Man-To-Man: Protect Your Prostate Special To MD Monthly August 2, 2016 Men's It’s a medical catch-22. Men, if you live long enough you’re most likely going to have prostate health issues. There’s no getting around it, but there are ways to stave off these problems and treat the issues that arise. Maintain a healthy lifestyle, get a regular screening, and if you encounter a problem, treat it early! According to Nathaniel Polnaszek, M.D., a urologist at Baylor Scott & White Medical Center in Round Rock, “a healthy lifestyle is an excellent place to start in preventing prostate problems; eat a healthy diet, low in saturated animal fats and low in high-fat milk products. In addition, us busy dads should consider taking supplements that include selenium and vitamin E. But, the single most important factor in fighting prostate disease is an annual screening.” Screening includes a digital rectal exam (DRE) along with a prostate specific antigen (PSA) every one to two years. Current recommendations include routine screening for: • Men 55- to 69-years-old • Men starting at 40-years-old, if you have a family history of prostate cancer, or if you are of African-American heritage Although most men typically don’t start experiencing prostate issues until their 50s, for some men earlier issues can develop, including enlarged prostate. Enlarged Prostate: As a busy father raising kids, you’re probably not thinking about benign enlargement of the prostate, known as BPH, but it’s the most common prostate problem. Almost all men will develop some enlargement of the prostate as they age. The prostate gland surrounds the urethra, the tube that carries urine outside the body, so an enlargement of the prostate can lead to blockage of the tube and trouble with urination, the most common problems associated with an enlarged prostate. Based on research, BPH does not seem to increase the risk of developing prostate cancer. However, BPH and prostate cancer have similar symptoms that need to be heeded early, they include: • Slowness or dribbling of the urinary stream • Hesitancy or difficulty starting to urinate • Frequent urination • Pain during urination • Feeling of urgency or sudden need to urinate • Need to get up at night to urinate • Blood in the ejaculate Patients with mild symptoms may not require treatment other than continued observation, but if symptoms increase, there are options including medication, minimally-invasive treatments and surgery. In addition, recent studies have shown the use of the herb saw palmetto can block the formation of DHT, the hormone responsible for prostate gland growth. Prostate Cancer: One in six American men will be diagnosed with prostate cancer in their lifetime. If you are diagnosed, treatment decisions are crucial. The good news is that there are new therapies that allow for rapid recovery, continued urinary control and return to sexual activity. Three potential options are: 1. Prostatectomy has been considered to be the “gold standard” for the treatment of prostate cancer, and it is often recommended for younger men with early-stage prostate cancers. Minimally invasive, robot-assisted laparoscopic surgery can completely remove the prostate with reduced side effects. Nerve sparing techniques using the da Vinci Robotic System can preserve urinary and erectile functions in many patients. The da Vinci is a robotic device controlled by the surgeon that allows for precise movement, enhanced control with 3-D vision and magnification. The da Vinci offers patients smaller incisions, less post-operative pain, reduced hospital stay and earlier return to full activity. 2. Radiation therapy is another option. Breakthrough technologies include intensity modulated radiotherapy (IMRT) and radioactive seeds. IMRT is radiation treatment in which a computer generates a process where thousands of tiny pencil-sized beams of radiation target only the cancerous areas and not surrounding normal tissues. Low-dose radioactive “seeds,” each about the size of a grain of rice, are implanted within the prostate to kill cancer cells locally. Called brachytherapy, the seeds are sometimes combined with IMRT for a “one-two punch.” Both therapies are used in early-stage patients. 3. Hormonal therapy can be used in all phases of prostate cancer treatment to help block production of the male hormones that have been shown to fuel prostate cancer. There is no “magic potion” that will significantly reduce prostate cancer cases or deaths. However, some strong possibilities are in the works like: • Several drugs and vaccines for treating prostate cancer currently in clinical trials. • Studies examining diet have identified a high-saturated fat diet as a risk factor for prostate cancer, and a possible inhibitory effect in the consumption of soy products and cooked tomatoes. *This information is intended for general knowledge and is not a substitute for professional medical advice or treatment. For more information visit www.sw.org or call 512.509.0200. Dr. Nathaniel M. Polnaszek is the director of the division of urology at Baylor Scott & White Health—Round Rock. Baylor Scott & White Health—Round Rock is located at 300 University Boulevard in Round Rock, TX 78665.