A diagnosis of prostate cancer can affect a man in many ways. It's normal to be scared, angry, or depressed after diagnosis. The good news is that prostate cancer is very treatable and physicians now have many tools in their tool box to successfully diagnose and treat this very common cancer.
In this segment, Dr. Shinoj Pattali shares tips for good prostate health and the latest advances and treatments for prostate cancer available at the Strecker Cancer Center of Memorial Health System.
The Latest Treatments for Prostate Cancer
From the Show: Memorial Ohio - Memorial Health Radio
Summary:
Air Date: 9/10/17
Duration: 10 Minutes
Transcription:
Melanie Cole (Host): A diagnosis of prostate cancer can affect a man in many ways. It’s normal to be scared, angry or depressed after diagnosis. The good news is that prostate cancer is very treatable. Prostate cancer physicians now have many tools in their toolbox to successfully diagnose and treat this very common cancer. My guest today is Dr. Shinoj Pattali. He is a hematologist/oncologist at the Strecker Cancer Center of Memorial Health System. Welcome to the show Dr. Pattali. Who is at risk for prostate cancer?
Dr. Shinoj Pattali, MD (Guest): Thanks for inviting me Melanie. Prostate cancer is the most common cancer in men. As we get older, the incidence of prostate cancer gets higher. Apart from the skin cancer, which is the most common; prostate cancer would be the leading cause of cancer in men.
Melanie: So, who would be at risk? Since it is so common, is there anything that would predispose somebody to prostate cancer?
Dr. Pattali: If you look at the prostate cancer incidence; it is much more common in African American race and also with somebody with a strong positive family history; there is a higher incidence. But most of the men as they get older; the incidence of prostate cancer goes up. Which if you look at men above 60 years; the incidence is almost one in forty or so and it is very common cancer that we see around in the country – all over the world.
Melanie: So, many men get BPH or an enlarged prostate; does that necessarily mean they will get prostate cancer?
Dr. Pattali: That’s not true. The prostate is a small gland that is wrapped around the urethra in front of the rectum which itself is more walnut-sized. As men get older, the prostate can get enlarged and sometimes – and that is part of the normal aging and some men can have an enlarged prostate which can cause benign enlargement. This does not mean they have prostate cancer, but though some of the symptoms can mimic a prostate cancer like difficulty in initiating urination or a weak stream or increase in the number of urinations especially at nighttime which may mimic some of the symptoms of prostate cancer, but that does not necessarily increase the risk.
Melanie: So, speak about screening just a little bit Dr. Pattali. What is the screening test available right now for men for prostate cancer and who should have it at what age?
Dr. Pattali: So, we have a blood test called PSA or prostate-specific antigen that we can test in blood. Most of the guidelines would recommend testing for men about 50 years of age or if you are an African American race or a strong family history to start screening sooner. There is also a fair bit of controversy about whether prostate cancer should be screened or not and that is mostly because if you see a PSA being elevated, that could be also from noncancer related, but it puts patients through a lot of anxiety and then puts them through biopsies which a lot of times turns out to be negative. So, there is always a slight controversy about whether we should screen or not screen for everybody. But overall, if you look at screening; there are two modalities mostly, do a blood work called PSA or you could do a digital rectal exam by a urologist or a primary doctor in the office to see the contour of the prostate. If they are smooth and not enlarged, depending on that they can talk about a biopsy.
Melanie: So, explain the numbers a little bit. Because as you said, it can cause anxiety, but many men are getting PSA checked. So, what do those numbers mean? What’s normal and what’s considered high?
Dr. Pattali: Usually a PSA less than four is considered normal and then about that, you could get PSA slightly elevated in benign prostatic hyperplasia or BPH, but it is more of the rate of the elevation that can support the biopsy. Even men with prostate cancer, they can be very slow growing and as you get older, not all of them need to be treated. So, an elevation of PSA above four kind of prefers further testing.
Melanie: So, then if somebody is diagnosed with prostate cancer; what are some treatment options? Because as the time goes on; you have so many more tools in your toolbox to help men. So, explain some of the treatments available.
Dr. Pattali: So, first of all, all prostate cancers need not be treated. Some of them are very slow growing and there is a lot of times prostate cancer is diagnosed in men with early stage, we probably do not need any treatment, maybe they can be watched or managed with a lot of treatment. In younger people, with prostate cancer, there is a surgical treatment called radical prostatectomy where the prostate is removed surgically versus there is a radiation treatment option for older people with one to two years of hormonal treatment blocking the male hormones. So, that could be by a shot – an injection once a month to six months shot to prevent male hormones from getting into the prostate cancer cells. So, that’s the hormonal treatment. So, one of the definitive ways to treat it is either surgery or radiation with hormones.
Melanie: Is surgery becoming less common, a prostatectomy, or are you still doing pretty many of them?
Dr. Pattali: In the less than 65 years age, radical prostatectomy for patients who are treated and young, that is still the standard of care to offer radical prostatectomy. Older patients, higher stage cancers, radiation therapy with the hormonal treatment is standard.
Melanie: And speak about radiation therapy just a bit. What can men expect from the types of radiation therapy available today?
Dr. Pattali: Yeah, there is radiation external beam radiation therapy, there is radiation seed implant. There are different modalities of radiation therapy that an experienced radiation oncology doctor would be able to determine for the patient. The hormonal treatment, which plays a part on it because of the way the male hormones, the testosterone kind of drives the prostate cancer; so blocking that is also important part of the treatment along with the radiation therapy on the prostate cancer. And seed versus external beam; they both work very well.
Melanie: How does a man know if the treatment is working?
Dr. Pattali: So, the PSA is serially watched. If the PSA comes down; that indicates the prostate cancer cells are being killed by the radiation or the hormone treatment. And we can use that as a marker in most of the prostate cancers types. There at one stages where the cancer has spread to other areas like lymph nodes, a CAT scan or a bone scan can sometimes determine the progress of the cancer.
Melanie: And what are some of the most common side effects of prostate cancer treatments, Dr. Pattali, because first of all, men don’t even always want to go see a doctor to be checked because they are afraid of those side effects that they hear about whether it is erectile dysfunction or any of these others? So, what do you tell men about these side effects and dealing with them after prostate cancer treatment?
Dr. Pattali: So, the side effects are mostly geared towards blocking the testosterone, because blocking the testosterone is one of the major arms of treatment in prostate cancer and that can cause erectile dysfunction, can cause hot flushes, loss of muscle mass, fatigue, decreased libido, and these are mostly experienced in people where the hormones are blocked by the either the shot or by doing a orchidectomy which is the removal of the testicles by surgical procedure. It is really less practiced in the United States. The surgery per se, surgery can have other side effects including sometimes very rarely incontinence, erectile dysfunction, but those are very less often with modern surgical techniques.
Melanie: And then what do you tell men about the importance of getting checked for prostate cancer? What would you like them to know?
Dr. Pattali: The prostate needs to be checked at least in men over 50 with a PSA and a digital rectal exam by the primary doctor. I would recommend checking it a little bit sooner if they have family history or if they are of the African American race. I would also recommend that if PSA is a good marker for them, that would be the test that is better to watch in the future.
Melanie: Thank you so much, Dr. Pattali, for being with us today. You are listening to Memorial Health Radio. For more information, please visit www.mhsystem.org . That’s www.mhsystem.org . I’m Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): A diagnosis of prostate cancer can affect a man in many ways. It’s normal to be scared, angry or depressed after diagnosis. The good news is that prostate cancer is very treatable. Prostate cancer physicians now have many tools in their toolbox to successfully diagnose and treat this very common cancer. My guest today is Dr. Shinoj Pattali. He is a hematologist/oncologist at the Strecker Cancer Center of Memorial Health System. Welcome to the show Dr. Pattali. Who is at risk for prostate cancer?
Dr. Shinoj Pattali, MD (Guest): Thanks for inviting me Melanie. Prostate cancer is the most common cancer in men. As we get older, the incidence of prostate cancer gets higher. Apart from the skin cancer, which is the most common; prostate cancer would be the leading cause of cancer in men.
Melanie: So, who would be at risk? Since it is so common, is there anything that would predispose somebody to prostate cancer?
Dr. Pattali: If you look at the prostate cancer incidence; it is much more common in African American race and also with somebody with a strong positive family history; there is a higher incidence. But most of the men as they get older; the incidence of prostate cancer goes up. Which if you look at men above 60 years; the incidence is almost one in forty or so and it is very common cancer that we see around in the country – all over the world.
Melanie: So, many men get BPH or an enlarged prostate; does that necessarily mean they will get prostate cancer?
Dr. Pattali: That’s not true. The prostate is a small gland that is wrapped around the urethra in front of the rectum which itself is more walnut-sized. As men get older, the prostate can get enlarged and sometimes – and that is part of the normal aging and some men can have an enlarged prostate which can cause benign enlargement. This does not mean they have prostate cancer, but though some of the symptoms can mimic a prostate cancer like difficulty in initiating urination or a weak stream or increase in the number of urinations especially at nighttime which may mimic some of the symptoms of prostate cancer, but that does not necessarily increase the risk.
Melanie: So, speak about screening just a little bit Dr. Pattali. What is the screening test available right now for men for prostate cancer and who should have it at what age?
Dr. Pattali: So, we have a blood test called PSA or prostate-specific antigen that we can test in blood. Most of the guidelines would recommend testing for men about 50 years of age or if you are an African American race or a strong family history to start screening sooner. There is also a fair bit of controversy about whether prostate cancer should be screened or not and that is mostly because if you see a PSA being elevated, that could be also from noncancer related, but it puts patients through a lot of anxiety and then puts them through biopsies which a lot of times turns out to be negative. So, there is always a slight controversy about whether we should screen or not screen for everybody. But overall, if you look at screening; there are two modalities mostly, do a blood work called PSA or you could do a digital rectal exam by a urologist or a primary doctor in the office to see the contour of the prostate. If they are smooth and not enlarged, depending on that they can talk about a biopsy.
Melanie: So, explain the numbers a little bit. Because as you said, it can cause anxiety, but many men are getting PSA checked. So, what do those numbers mean? What’s normal and what’s considered high?
Dr. Pattali: Usually a PSA less than four is considered normal and then about that, you could get PSA slightly elevated in benign prostatic hyperplasia or BPH, but it is more of the rate of the elevation that can support the biopsy. Even men with prostate cancer, they can be very slow growing and as you get older, not all of them need to be treated. So, an elevation of PSA above four kind of prefers further testing.
Melanie: So, then if somebody is diagnosed with prostate cancer; what are some treatment options? Because as the time goes on; you have so many more tools in your toolbox to help men. So, explain some of the treatments available.
Dr. Pattali: So, first of all, all prostate cancers need not be treated. Some of them are very slow growing and there is a lot of times prostate cancer is diagnosed in men with early stage, we probably do not need any treatment, maybe they can be watched or managed with a lot of treatment. In younger people, with prostate cancer, there is a surgical treatment called radical prostatectomy where the prostate is removed surgically versus there is a radiation treatment option for older people with one to two years of hormonal treatment blocking the male hormones. So, that could be by a shot – an injection once a month to six months shot to prevent male hormones from getting into the prostate cancer cells. So, that’s the hormonal treatment. So, one of the definitive ways to treat it is either surgery or radiation with hormones.
Melanie: Is surgery becoming less common, a prostatectomy, or are you still doing pretty many of them?
Dr. Pattali: In the less than 65 years age, radical prostatectomy for patients who are treated and young, that is still the standard of care to offer radical prostatectomy. Older patients, higher stage cancers, radiation therapy with the hormonal treatment is standard.
Melanie: And speak about radiation therapy just a bit. What can men expect from the types of radiation therapy available today?
Dr. Pattali: Yeah, there is radiation external beam radiation therapy, there is radiation seed implant. There are different modalities of radiation therapy that an experienced radiation oncology doctor would be able to determine for the patient. The hormonal treatment, which plays a part on it because of the way the male hormones, the testosterone kind of drives the prostate cancer; so blocking that is also important part of the treatment along with the radiation therapy on the prostate cancer. And seed versus external beam; they both work very well.
Melanie: How does a man know if the treatment is working?
Dr. Pattali: So, the PSA is serially watched. If the PSA comes down; that indicates the prostate cancer cells are being killed by the radiation or the hormone treatment. And we can use that as a marker in most of the prostate cancers types. There at one stages where the cancer has spread to other areas like lymph nodes, a CAT scan or a bone scan can sometimes determine the progress of the cancer.
Melanie: And what are some of the most common side effects of prostate cancer treatments, Dr. Pattali, because first of all, men don’t even always want to go see a doctor to be checked because they are afraid of those side effects that they hear about whether it is erectile dysfunction or any of these others? So, what do you tell men about these side effects and dealing with them after prostate cancer treatment?
Dr. Pattali: So, the side effects are mostly geared towards blocking the testosterone, because blocking the testosterone is one of the major arms of treatment in prostate cancer and that can cause erectile dysfunction, can cause hot flushes, loss of muscle mass, fatigue, decreased libido, and these are mostly experienced in people where the hormones are blocked by the either the shot or by doing a orchidectomy which is the removal of the testicles by surgical procedure. It is really less practiced in the United States. The surgery per se, surgery can have other side effects including sometimes very rarely incontinence, erectile dysfunction, but those are very less often with modern surgical techniques.
Melanie: And then what do you tell men about the importance of getting checked for prostate cancer? What would you like them to know?
Dr. Pattali: The prostate needs to be checked at least in men over 50 with a PSA and a digital rectal exam by the primary doctor. I would recommend checking it a little bit sooner if they have family history or if they are of the African American race. I would also recommend that if PSA is a good marker for them, that would be the test that is better to watch in the future.
Melanie: Thank you so much, Dr. Pattali, for being with us today. You are listening to Memorial Health Radio. For more information, please visit www.mhsystem.org . That’s www.mhsystem.org . I’m Melanie Cole. Thanks so much for listening.
Pastimenang Slot adalah platform menarik bagi penggemar slot online. Dengan berbagai pilihan permainan berkualitas tinggi dan peluang menang besar, Pastimenang menghadirkan hiburan seru untuk semua pemain! Achieve lean muscle gains and superior strength with Anavar 25. Elevate your performance and redefine your physique today!