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Prostate Cancer- A Silent Killer
September 16, 2015 | 11:25 PM


By Angelo Gousse, MD

Epidemiology of Prostate Cancer

Prostate cancer remains one of the most common cancers in men in the United States, and is the second leading cause of cancer death in men. In 2015 approximately 220, 800 new cases of prostate cancer were diagnosed and roughly 28,000 of these men will die from their disease.

What are the symptoms of Prostate Cancer

Contrary to popular belief, most men with early prostate cancer never experience any symptom whatsoever. Symptoms usually do not become apparent until the disease has progressed beyond the prostate and therefore, prostate cancer is considered a silent killer. Advanced stage prostate cancer can present with symptoms such as difficulty or pain with urination, painful ejaculation, blood in the urine or semen. Pain or stiffness related to the cancer growing in the bones can also develop.

It is important to note that that sexual dysfunction is not associated with the risk of developing prostate cancer.

Is it Possible to Prevent Prostate Cancer ?

Risk factors for prostate cancer include age, family history and race. One in seven men will develop prostate cancer. One in five if you are African-American and one in three if you have a family history of the disease. Therefore, family history of first degree relative is a significant risk factor.

There are no proven preventative measures to diminish the chance of developing prostate cancer. No food choice or vitamin has been shown to completely prevent prostate cancer. It is possible to lower your risk of prostate cancer by making healthy lifestyle choices including exercising regularly and eating a balanced diet which is low in animal fat and high in fruits and vegetables.

The best defense against prostate cancer remains early detection. Most cases diagnosed at an early stage are detected during routine prostate cancer risk assessment which includes a PSA blood test and digital rectal examination.

In Haitian men, prostate cancer risk assessment should be initiated at the age of 40-45.

What to Do Once Prostate Cancer Has been diagnosed

The first decision to be made in managing prostate cancer is to determine whether treatment is needed. Not every patient with prostate cancer is treated the same way. Treatment is largely dependent on the aggressive of the disease (Gleason score) and expected life span. Other factors to consider are the number of positive biopsies and, PSA level, age and a person's views about potential treatments and their possible side effects.

Prostate cancer, especially low-grade (Gleason less than 7, PSA less than 10ng/mL ) found in elderly men, often grows so slowly that no treatment is required. Treatment may also be inappropriate if a person has other serious health problems or has an expected lifespan of less than 10 years.

Patients with minimal, low risk prostate cancer (defined as PSA less than 10 ng/ml, less than 3 positive biopsy cores all with low volume disease [no more than 5 %-10% in any core]) can be managed by active surveillance without the need for immediate treatment. This option can prevent patients from experiencing the morbidities of prostate cancer treatment without increasing their cancer specific mortality.

Active surveillance includes careful monitoring after diagnoses with PSA testing at regular intervals with repeat prostate biopsies and proceeding with treatment if the cancer parameters change.

Radical prostatectomy and radiation treatment remain the most common choices to treat clinically localized prostate cancer. Cryotherapy (freezing of the prostate) and ultrasound ablation (not approved in USA) are less popular choices. All treatment options carry the risk of significant side effects such as erectile dysfunction, urinary incontinence and difficulty voiding. Therefore prior to deciding upon definitive therapy, detailed discussions with patients are undertaken which focus on balancing the goals of therapy with the risks of lifestyle alterations.




Angelo E. Gousse, MD
Clinical Professor of Urology - Herbert Wertheim College of Medicine - FIU
Voluntary Professor of Urology - University of Miami , Miller School of Medicine

Director of Fellowship:Female Urology,Voiding Dysfunction, Reconstruction
Memorial Hospital Miramar, South Broward Hospital District
1951 SW 172 Avenue, Suite 305,
Miramar, FL, 33029
Tel: 954-362-2720 Fax: 954-362-2761
www.bladder-health.net



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