Posts Tagged ‘PSA test’

Men Start Your Engines But First Check Under the Hood!

June 27, 2015

Men Start Your Engines But First Check Under the Hood!
This article appeared in the recent Baton Rouge Advocate on men’s health.

Celebrate Father’s Day with your health. Men need to let doctors look under the hood.

We have an attitude in our south Louisiana culture — if it ain’t broke, don’t fix it! In reality, men do more preventative maintenance on their cars and lawns than on their bodies. But, this attitude should never be applied to health.

Many men don’t receive checkups because they feel that they have a big “S” (for Superman) tattooed on their chests — but no one is Superman. On average, women live 5 to 7 years longer than men. That gap could close if men practiced preventive health as often as women. Fortunately, men’s attitude and behavior is slowly changing.

Not surprisingly, impotence drugs have lured men into the doctor’s office, which is half the battle and usually leads to a prostate screening. Over the years, public awareness campaigns, at-work health screenings and overall understanding of the male patient have aided in improving men’s health.

Before the 1990s, there were no male equivalents to the Pap test or mammogram. But now, the prostate-specific antigen (PSA) — the screening test for prostate cancer — is detecting problems early, giving men a myriad of treatment options and, more importantly, saving lives.
This means more time to enjoy their golden years, more time to walk their daughters down the aisle and more time to watch their grandchildren grow. Don’t wait for prostate cancer or other diseases to hit close to home; don’t wait for symptoms.
The only waiting should be done in your doctor’s waiting room.
Neil Baum
Professor of Clinical Urology At Tulane Medical School
New Orleans

Men Need To Let Doctors Look Under the Hood!

May 2, 2015

We have an attitude in our community if it ain’t broke, don’t fix it. This may apply to your car but not to our boides and our health. Mos men

Most men do more preventive maintenance on their cars than on their bodies. Many men don’t come in for checkups because they fell that they have a big S tattooed on their chests, i.e, Superman. Fortunately for men – and the women in their lives – this attitude is slowly changing. Women live 5-7 years on average longer than men. If men practiced preventive health as women do with Pap smears and regular breast exams the gap between women’s and men’s life expectancy may close.

Reasons for the change:

National public-awareness campaigns, such as Men’s Health Week (June 14-20). Increasing media coverage of men’s health issues and more public comfort with medical words such as prostate, penis, impotence (ED) and colon helps, as does the growth in men’s clinics that are dedicated to men’s health.

New treatments. Before the PSA – prostate-specific antigen – screening test for prostate cancer, which became widely available in the 1990s, there was no male equivalent for the Pap test and mammograms that drive women into the doctor’s office on a regular basis. In recent years, men have been lured by conservative therapy options available to treat early-stage illness and can actually cure men of some of these severe medical conditions.

Drugs for treating impotence. Not surprisingly, one of the biggest draws in recent years has been Viagra, Levitra, and Cialis – the impotence drugs that has brought men to the physician where other conditions such as prostate cancer can be investigated.

Sensitivity. Doctors are learning they have to look at the male patient as a whole and not just as an organ system. Doctors are making an effort to communicating more effectively with men.

At-work health screenings. Many businesses are now giving “health fairs” that offer simple on-site baseline tests, like blood pressure, diabetes, and prostate or cholesterol screening. There’s no better place than the workplace to reach men.

Bottom Line: Men need to be proactive about their health and take as good care of their body as they do of their cars and their lawns.

The End Of Screening For Prostate Cancer In Men Over Age 75

October 4, 2013

In a move that could lead to significant changes in medical care for older men, a national task force on Monday recommended that doctors stop screening men ages 75 and older for prostate cancer because the search for the disease in this group was causing more harm than good.

The guidelines, issued by the U.S. Preventive Services Task Force and published on Tuesday in the Annals of Internal Medicine, represent an abrupt policy change by an influential panel that had withheld any advice regarding screening for prostate cancer, citing a lack of reliable evidence.
Screening is typically performed with a blood test measuring prostate-specific antigen, or PSA, levels. Widespread PSA testing has led to high rates of detection. Last year, more than 218,000 men learned they had the disease.
Yet various studies suggest the disease is “overdiagnosed” — that is, detected at a point when the disease most likely would not affect life expectancy — in 29 percent to 44 percent of cases. Prostate cancer often progresses very slowly, and a large number of these cancers discovered through screening will probably never cause symptoms during the patient’s lifetime, particularly for men in their 70s and 80s. At the same time, aggressive treatment of prostate cancer can greatly reduce a patient’s quality of life, resulting in complications like impotency and incontinence.
Past task force guidelines noted there was no benefit to prostate cancer screening in men with less than 10 years left to live. Since it can be difficult to assess life expectancy, it was an informal recommendation that had limited impact on screening practices. The new guidelines take a more definitive stand, however, stating that the age of 75 is clearly the point at which screening is no longer appropriate.
Dr. Calonge said it was important that the guidelines not be viewed as “giving up” on older men. While the new rules should discourage routine testing of older patients, the recommendations will not prevent a man from seeking screening if he desires it, Dr. Calonge said. The new guidelines are not expected to alter Medicare’s current reimbursement for annual PSA screening of older men.
The guidelines focus on the screening of healthy older men without symptoms and will not affect treatment of men who go to the doctor with symptoms of prostate cancer, like frequent or painful urination or blood in the urine or the semen.
While the verdict is still out on younger men, the data for older men are more conclusive, experts say. The American Cancer Society and the American Urological Association both say annual PSA screening should be offered to average-risk men 50 and older, but only if they have a greater than 10-year life expectancy.
Treatments for prostate cancer can cause significant harm, rendering men incontinent or impotent, or leaving them with other urethral, bowel or bladder problems. Hormone treatments can cause weight gain, hot flashes, loss of muscle tone and osteoporosis.
Bottom Line: If you are 75 years of age or older, you probably don’t need any additional screening for prostate cancer.

This blog was excerpted from The New York Times, October 4, 2013
http://www.nytimes.com/2008/08/05/health/research/05prostate.html?_r=0

PSA Testing -To Screen Or Not to Screen-What the Experts are Saying

May 12, 2013

Prostate cancer is the most common non-skin cancer in men with 250,000 new cases every year. The disease can be detected by screening with a PSA blood test and a digital rectal exam. Some men with prostate cancer will go on to treatment and are at risk for complications including impotence or erectile dysfunction and urinary incontinence or leaking urine.
The American Urologic Association has just released new guidelines for prostate cancer screening that I would like to share with you and hope that you can use this information to make a decision if prostate cancer screening is appropriate for you.

Guideline Statement 1: The Panel recommends against PSA screening in men under age 40 years. In this age group there is a low prevalence of clinically detectable prostate cancer, no evidence demonstrating benefit of screening and likely the same harms of screening as in other age groups.

Guideline Statement 2: The Panel does not recommend routine screening in men between ages 40 to 54 years at average risk, i.e., those men who do not have a family member with prostate cancer or men of African American race. For men younger than age 55 years at higher risk (e.g. positive family history or African American race), decisions regarding prostate cancer screening should be individualized.

Guideline Statement 3: For men ages 55 to 69 years the Panel recognizes that the decision to undergo PSA screening involves weighing the benefits of preventing prostate cancer mortality in 1 man for every 1,000 men screened over a decade against the known potential harms associated with screening and treatment. For this reason, the Panel strongly recommends shared decision-making between doctor and patient for men age 55 to 69 years that are considering PSA screening, and proceeding based on a man’s values and preferences. The greatest benefit of screening appears to be in men ages 55 to 69 years.

Guideline Statement 4: To reduce the harms of screening, a routine screening interval of two years or more may be preferred over annual screening in those men who have participated in shared decision-making and decided on screening. As compared to annual screening, it is expected that screening intervals of two years preserve the majority of the benefits and reduce overdiagnosis and false positives. Additionally, intervals for rescreening can be individualized by a baseline PSA level.

Guideline Statement 5: The Panel does not recommend routine PSA screening in men over age 70 years or any man with less than a 10 to 15 year life expectancy.
Some men over age 70 years who are in excellent health may benefit from prostate cancer screening.

Bottom Line: I think not to screen men at all is probably not a good idea. However, in selected men, the decision not to screen is probably a good one. I do believe that men need to have a discussion with their doctors and decide on a case by case basis whether or not to screen for prostate cancer using the PSA test.

Worried About Prostate Cancer? Then Get Moving

April 26, 2013

Prostate cancer affects 250,000 men every year and is the second most common cause of death in men following lung cancer. If you have a relative with prostate cancer such as a father, brother, uncle or cousin and\or you are African American, you have a greater risk of developing prostate cancer. The diagnosis is made by a digital rectal exam and a prostate specific antigen or PSA blood test.

A report from the May Clinic (2013;88:11-21) pointed out that men who lead a sedentary life style or who have low levels of physical activity are more likely to have an elevated PSA test. For each hour increase in physical exercise, men are nearly 20% less likely to have an elevated PSA test.

Regular physical activity may reduce prostate cancer risk through changes in energy balance, enhanced immune function, decrease in inflammation, and an increase in anti-oxidant defenses.

Bottom Line: No one knows what exactly causes prostate cancer but it is possible that an increase in physical activity may decrease the PSA level and possibly decrease the risk of prostate cancer.

To Screen Or Not Screen-That’s the Question, What’s the Answer?

October 20, 2011

Annual cancer tests are becoming a thing of the past. New guidelines for cervical cancer screening have experts at odds over some things, but they are united in the view that the common practice of getting a Pap test for cervical cancer every year is too often and probably doing more harm than good.
A Pap smear once every three years is the best way to detect cervical cancer. Recently it was recommended against prostate cancer screening with PSA tests, which many men get every year.
Two years ago, it said mammograms to check for breast cancer are only needed every other year starting at age 50, although the American Cancer Society still advises annual tests starting at age 40. A large study found more false alarms for women getting mammograms every year instead of every other year.
It’s a fact that the more tests that you do, the more likely you are to be faced with a false-positive test that leads to unnecessary biopsies and possible harm. We see an emerging consensus that annual Pap tests are not required for us to see the benefits that we have seen from screening.
Those benefits are substantial. Cervical cancer has declined dramatically in the United States, from nearly 15 cases for every 100,000 women in 1975 to nearly 7 per 100,000 in 2008. About 12,200 new cases and 4,210 deaths from the disease occurred last year, most of them in women who have never been screened or not in the past five years.
The cancer society and other groups say using Pap smears together with tests for HPV, the virus that causes cervical cancer, could improve screening. Instead, reaching women who are not being adequately screened now probably could save more lives.
Bottom Line: Patients need to be informed about the benefits vs. the risks of screening. By being knowledgeable about the screening tests and having a discussion with your doctor is the best way to come to a decision about screening in your situation.

An Apple a Day May Keep the Doctor Away-and Proscar or Avodart May Keep Prostate Cancer at Bay

October 23, 2010

Prostate cancer is the most common non-skin malignancy in men and is responsible for more deaths than any other cancer, except for lung cancer. However, microscopic evidence of prostate cancer is found at autopsy in many if not most men. The American Cancer Society (ACS) estimated that about 218,890 new cases of prostate cancer were diagnosed in the United States during 2007. About 1 man in 6 will be diagnosed with prostate cancer during his lifetime, but only 1 man in 34 will die of it. More than 1.8 million men in the United States are survivors of prostate cancer.

There is some evidence that links exercise to better prostate health.  Exercise improves overall physical and mental health, so most medical professionals recommend at least a half an hour of exercise per week. Some studies indicate that regular exercise increases oxygen flow to the soft tissues of the body and helps to control glucose levels in the bloodstream. High levels of glucose may help fuel prostate cancer cells.

A healthy prostate diet is worth considering. High-fat and low-fiber diets and obesity seem to contribute to a higher risk of prostate cancer.  Some researchers believe that cancerous prostate cells can feed on fat, especially fats found in red meat and dairy products. Omega 3 fatty acids, found in fish, soy, and flaxseed is known as the “heart-healthy” fats. Now we believe that the Omega-3 fatty acids are prostate healthy as well. Countries, like China and Japan, whose diets are based on fish proteins rather than red meat have much lower rates of prostate cancer. Soy products include tofu, soymilk, soy creamers, soy yogurts, soy ice creams, and tofu burgers.  Red grapes, grape juice, green teas, and red wine contain anti-oxidants that can neutralize cancer-causing agents within the body. Lycopene found in tomatoes, and beta-carotene may be beneficial in helping to protect the body from the risk of prostate cancer.  Eating a variety of fresh fruits and vegetables may help boost the body’s cancer-fighting abilities.

Supplements such as vitamin E and selenium have been linked to a drastically decreased risk of prostate cancer. Studies of vitamin E and selenium seem to benefit those who were deficient in either Vitamin E or selenium, or who were ex-smokers. Studies have also noted that a daily regimen of aspirin or ibuprofen lowers risks of prostate cancer.

A few years ago a long-term study using the 5-alpha reductase inhibitor, Proscar or Avodart, lowers the risk of prostate cancer.  This study as well as others has shown a 25% reduction in prostate cancer.  However, the risk of developing a high-grade cancer or a more aggressive cancer was greater in those men taking finasteride as compared to a placebo or sugar pill.

So what is a man to do?  If you are at risk for prostate cancer, i.e., you have a relative such as a father, brother, uncle with prostate cancer, are Afro-American, or are obese and consume a high fat and meat diet, then you should talk to your doctor about prostate cancer prevention using one of the agents like Proscar or Avodart.  For the rest of the men: get an annual digital rectal exam and a PSA blood test once a year after age 50 or after age 40 if you are at high risk for prostate cancer.

Bottom Line: Knowledge is your best weapon for good prostate health and avoiding prostate cancer. Some lifestyles, eating habits, and dietary supplements are thought to lead to lower levels of prostate cancer, as well as other cancers. Nobody can guarantee prostate cancer prevention through behavior, diet, treatment, or medicine, but there are things you can do to improve your odds.

 

 

 

The Real Skinny On PSA Testing For Prostate Cancer

July 4, 2010

There are nearly 30,000 deaths due to prostate cancer each year in the United States.  To put that number in perspective that’s half the capacity of the Super Dome in New Orleans (home to the New Orleans Saints!)  However, if prostate cancer is detected early, it is curable.  Recently, PSA testing has come under controversy.  Researches from Sweden compared PSA screening vs. no screening and concluded that screening does, indeed, cut the deaths due to prostate cancer.

The researches concluded:

.Prostate cancer was diagnosed in 11.4% of the screening group vs. 7.2% of the control group.

.Among men with detected prostate cancer in the screening group, 78.7% were diagnosed as a result of enrolling in the study.

.Cancers were detected on average earlier in the screening group

The Bottom Line: The findings suggest the benefits of prostate cancer screening can outweigh the risks.  My suggestion is that all men over age 50 should be tested annually.

The French Have Done It Again- Dogs Can Use Their Noses to Sniff Out Prostate Cancer

June 10, 2010
Dogs can be trained to detect prostate cancer by smelling urine samples and signaling the presence of certain volatile organic compounds produced by cancer cells, according to French researchers.

Jean-Nicolas Cornu, MD, of Tenon Hospital in Paris, and colleagues obtained fresh urine samples that had been frozen for preservation from 66 men referred to a urologist because they had an elevated PSA level or abnormal findings on digital rectal examination. Of the 66 men, 33 had prostate cancer and 33 did not, as determined by prostate biopsy.

The dogs used in the study were trained in three phases. In the first phase, which lasted five months, dogs were trained to recognize cancer urine. In the second phase, which lasted 11 months, dogs were trained to discriminate cancer urine from control urine. In the final phase, dogs were presented with five urine samples and prompted to select the one sample that was cancer urine.

Dogs correctly classified 63 of 66 samples.  These results suggest that volitle organic compounds  produced by cancer cells can be detected in urine samples.
So if you come to a French doctor’s office and you find a dog in the exam room, don’t be alarmed.  The dog may just be one of the doctor’s helpers used to diagnose your illness!  For my office, I’m going to “go standard” and suggest for all men over the age of 50 that they have an annual PSA blood test and a digital rectal exam.  It’s the American way!

To your good health.  Dr. Baum

Prostate Cancer-The Least You Need To Know

May 24, 2010

Prostate cancer is the most commonly diagnosed cancer in American men (excluding skin cancers). Each day approximately 500 American men are diagnosed with prostate cancer.  There are over 26,000 men who die each year from prostate cancer making it the second most common cause of death.  The diagnosis is often made as the result of a blood test known as the prostate specific antigen (PSA) test, followed by a prostate gland biopsy.

Treatment options for prostate cancer include radiation, surgical removal, and watchful waiting or following the man with regular PSA tests and a digital rectal examination.  While a man’s initial reaction to a diagnosis of prostate cancer may be “I just want it out,” the reality is that a number of factors need to be considered before treatment options are selected. These factors include age, general health, and the results of other tests like the Gleason score, which is derived from prostate biopsy.

Most prostate cancers develop in older men and grow very slowly, but some grow quickly and spread beyond the gland. It is sometimes difficult to distinguish men who will benefit from treatment from others in whom the side effects of treatment will outweigh the benefits.

Many prostate cancers will grow so slowly that the man will probably die of another cause before the prostate cancer becomes threatening. Similarly, some prostate cancers at diagnosis have already spread beyond the prostate gland, and surgery or radiation would offer no benefits.

Patients with prostate cancer confined to the prostate gland might derive the most good from surgery or radiation.  You can obtain more information from  American Cancer Society (http://www.cancer.org/docroot/home/index.asp) or speak with your doctor.