Prostate Cancer: Early Detection and Screening

Prostate cancer screening means conducting tests to find the cancer in people with no symptoms. Screening helps in early detection of the cancer when it is still easier to treat. To detect prostate cancer before symptoms appear, urologists recommend either measuring the amount of prostate-specific antigen (PSA) in blood or doing a digital rectal exam (DRE), when the urologist inserts a gloved, lubricated finger into the rectum. If the results of a PSA or DRE are abnormal, the urologist will request further tests. Finding prostate cancer via a PSA or DRE screening means the disease is probably still at an early stage and will respond well to treatment.

PSA Screening

Prostate Cancer: Early Detection and ScreeningThe prostate-specific antigen (PSA) test measures the amount of the protein (PSA) released in blood by prostate cells. Even though both normal and cancerous (abnormal) prostate cells produce the protein, higher blood levels of PSA indicate the possibility of cancer. The PSA test is one of the best indicators of prostate cancer and is recommended by urologists because it is widely available, relatively inexpensive and is a low-risk blood test for patients.

Digital Rectal Exam (DRE)

To perform a digital rectal exam, the urologist inserts a gloved and lubricated finger into the rectum in order to feel the state of the prostate gland. Since prostate cancer often begins in the back of the prostate, DRE helps to assess the texture of this area and checks for hard areas and bumps (nodules) which might indicate cancer. DRE is also effective in detecting whether the cancer has spread to nearby tissues or has reoccurred after treatment.

Confirming Prostate Cancer

After a digital rectal exam (DRE) or PSA blood test, the urologist may request a biopsy to confirm the cancer. But before the doctor can decide whether biopsy is necessary, a number of supplementary tests and considerations must be made, including family history, ethnicity, prior biopsy findings and different forms of PSA. A biopsy means the doctor takes out a small portion of the prostate tissue to be examined under a microscope for cancerous cells. Since cancerous cells appear different from normal prostate cells, a close exam of biopsy cells will help to confirm the cancer.

When to Start Screening

The age of beginning or stopping prostate cancer screening depends on individual risk. Men with a higher risk of having prostate cancer should start screening at age 40. This includes African American men and all men with first and second degree relatives with a history of prostate cancer. Men with average risk should start screening at 50, but only after discussing it with their doctors to reduce the rate of unnecessary biopsies. Men age 75 and older or those with limited life expectancy (less than 10 years) should be discouraged from early detection testing for prostate cancer because they may not benefit much from screening. Nevertheless, a decision to go for prostate cancer screening must be made with the help of a urologist or GP and should depend on a man’s lifestyle, family history, overall health and life expectancy. For more information on screening, diagnosis and treatment of prostate cancer, visit the site, Advanced Urology Institute.

What is Prostate and Prostate Cancer?

The prostate gland is a chestnut-shaped male reproductive organ located below the urinary bladder and surrounding the upper portion of the urethra, the duct that allows passage of semen and urine. It is a conglomerate of secretory ducts that emit fluids into the urethra and ejaculatory ducts. The prostate produces a thick, white fluid which mixes with sperm from the testicles to create semen, contributing 15-30 percent of the semen secreted by a man. The gland also produces a protein known as prostate-specific antigen (PSA), which turns semen into liquid. While the prostate matures into a small, walnut-sized gland at puberty, usually between 10-14 years old, it will still grow slowly with age. However, prostate enlargement after age 50 may lead to urinary problems, often occurring as a result of inflammation or malignancy.

Prostate Cancer: What is it?

Prostate cancer is a disease that occurs when changes in prostate cells make them grow uncontrollably or abnormally. The abnormal or cancerous cells then may continue to multiply non-stop and even spread outside the prostate into nearby or distant areas of the body. Prostate cancer is rare before age 50, but is common among older men and is the second most frequent cause of all cancer-related deaths in American men. The disease is typically slow growing, often showing no symptoms until it reaches advanced stage. Hence, most men with the cancer will never know it and will just die of other causes. Nevertheless, when prostate cancer starts to grow and spread quickly, it can be very lethal and requires prompt treatment.

Causes of Prostate Cancer

Prostate cancer occurs mainly in older men, with more than 80 percent of cases seen in men older than 65 and less than 1 percent observed in men younger than 50. Men who eat lots of high-fat diets such as red meat have a higher risk of getting the disease. Studies have shown that the disease is more common among men who consume meat and dairy products regularly than in those who eat vegetables, rice and soybean products. Fats increase the amount of testosterone in the body and in turn speed up the growth and spread of prostate cancer. Men from families with a history of the cancer are at a higher risk, as are welders, rubber workers, battery manufacturers and men frequently exposed to metal cadmium. Failure to exercise regularly also may make the cancer more likely.

Symptoms of Prostate Cancer

Prostate cancer tends to show no symptoms in the early stages, but will show some symptoms in the later stages. Common symptoms include sudden or frequent urge to urinate, trouble starting a urine stream or knowing when to urinate, pain or discomfort when urinating, blood in urine or semen, and pain in the upper thighs, lower back or hips. While these symptoms may not necessarily mean you have prostate cancer, you should see a urologist or GP when you have any of them.

Diagnosis and Treatment

When you visit a urologist, a medical history and physical examination will be performed followed by a digital rectal exam (DRE) and PSA test. If the doctor detects that you are at risk of prostate cancer, a biopsy will be requested to confirm it. There are several treatment options for prostate cancer including active surveillance (watchful waiting), surgery, radiation therapy, cryotherapy, hormone therapy, chemotherapy and bone-directed treatment. Remember that early diagnosis and treatment of prostate cancer improves your chances of survival. For more information on treatment of prostate diseases, visit the site, Advanced Urology Institute.

Symptoms of Enlarged Prostate

An enlarged prostate, also called benign prostatic hyperplasia (BPH), is an increase in the size of the prostate. While most men have prostate growth throughout their life, not all men get bothersome symptoms. As the prostate grows it presses on the outside of the urethra and can slow down or even stop the flow of urine. BPH is common in men in their 50’s, with about 1 in 3 men above 50 years of age having urinary symptoms.

It is not clear what causes prostate enlargement. However, the following risk factors are involved:

Age – While prostate gland enlargement hardly causes symptoms in men below age 40, about a third of men in their 60’s and about half of men in their 80’s have BPH symptoms.

Hormone Levels – The balance of hormones in the body changes as men grows older, causing the prostate to grow.

Family History – Those with a blood relative, especially a father or brother, with prostate problems are more
likely to have BPH.

Ethnic Background – BPH symptoms are more common in white and black men than Asian men. Black men tend to experience BPH symptoms at a younger age than white men.

Lifestyle – Regular exercise lowers the risk of BPH while obesity increases the risk.

Diabetes and Heart Disease – The risk of BPH increases in men with diabetes, heart disease and those on beta blockers.

What are the symptoms of an enlarged prostate?

The severity of symptoms in people with BPH varies, but tends to worsen over time. Common symptoms include:

  • urgent or frequent need to urinate
  • nocturia (increased frequency to urinate at night)
  • difficulty starting urination
  • inability to completely empty the bladder
  • weak urine stream or a urine stream that stops and starts
  • straining while urinating
  • dribbling at the end of urination

The less common symptoms of BPH are:

  • inability to urinate
  • urinary tract infection
  • blood in the urine

You may never get all of these symptoms. In fact, some men with an enlarged prostate do not get any symptoms at all. In some men, the symptoms eventually stabilize and may even improve over time, while in others they may get worse. Some of these symptoms may be caused by other conditions, like anxiety, cold weather, lifestyle factors, certain medicines and other health problems. Therefore, if you have any of the above symptoms, visit your physician to find out what could be causing them.

How can a urologist help?

A urologist will take your medical history and conduct a physical exam. Depending on the severity of the symptoms, the urologist will order tests such as digital rectal exam, urine test, blood test for kidney problems, prostate-specific antigen (PSA) blood test or a neurological exam. The doctor may also request additional tests such as urinary flow test, post-void residual volume test, and 24-hour voiding diary. If the problem is more complex, the urologist may recommend a transrectal ultrasound, prostate biopsy, cystoscopy, urodynamic and pressure flow studies, intravenous pyelogram or CT urogram. If an enlarged prostate is diagnosed, the urologist has various treatment options to offer including lifestyle modifications and medicines. In severe cases, the urologist will opt for surgery. For more information and help with BPH, visit Advanced Urology Institute.

4 Common Symptoms of Enlarged Prostate

Prostate gland enlargement occurs in men as they age and is quite common in men above the age of 50. Medically referred to as benign prostatic hyperplasia (BPH), the condition can be completely benign or have serious complications such as bladder blockage, urinary retention, bladder infections, kidney stones or kidney damage. Since the prostate gland is located underneath the bladder, its increased size can block the flow of urine through the urethra, a tube that carries urine from the bladder out of the body via the penis. This in turn results in problems with urination and other complications.

Benign prostate enlargement (BPH) is not prostate cancer.

Even though the complications of an enlarged prostate may be serious, BPH is not prostate cancer. Neither does it imply you have a greater risk of getting prostate cancer. Usually, the growth of prostate tissue associated with BPH starts around the inner prostate (a ring of tissue around the urethra) and progresses inward. In contrast to this, prostate cancer often grows from the outer part of the prostate and continues outward. Therefore, having an enlarged prostate does not increase your risk of prostate cancer because the two conditions typically begin in different areas of the prostate. Nevertheless, men can have prostate cancer and enlarged prostate at the same time, so you should speak with your urologist or GP if you have any concerns about prostate cancer. Keep in mind that BPH does not cause erection problems and does not affect a man’s capacity to father children.

What causes BPH?

Generally, an enlarged prostate is considered a normal part of the aging process in men, believed to result from changes in hormone levels and cell growth. And while the actual cause of benign prostate enlargement is still unknown, studies have shown that changes in the cells of the testicles play a role in the growth of the gland. This is confirmed by the fact that men whose testicles are removed at a young age never develop the condition while those whose testicles are removed after developing BPH experience shrinkage in the size of the prostate. Some studies have also revealed that men with obesity or diabetes, as well as men with a father or brother with the condition, are more likely to develop BPH.

What are the 4 common symptoms of an enlarged prostate?

One of the more common symptoms of BPH is a frequent or urgent need to urinate. Men with BPH will have the urge to urinate more often and particularly at night, a condition known as nocturia. By frequent urination, we mean having to pass urine eight or more times a day. The need to urinate will be urgent because the increased pressure placed on the bladder and urethra by the enlarged prostate make holding urine more difficult.

On the other hand, urinating can be made more difficult by BPH because the increased pressure on the urethra may block urine flow from the bladder out through the penis. You may find it hard to start a urine stream or experience an interrupted or weak urine stream. Depending on the severity of your BPH, you may find it difficult to pass urine, a condition resulting in urine retention. When this happens, you must see your doctor immediately so that a catheter can be inserted into your bladder to drain the urine. Your doctor may recommend you see a urologist for surgery to remove a portion of the enlarged prostate tissue or make cuts on the prostate in order to widen the urethra.

Another symptom is pain during urination or ejaculation caused by pressure on the urinary tract or reproductive system due to BPH. In fact, some men even feel the need to push out urine, which may also cause pain. Remember, pain during ejaculation or urination may also be due to infection.

Other problems associated with an enlarged prostate include urinary tract infections, unusual urine color or smell, blood in urine, bladder stones, and bladder or kidney damage. But not all men with BPH show these symptoms. In fact, some men with enlarged prostate do not get any symptoms at all. If you do have symptoms, you should definitely see your doctor.

How is an enlarged prostate treated?

Your urologist will ask you questions about your symptoms and about your past health. A physical exam, a urine test (urinalysis) and a digital rectal examination will also be performed to aid diagnosis. In some cases, your doctor will request the prostate-specific antigen (PSA) test in order to rule out prostate cancer.

If you only have mild to moderate symptoms, your doctor can recommend “watchful waiting” for lifestyle changes and regular check-ups to monitor symptoms. Your doctor may also prescribe medications such as alpha-blockers or 5-alpha-reductase inhibitors to alleviate the symptoms.

If your condition does not improve after trying recommended lifestyle changes and medications, your doctor may opt for surgery. The type of surgery chosen by the urologist will depend on the size of your prostate, any other medical problems you have and the potential risks and benefits of the operation. For more information about treatments for enlarged prostate, visit an Advanced Urology Institute clinic near you.

Effective Ways To Detect Prostate Cancer

If you are a man, there is a 1-in-6 chance that you will develop prostate cancer at some point in your life. Prostate cancer is basically a tumor of the prostate, the gland located in front of the rectum and just below the bladder. The prostate helps in making the milky fluid called semen, which carries sperm out of the body during ejaculation. Prostate cancer is most common among men over 65 years of age and fairly prevalent in men aged 50-64 years. Still, the cancer can occur in younger men below 50 and screening for it should begin between 40 and 45 years of age.

Risk factors of the cancer include:

  • (Age
  • Obesity
  • Family history
  • Race
  • History of STDs (sexually transmitted diseases)
  • Diets high in fats from red meat

While prostate cancer is a highly treatable condition, many men suffer needlessly because they did not know the symptoms in order to catch it before the advanced stages. And though the cancer typically shows few signs until it has reached advanced stages, knowing the symptoms can be the difference between having to face surgery and just making a few lifestyle changes. The symptoms of prostate cancer include:

In some instances of early prostate cancer, no symptoms occur and the cancer can only be detected through routine screenings.

Effective Ways to Detect Prostate Cancer

Your urologist will start by asking you about your medical history, symptoms and risk factors. A physical examination will also be performed. The doctor will then request a prostate-specific antigen (PSA) test to analyze your blood sample for higher-than-normal levels of the prostate-specific antigen, which is a protein secreted by the prostate gland. Higher PSA levels may indicate presence of cancer. In some cases, your doctor will opt to use the PSA3 test to check for levels of antigen 3 in your urine. When PSA levels are abnormal, the urologist will usually suggest that you return in 6 months for a second PSA test to confirm the presence of the cancer. Other test options that may be used to confirm a diagnosis of prostate cancer are:

(a) Digital rectal exam: The doctor will insert a gloved finger into your lower rectum and prostate gland to check for any abnormalities in size, texture or shape of the prostate.

(b) Targeted biopsy: The doctor removes tissue samples from the prostate by using either MRI fusion-targeted 3D imaging method or the ultrasound high-yield saturation method. Samples taken are analyzed to detect the cancer and determine its severity.

(c) Prostate imaging: Also called perfusion dynamic MRI, prostate imaging uses a special contrast agent inserted into the prostate to precisely identify patients with the risk of prostate carcinoma.
Once prostate cancer is confirmed, the next step is determining its aggressiveness. The aggressiveness of a cancer helps the urologist to choose the best treatment option for the condition. So, after knowing how aggressive the cancer is, the urologist can recommend:

(a) Active surveillance: You are not offered any treatment but kept under careful observation and medical monitoring.

(b) External beam therapy (EBT): The urologist refers you to a radiation oncologist to deliver a beam of high-energy proton beams or x-ray to the tumor location. The oncologist may also use other radiation techniques such as conformal external beam radiation therapy, stereotactic body radiation therapy, proton beam therapy, or image-guided radiation therapy.

(c) Brachytherapy: In this case, radiation is delivered to your prostate by placing radioactive materials inside the prostate. The two forms used are low-dose rate (LDR) and the high-dose rate (HDR) Brachytherapy.

(d) Cryotherapy: This method uses extremely low temperatures (as low as -190 degrees Celsius) to freeze and destroy cancer cells.

(e) Surgery: The urologist makes an incision through the perineum or in the lower abdomen to remove the prostate. A skilled and experienced urologist will perform the surgery without interfering with your sexual function.
At Advanced Urology Institute, we have the best pool of urologists and state-of-the art equipment to help detect and treat prostate cancer. If you want to be screened for the condition, even without symptoms, never hesitate to see a urologist. Remember, early detection is the key to successful prostate cancer treatment. To learn more about prostate cancer screening, prevention and treatment, visit Advanced Urology Institute.

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The PSA Test, The Best Tool for Prostate Cancer Screening – Dr Matthew Merrell

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Why did Dr. Evan Fynes choose urology?

KEY TAKEAWAYS:

  • Dr. Evan Fynes, a urologist in Port Orange, FL, chose urology as his specialty due to the diversity of cases and the daily challenges it offers.
  • Patient interaction is one of Dr. Fynes’ favorite aspects of his work, as it allows him to build relationships and better understand his patients’ needs.
  • Dr. Fynes finds great fulfillment and reward in helping patients overcome their urological problems and improve their quality of life.

Dr. Evan Fynes, a urologist in Port Orange, FL, has a passion for his work and a deep appreciation for the variety and patient interaction that comes with practicing urology. In this article, we will explore the factors that led Dr. Fynes to choose urology as his specialty and how his work positively impacts patients’ lives.

The Path to Urology

Dr. Fynes grew up in Toledo, Ohio, and completed his undergraduate and medical education, as well as his six-year urologic residency, at the University of Toledo. Early on in his training, Dr. Fynes was encouraged by a friend who was a urology resident to explore the field of urology. He quickly found that he enjoyed the diversity of cases and the daily challenges that came with the specialty. From kidney stones and enlarged prostates to kidney cancer, every day brought something different to his work.

Patient Interaction

One of the aspects of urology that Dr. Fynes particularly enjoys is the patient interaction. He values the opportunity to develop relationships with his patients, often bonding over shared interests, such as football. This rapport allows him to better understand his patients’ concerns and provide tailored treatment plans to address their specific needs.

Making a Difference in Patients’ Lives

Dr. Fynes finds great fulfillment and reward in helping patients overcome their urological problems. Whether it’s removing a kidney stone or vaporizing prostate tissue to enable a patient to urinate without a catheter, he takes pride in the positive impact his work has on patients’ lives. Their gratitude and satisfaction make his efforts worthwhile and further solidify his passion for the field of urology.

Advanced Urology Institute

Dr. Evan Fynes is a part of the Advanced Urology Institute, the largest urology practice in Florida. The institute is dedicated to providing the highest quality of care for their patients through the use of state-of-the-art technology and evidence-based treatment approaches. By choosing the Advanced Urology Institute for your urological needs, you can trust that you are receiving the best possible care from highly skilled and experienced professionals.

TRANSCRIPTION:

I never met an unhappy urologist. They all seemed to really like what they did for a
living and were really enthusiastic about their job.
Hello, Dr. Evan Fynes. I’m a urologist with Advanced Urology Institute. I’ve been down
here in Florida about 15 months now. I came down from the great state of Ohio. I grew
up in northwest Ohio, Toledo, Ohio. I went to school at the, basically did all my training
in Toledo. Went to undergrad, med school, and then did a six-year urologic residency
at the University of Toledo. Urology really caught my interest early on in my training.
I had actually a good friend that was a urology resident, and he told me to kind of check
out urology. And so when I really looked into it, I mean, I really liked the diversity of
the cases. Every day you’re doing something different, whether it’s kidney stones, somebody
with a large prostate, to taking out or removing kidneys because of kidney cancer. You never
knew what you were going to do that day. It was a wide variety.
One of the favorite things I like about my work is just patient interaction. A lot of
times when I initially talk about a patient, they’ll walk in with a Pittsburgh Steelers
hat on, and the first 10 minutes of my conversation is talking about football. And so I really
enjoyed the patient interaction of getting to know somebody, developing that relationship
with somebody, and then trying to help them with their problem. From that, when you get
to help them with their problem and basically correct their situation, whether it’s removing
a kidney stone or they have a catheter in and you take away their, you know, vaporize
their prostate tissue and they’re able to pee on their own, they’re very satisfied with
having that catheter out. It does give you a sense of fulfillment and reward that
you’ve helped somebody, and they’re usually very grateful.

REFERENCES:

Advanced Urology Institute – Urologists Working Together for You

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What are the benefits of Green Light Laser Therapy according to Dr. Evan Fynes?

KEY TAKEAWAYS:

  • Green Light Laser Therapy is a minimally invasive, outpatient procedure for treating enlarged prostates, offering an alternative to traditional surgical methods.
  • The therapy is particularly beneficial for patients on blood-thinning medications, as it helps stop bleeding while vaporizing the prostate.
  • Studies show that the outcomes of Green Light Laser Therapy are comparable to those of the classic TURP at five years, providing patients with similar symptom relief and fewer complications.

Green Light Laser Therapy is a minimally invasive, outpatient procedure that has revolutionized the treatment of enlarged prostates. Dr. Evan Fynes, a urologist in Port Orange, FL, highlights the advantages of this cutting-edge technology over traditional surgical methods, particularly for patients on blood-thinning medications.

 

The Green Light Laser Technology

Dr. Fynes explains that the Green Light Laser is a special laser designed to vaporize the prostate in men with enlarged prostates causing urinary symptoms such as frequent nighttime urination, weak urinary stream, or difficulty forcing urine out. Initially, patients are prescribed medications to alleviate symptoms, but if these fail to improve their quality of life, Green Light Laser Therapy may be considered as an alternative treatment option.

This third-generation laser technology enables the vaporization of prostatic tissue, offering a less invasive and more efficient treatment for enlarged prostates.

 

Benefits for Patients on Blood Thinners

One of the primary advantages of Green Light Laser Therapy is its suitability for patients who cannot discontinue blood-thinning medications due to heart disease, stroke, or other conditions. The laser treatment not only vaporizes the prostate but also helps stop bleeding, making it a safer option for these patients compared to traditional surgical methods.

 

Comparable Outcomes to Classic TURP

Dr. Fynes notes that studies have demonstrated the outcomes of Green Light Laser Therapy to be equivalent to those of the classic Transurethral Resection of the Prostate (TURP) at five years. This means that patients can experience the same benefits in terms of symptom relief, but with a less invasive procedure and fewer complications.

Advanced Urology Institute

Dr. Evan Fynes is a dedicated urologist at the Advanced Urology Institute, the largest urology practice in Florida. The institute is committed to providing state-of-the-art, evidence-based care for patients, ensuring that they have access to the latest advances in urological treatment. With a team of highly skilled professionals, the Advanced Urology Institute offers comprehensive care for a wide range of urological conditions.

TRANSCRIPTION:

Five, ten years ago, you’d have to do an open surgery to remove the prostate gland.
Now, the green light laser allows you to do an outpatient surgery on a really big prostate
and then they go home with a catheter usually for a day.
Hello, Dr. Evan Fynes , I’m a urologist with Advanced Urology Institute.
The green light laser, it’s a special laser we use to basically vaporize the prostate
for guys who have enlarged prostates that cause urinary symptoms, whether it’s getting
up a lot at night, if they have a weak stream, if they really have to force their urine out.
Usually we initially start them on medications, there’s several medications to start.
If they fail those medications and they’re still, the symptoms are affecting their quality
of life, then the option we choose is to basically resect their prostate by going through their urethra.
The green light’s a new technology, I think they’re on their third generation laser.
With this new generation laser, you’re able to vaporize the prostatic tissue.
The benefits of the laser really, these days, it’s meant for guys who are still on blood
thinner medication, who can’t come off those because of heart disease or stroke or things like that.
So the laser’s meant to actually vaporize the prostate while they’re on these blood
thinners because it helps stop the bleeding as you vaporize the prostate.
I feel like the outcomes are very similar to the classic TURP.
There’s been several studies out that show they’re basically equivalent at five years.

REFERENCES:

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Dr. Evan Fynes is a practicing urologist at Florida’s Advanced Urology Institute. The Advanced Urology Institute provides patient centered care with innovative and personalized treatments. For Dr Fynes, caring for his patients is one of the greatest joys of being a urologist. [Read Full Article…]