Archive for September, 2013

Saw Palmetto Effect On the PSA Level

September 29, 2013

Saw palmetto is a commonly used herbal supplement used to treat men with mild symptoms of the enlarged prostate gland or BPH (benign prostatic hyperplasia). Despite years of controversy regarding efficacy, saw palmetto remains the most common herbal treatment for men with lower urinary tract symptoms.
Extracted from the fruit of the saw palmetto dwarf tree, the extract exerts effects by diminishing 5-alpha-reductase activity and binding to androgen receptors in prostatic cells. Saw palmetto reduces prostatic dihydrotestosterone by 32%. As a result of this anti-androgen effect, concerns have been raised as to whether serum PSA values should be adjusted accordingly.

In a new study published in the Journal of Urology (2013;189:486-492), researchers evaluated serum PSA values in 369 patients randomized to receive saw palmetto or placebo.
These men were part of the CAMUS (Complementary and Alternative Medicine for Urological Symptoms) trial, a double-blinded, randomized controlled study designed to determine whether saw palmetto extract reduced the American Urological Association symptom score compared with placebo at 72 weeks.
Even with triple the recommended dose of saw palmetto, serum PSA remained unaffected compared with placebo. These data can help guide clinicians using PSA for the early detection of prostate cancer in those patients taking this common herbal remedy.

Bottom Line: Many men will use the herbal supplement, saw palmetto, for the treatment of their lower urinary tract symptoms of benign enlargement of the prostate gland. There is no affect on the PSA level but middle aged men taking saw palmetto should be tested with a PSA and no adjustment need to be made in the PSA level.

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Tricks and Tips for Saving Money On Prescriptions

September 29, 2013

I truly recognize that prescription medicines are costly and often beyond the reach of many patients. I am often amazed at how expensive prescribed medications are and how the price is so variable from one pharmacy to another. Here are a few tricks and trips to save money on your prescription medications.

1. Price compare between pharmacies. Prices can be double and even triple from different pharmacies. Generic medicine prices vary more than branded/trademarked medicine prices.

For example a Z-pack 5 day antibiotic (generic) Costco- $11 OR Kmart- $55
Tricyclen birth control (generic) Target- $9 OR Osco- $33
Suggestion: call the pharmacies yourself and find out which one is offering the lowest price. The pharmacy tech or the pharmacist will give you the price over the phone. You need to be able to tell the pharmacist the strength and quantity of the medication.
Another idea: Take your “combo pill” as two separate pills. If you are taking a medication that is a combination of medicines, consider taking it as two separate pills. For example if you have an elnlarge prostate gland and the doctor has presicrbed a pill that combines two medications such as an alpha blocker and a pill to decrease the size of the prostate gland, you can ask the doctor to prescribe both drugs and you take two pills instead of one at a much reduced cost. If you are not sure if you are taking a “combo pill” try Googling the name to find out. Usually you can save money by taking the meds separately (even if there is a generic version of your combo med!)
Lotrel (generic) 10/20, #30 tabs – $81 per month OR amlodipine 10 mg, #30 tabs + benazepril 20 mg, #30 tabs= $8 + $6 = $14 per month.
Change the dosing schedule of your medication. If you are taking a medication that ends with “XL”, “XR”, “CD”, or “SR”- then you are probably taking a long acting, albeit expensive version of your medicine. Therefore, there is probably a short- acting generic version of your medication also available. The trade off would be that you might have to take a pill two or three times a day instead of once or twice a day but at a significant saving. If your doctor thinks this is appropriate for you, it could save you big bucks.
Rythmol SR 225 mg, #60 tabs (taken twice a day)- $367/month OR propafenone (generic Rythmol) 225 mg #100 tabs (taken three times a day)- $34/month

Bottom Line: Prescription medications are expensive. However, there are effective ways to reduce the costs without negatively impacting your health.

Got an Elevated PSA Level and the Prostate Biopsy Is Negative? Managing the Dilemma

September 29, 2013

Approximately 700,000 American men receive a negative prostate biopsy result; however approximately 25% of these results are false-negative and that is the man has prostate cancer but the biopsy was not able to discover or confirm the disease. Under the current standard of care, prostate biopsy procedures sample less than 1% of a man’s prostate. This approach leaves men at risk of occult cancer, leading to a high rate of repeat biopsies. ConfirmMDx for Prostate Cancer addresses the unmet medical need for a clinically effective diagnostic test to address this dilemma.
ConfirmMDx for Prostate Cancer is a test to help distinguish patients who have a true-negative biopsy from those who may have occult cancer. The test helps your doctor to rule-out prostate cancer and to make it possible to perform repeat biopsies.
ConfirmMDx is a sophisticated test that detects subtle changes in the DNA level in cells adjacent to cancer cells. This halo around a cancer lesion can be present despite having a normal appearance under the microscope.
The MDX aids in the identification of high-risk men who may need a repeat biopsy and potential treatment.

Bottom Line: Prostate cancer is the most common cancer in middle age and older men. It is the second most common cause of death in men with lung cancer being at the top of the list. A negative biopsy does not definitively rule out prostate cancer. The MDX helps men spare the need for unnecessary repeat biopsies.

Men, Having Trouble Urinating? A Pin In the Prostate May Cure Your Problem

September 29, 2013

Men with enlarged prostate glands have symptoms of going to the bathroom frequently, dribbling after urination, and getting up at night to go to the bathroom.  The problem is usually caused by a benign enlargement of the prostate gland, which blocks the flow of urine from the bladder to the outside of the body. 

Prostate, shown in yellow, with blockage of the urethra

Prostate, shown in yellow, with blockage of the urethra


The cause of the benign enlargement is not known but is probably related to alternations in the hormones, testosterone, of middle aged and older men.  Treatment usually consists of medications, alpha blockers and medications to actually relax the muscles in the prostate gland but these are often ineffective especially if used for long period of time.  The other options include minimally invasive procedures such as microwaves that can actually shrink the prostate gland.  Now there’s a new treatment option that will soon be available. 

The UroLift system, made by NeoTract Inc. of Pleasanton, Calif., is the first permanent implant to relieve low or blocked urine flow in men age 50 and older with an enlarged prostate.

By pulling back prostate tissue that presses on the urethra, the system allows more natural urine flow.  

4 pins in the prostate open the gland and allow improvement in urinary symptoms

4 pins in the prostate open the gland and allow improvement in urinary symptoms


The procedure can be done in the doctor’s office under a local anesthesia and will actually open up the urethra to allow the flow of urine and reduce the urinary symptoms of frequency of urination, improve the force and caliber of the urine stream, and decrease the number of times a man needs to get up at night to empty his bladder.

Of course with any procedure there may be side effects and complications.  Some patients reported pain or burning during urination, increased urgency, decreased urine flow, incomplete bladder emptying, and blood in the urine.  Most of these symptoms and side effects were temporary and resolved a few days or weeks after the Urolift was performed.

 

Bottom Line:  Millions of American men suffer from symptoms as a result of an enlarged prostate gland.  Certainly medications are a first line treatment option.  However, the Urolift may be a permanent solution to this common problem and help men get a good night’s sleep!

Spicing Up Your Treatment Prostate Cancer

September 8, 2013

Would you ever imagine that a common spice added to food could be helpful in preventing and perhaps treating prostate cancer?  Allspice, a popular flavoring contains an antioxidant that decreases the growth of prostate cancer cells in experiments. Allspice a popular folk medicine remedy for a number of maladies, and it has the highest amount of antioxidants of any food we know.

Allspice is produced from the dried, unripe berries of the Pimenta diocia tree, which grows in the Caribbean and Central America. 

Allspice contains an active ingredient, Ericifolin, which significantly slowed the growth of cancer cells.  The study was conducted in mice with implanted prostate tumors.  Tumor growth was inhibited in more than half of the mice.  Also prostate specific antigen (PSA) was lowered in the mice treated with the Allspice. 

Since allspice is not toxic, men would be ideal candidates to take Ericifolin as a daily dietary supplement to prevent prostate cancer and in men with slow growing prostate cancer or in men who are not candidates for surgery or radiation therapy.

Bottom Line: It may be too soon to tout the benefits of Allspice since there are few scientific studies on allspice, but the researchers were intrigued by what they learned.