Tag Archives: Prostate cancer

Straight, No Chaser: Recommendations for Early Detection of Prostate Cancer

prostate-to-do-2

Every so often, controversies regarding medical treatment recommendations get in the news and seemingly only serve to confuse the public. Every blog, article or research paper is a single entity that may or may not adjust the body and weight of evidence on a given topic. Even most well-done research articles do not completely change the standard of care for medical practice. Prostate cancer screening is a great example. At the end of it all, controversies aren’t as important as the consensus recommendations that emerge from medical and public health professionals tasked with reviewing such information.
In this Straight, No Chaser, we will review the latest (2016) recommendations from the American Cancer Society (ACS) for early detection of prostate cancer. Remember, when you hear dissenting views, consider the source and balance that against the formal recommendations of ACS.
In an earlier Straight, No Chaser, several questions regarding prostate cancer were addressed. However, there is one additional question that is important to review.
Does Everyone With Prostate Cancer Get Treated?


prostate screening risks benefits

This is the source of controversies regarding screening of prostate cancer. Most men diagnosed with prostate cancer do not die from the disease. I mentioned previously that 30,000 men with prostate cancer die of the disease every year. However, over 3 million men in the U.S. are currently living with a diagnosis of prostate cancer. Based on these statistics, the question then becomes…

Why Do All Men Need to Be Screened For Prostate Cancer?
A certain stream of logic asks why screening is necessary if most of those who are diagnosed don’t die. Many treatments (e.g. surgery, medications, radiation) have additional risks that could be avoided if interventions were avoided. Similarly, some have taken to asking if any screening program is necessary. The view here is information is empowering. It’s always better to have information regarding the state of your health. Working with your medical team and family, the correct decisions about next steps can be made. This option is only available if you know what’s happening with your health.
How Does Screening Occur?

prostate exam

There are two tests commonly used to screen for prostate cancer.

  • A digital rectal exam (DRE) is when a doctor inserts a gloved, lubricated finger into the rectum and estimates the size of the prostate and assesses it for lumps or other abnormalities.
  • The prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate, and PSA blood levels can be higher in men who have prostate cancer. Unfortunately the PSA level isn’t specific for prostate cancer, as it can be elevated in other conditions that affect the prostate such as age, race, certain medications or medical procedures, prostate enlargement or infection.

So What Are The Current Recommendations for screening?

prostate cancer screening guidelines

The American Cancer Society (ACS) recommends that men get to decide if they want to be screened, based on a recommendation from their physician and having received information about the risks, benefits and uncertainties surrounding screening. In other words, we don’t even talk about screening anymore; now it’s “Who should have a conversation with their physician about getting screened?”

  • If you’re age 50 and have an average risk of prostate cancer and are expected to live at least 10 more years. Because prostate cancer grows slowly, if your life expectancy is less than 10 years, you wouldn’t benefit from screening or treatment for prostate cancer.
  • If you’re age 45 for men and are at high risk of developing prostate cancer. This includes African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
  • If you’re age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

Among these groups, when the decision is made to screen, those men will be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.
Assuming no prostate cancer is found as a result of screening, the need for future screenings depends on the results of the PSA blood test:

  • Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years.
  • Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher.

Even after a decision about testing has been made, the discussion about the pros and cons of testing should be repeated as new information about the benefits and risks of testing becomes available. Further discussions are also needed to take into account changes in the patient’s health, values, and preferences. Please at least have the conversation with your physician.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Facts About Prostate Cancer – 2018 Update

prostate-cancer_medium

Men (and those who care for men – meaning everyone) should be knowledgeable about prostate cancer. I don’t mean physician-level knowledgeable, but there are just a few facts that you should know that are meaningful. We’ll cover those in this Straight, No Chaser.
Aside from skin cancer, prostate cancer is the most common cancer among men in the U.S. It is also one of the leading causes of cancer death among men of all races. According to the National Cancer Institute, in 2018, there will be over 164,6900 new cases and well over 29, 430 deaths (13% increase from 2017) from prostate cancer. Approximately 11.2% of men will be diagnosed with prostate cancer at some point during their lifetime. Here are some prostate cancer basics.
Prostate NormalCancer
What’s the prostate exactly?
The location and function of the prostate was covered in this previous post.
Who’s at risk for prostate cancer?

  • Age: This is simple. The older you are, the greater your risk of developing prostate cancer.
  • Race: Prostate cancer is more common in certain racial and ethnic groups.
  • Genetics: Your risk is increased, which is not the same as saying you’ll develop it if a family member has. This risk is twice to three times more likely if you have a father, brother or son who has had prostate cancer.

prostate cancer symptoms-of-prostate-cancer-c77ttmeb

What are the symptoms of prostate cancer?
It is of interest that a wide variety of presentations exists in those later diagnosed with prostate cancer. Some men don’t have symptoms (meaning it’s discovered on screening examinations), and other men present with several symptoms, which may include the following.

  • Blood in the urine or semen
  • Difficulty completely emptying the bladder
  • Difficulty starting urination
  • Frequent urination (especially at night)
  • Pain in the back, hips, or pelvis that doesn’t go away
  • Pain or burning during urination
  • Painful ejaculation
  • Weak or interrupted flow of urine

Prostate-Cancer-Treatment

How Is Prostate Cancer Treated?
See the above chart for more detailed information. Optimally, treatment for prostate cancer should take into account

  • Your age and expected life span with and without treatment
  • Other health conditions you have
  • The severity (i.e. stage and grade) of your cancer
  • Your feelings (and your physician’s medical opinion) about the need to treat the cancer
  • The likelihood that treatment will cure your cancer or provide some other measure of benefit
  • Possible side effects from treatment

Different types of established treatments are available for prostate cancer, including the following:

  • Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms. This is known as active surveillance.
  • Surgery to remove the prostate and or surrounding tissue. This surgery is called a prostatectomy.
  • Radiation therapy with high-energy rays to kill the cancer..
  • Hormone therapy perhaps could be named “hormone blocking therapy,” because these medicines blocks cancer cells from getting the hormones they need to grow.

The next Straight, No Chaser will provide an update on prostate cancer screening recommendations.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Prostate Cancer Screening

prostate-to-do-2

Every so often, controversies regarding medical treatment recommendations get in the news and seemingly only serve to confuse the public. Every blog, article or research paper is a single entity that may or may not adjust the body and weight of evidence on a given topic. Even most well-done research articles do not completely change the standard of care for medical practice. Prostate cancer screening is a great example. At the end of it all, controversies aren’t as important as the consensus recommendations that emerge from medical and public health professionals tasked with reviewing such information.
In this Straight, No Chaser, we will review the 2015 recommendations from the American Cancer Society (ACS) for early detection of prostate cancer. Remember, when you hear dissenting views, consider the source and balance that against the formal recommendations of ACS.
In an earlier Straight, No Chaser, several questions regarding prostate cancer were addressed. However, there is one additional question that is important to review.
Does Everyone With Prostate Cancer Get Treated?


prostate screening risks benefits

This is the source of controversies regarding screening of prostate cancer. Most men diagnosed with prostate cancer do not die from the disease. I mentioned previously that 30,000 men with prostate cancer die of the disease every year. However, over 2.5 million men in the U.S. are currently living with a diagnosis of prostate cancer. Based on these statistics, the question then becomes…

Why Do All Men Need to Be Screened For Prostate Cancer?
A certain stream of logic asks why screening is necessary if most of those who are diagnosed don’t die. Many treatments (e.g. surgery, medications, radiation) have additional risks that could be avoided if interventions were avoided. Similarly, some have taken to asking if any screening program is necessary. The view here is information is empowering. It’s always better to have information regarding the state of your health. Working with your medical team and family, the correct decisions about next steps can be made. This option is only available if you know what’s happening with your health.
How Does Screening Occur?

prostate exam

There are two tests commonly used to screen for prostate cancer.

  • A digital rectal exam (DRE) is when a doctor inserts a gloved, lubricated finger into the rectum and estimates the size of the prostate and assesses it for lumps or other abnormalities.
  • The prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate, and PSA blood levels can be higher in men who have prostate cancer. Unfortunately the PSA level isn’t specific for prostate cancer, as it can be elevated in other conditions that affect the prostate such as age, race, certain medications or medical procedures, prostate enlargement or infection.

So What Are The Current Recommendations for screening?

prostate cancer screening guidelines

The American Cancer Society (ACS) recommends that men get to decide if they want to be screened, based on a recommendation from their physician and having received information about the risks, benefits and uncertainties surrounding screening. In other words, we don’t even talk about screening anymore; now it’s “Who should have a conversation with their physician about getting screened?”

  • If you’re age 50 and have an average risk of prostate cancer and are expected to live at least 10 more years. Because prostate cancer grows slowly, if your life expectancy is less than 10 years, you wouldn’t benefit from screening or treatment for prostate cancer.
  • If you’re age 45 for men and are at high risk of developing prostate cancer. This includes African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
  • If you’re age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

Among these groups, when the decision is made to screen, those men will be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.
Assuming no prostate cancer is found as a result of screening, the need for future screenings depends on the results of the PSA blood test:

  • Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years.
  • Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher.

Even after a decision about testing has been made, the discussion about the pros and cons of testing should be repeated as new information about the benefits and risks of testing becomes available. Further discussions are also needed to take into account changes in the patient’s health, values, and preferences. Please at least have the conversation with your physician.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Prostate Cancer – 2017 Update

prostate-cancer_medium

Men (and those who care for men – meaning everyone) should be knowledgeable about prostate cancer. I don’t mean physician-level knowledgeable, but there are just a few facts that you should know that are meaningful. We’ll cover those in this Straight, No Chaser.
Aside from skin cancer, prostate cancer is the most common cancer among men in the U.S. It is also one of the leading causes of cancer death among men of all races. According to the National Cancer Institute, in 2017, there will be over 161,000 new cases and well over 26,000 deaths from prostate cancer. Approximately 11.6% of men will be diagnosed with prostate cancer at some point during their lifetime. Here are some prostate cancer basics.
Prostate NormalCancer
What’s the prostate exactly?
The location and function of the prostate was covered in this previous post.
Who’s at risk for prostate cancer?

  • Age: This is simple. The older you are, the greater your risk of developing prostate cancer.
  • Race: Prostate cancer is more common in certain racial and ethnic groups.
  • Genetics: Your risk is increased, which is not the same as saying you’ll develop it if a family member has. This risk is twice to three times more likely if you have a father, brother or son who has had prostate cancer.

prostate cancer symptoms-of-prostate-cancer-c77ttmeb

What are the symptoms of prostate cancer?
It is of interest that a wide variety of presentations exists in those later diagnosed with prostate cancer. Some men don’t have symptoms (meaning it’s discovered on screening examinations), and other men present with several symptoms, which may include the following.

  • Blood in the urine or semen
  • Difficulty completely emptying the bladder
  • Difficulty starting urination
  • Frequent urination (especially at night)
  • Pain in the back, hips, or pelvis that doesn’t go away
  • Pain or burning during urination
  • Painful ejaculation
  • Weak or interrupted flow of urine

Prostate-Cancer-Treatment

How Is Prostate Cancer Treated?
See the above chart for more detailed information. Optimally, treatment for prostate cancer should take into account

  • Your age and expected life span with and without treatment
  • Other health conditions you have
  • The severity (i.e. stage and grade) of your cancer
  • Your feelings (and your physician’s medical opinion) about the need to treat the cancer
  • The likelihood that treatment will cure your cancer or provide some other measure of benefit
  • Possible side effects from treatment

Different types of established treatments are available for prostate cancer, including the following:

  • Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms. This is known as active surveillance.
  • Surgery to remove the prostate and or surrounding tissue. This surgery is called a prostatectomy.
  • Radiation therapy with high-energy rays to kill the cancer..
  • Hormone therapy perhaps could be named “hormone blocking therapy,” because these medicines blocks cancer cells from getting the hormones they need to grow.

The next Straight, No Chaser will provide an update on prostate cancer screening recommendations.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Prostate Cancer Screening

prostate-to-do-2

Every so often, controversies regarding medical treatment recommendations get in the news and seemingly only serve to confuse the public. Every blog, article or research paper is a single entity that may or may not adjust the body and weight of evidence on a given topic. Even most well-done research articles do not completely change the standard of care for medical practice. Prostate cancer screening is a great example. At the end of it all, controversies aren’t as important as the consensus recommendations that emerge from medical and public health professionals tasked with reviewing such information.
In this Straight, No Chaser, we will review the 2015 recommendations from the American Cancer Society (ACS) for early detection of prostate cancer. Remember, when you hear dissenting views, consider the source and balance that against the formal recommendations of ACS.
In an earlier Straight, No Chaser, several questions regarding prostate cancer were addressed. However, there is one additional question that is important to review.
Does Everyone With Prostate Cancer Get Treated?


prostate screening risks benefits

This is the source of controversies regarding screening of prostate cancer. Most men diagnosed with prostate cancer do not die from the disease. I mentioned previously that 30,000 men with prostate cancer die of the disease every year. However, over 2.5 million men in the U.S. are currently living with a diagnosis of prostate cancer. Based on these statistics, the question then becomes…

Why Do All Men Need to Be Screened For Prostate Cancer?
A certain stream of logic asks why screening is necessary if most of those who are diagnosed don’t die. Many treatments (e.g. surgery, medications, radiation) have additional risks that could be avoided if interventions were avoided. Similarly, some have taken to asking if any screening program is necessary. The view here is information is empowering. It’s always better to have information regarding the state of your health. Working with your medical team and family, the correct decisions about next steps can be made. This option is only available if you know what’s happening with your health.
How Does Screening Occur?

prostate exam

There are two tests commonly used to screen for prostate cancer.

  • A digital rectal exam (DRE) is when a doctor inserts a gloved, lubricated finger into the rectum and estimates the size of the prostate and assesses it for lumps or other abnormalities.
  • The prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate, and PSA blood levels can be higher in men who have prostate cancer. Unfortunately the PSA level isn’t specific for prostate cancer, as it can be elevated in other conditions that affect the prostate such as age, race, certain medications or medical procedures, prostate enlargement or infection.

So What Are The Current Recommendations for screening?

prostate cancer screening guidelines

The American Cancer Society (ACS) recommends that men get to decide if they want to be screened, based on a recommendation from their physician and having received information about the risks, benefits and uncertainties surrounding screening. In other words, we don’t even talk about screening anymore; now it’s “Who should have a conversation with their physician about getting screened?”

  • If you’re age 50 and have an average risk of prostate cancer and are expected to live at least 10 more years. Because prostate cancer grows slowly, if your life expectancy is less than 10 years, you wouldn’t benefit from screening or treatment for prostate cancer.
  • If you’re age 45 for men and are at high risk of developing prostate cancer. This includes African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
  • If you’re age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

Among these groups, when the decision is made to screen, those men will be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.
Assuming no prostate cancer is found as a result of screening, the need for future screenings depends on the results of the PSA blood test:

  • Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years.
  • Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher.

Even after a decision about testing has been made, the discussion about the pros and cons of testing should be repeated as new information about the benefits and risks of testing becomes available. Further discussions are also needed to take into account changes in the patient’s health, values, and preferences. Please at least have the conversation with your physician.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Prostate Cancer

prostate-cancer_medium

Men (and those who care for men – meaning everyone) should be knowledgeable about prostate cancer. I don’t mean physician-level knowledgeable, but there are just a few facts that you should know that are meaningful. We’ll cover those in this Straight, No Chaser.
Aside from skin cancer, prostate cancer is the most common cancer among men in the U.S. It is also one of the leading causes of cancer death among men of all races. In 2011, well over 200,000 men in the U.S. were diagnosed with prostate cancer with almost 30,000 deaths. Approximately one in six men will be diagnosed with prostate cancer. Here are some prostate cancer basics.
Prostate NormalCancer
What’s the prostate exactly?
The location and function of the prostate was covered in this previous post.
Who’s at risk for prostate cancer?

  • Age: This is simple. The older you are, the greater your risk of developing prostate cancer.
  • Race: Prostate cancer is more common in certain racial and ethnic groups.
  • Genetics: Your risk is increased, which is not the same as saying you’ll develop it if a family member has. This risk is twice to three times more likely if you have a father, brother or son who has had prostate cancer.

prostate cancer symptoms-of-prostate-cancer-c77ttmeb

What are the symptoms of prostate cancer?
It is of interest that a wide variety of presentations exists in those later diagnosed with prostate cancer. Some men don’t have symptoms (meaning it’s discovered on screening examinations), and other men present with several symptoms, which may include the following.

  • Blood in the urine or semen
  • Difficulty completely emptying the bladder
  • Difficulty starting urination
  • Frequent urination (especially at night)
  • Pain in the back, hips, or pelvis that doesn’t go away
  • Pain or burning during urination
  • Painful ejaculation
  • Weak or interrupted flow of urine

Prostate-Cancer-Treatment

How Is Prostate Cancer Treated?
See the above chart for more detailed information. Optimally, treatment for prostate cancer should take into account

  • Your age and expected life span with and without treatment
  • Other health conditions you have
  • The severity (i.e. stage and grade) of your cancer
  • Your feelings (and your physician’s medical opinion) about the need to treat the cancer
  • The likelihood that treatment will cure your cancer or provide some other measure of benefit
  • Possible side effects from treatment

Different types of established treatments are available for prostate cancer, including the following:

  • Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms. This is known as active surveillance.
  • Surgery to remove the prostate and or surrounding tissue. This surgery is called a prostatectomy.
  • Radiation therapy with high-energy rays to kill the cancer..
  • Hormone therapy perhaps could be named “hormone blocking therapy,” because these medicines blocks cancer cells from getting the hormones they need to grow.

The next Straight, No Chaser will provide an update on prostate cancer screening recommendations.
Feel free to ask any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Prostate Cancer Screening

prostate-to-do-2

Every so often, controversies regarding medical treatment recommendations get in the news and seemingly only serve to confuse the public. Every blog, article or research paper is a single entity that may or may not adjust the body and weight of evidence on a given topic. Even most well-done research articles do not completely change the standard of care for medical practice. Prostate cancer screening is a great example. At the end of it all, controversies aren’t as important as the consensus recommendations that emerge from medical and public health professionals tasked with reviewing such information.
In this Straight, No Chaser, we will review the 2015 recommendations from the American Cancer Society (ACS) for early detection of prostate cancer. Remember, when you hear dissenting views, consider the source and balance that against the formal recommendations of ACS.
In an earlier Straight, No Chaser, several questions regarding prostate cancer were addressed. However, there is one additional question that is important to review.
Does Everyone With Prostate Cancer Get Treated?


prostate screening risks benefits

This is the source of controversies regarding screening of prostate cancer. Most men diagnosed with prostate cancer do not die from the disease. I mentioned previously that 30,000 men with prostate cancer die of the disease every year. However, over 2.5 million men in the U.S. are currently living with a diagnosis of prostate cancer. Based on these statistics, the question then becomes…

Why Do All Men Need to Be Screened For Prostate Cancer?
A certain stream of logic asks why screening is necessary if most of those who are diagnosed don’t die. Many treatments (e.g. surgery, medications, radiation) have additional risks that could be avoided if interventions were avoided. Similarly, some have taken to asking if any screening program is necessary. The view here is information is empowering. It’s always better to have information regarding the state of your health. Working with your medical team and family, the correct decisions about next steps can be made. This option is only available if you know what’s happening with your health.
How Does Screening Occur?

prostate exam

There are two tests commonly used to screen for prostate cancer.

  • A digital rectal exam (DRE) is when a doctor inserts a gloved, lubricated finger into the rectum and estimates the size of the prostate and assesses it for lumps or other abnormalities.
  • The prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate, and PSA blood levels can be higher in men who have prostate cancer. Unfortunately the PSA level isn’t specific for prostate cancer, as it can be elevated in other conditions that affect the prostate such as age, race, certain medications or medical procedures, prostate enlargement or infection.

So What Are The Current Recommendations for screening?

prostate cancer screening guidelines

The American Cancer Society (ACS) recommends that men get to decide if they want to be screened, based on a recommendation from their physician and having received information about the risks, benefits and uncertainties surrounding screening. In other words, we don’t even talk about screening anymore; now it’s “Who should have a conversation with their physician about getting screened?”

  • If you’re age 50 and have an average risk of prostate cancer and are expected to live at least 10 more years. Because prostate cancer grows slowly, if your life expectancy is less than 10 years, you wouldn’t benefit from screening or treatment for prostate cancer.
  • If you’re age 45 for men and are at high risk of developing prostate cancer. This includes African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
  • If you’re age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

Among these groups, when the decision is made to screen, those men will be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.
Assuming no prostate cancer is found as a result of screening, the need for future screenings depends on the results of the PSA blood test:

  • Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years.
  • Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher.

Even after a decision about testing has been made, the discussion about the pros and cons of testing should be repeated as new information about the benefits and risks of testing becomes available. Further discussions are also needed to take into account changes in the patient’s health, values, and preferences. Please at least have the conversation with your physician.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Prostate Cancer

prostate-cancer_medium

Men (and those who care for men – meaning everyone) should be knowledgeable about prostate cancer. I don’t mean physician-level knowledgeable, but there are just a few facts that you should know that are meaningful. We’ll cover those in this Straight, No Chaser.
Aside from skin cancer, prostate cancer is the most common cancer among men in the U.S. It is also one of the leading causes of cancer death among men of all races. In 2011, well over 200,000 men in the U.S. were diagnosed with prostate cancer with almost 30,000 deaths. Approximately one in six men will be diagnosed with prostate cancer. Here are some prostate cancer basics.
Prostate NormalCancer
What’s the prostate exactly?
The location and function of the prostate was covered in this previous post.
Who’s at risk for prostate cancer?

  • Age: This is simple. The older you are, the greater your risk of developing prostate cancer.
  • Race: Prostate cancer is more common in certain racial and ethnic groups.
  • Genetics: Your risk is increased, which is not the same as saying you’ll develop it if a family member has. This risk is twice to three times more likely if you have a father, brother or son who has had prostate cancer.

prostate cancer symptoms-of-prostate-cancer-c77ttmeb

What are the symptoms of prostate cancer?
It is of interest that a wide variety of presentations exists in those later diagnosed with prostate cancer. Some men don’t have symptoms (meaning it’s discovered on screening examinations), and other men present with several symptoms, which may include the following.

  • Blood in the urine or semen
  • Difficulty completely emptying the bladder
  • Difficulty starting urination
  • Frequent urination (especially at night)
  • Pain in the back, hips, or pelvis that doesn’t go away
  • Pain or burning during urination
  • Painful ejaculation
  • Weak or interrupted flow of urine

Prostate-Cancer-Treatment

How Is Prostate Cancer Treated?
See the above chart for more detailed information. Optimally, treatment for prostate cancer should take into account

  • Your age and expected life span with and without treatment
  • Other health conditions you have
  • The severity (i.e. stage and grade) of your cancer
  • Your feelings (and your physician’s medical opinion) about the need to treat the cancer
  • The likelihood that treatment will cure your cancer or provide some other measure of benefit
  • Possible side effects from treatment

Different types of established treatments are available for prostate cancer, including the following:

  • Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms. This is known as active surveillance.
  • Surgery to remove the prostate and or surrounding tissue. This surgery is called a prostatectomy.
  • Radiation therapy with high-energy rays to kill the cancer..
  • Hormone therapy perhaps could be named “hormone blocking therapy,” because these medicines blocks cancer cells from getting the hormones they need to grow.

The next Straight, No Chaser will provide an update on prostate cancer screening recommendations.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, AmazonBarnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Superfoods – The Battle of Antioxidants and Free Radicals

Antioxidants
People engage in a lot of fads and off the wall activity to pursue health instead of following tried and true principles of basic science. One thing that I wish didn’t fit that trend is use of supplemental antioxidants. Before talking about using antioxidants, this Straight, No Chaser will discuss why they’re necessary.
Free radicals are like the Tasmanian Devil. These molecules are byproducts of many activities that create cell damage. Think about cigarette smoke, trauma (even vigorous exercise), excessive heat and sunlight (and its radiation), to name a few examples. The process of creating and releasing these molecules is called oxidation. The key point is free radicals are unstable and too many of them lead to a process called oxidative stress. This process is implicated in the development of many illnesses, including Alzheimer’s disease, cancer, cataracts and other eye diseases, cardiovascular diseases, diabetes and Parkinson’s disease.

Antioxidants

Antioxidants are substances that prevent or delay cell damage caused by free radicals. Antioxidants may be natural or artificial (e.g. man-made). The healthy diets we’re always asking you to eat (e.g. those high in fruits and vegetables) contain lots of antioxidants; in fact this has a lot to do with why we believe they’re good for us. Superfoods are those especially rich sources of antioxidants, as illustrated above.
Of course, now you can get many forms of antioxidants in pills. That’s where things get a little less certain. Logically, you’d think that if some antioxidants are good, a lot would be better, and they would really be effective against free radicals. Furthermore, you’d think a convenient and efficient way of doing this would be putting a lot of antioxidants in a pill. Unfortunately, medical science (including over 100,000 people studied) has shown this not to be as simplistic as our logic would have us believe. I can’t say this any simpler. Antioxidant supplements have not been shown to be helpful in preventing disease. In fact, high-dose supplementation has been shown to have harmful effects, including increasing the risks of lung and prostate cancer. In short, our body doesn’t function in as linear a manner as we would like to think.
Here’s your take home message: We have yet proven that we’re able to cheat Mother Nature. You will not find your health in a bottle. Diet and exercise remain the champions of the battle of pursuing good health. Get your antioxidants the old fashioned way – in your fruits and veggies. Here’s a nice chart for your reference.
Top-Antioxidants
 
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC

Straight, No Chaser: Prostate Cancer Screening

prostate-to-do-2

Every so often, controversies regarding medical treatment recommendations get in the news and seemingly only serve to confuse the public. Every blog, article or research paper is a single entity that may or may not adjust the body and weight of evidence on a given topic. Even most well-done research articles do not completely change the standard of care for medical practice. Prostate cancer screening is a great example. At the end of it all, controversies aren’t as important as the consensus recommendations that emerge from medical and public health professionals tasked with reviewing such information.
In this Straight, No Chaser, we will review the current recommendations from the American Cancer Society (ACS) for early detection of prostate cancer. Remember, when you hear dissenting views, consider the source and balance that against the formal recommendations of ACS.
In an earlier Straight, No Chaser, several questions regarding prostate cancer were addressed. However, there is one additional question that is important to review.
Does Everyone With Prostate Cancer Get Treated?


prostate screening risks benefits

This is the source of controversies regarding screening of prostate cancer. Most men diagnosed with prostate cancer do not die from the disease. I mentioned previously that 30,000 men with prostate cancer die of the disease every year. However, over 2.5 million men in the U.S. are currently living with a diagnosis of prostate cancer. Based on these statistics, the question then becomes…

Why Do All Men Need to Be Screened For Prostate Cancer?
A certain stream of logic asks why screening is necessary if most of those who are diagnosed don’t die. Many treatments (e.g. surgery, medications, radiation) have additional risks that could be avoided if interventions were avoided. Similarly, some have taken to asking if any screening program is necessary. The view here is information is empowering. It’s always better to have information regarding the state of your health. Working with your medical team and family, the correct decisions about next steps can be made. This option is only available if you know what’s happening with your health.
How Does Screening Occur?

prostate exam

There are two tests commonly used to screen for prostate cancer.

  • A digital rectal exam (DRE) is when a doctor inserts a gloved, lubricated finger into the rectum and estimates the size of the prostate and assesses it for lumps or other abnormalities.
  • The prostate specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate, and PSA blood levels can be higher in men who have prostate cancer. Unfortunately the PSA level isn’t specific for prostate cancer, as it can be elevated in other conditions that affect the prostate such as age, race, certain medications or medical procedures, prostate enlargement or infection.

So What Are The Current Recommendations for screening?

prostate cancer screening guidelines

The American Cancer Society (ACS) recommends that men get to decide if they want to be screened, based on a recommendation from their physician and having received information about the risks, benefits and uncertainties surrounding screening. In other words, we don’t even talk about screening anymore; now it’s “Who should have a conversation with their physician about getting screened?”

  • If you’re age 50 and have an average risk of prostate cancer and are expected to live at least 10 more years. Because prostate cancer grows slowly, if your life expectancy is less than 10 years, you wouldn’t benefit from screening or treatment for prostate cancer.
  • If you’re age 45 for men and are at high risk of developing prostate cancer. This includes African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65).
  • If you’re age 40 for men at even higher risk (those with more than one first-degree relative who had prostate cancer at an early age).

Among these groups, when the decision is made to screen, those men will be tested with the prostate-specific antigen (PSA) blood test. The digital rectal exam (DRE) may also be done as a part of screening.
Assuming no prostate cancer is found as a result of screening, the need for future screenings depends on the results of the PSA blood test:

  • Men who choose to be tested who have a PSA of less than 2.5 ng/ml, may only need to be retested every 2 years.
  • Screening should be done yearly for men whose PSA level is 2.5 ng/ml or higher.

Please at least have the conversation with your physician.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offer. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress.

Straight, No Chaser: Prostate Cancer

Prostate cancer awareness wk
 
Men (and women who care for men – meaning everyone) should be knowledgeable about prostate cancer. I don’t mean physician-level knowledgeable, but there are just a few facts that you should know that are meaningful. Of course, we’ll cover those in this Straight, No Chaser.
Aside from skin cancer, prostate cancer is the most common cancer among men in the U.S. It is also one of the leading causes of cancer death among men of all races. In 2011, well over 200,000 men in the U.S. were diagnosed with prostate cancer with almost 30,000 deaths. Approximately one in six men will be diagnosed with prostate cancer. Here are some prostate cancer basics.
Prostate NormalCancer
What’s the prostate exactly?
The location and function of the prostate was covered in this previous post.
Who’s at risk for prostate cancer?

  • Age: This is simple. The older you are, the greater your risk of developing prostate cancer.
  • Race: Prostate cancer is more common in certain racial and ethnic groups.
  • Genetics: Your risk is increased, which is not the same as saying you’ll develop it if a family member has. This risk is twice to three times more likely if you have a father, brother or son who has had prostate cancer.

prostate cancer symptoms-of-prostate-cancer-c77ttmeb

What are the symptoms of prostate cancer?
It is of interest that a wide variety of presentations exists in those later diagnosed with prostate cancer. Some men don’t have symptoms (meaning it’s discovered on screening examinations), and other men present with several symptoms, which may include the following.

  • Blood in the urine or semen
  • Difficulty completely emptying the bladder
  • Difficulty starting urination
  • Frequent urination (especially at night)
  • Pain in the back, hips, or pelvis that doesn’t go away
  • Pain or burning during urination
  • Painful ejaculation
  • Weak or interrupted flow of urine

Prostate-Cancer-Treatment

How Is Prostate Cancer Treated?
See the above chart for more detailed information. Optimally, treatment for prostate cancer should take into account

  • Your age and expected life span with and without treatment
  • Other health conditions you have
  • The severity (i.e. stage and grade) of your cancer
  • Your feelings (and your physician’s medical opinion) about the need to treat the cancer
  • The likelihood that treatment will cure your cancer or provide some other measure of benefit
  • Possible side effects from treatment

Different types of established treatments are available for prostate cancer, including the following:

  • Closely monitoring the prostate cancer by performing prostate specific antigen (PSA) and digital rectal exam (DRE) tests regularly, and treating the cancer only if it grows or causes symptoms. This is known as active surveillance.
  • Surgery to remove the prostate and or surrounding tissue. This surgery is called a prostatectomy.
  • Radiation therapy with high-energy rays to kill the cancer..
  • Hormone therapy perhaps could be named “hormone blocking therapy,” because these medicines blocks cancer cells from getting the hormones they need to grow.

An additional Straight, No Chaser will address the guidelines and concerns surrounding screening for prostate cancer.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offer. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress.
 

Straight, No Chaser: So What Do I Need to Know About the Prostate?

Continuing in our review of topics of Men’s Health, today we explore the prostate. There are generally five questions people ask me about the prostate, so let’s take the time to address them. These topics are individually discussed in detail at www.sterlingmedicaladvice.com.

1. What is the prostate?

prostate

The prostate is a male-only organ located in front of the rectum and under the bladder. It surrounds the urethra, which is the tube through which urine flows on its way out of the penis. Understanding this anatomy helps one understand the nature of problems that arise related to the prostate. The prostate is part of the male reproductive system. It’s a gland that contributes to the fluid (seminal fluid) that carries sperm out of the body (i.e., semen).
2. Doesn’t it get infected?

Prostatitis

Prostatitis is the presence inflammation or infection of the prostate gland. It has many different causes. When an infection with bacteria causes prostatitis, it is called bacterial prostatitis. Bacterial prostatitis can be a particularly long-lasting infection, requiring antibiotics to treat.

  • Acute bacterial prostatitis is an infection that produces signs and symptoms rapidly.
  • Chronic bacterial prostatitis is an infection that lasts for at least three months.

3. Why does the prostate get large?

BPH

A condition known as benign prostatic hypertrophy (BPH) occurs in men as they age. As a general rule, 50% of men have it by age 50, and 80% have it by age 80. The prostate normally is only the size of a walnut. When BPH occurs, the prostate has enlarged to a point where it may press upon the urethra, disrupting the normal flow of urine, preventing normal emptying. It is important to understand that the growth seen in BPH is not cancer.
4. What’s the relationship between the prostate and sex?
When people ask me this question, they have one of two concerns.

  • Some medical studies have drawn a relationship between a higher frequency of ejaculations and a lower risk of prostate cancer. This trend is not currently considered definitive; to be clear there is no conclusive evidence that the risk of prostate cancer is reduced by frequent ejaculation.
  • The male equivalent of a “G-spot” is described as being near the prostate.

5. Is prostate cancer deadly?

Prostate-cancer-risk

Prostate cancer is usually slow growing, but may occasionally be aggressive. Cancerous prostate cells may break off and spread to other parts of the body, particularly the bones and lymph nodes. Prostate cancer usually is seen in men after 50 and even when discovered often doesn’t require especially aggressive management.
Your bottom line? You especially need a prostate exam and other considerations yearly after age 50.
Feel free to contact your SMA expert consultant with any questions you have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress
 

From the Health Library of SterlingMedicalAdvice.com: "What’s a PSA test, and why is it important?"

GU

Prostate-specific antigen (PSA) is a protein that is secreted from the prostate gland. It is important marker of disease. The higher the PSA level, the more likely it is that prostate cancer is present (this is not the same as saying that if your PSA level is high, you have or will have prostate cancer). It is useful and important as a screening tool and a monitor for prostate cancer recurrence after treatment or response to treatment.
According to the American Cancer Society, the following groups of men should consider having a PSA test.

  • Those at age 50 if they are at average risk of prostate cancer
  • Those at age 45 if they are at high risk
  • Those at age 40 if they are at very high risk (those with first-degree relatives who had prostate cancer at an early age)

Please discuss the value of prostate cancer screening with your physician. There is a fair amount of controversy about the test, which is why having the test done is a ‘consideration’ instead of a must. The specifics of this can be discussed with your physician or personal healthcare consultant at SterlingMedicalAdvice.com.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

Straight, No Chaser: The Battle of Antioxidants and Free Radicals

Antioxidants
We engage in a lot of fads and off the wall activity to pursue health instead of following tried and true principles of basic science. One thing that I wish didn’t fit that trend is use of supplemental antioxidants. Before talking about using antioxidants, allow me to discuss why they’re necessary.
Free radicals are like the Tasmanian Devil. These molecules are byproducts of many activities that create cell damage. Think about cigarette smoke, trauma (even vigorous exercise), excessive heat and sunlight (and its radiation), to name a few examples. The process of creating and releasing these molecules is called oxidation. The key point is free radicals are unstable and too many of them lead to a process called oxidative stress. This process is implicated in the development of many illnesses, including Alzheimer’s disease, cancer, cataracts and other eye diseases, cardiovascular diseases, diabetes and Parkinson’s disease.
Antioxidants are substances that prevent or delay cell damage caused by free radicals. Antioxidants may be natural or artificial (e.g. man-made). The healthy diets we’re always asking you to eat (e.g. those high in fruits and vegetables) contain lots of antioxidants; in fact this has a lot to do with why we believe they’re good for us. Of course, now you can get many forms of antioxidants in pills. That’s where things get a little less certain.
Logically, you’d think that if some antioxidants are good, a lot would be better, and they would really be effective against free radicals. Furthermore, you’d think a convenient and efficient way of doing this would be putting a lot of antioxidants in a pill. Unfortunately, medical science (including over 100,000 people studied) has shown this not to be as simplistic as our logic would have us believe. I can’t say this any simpler. Antioxidant supplements have not been shown to be helpful in preventing disease. In fact, high-dose supplementation has been shown to have harmful effects, including increasing the risks of lung and prostate cancer. In short, our body doesn’t function in as linear a manner as we would like to think.
Here’s your take home message: We have yet proven that we’re able to cheat Mother Nature. You will not find your health in a bottle. Diet and exercise remain the champions of the battle of pursuing good health. Get your antioxidants the old fashioned way – in your fruits and veggies. Here’s a nice chart for your reference.
Top-Antioxidants