THE SKY STAGE OF BLUE | LOW RISK
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Many treatments have irreversible consequences, so it is worth doing it right the first time. It is commonly understood in medical circles that long-term survival is improved by receiving optimal treatment up front...
PSA plays a variety of roles, the most familiar being screening to detect prostate cancer at an early stage. PSA also helps to define the Stages of Blue. Another role of PSA is to detect cancer relapse after surgery or radiation. Lastly, rises or declines in PSA after hormone therapy or chemotherapy help determine whether a treatment is working...
The two major components of the pathology report from a random 12-core biopsy are the Gleason score, which measures how aggressive the tumor appears, and the quantity of cancer in the 12-core specimen...
Multiparametric MRI (MP-MRI) provides a three-dimensional image of the prostate, giving important information about the cancer’s location, size, and how “aggressive” it appears. MP-MRI also greatly increases the confidence that higher-grade cancers are not being overlooked in men on active surveillance. MP-MRI is usually performed without an endorectal coil...
This article will discuss an alternative type of imaging, called color Doppler ultrasound (CDU). Unfortunately, CDU followed by targeted biopsy is available in only a few centers around the United States. Even so, this article will expound the many advantages of CDU for the diagnosis and staging of prostate cancer...
Once the proper Stage of Blue is assigned, the different treatments appropriate for that Stage can be considered. Overall, there are four broad categories of treatment available for prostate cancer: observation, local treatments, systemic treatments, and combination therapy...
If every available candidate in North America and Europe pursued active surveillance, close to 300,000 men could be spared from unnecessary surgery and radiation every year. In one observational study of men on active surveillance with Gleason 3+3=6 or low-volume...
It is estimated that as many as a third of newly-diagnosed men have only one spot of cancer. These patients may be candidates for focal treatment. Focal cryotherapy is defined as the destruction of a section of the prostate gland by freezing...
In 2012, a survey from the Mayo Clinic and Harvard was sent to 1,439 physicians. The conclusion was that even though active surveillance is widely viewed as effective, most urologists continue to recommend surgery, while most...
Patients in Sky are still frequently advised to have treatment. It behooves them, therefore, to learn about its side effects. Unlike the other Stages of Blue, men in Sky have a choice—the option of postponing treatment by pursuing active surveillance. Therefore...
Erectile dysfunction (ED) is a risk with every type of treatment for prostate cancer, but the exact risk is very specific to each patient. The better a man’s erections are before prostate cancer treatment, the better chance he has of preserving function...
Loss of bladder control (urinary incontinence) after surgery can be a devastating complication with a very negative impact on quality of life. The good news is that, with appropriate evaluation and treatment, incontinence is usually treatable. Bladder control problems for...
Radiation for prostate cancer may cause short- or long-term side effects. Even though radiation targets the cancer cells, normal body tissues near the tumor can be affected. Specifically, we are talking about...
The surveillance policy, after surgery or radiation, is to check PSA quarterly for the first two years, biannually for the next three, and annually thereafter. For radiation patients, a yearly digital rectal examination is also recommended. After treatment with...
Ideally, the bulk of human food intake should be from whole food sources (unprocessed, unadulterated, natural), with only a small percentage of food products (processed, refined, boxed, bottled, canned, packaged, and powdered). Whole foods provide...
The risk of a sedentary lifestyle is about the same as a pack-a-day smoking habit. “Sitting is the new smoking.” After age 60, just through the normal aging process, men lose 1% of their muscle every year. Hormonal treatments accelerate...
When it comes to dietary supplements, less is more. Mega-doses suggest a worse outcome or prognosis in patients with cancer...
Prostate cancer grows at a snail’s pace compared to other cancers. It’s such a common condition, it would be illogical to assume every case is deadly. PSA, Gleason score, imaging studies, and new genetic tests enable us to accurately identify a...