Prostate Cancer
Prostate Cancer
Prostate Cancer
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<strong>Prostate</strong> Health<br />
Hani Rashid, MD<br />
Assistant Professor of Urology and Oncology
<strong>Prostate</strong> Health<br />
Overview<br />
• Screening<br />
• <strong>Prostate</strong> Role<br />
• <strong>Prostate</strong> <strong>Cancer</strong><br />
• Enlarged <strong>Prostate</strong><br />
• Questions?<br />
2
Men Live Sicker and Die Younger<br />
• Lower rates of Health coverage<br />
• Higher prevalence and death rates<br />
of 10 leading causes of death<br />
• Less health maintenance visits<br />
3
The Weaker Sex<br />
• 115 males conceived for every 100<br />
females<br />
• By age 36, males=females<br />
• By age 100, 8 females to every 1<br />
male<br />
4
<strong>Prostate</strong> Screening<br />
• <strong>Prostate</strong> <strong>Cancer</strong> #1 diagnosed cancer in<br />
men<br />
• BPH most common benign growth in<br />
men<br />
• <strong>Cancer</strong> and enlargement can lead to<br />
serious medical issues if left untreated in<br />
some patients.<br />
5
<strong>Prostate</strong> Anatomy<br />
6
<strong>Prostate</strong> Anatomy<br />
7
<strong>Prostate</strong>: Role<br />
• Secretory gland<br />
• Helps sperm<br />
• Prevents retrograde ejaculation<br />
• Helps continence<br />
•Issues with age<br />
8
<strong>Prostate</strong> <strong>Cancer</strong><br />
• 192,280 new cases this year<br />
• 23,360 deaths<br />
• 10% of all cancer deaths<br />
• 1 in 6 lifetime diagnosis<br />
• USUALLY NO SYMPTOMS<br />
• 2 million prostate cancer patients<br />
alive in US<br />
9
<strong>Prostate</strong> <strong>Cancer</strong>: Risk Factors<br />
• Age<br />
• Race/ethnicity<br />
• Family History<br />
• Nationality<br />
• Diet<br />
• Obesity<br />
• Exercise<br />
• Inflammation<br />
10
<strong>Prostate</strong> <strong>Cancer</strong>:<br />
Prevention<br />
• Screening:<br />
• General: PSA/DRE<br />
Age 50-75<br />
• Family History:<br />
Age 40-45<br />
• PSA controversy<br />
• Diet<br />
• Medication<br />
11
<strong>Prostate</strong> <strong>Cancer</strong>: Treatments<br />
• Active Surveillance<br />
• Cryotherapy<br />
• Radioactive Seed Implantation<br />
• External Radiation<br />
• Robotic Surgery<br />
• Testosterone blockade<br />
• Chemotherapy<br />
12
<strong>Prostate</strong> <strong>Cancer</strong> Prevention:<br />
Why and How?<br />
• Early diagnosis = cure<br />
• Late diagnosis=containment<br />
• PCP<br />
• Urologist<br />
13
Benign Prostatic Hyperplasia
<strong>Prostate</strong> <strong>Cancer</strong> Prevention:<br />
Why and How?<br />
• Early diagnosis = cure<br />
• Late diagnosis=containment<br />
• PCP<br />
• Urologist<br />
15
Negative Impact of BPH on Daily<br />
QOL Increases With Symptom<br />
Severity<br />
16
Potential Complications of BPH<br />
• Urinary retention<br />
• Renal impairment<br />
• Urinary tract infection<br />
• Gross hematuria<br />
• Bladder stones<br />
• Bladder decompensation<br />
• Overflow incontinence as a result of<br />
retention<br />
Jensen JV, et al. Urol Clin North Am. 1988;25:545-554.<br />
17
Potential Complications of BPH<br />
LUTS 1,2<br />
Bothersome<br />
Interference with daily<br />
activities and sexual<br />
function<br />
BPH<br />
(Benign Prostatic<br />
Hyperplasia)<br />
BOO 3<br />
(Bladder Outlet<br />
Obstruction)<br />
AUR<br />
Surgery<br />
Nonfunctioning bladder<br />
UTI<br />
Stones<br />
Renal failure<br />
1. AUA Practice Guidelines Committee. J Urol. 2003;170:530-547.<br />
2. Rosen R et al. Eur Urol. 2003;44:637-649.<br />
3. Lepor H, Lowe FC. In: Walsh PC et al, eds. Campbell’s s Urology. . 8th ed. Philadelphia, Pa: Saunders; 2002:1337-1377.<br />
18
AUA Symptom<br />
Index (AUA-SI)<br />
• Incomplete bladder emptying<br />
• Frequency<br />
• Intermittency<br />
• Urgency<br />
• Weak stream<br />
• Straining<br />
• Nocturia<br />
AUA Practice Guidelines Committee. J Urol. 2003;170(2 pt 1):530−537.<br />
Barry MJ et al. J Urol. 1992;148:1549−1557.<br />
19
Goals of Therapy for BPH<br />
Successful treatment of BPH results in:<br />
• Relieving Urinating Symptoms<br />
• Decreasing Bladder Outlet Obstruction<br />
• Improving bladder emptying<br />
• Ameliorating detrusor instability<br />
• Preventing progressive renal damage<br />
• Preventing further episodes of gross<br />
hematuria, UTI, and Retention<br />
Lepor H, Lowe FC. In: Walsh PC et al, eds. Campbell’s Urology. 8th ed. Philadelphia, Pa:<br />
Saunders; 2002:1337-1377.<br />
20
Treatment options for BPH<br />
21
Treatments for LUTS, BPH, BOO<br />
• Watchful waiting<br />
• Behavioral Changes<br />
– Diet<br />
– Weight loss<br />
– Exercise<br />
– Reduced Caffeine<br />
• Medical therapy<br />
– Phytotherapy<br />
– 5α-reductase inhibitors<br />
– α-blockers<br />
– Combination therapy<br />
• Office-based treatment<br />
– Microwave<br />
– Laser or radiofrequency<br />
• Hospital-based<br />
treatment<br />
– TURP<br />
– Laser surgery<br />
– Robotic surgery<br />
– Open surgery<br />
22
Summary<br />
• Men die earlier than women<br />
• One issue is lack of screening and<br />
health maintenance<br />
• <strong>Prostate</strong> cancer and enlargement very<br />
common<br />
• Early diagnosis can prevent future<br />
morbidity and mortality<br />
• See your doctor or urologist regularly<br />
23
Questions?<br />
24