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Doctors Pushing for 15-Year Followup for Prostate Cancer Patients

For many cancer patients, surviving 10 years past cancer treatment is a cause for celebration, as they can be declared cancer-free. Yet prostate cancer is one form of cancer that has a higher risk of late recurrence or a recurrence occurring 10 to 15 years after a perceived successful treatment. Because of this risk of late recurrence, the American Urological Association recommends a 15-year follow-up after prostate cancer treatment.

Research presented at the 2014 meeting of the American Urological Association pointed to the need for this follow-up treatment. Researchers, led by Frank Critz, MD, of Radiotherapy Clinics of Georgia, attempted to determine how long treatment follow-up should occur. They found that a minimum of 15 years wasnecessary.

The treatment followed 2,808 prostate cancer patients from 1984 to 2002. The men were treated by radiotherapy and were declared disease free at their 10-year follow up. Of these men, 48 ended up with a late recurrence of the disease. The median time frame for the late recurrence was 12 years after treatment. The men had a medium time from the follow up to the recurrence of three years.

In addition, four of the patients had a PSA of less than 0.2 ng/ml at their 15-year follow-up, but went on to have their disease recur some 15-20 years after treatment. One of the men died after 25 years because of metastatic prostate cancer. The total recurrence rate was 3 percent at 15 years and 5 percent at 20 years. None of the patients had recurrence at 10 years, which is a common time span for being considered “cured”.

Prostate cancer is one from of cancer that is often misunderstood.

To learn more about prostate cancer and the best treatment options available, visit Dr. Bert Vorstman at http://www.urologyweb.com/exclusive-medical-reports/ Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/

Contact him directly at bvorstmanmd@gmail.com.

Posted in: Mens Health, Prostate Cancer News

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Obesity Linked to Higher Survival Rate for Radical Cystectomy

Patients who undergo a radical cystectomy as treatment for bladder cancer have an improved survival rate if they are obese, a recently reported finding shows. The findings were reported at the American Urological Association’s 2014 annual meeting and showed that, for muscle-invasive bladder cancer, obesity is actually a benefit in treatment outcomes.

The study followed 728 patients retrospectively. The median age of the patients was 70 years old, and all had received a radical cystectomy to treat bladder cancer. The overall survival rate for those with a BMI of 30 kg/m2 was higher than that for those who were not obese. In the study, the average survival rate for obese patients was 4.6 years, compared to 2.7 years for non-obese patients.  In total after necessary adjustments, obese patients were shown to have a 40 percent lower risk of death compared to their non-obese counterparts.

This is not the first time that obesity has been linked to higher survival rates for cancer patients. The same link has been seen in esophageal and lung cancers. Obesity did affect the treatment in other ways as well. Obese patients had a longer surgery time and lost more blood than non-obese patients. They did not, however, require more blood transfusions as a result.

Obesity is just one of several factors that affect the outcome for a patient dealing with urologic cancers.

To learn more about treatment methods for common urological conditions and especially for localized prostate cancer, visit Dr. Bert Vorstman athttp://www.urologyweb.com/exclusive-medical-reports/

Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/

Contact him directly at bvorstmanmd@gmail.com.

Posted in: Mens Health

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HIFU for Prostate Cancer Treatment Shows Promise in Preserving Erectile Function

For men who have prostate cancer, the treatments often carry side effects that are worse than the disease itself. Erectile dysfunction is one of these. This problem was the subject of a study performed by British researchers at the London NHS Trust, and the research was reported at the American Urological Association 2014 annual meeting.

According to the report, men who have high-intensity focused ultrasound (HIFU) treatment for prostate cancer do often experience a postoperative decline in erectile function. However, unlike other treatment options, HIFU does not appear to create a permanent problem. Most men have their erectile function return to their baseline level in around six months.

The researchers studied 116 patients who received HIFU treatment. They established a baseline erectile function score of 19.8. The men studied showed a significant decline in erectile health at one month, with a level of 12.5 being average. At three months this had increased to 15.7, and by six months it was as high as the baseline. The study also showed that 65 percent of patients were potent without medication after receiving HIFU.

What does this mean for prostate cancer patients? It means that prostate cancer has a new treatment option that may eliminate the risks, including the risk of erectile dysfunction.

Of course, prostate cancer does not always need to be treated, and in many cases is not a true cancer at all. To learn more about the potential dangers of prostate cancer treatment, visit Dr. Bert Vorstman athttp://www.urologyweb.com/exclusive-medical-reports/

Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/

Contact him directly at bvorstmanmd@gmail.com.

Posted in: Prostate Cancer News

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Waiting Before Starting Hormone Therapy May Be Best Option for Prostate Cancer Recurrence

Do men who are showing signs of a prostate cancer relapse need to start hormone therapy immediately? New research from the American Society of Clinical Oncology says no. Dr. Clifford A. Hudis, president of the Society, has produced a study that shows that starting hormone therapy at the first sign of relapse may not be the best option.

The study was released in a telephone news conference in advance of the American Society of Clinical Oncology’s summer meeting. In the study, men who had undergone either radiation therapy or surgery for prostate cancer, then had a rise in PSA levels after treatment, were studied. These patients had no other signs of prostate cancer problems other than PSA level increases, and this is a situation affecting around 60,000 men a year.

In a typical course of treatment, men in this situation would be given hormone therapy to block the development of testosterone and, in theory, stop the growth of the prostate cancer tumor. However, this creates unwanted side effects, including hot flashes, muscle weakness, osteoporosis, cardiac issues and problems with sex drive.

The study followed around 2,000 men with these PSA relapses, some of which chose immediate hormone therapy and some of which chose to wait until they had other signs of relapse. The 5- and 10-year overall survival rates or death rates showed no true difference. While the study was not randomized, it does point to a significant fact. Waiting to deliver hormone treatment after a relapse based on PSA alone can help preserve quality of life without harming the patient’s overall outcome. Doctors and patients need to weigh all of their options when choosing the best solution for treating their prostate cancers.

Prostate cancer is one of the most misunderstood diseases the modern man can face. To learn more about treatment options, and why waiting is often the best course of treatment, visit Dr. Bert Vorstman athttp://www.urologyweb.com/exclusive-medical-reports/

Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/

Contact him directly at bvorstmanmd@gmail.com.

Posted in: Prostate Cancer News

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Shedding New Light on Bladder Cancer

Bert Vorstman MD, MS, FAAP, FRACS, FACS

www.urologyweb.com

For patients with localized high-risk bladder cancer, ta new blue light technology is available.

Using the new blue light technology, doctors are able to make cancer cells in the bladder light up and glow in a color different than the surrounding tissue. This process is similar to the way a blue light exposes blood or other bodily fluids at a crime scene. This technique can help doctors target treatment more effectively and successfully.

Once the blue light has highlighted the bladder cancer, the area is then treated.Furthermore, the light allows for the area to be checked after treatment to ensure that all of the cells have been destroyed, lessening the chance of recurrence.

For many patients, bladder cancer symptoms can, at times, mirror those of a urinary tract infection. For example,

> Visible blood in the urine

> Urgency to urinate

> Burning on urination

Patients experiencing these voiding symptoms should seek the help of a urologist to rule out bladder cancer.

To learn more about recent advances in the field of urology, visit

Dr. Bert Vorstman at http://www.urologyweb.com/exclusive-medical-reports/

Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/ andhttp://www.hifurx.com/blog

Contact him directly at bvorstmanmd@gmail.com.

 

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Testosterone Supplementation May Be a Risky Choice

Bert Vorstman MD, MS, FAAP, FRACS, FACS

www.urologyweb.com

When men start to struggle with a loss of libido, testosterone may be the culprit. Low testosterone levels can cause a range of symptoms, but loss of libido is often the first one men notice. Supplementing with testosterone is a common approach, but it may be too risky.

A recent study finds that using testosterone as a supplement raises a man’s risk of heart attack if he is over the age of 65 or already has heart disease. For many men this is not a risk worth taking.

Of course, there are potential benefits as well. Diabetic men who supplement with testosterone may find that they can better control their diabetic symptoms. The increased metabolism and body muscle caused by increased testosterone in the system can contribute to better control of diabetes.

Are there other ways to treat low testosterone? Absolutely. Increasing exercise, decreasing weight and lessening alcohol consumption all contribute to higher testosterone levels. The Endocrine Society has shown that obese men that lose around 17 pounds will have increased testosterone levels.

Statins to control cholesterol and antihypertensive medicines to control blood pressure are also notorious for compromising libido and erections. Check on the possible side effects of the medicines you have been prescribed and if you believe them to be affecting you adversely, have your doctor prescribe an alternative. Remember to monitor your own blood pressure periodically to ensure your pressure has been normalized.

If you are struggling with low testosterone levels, testosterone supplementation may not be your best line of defense.

To learn more about this and other urological treatment options, visit

Dr. Bert Vorstman at http://www.urologyweb.com/exclusive-medical-reports/

Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/ andhttp://www.hifurx.com/blog

Contact him directly at bvorstmanmd@gmail.com.

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New Recommendations for Lipid Profiles in Kidney Disease Patients

Bert Vorstman MD, MS, FAAP, FRACS, FACS

www.urologyweb.com

 

A new recommendation for patients with chronic kidney disease asks physicians to perform a full lipid profile at first presentation of the condition. The new recommendations come from a work group working on behalf of the Kidney Disease: Improving Global Outcomes organization.

 

According to the guidelines, measuring lipid status at the discovery of chronic kidney disease will not improve clinical outcomes. It will, however, improve the health of people who suffer form dyslipidemia as part of their condition. The procedure is noninvasive and inexpensive, and the potential benefit is worth the small inconvenience or additional cost.

 

The work group that presented the recommendation believed that the low quality of supporting evidence was not a problem because of the low cost and low risk of the procedure. Follow up lipid measurement was not recommended, except in those cases where doctors believed a new treatment may be warranted or a new condition has developed.

 

The guidelines also made recommendations in statin treatment, which are different depending on the age of the patient. For those ages 50 and older with an estimated glomerular filtration rate below 60 mL/min/1.73m2, but who are not on dialysis or awaiting transplant, treatment with a statin alone is sufficient, or treatment with statins combined with ezetimibe.

 

For those ages 18 to 49, statin treatment is only recommended if other conditions, like diabetes mellitus, coronary disease or an ischemic stroke, are present. Adults on dialysis should not be treated with statins alone or statins with ezetimibe, due to inconclusive benefits of the treatment on patients undergoing dialysis. However, patients who begin dialysis and are already taking these medications should continue.

 

The new guideline was published online in Kidney International.

To learn more about kidney disease, other urological conditions and

prostate cancer, visit Dr. Bert Vorstman’s website,http://www.urologyweb.com/exclusive-medical-reports/

Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/ andhttp://www.hifurx.com/blog

Contact him directly at bvorstmanmd@gmail.com.

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Patients Report Being Unaware of Over-diagnosis/Over-treatment Risk from Cancer Screenings

Bert Vorstman MD, MS, FAAP, FRACS, FACS

www.urologyweb.com

 

Overdiagnosis and overtreatment of prostate cancer is a very real risk, yet very few men are actually told of the potential for this risk. In fact, patients are not regularly informed of the risks of overdiagnosis and overtreatment for most types of cancers. In one online study of 317 men and women ages 50 to 69 years, less than 10 percent of patients surveyed indicated they had been told of these possibilities.

 

The survey asked the respondents how many had been informed of overdiagnosis and overtreatment when they were diagnosed, and how much overdiagnosis they were wiling to tolerate. Among men, PSA testing and colonoscopy/sigmoidoscopy testing were the two most common screenings reported. Only 9.5 percent of the survey participants indicated they had been told about the possibilities of prostate cancer overdiagnosis and overtreatment. The number of men who were informed was slightly higher than the number of women, with 10.6 percent and 8.4 percent respectively.

 

Interestingly, patients indicated that they, in theory, were not very tolerant of overtreatment. Half of the participants reported they would not start a screening that resulted in more than one overtreated person per live saved from death due to cancer. However, when the study became personal, 59 percent indicated they would continue the cancer screenings they were already receiving, even if they learned that the results led to overdiagnosis.

 

What can be concluded from this study? Currently, physicians are not providing adequate counseling about screening to meet the standards and expectations their patients have. This lack of patient education could point to a lack of physician understanding about the dangers of overscreening for certain types of cancers.

 

Prostate cancer is one of the cancers that is prone to overdiagnosis and overtreatment. Men who are undergoing routine screening for prostate cancer need to understand the risk of overdiagnosis and overtreatment and posed by ongoing screenings, and need to discuss their options with their doctors to avoid these risks.

To learn more about these risks and alternatives to conventional prostate cancer treatments, visit Dr. Bert Vorstman’s website,http://www.urologyweb.com/exclusive-medical-reports/

Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/ andhttp://www.hifurx.com/blog

Contact him directly at bvorstmanmd@gmail.com.

 

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Non-Surgical Treatments for Pelvic Floor Issues Show Promise

Women suffering from pelvic floor dysfunction often suffer in silence, either because they are embarrassed by their symptoms or because they have sought help in the past and come up empty. New research points to some simple, yet effective solutions. For the one in three women who suffer from pelvic floor dysfunction (PFD), this is good news.

Surgery and Medication May Not Be Necessary

Researchers at the University of Missouri have demonstrated through a recent study that comprehensive, non-surgical treatment provides a solution that improves the symptoms of this uncomfortable condition. Pelvic floor rehabilitation, for example, can solve many pelvic problems without the need for medication or surgery. The goal of this treatment, according to Julie Starr, doctoral student and family nurse practitioner, is to strengthen muscles for bladder control problems or relax muscles for constipation and pelvic pain problems.

The study, which Starr participated in with other University of Missouri researcher looked at data from close to 800 women with PFD. Specifically, the women were treated for urinary, bowel or pelvic pain and sexual dysfunction symptoms. The results were interesting:

According to their findings, patients who underwent at least five comprehensive pelvic floor rehabilitation therapy sessions had the best result, with an 80 percent average improvement in defecatory dysfunction, pelvic pain and urinary incontinence.

Understanding Pelvic Floor Rehabilitation Therapy

What is this comprehensive pelvic floor rehabilitation therapy? According to Starr, it involves:

  • Vaginal electrogalvanic therapy
  • Biofeedback
  • Kegel exercises
  • Behavior modification

Of these, the electrogalvanic therapy (e-stim) proved to be very effective at relaxing muscles and lessening or eliminating pelvic pain during intercourse. Based on the results of the research, Starr states that she rarely offers medication to women with PFD, and does not advise surgery unless pelvic floor rehabilitation does not work.

In light of this study, women who have pelvic floor issues need to realize that less invasive treatment options do, in fact, exist. As men with prostate cancer often learn, the most aggressive treatment is not always the best, as it has the potential to cause unwanted risk and side effects. Whether treating a woman dealing with pelvic floor issues or a man with a recent prostate cancer diagnosis, Dr. Bert Vorstman recommends taking the least invasive approach.

Learn more about this by visiting his website athttp://www.urologyweb.com/exclusive-medical-reports/

Dr. Vorstman also blogs at http://www.urologyweb.com/uro-health-blog/ andhttp://www.hifurx.com/blog

Contact him directly at bvorstmanmd@gmail.com.

Posted in: Womens Health

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