ALLEGANY MAGAZINE FEBRUARY 2021: The Men’s Health Issue Most Men Don’t Like to Talk About – Cumberland Times-News

The Mens Health Issue Most Men Dont Like to Talk About

How and Why a Local Specialist Emerged as Research Pioneer

Over the past 18 years, I have had the privilege of caring for men, women and children with a myriad of urologic conditions. As a Urologist, I treat a spectrum of conditions that span from urinary infections and kidney stones, to cancers of the kidney, bladder and prostate. Prostate cancer is the most common non-skin cancer in American men. More than 160,000 men are diagnosed each year according to the National Cancer Institutes Surveillance, Epidemiology, and End Results Program (SEER). Prostate cancer takes more lives each year, second only to lung cancer.

The good news when it comes to prostate cancer is that in the majority of cases, the cancer is curable. More than 98 percent of men who are diagnosed with prostate cancer survive for five years or more. But like many cancers there are other factors which can affect a positive outcome when treatment is pursued. For example, when prostate cancer is detected at an advanced state, the five-year survival rate is just 30 percent. The other difficult issue with prostate cancer is that it is notoriously symptom-free at its very early stages.

Similar to many cancers, prostate cancer patients may not have symptoms until the cancer is advanced. The vast majority of these patients are not curable. Some of the symptoms that they may experience include changes in their ability to urinate, finding blood in the urine or semen or lower back pain and stiffness. Any of these symptoms may occur with conditions other than prostate cancer but should not be ignored. Promptly address any of these issues with a primary care provider or urologist who can safely and effectively screen for prostate cancer.

The ideal management of men includes annual PSA testing and the digital rectal examination (DRE). The screening blood test is called a PSA, which stands for prostate specific antigen. Increases in your PSA results over time and in terms of how rapidly they rise can be an indication of prostate cancer. The recommendation for PSA screening has been controversial in the past but is currently endorsed by the American Cancer Society and the American Urological Society. Men should consider PSA screening around age 50 and earlier if you have a family history of prostate cancer or are of African descent.

Once prostate cancer is suspected, either through increases in PSA or perhaps an MRI image of the prostate, a biopsy of the prostate is required to establish the actual diagnosis of prostate cancer. Almost two million prostate biopsies are performed in the world each year. My research and efforts have been devoted to developing a better, safer biopsy for prostate cancer.

The current standard of care for a prostate biopsy is a trans-rectal biopsy. It requires the urologist to take samples of the prostate by passing a needle through the rectum of the patient in order to access the prostate. This procedure runs the risk of infecting the patient with fecal matter during the procedure. Generally, patients are given antibiotics to reduce this risk, however the procedure requires 12 -18 needle sticks through the rectum to access the prostate for biopsy samples. Approximately 3-6% of patients worldwide develop an infection with requires hospitalization due to these infections, called sepsis. Other complications from the trans-rectal procedure include the inability to urinate after the biopsy and the appearance of blood in the stool and urine after the procedure. I decided these risks were unacceptable for my patients.

To address these risks, I developed a device here in Cumberland, called the PrecisionPoint Transperineal Access System, which allows urologist to perform the prostate biopsy in a revolutionary way that eliminates the complications and risks associated with the trans-rectal method of biopsy. This system uses a safer route for taking samples of the prostate by passing an access needle through the perineum or taint. From there, the prostate is sampled thoroughly with the patient only experiencing two needle sticks and little or no discomfort. The risk of infection using this approach is reduced to nearly zero and the complications of urinary retention and bloody urine and stool are eliminated. While my major focus was to eliminate the risk of infection, another added benefit of this novel approach presented itself. That benefit included better access to difficult to reach parts of the prostate gland during the biopsy resulting in nearly 25% better cancer detection rates. We have treated more than 3,000 patients in the Cumberland area with this new device and procedure and have had patients visit us from around the world to have their biopsies done in our clinic.

This new method is quickly being adopted around the world. Twelve of the 15 US News and World Reports top rated urology centers are using the PrecisionPoint Transperineal Access System. Additionally, more than 12 countries outside the U.S. are utilizing the device and method. Many of the countries have made the commitment to eliminate the trans-rectal biopsy and use the PrecisionPoint biopsy as the standard of care. We are working to make it the standard of care throughout the United States in order that all men can have all the benefits of a better, safer biopsy.

It is very important to detect and confirm prostate cancer as early as possible. Like many cancers, early detection means greater numbers of treatment therapies are available to cure the cancer. Prostate cancer is no exception. There are several approaches to treatment of prostate cancer. These range from the removal of the prostate gland or prostatectomy, or treatment with radiation and/or chemotherapy. In some cases, the prostate cancer can be monitored closely. This is called active surveillance. In active surveillance, the patient is followed closely for changes in the prostate cancer. When changes are noticed, then treatment of the cancer is begun.

It is important to remember that prostate cancer is a very treatable cancer. Early detection and confirmation of prostate cancer begins with patient awareness and good relationships between men and their healthcare providers. It is vital to visit your doctor if you are experiencing any symptoms as described above. Timely referral to a urologist can quickly support the diagnosis, staging and development of a treatment plan where indicated. Early detection and treatment of prostate cancer allows men to live a fuller, healthier life.

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ALLEGANY MAGAZINE FEBRUARY 2021: The Men's Health Issue Most Men Don't Like to Talk About - Cumberland Times-News

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