“but, doc, do i really need that part of my annual physical?”
These words are heard by physicians everywhere uttered by the “stronger sex”. There is a natural dread of having your doctor probe an area of your body better left alone. The easy answer to that plea is “YES”. By doing a digital rectal exam, your doctor can get a sense of the size and consistency of your prostate, evaluate for rectal growths, and test your stool for blood. As an urologist, I am interested in finding prostate abnormalities early before they can get out of hand. As a man ages he has a greater chance of having a benign enlargement of his prostate as well as developing prostate cancer. The American Cancer Society reports that this year about 241,000 new cases of prostate cancer will be diagnosed and around 34,000 men will die of prostate cancer. PROSTATE CANCER IS A CURABLE DISEASE!
In order to successfully treat and cure prostate cancer, it has to be discovered at an early stage. This is why at 40 years old your doctor needs to perform a digital rectal exam. At 50 years old he will begin drawing blood for a PSA (Prostate Specific Antigen) level. In most individuals, these two tests allow prostate cancer to be found early. Early equates with curable. If both the rectal exam and PSA are normal, they should be repeated in a year. If either one is a concern to your doctor, he will most likely refer you to an urologist for further evaluation. The majority of those men referred do not have cancer.
The urologist, who is specially trained to diagnose prostate problems, will review your findings and make recommendations for further testing. This might mean just repeating the PSA in several months or he may advise that a biopsy of the prostate be performed. Prostate biopsies are done in the doctor’s office under local anesthesia and are well tolerated with some mild bleeding in the urine or the stool for several days later. The results of the biopsy will be available within a week. Seventy percent of prostate biopsies done for an elevation of the PSA turn out not to be cancer.
If your biopsy reveals prostate cancer, then you can expect your urologist will discuss various treatment options. Prostate cancer responds to several completely different treatments. These include the removal of the entire prostate (radical prostatectomy), radiation therapy either given externally or internally, freezing the prostate (cryotherapy), and close observations. The doctor will help you to decide which treatment is best for you.
“i heard that the psa test wasn’t good anymore”
Recently there has been some controversy about whether the PSA blood test should be used to screen for prostate cancer in patients that don’t have risk factors such as a family history of prostate cancer or a lump on the prostate discovered during a physical. Several consumer health groups have stated that the mortality (how many men die from prostate cancer) has not been improved by screening with the PSA test. The American Cancer Society recommends that men without risk factors thinking about prostate cancer screening tests should make their decision based on available prostate cancer information and a thorough discussion with their doctors.
“is there anything that i can do to lessen my chance of developing prostate cancer?”
Generally, a heart healthy diet is a prostate healthy diet. Avoidance of fatty foods and limiting the amount of red meat in the diet is the first step. A Mediterranean style diet that is based on fresh vegetables, chicken and broiled seafood is beneficial to the heart and the prostate. Soy protein, green tea, and pomegranates have been shown to decrease the incidence of prostate cancer in some studies. Prostate cancer is rare in Japan where the diet is based on vegetables, soy protein and fish. If you take a man from Japan and move him to Virginia and he changes his diet to a fast food based diet, his risk of developing prostate cancer equals that of an American.
In conclusion, prostate cancer can be cured if diagnosed early. You can’t change your family history, but remember, you can change your diet and get your annual rectal exam and PSA test. Your family wants to keep you around for a while longer. When we were younger we talked about girls, baseball, swimming holes. Now it seems that all we talk about is prostate, prostate, prostate.
Submitted by Fredrick S. Arnold M.D., Board Certified by the American Board of Urology. Dr. Arnold’s office is located on the campus of Riverside Walter Reed Hospital at 7552 Hospital Drive, Suite 302, Gloucester Va. For more information or to schedule an appointment please call 804-693-9062.
Dr. Arnold will be offering a free prostate cancer screening at the Riverside Middle Peninsula Cancer Center on September 17,
2011 from 8:00 am to 10:30 am. For more information or to schedule a free screening please call 800-520-7006.
THE MOST COMMONPROSTATE ISSUE
Prostate issues are not always about cancer. Once a man reaches the age of 50; this tiny unassuming walnut sized gland can cause a whole world of trouble. Frequent urination, strain, weakened stream and having to get up several times during the night: all these symptoms might mean you have an enlarged prostate or a condition called Benign Prostatic Hyperplasia or BPH. It’s important to note that these conditions are not life threatening. But they are inconvenient and embarrassing. And by the time you’ve reached your golden years, you should be concentrating on having fun and not what’s going on in the bathroom. Luckily there are all kinds of tests and technologies available to check for BPH. Physical exams, blood tests, urinary flow test and ultrasounds are all ways in which this problem can be detected. There is also a procedure called cystoscopy in which a small camera is actually inserted into the urethra to check for irregularities.
There are just as many ways to safely and effectively treat BPH. Drugs, such as alpha-blockers, can relax the muscles in the bladder, shrink the prostate and increase bladder capacity. Microwave Thermal Therapy, also known at transurethral microwave thermotherapy (TUMT), removes the excess prostate tissue that disrupts urine flow. There are also minimally invasive laser therapies that accomplish the same thing. If you’re looking for a non-surgical answer to BPH, try these simple therapies: Limit your caffeine and alcohol intake. Try not to drink anything within a couple hours of your bedtime. And as always, maintain a healthy weight, exercise and eat healthy foods.
Please note that an enlarged prostate doesn’t have to disrupt your life. This condition is very treatable. Please contact your local doctor or urologist if you have any questions about the diagnostics or treatments you’ve read about in this article. The sooner you can resolve issues like BPH, the sooner you can concentrate on the things in life that really matter.
Submitted by Jeffrey Haskins, M.D., Board Certified by the American Board of Urology. Dr. Haskin’s office, Riverside Tappahannock Urological Center, is located in the Riverside Medical Arts Building B, 668 Hospital Road, Suite 300 Tappahannock, Va. For more information or to schedule an appointment