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"You have turned my life around"
 

I am 87 years old, with a problem of the prostate gland. Before I met Dr. Baum, I went to the bathroom every 30-60 minutes. After Dr. Baum's treatment on my prostate, I go only 5 times per day and only 1 time at night! You turned my life around. I am so very grateful!

-Sidney Daigle


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Posts for tag: PSA testing

Men need to treat their bodies like their cars and visit to the doctor to check what's under the hood Men do not usually talk about going to the doctor. Most of the time, it takes serious pain or a major concern to get them to schedule a visit. You may be surprised to know that the urinary tract is most commonly responsible for men's complaints, as it can bring on problems with obstructive or irritative symptoms. " 'Obstructive' means things like slow urinary stream, difficulty getting the stream to start, difficulty emptying the bladder completely and 'irritative' means things like urgency or feeling a strong desire to urinate that you may have trouble inhibiting, having leakage of urine with urge incontinence or nocturia or going to the bathroom at nighttime," says Dr. Sean Collins, an urologist at East Jefferson General Hospital.
Kidneys can bring on troubles of their own. "Kidney stones can develop with back pain or cause blood in the urine, and the biggest risk factor is not drinking enough fluids when it gets hot outside," says Dr. Benjamin Lee, a urologist at Tulane Medical Center. The majority of stones are made of calcium but can also be due to recurrent urinary tract infections. "We know that lemonade has a chemical called citrate, which helps dissolve calcium to help prevent stones from forming," says Lee. It is important to be proactive because if you develop a kidney stone, there is a 50 percent chance you will have a second one in the next five years.
Prostate screenings are vital but keep some men far from the doctor's office. "Men are intimidated by the rectal examination, but it is not a big deal and takes 30 seconds while the doctor puts a gloved finger in the rectum and feels the prostate," says Collins. The doctor checks the size of the prostate and whether there is a mass, nodule or hard area that would be concerning and warrant a biopsy. The exam is not anything to be scared of. "Most men leave and say it was not that bad and was worth it if we could find something that could save their life," says Collins.
Lifestyle choices affect the prostate. "The diet that is best for the health of the prostate is the diet we should be on for cardiovascular health: a low-fat diet, rich in fruits and vegetables," says Collins. There is evidence that lycopene, a substance found in tomatoes, is good for the prostate. Cruciferous vegetables like broccoli and cauliflower are also helpful.
Sexual issues are not often talked about by men but are more common than you may think. "We find that erectile dysfunction is a barometer for a man's overall health," says Collins. The risk factors for erectile dysfunction are the same for cardiovascular disease. "The reason is the blood supply to the penis is a very tiny artery about two millimeters in diameter, whereas the blood supply to the heart is four to five millimeters in diameter, so it does not take much blockage of the blood supply to the penis to result in impotence," says Dr. Neil Baum, a urologist at Touro Infirmary.
Thankfully, a lot of progress has been made in this area. "Viagra, Levitra and Cialis are the big advances that totally changed the way the field is approached and who you can help with it," says Dr. Robert McLaren, a urologist at Ochsner Health System.
Infertility is a common issue with men being responsible half of the time. "If you have borderline problems with your semen, you can avoid hot baths and jockey underwear and should wear boxer shorts because of the excessive heat of bringing the testicles close to the body," says Baum. A semen analysis can be done at a urologist or reproductive endocrinologist's office.
Young men may think they are invincible when it comes to health issues but they aren't. "In young men, the most common thing we see is prostititis, which is an infection or inflammation of the prostate, and some men who are active or do bicycle riding can have numbness of the bicycle area, which can resolve if they cut back on riding or use specialized seats," says Collins.
Every man responds differently. "Prostate enlargement is a normal part of aging but not everybody develops problems from it," says McLaren. Know what to expect. "The prostate is a gland that sits outside the bladder and is normally about the size of a walnut," says Lee.
Robotic surgery has revolutionized the way prostate cancer is treated and gives men hope as recovery is quicker and less painful. "The da Vinci robot has made the greatest impact and there are medications that can shrink your prostate that were not around 20 years ago," says McLaren.
It is a good idea to get a blood test to check your testosterone level as well. "It indicates a decrease in production of testosterone by the testicles, which can be treated with hormone replacement therapy," says Baum. You can do a self-exam of the testicles to screen for testicular cancer, which is common in men between 20 and 45. "They look for a little bump or lump on the scrotum on the testicle. I tell men that if they make a fist and feel the knuckle, that is what the testicle tumor feels like and they can get an ultrasound exam and blood test to help diagnose testicular cancer," says Baum.
Making wise choices is helpful for all ages. "If you want to make yourself healthier, exercise, eat right and do not smoke," says McLaren. To prevent heart disease, you should stay away from red meat, salt and other high cholesterol-containing foods. Your health may be partly determined by what you eat. "Men who have diets that are low in fiber and do not have regular bowel movements or have firm, hard bowel movements are at risk for colon disease such as diverticulitis and diverticulosis, which is inflammation around the colon that results in cramping, abdominal pain and difficulty with the stool," says Baum. Foods with omega-3 fatty acids like cold water oily fish, salmon, herring, mackerel, anchovies and sardines are helpful.
Self-care is important for men of all ages. "It is interesting that in the top seven cancers in the United States, number one is prostate, number four is bladder and number seven is kidney," says Lee. Thanks to screenings, lives are being saved. "The message we are trying to get out is that many of these issues are very treatable at an early stage," says Lee. The health-care community has adapted guidelines with this in mind. "The American Urological Association and the American Cancer Society are really trying to get the word out," says Lee.
This month is the time to take charge of your health. "The most common problems men run into are cardiovascular disease, prostate cancer and colon and rectal cancer, all of which can be prevented by visiting the doctor on a regular basis," says Baum. A few tests can also be useful. "A stress test checks the heart and blood supply to the heart, a prostate-specific antigen and digital rectal exam rule out prostate cancer and a colonoscopy every five years checks for colon and rectal cancer," says Baum.
Even if you feel fine, it is important to see your doctor. "Early hypertension has no symptoms whatsoever unless you go to the doctor and have your blood pressure taken," says Baum. It can lead to a stroke, kidney disease or heart disease if it is not adequately treated. If you do experience any new or unusual symptoms, it is important to report them. "Heart disease can manifest itself as chest pain, indigestion, lightheadedness or headaches, which are signs of high blood pressure and decrease of blood supply to the coronary arteries and to the heart," says Baum.
Self-awareness is an asset when it comes to protecting your health. Men are often consumed with taking care of their loved ones, however, and end up neglecting themselves. "The main point is that men need to take an active role in their medical care and need to treat their bodies as something very special that needs fine tuning just like their car," says Baum.

By contactus
July 27, 2010
Tags: PSA testing   PSA   prostate cancer  
Coming soon.

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.

PSA Testsing-WWYDD or What Would Your Doctor Do?

June 13, 2010 by neilbaum

There is probably nothing that has become more controversial than the PSA screening for prostate cancer in men. There is one group that suggests annual screening for all men after age 50 and sooner after age 40 for African-American men and men with a relative, i.e., a father, a brother or an uncle with prostate cancer. Then another group that recommends no PSA testing be done as the testing does not significantly reduce death from prostate cancer and screening tends to over-diagnose prostate cancer and with over-diagnosis more men receive treatment including radiation and surgery that results in complications such as erectile dysfunction and urinary incontinence. So what is a man to do?For this article I will not definitively answer the question but will shed light on the issue and then let you decide what you should do or what advice you should give the important men in your family.

What are the facts? Approximately 35,000 men die each year from prostate cancer, which is the second most common cause of cancer death in men. There are 250,000 newly diagnosed cases of prostate cancer diagnosed each year. The PSA test is the screening method of choice for dearly detection of prostate cancer. The determination of PSA values, when followed annually is the single most convenient, cost-effective and workable way of selecting men who need close monitoring, close follow up, or need to consider further treatment with radiation, surgery or hormone therapy.

What is PSA? PSA is a blood test that measures a protein manufactured in the prostate gland, which is secreted into the blood stream. We do know that PSA is age-dependent or increases naturally as men get older. In normal men less than 50 years of age the value should be less than 2.5ng\ml and in men over age 70 a normal PSA values is less than 6.5ng\ml.

The real value of the PSA test in early detection is based on establishing a baseline PSA value and performing the test once a year in order to observe changes from the baseline value. Increases of PSA of .75ng\ml in a year should be investigated. The take home message is that a trend is more important than a single measurement. An elevation of the PSA may not automatically represent prostate cancer. Elevated levels occur with advancing years, large prostates, prostate infections, a digital rectal prostate exam, and even sexual intimacy with ejaculatin 24-48 hours before the blood test.

For those who have an elevated PSA test, there is a more refined test called the free\total ration of PSA. The ratio of free\total PSA is less than 25% in men with prostate cancer and if the free\total is greater than 25% is much less likely to have prostate cancer and probably doesn't need a further workup such as a prostate biopsy.

So what to do? If you are at risk for prostate cancer with a relative who has prostate cancer or an African American man, I suggest a PSA and a digital rectal exam beginning at age 40. All others should consider a PSA test once a year. If the PSA increases more than 0.75ng\ml\year, then you should consider an evaluation by a urologist and a prostate biopsy if you have more than ten years of life expectancy and would be a candidate for treatment.

Bottom Line: So what would Dr Baum do? He gets a PSA every year and the last time it was 0.7ng\ml!