Screening for Prostate Cancer – Dr. Brian Hale

Urologist Dr. Brian Hale recommends that men over 50 years old be checked regularly for prostate cancer. It is the second most common cause of cancer deaths in men and it increases in likelihood as men age. Tests such as the PSA can help detect prostate cancer in its early stages when treatment is most effective.

The most common way to screen for prostate cancer is the prostate-specific antigen (PSA) test. The PSA test is simple and works like this: Both cancerous and noncancerous prostate tissues create protein, and small amounts of that protein will enter the bloodstream. Prostate cancer cells produce more proteins than noncancerous ones, so if cancer cells are present there will be an increase in the proteins in the blood. The PSA test works by checking the blood for increased protein levels.

Dr. Brian Hale: Board Certified UrologistThere are pros and cons to PSA screening for prostate cancer. PSA tests can show increases in proteins when cancerous tissue is not actually present. This is called a false positive and can cause a great deal of stress for the patient and lead to more invasive tests that may not be necessary. For these reasons, among others, PSA tests were not recommended to patients for a period of time.

A few years after PSA tests stopped being recommended, Dr. Hale began noticing a troubling trend. He began seeing an increasingly large number of patients with prostate cancers that had metastasized, which is when it spreads to other parts of the body. This happens when prostate cancer goes undetected and has time to grow untreated. Dr. Hale noticed a correlation between the time PSA screening stopped being recommended and the up-tick in cases of fast-growing and metastasized cancers.

Because of this finding, Dr. Hale recommends that men continue PSA screening as part of their preventative care. Although it may not be a perfect test, its pros far outweigh its cons. Prostate cancer, when caught early is far easier to treat, and can often be treated with less extreme methods. Prostate cancers that have metastasized can be trickier and far more expensive to treat. Although some men may not like blood tests, it is better to take a simple blood test and catch an issue early than it is to let prostate cancer spread and turn into a much more serious medical problem.

As you age, it is important to take care of yourself and see the right doctors to discuss what is best for you. Dedicated urologists like Dr. Brian Hale at the Advance Institute of Urology have been discussing these issues with their patients for many years and will continue looking out for them. For more information, visit the Advanced Urology Institute website.

Understanding Common Prostate Problems

The prostate gland is a uniquely male body organ. It is small, walnut-shaped and located just under the bladder. The urethra passes through it, carrying both urine and semen. Its main job is to make fluid for the semen.

Many different prostate problems have similar symptoms. If a person experiences these symptoms, it is time to see a urologist. For example, a man may find his urine flow to be too slow or have difficulty urinating. Or he may have the sudden uncontrollable urge to urinate that can cause leaking. Occasional leakage may occur if the urge comes when there is no restroom nearby.

But if such urges happen frequently and too quickly to reach facilities, there may be a problem. If there is a need to struggle or strain to maintain a urine flow, or if the flow is abnormally slow for more than a few days, it is time to talk to your doctor. Pain in the scrotum or penis or a feeling that the bladder is still full after urinating can be indications of a problem. Any combination of these symptoms should be reason to contact a urologist or your primary care doctor as soon as possible.

Some symptoms require prompt attention. You should go to an emergency room if your urine has blood in it or a cloudy appearance, if it develops a very strong unusual smell or if you experience severe pain when urinating. Seek immediate medical attention if you develop a fever, chills or strong body aches in the pelvic region.

Prostate cancer is the most frequently diagnosed cancer in men. Nearly one out of every ten men will develop it in their senior years. Most prostate cancers grow slowly, so quality of life over a long period of time is the issue. There are many effective treatments that, unfortunately, have side-effects men find difficult to discuss. Although prostate cancer is not necessarily a terminal illness, it can be. It is important to see a doctor about symptoms because an early diagnosis increases the likelihood of successfully managing and outliving the condition.

PSA tests are good indicators of the health of the prostate, but slowly increasing levels may mean doing more testing. A PSA test looks for a prostate-specific antigen (PSA) in the bloodstream. Modern medical science is still trying to figure out how quickly and how much to do when PSA tests are abnormal. Your urologist will have the latest information for determining proper treatment.

Benign prostatic hyperplasia (BPH) is one medical condition that, like cancer, often has no clearly known reason for happening. Doctors do know that it often responds to certain types of treatments, albeit not the same way for each person. Any change in the size of the prostate, such as from cancer or from an enlarged prostate, puts pressure on the urethra, affecting urine flow and the ability to properly urinate.

The board-certified urologists at the Advanced Urology Institute are all qualified to diagnose and treat prostate problems with the best options available today. For more information, visit the Advanced Urology Institute website.

What Do Physician Assistants Do? – Mikhail Lezhak, PA

Ask Mikhail Lezhak what physician assistants do and you may be surprised by the answer. In the past, all professional medical care was performed by doctors and nurses. But doctors and nurses often spent a lot of time doing repetitive work that limited the time they had to focus on their specialty.

Mikhail Lezhak, Physician AssistantPhysician assistants, especially those in urology, may be called upon to do any of these things to assist the doctor:

  • Patient history checks, both directly with the patient and with recorded medical records. They will review records and update records. Based on what they learn, they will brief their supervising physicians about anything noteworthy
  • Perform physical exams. They can do the basic exams, but they also are trained to spot symptoms that require more advanced medical care
  • Order and interpret basic laboratory tests
  • For many relatively minor types of injuries, they may be qualified to handle the direct treatment
  • Assist surgeons doing surgical procedures
  • Perform minor surgical procedures, including suturing (making stitches); immunizations and injections; setting up, monitoring and removing intravenous feeds
  • Perform preoperative and postoperative care, including managing infection prevention
  • Prescribe medications as permitted
  • Provide patient counseling on medical issues, including self-care and follow-up
  • Set up health management plans and diets
  • Assist in maintaining a healthy, safe and sanitary healthcare environment, in accordance with health laws, regulations and accepted medical practices
  • Help maintain the proper stocks of medical supplies
  • Work with administrators and administrative staff to assure a more smoothly operating medical care environment

Essentially, PAs perform tasks that free up their supervising doctors for more difficult and complicated health issues. If this job sounds a lot like what nurses do, you are right. There is considerable overlap of responsibilities within medical communities.

In Florida, physician assistants do have a limited ability to prescribe and dispense medications. The ability for PAs to prescribe drugs is based on a written agreement between the PAs and their supervising board-certified doctors. That written agreement must have the following:

  • Effective for only five years, whereupon a new license is required
  • Requires the PA to take 10 continuing medical education credits before each license renewal period, including three hours about safe and effective prescribing of controlled substances
  • Only effective with that one PA-doctor agreement; it must be remade if the supervising doctor changes
  • Filed with the Florida Board of Medicine

There are some drugs that a PA cannot prescribe. For example, a PA working in urology cannot prescribe many of the same drugs that a PA working in psychiatry would prescribe, and vice-versa. Thus, there is local accountability for physician assistants within Florida about how they handle drugs.

Supervising doctors may have their PAs handle such duties as researching new medical device company products and keep the doctors advised on new drug formularies. PAs may be asked to scan medical journals for interesting issues as well as follow interesting and related legal cases involving their profession. They may help in medical research.

Just like nurses and nurse practitioners, PAs help the system run more smoothly by letting those who specialize spend more time on their side of the practice. The doctors can function more professionally as medical experts, and administrators can spend more time working with business management.

When you see Mikhail Lezhak, PA, at Advanced Urology Institute, you are seeing someone who has a wealth of training and experience in many of the same functions performed by a licensed medical doctor. Rest assured that your doctor still has you in good hands when your visit is with a medical professional who is a PA. For more information about physician assistants, visit the Advanced Urology Institute website.

How are Urinary Problems Treated?

Because urinary problems can be a sensitive and potentially embarrassing subject, many people are nervous about discussing these issues with their medical provider, even though they are very common conditions. Experts estimate that around a third of the U.S. population suffers from urinary incontinence. Luckily, these issues are treatable, according to Luis Camacho, PA, a physician assistant with the Advanced Urology Institute.

“If the patient has prostate problems, bladder problems, for the most part, the patient can be treated with oral medications,” Camacho explains. “If that is not effective, then we can incorporate different procedures or surgeries in order to improve the patient’s symptoms.”

Urinary Incontinence

Urinary incontinence is the most common problem. There are five different types of incontinence, but one of the most common types is stress urinary incontinence, or SUI. SUI occurs when a patient’s pelvic muscles are weakened, allowing urine to escape during normal everyday movements, such as sneezing, coughing or bending over. This condition is particularly common with older women, especially those who have had children. SUI can be managed with lifestyle changes or pelvic floor strengthening exercises like kegels.

Another common type of incontinence is overactive bladder, or OAB. Patients dealing with OAB feel an urge to go to the bathroom frequently throughout the day and night, even though their bladder isn’t full. This urge can be difficult to ignore and can lead to a lot of stress for patients in their daily lives. OAB and SUI can occur together in a condition known as mixed incontinence.

Other Urinary Problems

Other common urinary problems that should be discussed with a doctor include urinary tract infections, also known as UTIs; hematuria, or blood in the urine; and urinary retention or frequent urination. These problems are often signs of a larger issue that should not be ignored, such as diabetes, kidney stones, or prostate or bladder cancer. It’s important to bring up any issues like these with a doctor to ensure that the underlying issues can be treated promptly.

Getting Help

Although urinary problems are common, that does not mean they should be ignored, especially when they could potentially be signs of a more serious problem. Medical professionals know how wide-ranging both the symptoms and causes of urinary problems can be. “It’s important to listen to the patient and then establish a course of assessments, so we can help the patient effectively,” Camacho says. He and the other experts at the Advanced Urology Institute understand the sensitive nature of urinary problems and are well-prepared to help patients deal with these issues and get back to living their lives with confidence. For more information, visit the Advanced Urology Institute website.

Prostate Cancer Treatment: How to Choose What’s Best for You

Prostate cancer is one of the most common types of cancer that affects men. The prostate is a small gland, similar in shape to a walnut, that produces the seminal fluid that helps transport sperm. Although anyone can get prostate cancer, it becomes more common as men age.

It can be difficult to detect prostate cancer as it has little to no symptoms in its early stages. For this reason, it is important for men to have their prostate routinely checked by their doctor. Only after the cancer advances do symptoms occur like trouble urinating, blood in semen, bone pain, erectile dysfunction and discomfort in the pelvic area.

Advanced Urology Institute Doctor: Dr. David HarrisSome prostate cancers grow slowly and, in some cases, need little to no treatment. Other cancers can be aggressive and spread quickly. It is important to see your urologist often to monitor your cancer, as the best treatment for you will depend on the type of prostate cancer you have and how it reacts to treatment.

Treatments for prostate cancer vary depending on multiple factors. Urologists will look at a patient’s age, health and the type of prostate cancer when deciding on the best treatment. In a healthy young patient, a urologist may recommend robotic surgery or a radical prostatectomy. These are well-tested and invasive treatments that can produce very good outcomes.

For patients who may be a little older and not in the best of health, radiation therapy may be their best option. Having access to quality radiation therapy can be a game changer in prostate cancer treatment and can create excellent outcomes. It also will be easier on a patient with other health issues.

There are also newer advances that can be used to treat prostate cancer. For example, cryotherapy uses extremely cold temperatures to destroy cancerous tissues in the prostate by freezing them. Another example is HIFU therapy. This stands for stands for High Intensity Focused Ultrasound and uses an intense ultrasound, focused on the prostate, to treat the cancer and is minimally invasive.

Prostate cancer is a serious and often frightening prospect. Many men will suffer from this cancer, but they are not alone. Along with their urologist, men can combat their cancer in a way that produces the best outcomes. Dedicated urologists, like David S. Harris, MD at Advanced Urology Institute, have an arsenal of treatment options and are ready to help men live healthy lives. For more information, visit the Advanced Urology Institute website.