“Overtreatment is a cause of preventable harm and waste in healthcare.” This statement opens a published study[i] of physician perspectives on overtreatment. The article is based on a survey of 2,106 doctors. The study authors reported the MDs’ opinions as follows: 6% of overall medical care is unnecessary 0% of prescription medications are unnecessary 1% keep reading
If you’re wondering what “castration resistant prostate cancer (CRPC)” is, so are many others. Before I write about the good news, I want to back up and talk about what this means. Prostate cancer and testosterone The most newly diagnosed prostate cancer (PCa) cases are composed of slow-growing cell lines. They are typically discovered while keep reading
Men need testosterone, but prostate cancer does not. While there is new evidence that use of testosterone replacement therapy does not lead to prostate cancer, once prostate cancer has occurred, it appears to be fueled by testosterone. This is particularly bad news if prostate cancer has penetrated the edges of the gland capsule and begun keep reading
“Change is inevitable. Progress is optional.” Tony Robbins In medicine, change sometimes happens with two steps forward but one step back. For example, in the early 20th century, delivering babies in hospitals became more popular than home births in order to have “painless” births with anesthesia. However, for many women the higher complication and infection keep reading
Two problems face men who have a high PSA or abnormal digital rectal exam (DRE). First, they are often referred for a conventional TRUS needle biopsy of the prostate because there is suspicion of prostate cancer (PCa). Second, multiparametric MRI is considered too time-consuming and expensive for routine determination of the need for a biopsy. keep reading
There are so many benefits to detecting prostate cancer (PCa) using multiparametric MRI that it’s hard to single out just one. However, the merits of mpMRI to find PCa in large glands deserve a spotlight. First, a word about prostate size. An average adult gland in younger men is about 30 – 40cc, roughly the keep reading
With Active Surveillance on the rise, one would think that doctors who support AS for their prostate cancer patients have similar commitment and protocols. A new study (Sep. 2016) in the British Journal of Urology International (BJUI) spells out 8 areas of qualitative differences among AS doctors: physician comfort with active surveillance protocol selection beliefs keep reading
Terrific news and a great way to start off 2017! On January 17, the prestigious medical journal The Lancet issued online publication of a British study, “Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study” (Ahmed et al., 2017[i]). This large trial validated the importance of multiparametric keep reading
When it comes to Active Surveillance (AS) decisions, there’s good news and bad news. The good news: based on biopsy results, more doctors are recommending AS for prostate cancer (PCa) patients with insignificant disease. The bad news: the biopsy might have missed significant PCa so the patient can’t know for sure if AS is a keep reading
Testosterone has important benefits for men. When it’s at a normal level, it helps develop muscle mass, decrease fat, avoid depression, keep bones strong, maintain libido, improve erections, and may help reduce risks of cardiovascular and cognitive disease. However, about 40% of men over the age of 45 have symptoms of reduced blood levels of keep reading