Men and women striving for equality are finding it in surprising areas.
For example, about 200,000 men are diagnosed every year with prostate cancer, most of them over age 55.
"For men, it is the equivalent of breast cancer and behaves very much the same way," says Dr. S. Adam Ramin, diplomate of the American Board of Urology.
An expert in prostate cancer and robotic laparoscopic prostatectomy, he has published numerous peer review articles and research papers. He is on staff at a number of medical centers, including Cedars Sinai Medical Center, Century City Doctors Hospital, Ventura Community Memorial Hospital and City of Hope Medical Center. He is the president of the Los Angeles Urological Association.
Q: Women often find a lump before a medical diagnosis of breast cancer. What should men look for?
A: Nowadays, prostate cancer is diagnosed at such an early stage there are no apparent symptoms. The patient is initially screened and diagnosed through a digital rectal exam and a PSA blood test.
If these are abnormal, either a biopsy of the prostate or a more specific type of test is ordered. Not all patients with elevated PSA have cancer, for example, which makes this test good but not completely accurate in making a diagnosis.
Q: Tell me about the tests.
A: One test is doing a transrectal ultrasound looking for abnormal areas in the prostate.
Another test, PCA3, is relatively new. This is a urine test. It is done after a prostate massage. The massage expresses urine in the prostatic fluid that comes out. The urine contains those prostate massage fluids, and if that's elevated, we definitely do a biopsy of the prostate.
Q: Who is at risk for prostate cancer?
A: The median age for men who show signs of this disease is 55 to 65. However, we know as a man gets older the risk increases.
Prostate cancer is very much like breast cancer and the two behave much alike.
For example, one in eight men get prostate cancer and one in eight women get breast cancer. If you have a mother or sister with breast cancer, you are more likely to get it. If you have a father or brother with prostate cancer, you are more likely to get it.
But also, the fact is a man is more likely to get prostate cancer if his mother or sister had breast cancer. The genes that cause breast cancer in women are the same with men in prostate cancer.
Q: What are the treatment options?
A: Broadly speaking, they range from watchful waiting (or not doing anything at all) to hormone therapy, which is one of the more exciting treatments available today.
And then there is robotic-assisted surgery and radiation and seed implantation.
Q: Robotic surgery is the fastest-growing treatment, and you are considered one of the top experts. Can you explain this treatment?
A: This newer way of treatment can avoid complications.
But there are three things for patients to know:
—Always look for an expert doctor in the field.
—It's critical for every man over 55 to get a yearly PSA or rectal exam.
—Not all forms of prostate cancer require treatment. Some are slow-growing and can be monitored.
Q: Diagnosis then determines treatment?
A: Absolutely.
And if the prostate is removed, there is a recovery period that may include loss of continence. However, with robotic surgery, the chance of any long-term incontinence is reduced to 2 to 3 percent.
Most problems associated with this surgery — such as loss of erection or bladder control — can be eliminated through newer forms of treatment. And, yes, Viagra even helps very well with the combination of nerve-sparing surgery.
source: www.nwitimes.com
