 50% of men suffer erectile issues, temporarily in the 6 to 12 months following prostate cancer treatment.

Myth #2. Prostate cancer is a disease that affects elderly men only

Most people think that only senior men (65 years or older) are at risk for prostate cancer. That’s why when men in their 40s and 50s are diagnosed people think it’s rare or not common.

The risk: If a man believes that you have to be a senior to be at risk of prostate cancer, he may ignore the symptoms of the disease or think that he doesn’t have to worry and avoid or delay treatment if he’s diagnosed.

Myth #3. The symptoms of prostate cancer are obvious

Unfortunately, this is not the case. Prostate cancer in the early stages typically shows zero symptoms. The symptoms, most commonly urinary tract and back issues, become evident only when you are in the advanced stages of the disease and by then the cancer is treatable to prolong life, but no longer curable.

The risk: If you are only looking for the obvious symptoms, you may avoid annual prostate screens. That’s why awareness events like Movember exist, to remind men (aged 40 and up) to get their prostate specific antigen (PSA) blood levels checked annually.

Myth #4. People don’t die of prostate cancer

According to the National Cancer Institute, more than 240,000 American men will be diagnosed with prostate cancer in 2011. Still, many men believe that no one man ever dies of prostate cancer.

The risk: The good news is that in most cases, if a doctor catches prostate cancer early on, it’s not only treatable, but curable. However, it’s still the second leading cancer killer for American men. Risk of death occurs if your doctor catches prostate cancer early on and you avoid treatment in belief that the disease can’t kill you.

Bernice Spradlin is an avid hiker and runner. She works at a gym in
Brooklyn, New York, where she gets great inspiration for her freelance
health-related articles and blogs. In her off time, you can often find
Bernice jogging the East River path along the waterfront and enjoying
the cool breeze. Bernice is currently looking for freelance writing
work, and can be contacted at BerniceG.Spradlin@gmail.com

Editor’s Note: If you’re interested in submitting a guest post, please click the “guest post” tab at the top of this blog’s main page. You’ll find submission guidelines. Facts, opinions, research and advice from our guest writers cannot substitute for a visit to your family physician.

 

 

 

Sex after prostate cancer? An Arizona-based writer tackles the touchy subject in a new book — article by Scott Keith

Let’s face it. Prostate Cancer is a “Guy Thing.” It’s an extremely common cancer as men get older. Luckily, in recent years, with effective prostate cancer screening, more men have been diagnosed while the cancer is small enough to be treated or cured. But guys will be guys. There are sexual side effects associated with prostate cancer treatment, whether the treatment is surgery or radiation. And many guys simply don’t want to talk about it.

The wife of a prostate cancer survivor, Cindie Hubiak, is out to help married couples navigate through the ups, downs and sexual frustrations associated with the disease. Hubiak, a Scottsdale, Arizona-based author and co-founder of Solutions for Intimacy, has written A Woman’s Guide to Thriving after Prostate Cancer.

Nearly one in six men are diagnosed with prostate cancer each year in the United States. Treatment can lead to unpleasant side effects, such as erectile difficulty. Hubiak, noticing there were very few prostate cancer resources for women, decided to spark a dialogue, and help married couples face the disease.

Hubiak, in an interview with Men and Health: It’s a Guy Thing, says it was time to write this book. “Steve (her husband, diagnosed in 2007) and I had struggled so much with how prostate cancer had impacted our relationship that it was an important topic for me to write about, for my own healing.”

Hubiak recalls meeting a woman at a class called “Men and Marriage.” She says the woman and her husband had divorced after 16 years because of his prostate cancer. According to Hubiak, “They could not get their relationship back together. I told Steve this just isn’t right. Relationships should not break up because of prostate cancer. Women should not have struggles with their sexuality. What can we do to help?

“For me as a woman, it was all about Steve’s health. Let’s get him healthy, cancer free and treat it. Once that happened, though, I realized I had a whole lot of healing to do myself. I needed to do a lot of grieving, I needed to look at sex in a whole new way. I had to learn some new skills to support Steve…Men don’t tend to want to grieve and they may feel that’s not masculine,” says Hubiak.

According to Hubiak, “Steve retreated and withdrew from me. I now realize that was his way of surviving. He needed to take care of himself so that he could then be around to take care of me later. I didn’t understand that. It was extremely isolating and frightening for me.” Hubiak says this is a similar occurrence among men, according to women she has talked with.

Steve, also interviewed by Men and Health, says, “I’ve always been a rather private person. This was not something that I felt I wanted to share with a lot of people.” He says his relationship with Cindie was affected because Cindie had difficulty getting the support she needed from her friends.

Cindie and Steve decided to create a business called  Solutions for Intimacy to help men and women who face prostate cancer

In A Woman’s Guide to Thriving after Prostate Cancer, readers will learn how to honor and grieve losses, effectively communicate desires, build deeper physical, emotional and spiritual connections, and improve intimacy through tantric principles.

Hubiak says, “Sex is different after prostate cancer. I believe it can be much better than it was before. Steve and I have a much improved sex life…Women can really learn to take the lead after prostate cancer.”

Visit Cindie and Steve at http://www.solutionsforintimacy.com. Their book is available at Amazon.com and Barnes and Noble.com.

Mark your calendar: September is prostate cancer awareness month

Prostate cancer is a topic I like to bring up regularly on this blog. Two reasons: I want men to get screened for prostate cancer. And I like to share my first-hand knowledge of the disease. After being diagnosed with cancer of the prostate (at a relatively younger age — mid-50s), I chose radiation therapy. My PSA level went from a high of 8-something to a much lower 1.5. My radiation oncologist was satisfied with the PSA result and told me there’s a very high probability the radiation did the trick.

Just the same, I have a very healthy respect for cancer and know it can always return and bite you hard. That’s why I will need to continue PSA blood tests for the rest of my life. If my PSA goes up in the future, I’ll have to consider other treatment options.

The following is a great article by Jeff Axtell in the Arizona Daily Sun in Flagstaff. Axtell reviews some prostate cancer facts and figures. This is a great read for any guy, baby boomer or otherwise. After all, one in six men will get prostate cancer.

Depending on where you live, there may be free prostate screenings during prostate cancer awareness month, so check with your local health authority.

Prostate cancer: Treatment options can be tailored to individuals

Not too many years ago, more men were being diagnosed with advanced, perhaps incurable, prostate cancer. This was before the PSA blood test. Perhaps the only clue of a problem was some prostate symptoms. In recent  years, with effective prostate cancer screening, more men are being diagnosed with treatable, early-stage disease.

There’s a great article by Harry Jackson Jr. in the St. Louis Post-Dispatch that quotes doctors in the field. For instance, Dr. Arnold Bullock, a urologist with the Center for Advanced Medicine at Barnes-Jewish Hospital, says more treatments are tailored to the individual. This compares with an era when treatment was more of a “one size fits all.”

Doctors, according to the article, say that after surgery, man no longer experience weeks of uncomfortable side effects; 80 to 90 percent of men can expect to be back to normal after prostate cancer.

Overall, says the article, it’s getting easier to cure the disease or manage it long-term.

If you’re a man, you need to discuss prostate health, including cancer, with your physician.  Urologists can suggest a treatment plan, based on the aggressiveness of the tumor. And, in many cases, you’ll have plenty of time to discuss treatment options with your doctor and family.

Cancer screening can help spot an early stage prostate cancer, before it has spread and becomes incurable. A heart-to-heart talk with your doc is vital.

Is a prostate exam really so bad? — guest post by Maria Rainier

Editor’s note: Throughout this blog, I write about the importance of getting prostate exams.  With effective and regular screenings, you have a fighting chance to catch prostate cancer in it’s earlier stages — when it’s treatable. I thought you would enjoy a guest article on prostate exams, from a woman’s perspective. As always, talk with your doctor and determine at what age you should begin prostate exams.

It’s one of the exams that men dread the most. Many have to be dragged in to see the doctor by their wives and partners. But really guys – is it so bad? It’s far less painful or traumatic than passing a kidney stone or getting a colonoscopy. And haven’t you already learned to handle awkward exams? “Turn your head and cough.” It’s time to get over those fears and do the right thing for your health.

What to Expect

A prostate exam is simply a digital rectal exam. (I know: “Simply.”) The doctor will use a gloved finger to feel inside your anus to check that there are no abnormalities on your prostate. He’ll check to make sure that it is smooth and isn’t hard or protruding into your rectum. That’s one finger. With lubrication. For a minute or two. And then it’s over! There’s no deep drilling and no sedatives involved. You won’t linger on the exam table in agony for hours. You won’t walk funny later. You won’t even feel any pain

You can handle it!

Who Needs Them

The American Cancer Society and the American Urological Association agree that all men should begin receiving annual prostate exams starting at age 50. Men who have a family history of prostate cancer are at higher risk and should begin screening at 45.  African-American men are also at higher risk of developing the disease and should start screening at 45.  Prostate cancer is 60 percent more likely to be diagnosed in African-American men than in white men of the same age. Those determined very high risk because of genetics or other factors may be encouraged to start screening at 40.

The American Urological Association also urges men to get at least one preliminary screening at age 40, and then to continue regular annual testing at 50.

Why You Need the Exam

Prostate cancer is the most common cancer in American men, and it can spread to other parts of the body, including the bones and lymph nodes.  Prostate cancer is a slow-growing disease with few symptoms, and most men are not diagnosed until they are in their 60s. Because the prostate is near the rectum, a prostate exam can detect abnormalities that can lead to early diagnosis. Though a blood test is also used to screen for prostate cancer, it is not always reliable for early detection.

Some symptoms of prostate cancer include:

        Frequent urination

        Difficulty urinating

        Weak or interrupted urination

        Pain during intercourse

        Erectile dysfunction

        Inability to urinate standing up

        Blood in urine or semen

However, many of these symptoms are not present until the cancer has spread. In the early stages, there may be no symptoms at all. Early detection can help catch the cancer before it is untreatable.

Just Do It

Yeah, so it’s uncomfortable, and it’s awkward. We ladies don’t like having our breasts smooshed on a glass plate for inspection either. But we have to do it. Because as awkward or uncomfortable as it might be, it will be far more traumatic and painful to find that you have an untreatable cancer or that you are facing months of intensive and painful medical treatments. Opt for the two minutes of embarrassment and give yourself many more years to fill with other happier, more exciting moments.

Maria Rainier is a freelance writer and blog junkie. She is currently a resident blogger at First in Education where she’s written on urban & regional planner jobs along with electrical engineering technology programs. In her spare time, she enjoys yoga, playing piano, and working with origami.

Prostate cancer: A variety of treatment options

Men and Health: It’s a Guy Thing had a chance to conduct an e-mail interview with Dr. Pablo Lavagnini, a board-certified radiation oncologist.

Since prostate issues start appearing in middle age, what do men (after the age of 40) need to focus on?

Prostate cancer is the most common type of cancer found in American men, after skin cancer. But luckily it is also one of the most curable types of cancer—if caught early. Men should receive regular checkups. After the age of 40, men should keep an eye out for burning urination and a decrease in flow of urine. Men should also look out for blood in their urine. This is most likely not related to the prostate, but can be linked to kidney cancer. This is very rare, but still worrisome.

Prostate cancer primarily strikes older men, but how young can a man be diagnosed with this disease?

It’s extremely rare, but men can be diagnosed with prostate cancer anywhere after their 20’s. However, as you age, the chances of being diagnosed with prostate cancer increase. Typically, after your 50’s, it’s recommended to have a periodic (2-3 years) Prostate-Specific Antigen (PSA) and a digital rectal exam as a screening method.

I have heard….you might confirm….that even a 20-something guy can have a very miniscule (tiny) amount of prostate cancer. Is this so?

Yes, this is true. But, consider this: If you take 100 men who are 75 yrs old who would die of other causes and do an autopsy on all of them, you would find that about 75% harbor an asymptomatic cancer in their prostate. However, in the general population only 8% of prostate cancers are significant enough to become clinically relevant.

The important takeaway here is that even if there are no symptoms, men after their 50’s should take precautions and be sure to see their doctors and get screening done so when and if prostate cancer is found, your doctor will advise you whether treatment is necessary and the kind of treatment that is best for you.

When diagnosed with early stage (confined to the prostate) cancer, a man may think he needs the prostate surgically removed the next week. Generally speaking, does a man have time to think about treatment options?

Absolutely! Most newly diagnosed prostate cancer patients have even two to three months to get second opinions and make a decision about treatment. It is important for any patient facing a cancer diagnosis to take the time to find a team of cancer experts who you trust. At Cancer Treatment Centers of America (CTCA) my colleagues and I place a lot of attention on education and communication. We want our patients to understand all of their options so that they can make the choice that is best for them, based on their individual case and situation.

In early stage disease, can radiation be as effective as surgery in treating, or perhaps, curing prostate cancer?

Yes, radiation can absolutely be as effective as surgery in treating prostate cancer. At CTCA, we use several different treatment options to treat prostate cancer, all of which are equally effective. They include:

Surgery – Prostatectomies

External beam radiation – Tomotherapy and Varian’s Trilogy are two advanced radiation technologies that allow highly focused, powerful radiation beams to reach the tumor, while sparing healthy surrounding tissue

Calypso® – Called “GPS for the Body,” transponders are implanted into the prostate so that movement of the tumor is monitored while delivering focused doses of external beam radiation

HDR Brachytherapy – a form of internal radiation that includes a procedure where a series of tiny catheters are placed in and around the tumor

Chemotherapy, Hormone therapy and other types of Immunotherapies and biotherapies might also be treatment options.

The main differences between choosing surgery or radiation are the side effects. Your physician should inform you of the side effects of each option in order to help you make an educated decision about which treatment option is best for you.

Explain external beam radiation vs. radiation seeds?

External Beam Radiation Therapy (EBRT) is targeted to the prostate, but delivered from outside of the body. Over the last 15 years, technologies including Tomotherapy and GPS guided radiation with Calypso have significantly improved the ability of EBRT in targeting the prostate and sparing healthy surrounding tissues like the bladder and especially the rectum.

Radiation seeds, better known as brachytherapy, is performed by placing permanent radioactive seeds like iodine 125, palladium or with a temporary high dose rate Iridium implant inside the prostate. One of the major benefits of brachytherapy is that the entire treatment only takes one and a half days, as opposed to the eight to nine weeks for ERBT. This is one reason that brachytherapy has become a more popular option over the last few years.

Can a younger man (diagnosed in his 50s) be a good candidate for radiation?

Yes. Age is generally not a factor when choosing the treatment option that is best for a patient.

When is it absolutely necessary to have the prostate removed…and quickly?

Personally, I would say it is never necessary to come to that type of decision hastily. You should always take the adequate time to get second opinions and make an educated and informed decision.

Are more men choosing radiation……or is surgery still preferred?

As of right now, men are choosing radiation and surgery equally. As mentioned before, a man has to weigh his options after learning about the side effects of each treatment option. There are many factors that come into play when faced with cancer and treatment planning, and every individual is different, as is their cancer.

What are some side effects of external beam radiation?

All treatments have potential side effects. Patients receiving external beam radiation could experience a higher risk of rectal irritation, bleeding and in some rare cases, ulceration. Fortunately, many of my patients benefit because of our integrated approach to cancer care. By working with complementary care providers, including nutritionists, naturopathic doctors, oncology rehabilitation therapists and mind/body medicine therapists, the physical pain and discomfort associated with traditional treatments, as well as the mental and emotional effects of the disease, can be minimized and made a lot more tolerable.

What are some side effects of brachytherapy (seeds)?

Patients receiving brachytherapy could experience a higher risk of acute burning of urination that can sometimes take a week to a few months to resolve. Some patients also may notice blood in their urine. These side effects are common and usually temporary.

How do you see prostate cancer treatment a decade from now? Could the PSA test be a thing of the past?

There will certainly be technological advances in both surgery and radiotherapy a decade from now, but I believe that both options will still remain an equal choice for patients. While it’s unlikely that the PSA test will be abandoned anytime soon, researchers are working hard to find better ways to screen prostate cancer, for the future.

In terms of treatment options there are also some exciting things on the horizon. For example, at CTCA we recently began offering patients intraoperative radiation therapy (IORT). We are currently the only hospital in the country to offer this technique using the Novac7 technology, which allows patients to receive a single, large dose of radiation while in the operating room undergoing surgery, thereby minimizing, and in some cases, eliminating the amount of external beam radiation therapy required. Patients experience few side effects and are able to get back to their lives faster than they previously thought possible. While we have been using IORT largely to treat breast cancer, the Novac7 technology also allows us to treat additional disease types. We hope that in the near future we will also be able to use IORT at the time of prostatectomies.

What are your closing thoughts about prostate cancer? What advice do you have for the middle-aged guy with no symptoms?

Don’t hide your head in the sand (pun intended). Visit your doctor regularly and get tested when you reach middle age. It’s better to be aware of an issue and take care of it while it’s manageable, than ignore and regret it later. There have been tremendous advancements in technology and treatment options, so find a doctor who you trust and who takes the time to explain them to you. Also, be aware of complementary therapies that can help improve quality of life and keep you feeling and acting like you!

Dr. Lavagnini serves as the Director of Radiation Oncology at Cancer Treatment Centers of America at Eastern Regional Medical Center.

Visit: www.cancercenter.com

 

 

 

It’s the prostate, not the prostrate — article by Scott Keith

The more I interview doctors and specialists for this blog, the more I notice that men do not have the same laser-sharp focus on their personal health as women seem to have. While women keep current on all their medical screenings, men find it hard to see the doctor, until they are doubled up in pain or frightened to death over a symptom.

A urologist who notices this is Dr. Edward Karpman, who specializes in the diagnosis and treatment of male sexual dysfunction. “It is true that women tend to be more proactive about their health care. They tend to see a doctor for their routine screenings, mammograms and tests…It’s hard to explain at a physiological or biochemical level.” Karpman says it may have something to do with our society and culture. “Guys have to appear resilient and indestructible. I think going to the doctor is almost an admission of some type of vulnerability in their armor…they don’t want to go see a doctor until it’s too late, until it hurts,” says Karpman.

The road seems especially tough for single men. In an interview with Men and Health: It’s a Guy Thing, Karpman believes female partners help men focus on health. “I think that’s really the reason why we see longer life spans in guys who are in relationships.” Many men see the doctor only after being told to do so by their partner.

Women can provide the careful nudge, convincing their hubbies, fathers or boyfriends to pay better attention to aches, pains, even subtle symptoms. Karpman says a survey of households in the Silicon Valley revealed that women (approximately 80 percent of the time) were the primary medical caretaker in the family. “I think it’s kind of an enigma as to why this happens. We can probably look at our society and culture and attribute some of this kind of behavior to the way we’re brought up,” says Karpman.

Foot dragging and a lack of knowledge can cause men to delay prostate screenings. “I think there is still a gap in knowledge about the prostate among the general population. Guys still refer to it as the prostrate,” says Karpman, adding that he’s surprised some guys still don’t know about PSA blood tests. “That tells me that our general knowledge about prostate health is not where it really should be.”

Men need to know that many diseases, in the early stages, show no symptoms. So it’s not a good idea to think you are free of illness, just because you feel healthy and strong. “The vast majority of medical problems only manifest themselves when it’s kind of at a critical point,” says Karpman, Medical Director of the Men’s Health Center at El Camino Hospital in Los Gatos, California. The idea behind cancer screening is to catch a cancer early, when there’s a much greater chance of cure.

Regardless of how good you feel, Karpman says “You’re not immune, you’re not invincible to disease. Get checked out.”

Visit Dr. Karpman at www.healthy-male.com