Immunotherapy for Cancer

Immunotherapy

Cancer comes in many forms and choosing the right treatment options depends heavily on the patient, their health, and the type of cancer present. For patients with metastatic cancer (cancer that has spread to other parts of the body from where it started), chemotherapy has been a long-standing choice. However, for some patients, immunotherapy is the more effective treatment with fewer side effects.

Immunotherapy works by working with the patient’s body. The human body is designed to fight against infections and diseases, including cancer cells that grow and spread unchecked as they avoid the body’s natural defenses. Immunotherapy boosts the natural immune system, making it more effective in fighting cancer cells. It helps the body identify which cells should be left alone and which cells are cancerous and need to be attacked and eradicated. Immunotherapy utilizes the immune system to better recognize and target cancer cells, even after treatment has ended.

Dr. Amar Rava of Palm Harbor, FL l discusses ImmunotherapyOne of the biggest benefits of immunotherapy is its less severe side effects. Chemotherapy is known for its harsh side effects that can be devastating to patients. Side effects such as severe fatigue, hair loss, nausea and vomiting diminish quality of life for cancer patients. While immunotherapy is not without its side effects, most patients find that muscle aches, shortness of breath and headaches are easier to endure.

Immunotherapy can be used to treat many types of cancers. Urologists have been using it to treat bladder and prostate cancers, and typically for patients who have asymptomatic, castrate-resistant prostate cancer. Having more treatment options for prostate cancer—the most common form of cancer found in men—means a successful outcome is more likely.

Immunotherapy is less toxic than chemotherapy and its less intense side effects allow for a better quality of life for patients with prostate and bladder cancer. According to Dr. Amar J. Patel, Board Certified Urologist, immunotherapy is also shown to increase life expectancy for cancer patients by up to three months. Advance Urology Institute achieves better outcomes for patients by utilizing all of the tools available in the fight against cancer, including the patient’s very own immune systems. For more information about immunotherapy, visit the Advanced Urology Institute website.

Should You Be Screened for Prostate Cancer

Prostate cancer is a common cancer that affects the walnut-shaped male prostate gland. As with most cancers, early detection is an important part of any successful treatment. The most common way prostate cancer is detected is through prostate cancer screenings during a patient’s appointment with a urologist. According to Dr. Amar Raval, “Screenings are important, along with a digital rectal exam, because prostate cancer continues to be the number one cancer found in men.”

Should you be screened for prostate cancer? If you can answer yes to one or more of the following conditions, then you may need to be screened:

• If you are between the ages of 55 and 69.
• If there is a history of prostate cancer in your family.
• If you are African-American.
• If you have a pre-existing medical condition that makes treatment difficult.

Dr. Amar Raval of Palm Harbor, FLThese factors are known to increase the risk of developing prostate cancer, and it is recommended that someone who has one or more of these conditions is screened at least once a year.

There are two main types of prostate cancer screening tests that a patient may receive. The most common is a digital rectal examination (DRE). For this exam, the health care provider puts on a glove and inserts a finger into the patient’s rectum to feel for any abnormalities on the prostate that can be attributed to cancer. The other screening is a prostate specific antigen (PSA) blood test. This blood test checks the PSA level in the blood, as someone with prostate cancer will have an elevated PSA level.

If one of these tests leads to a prostate cancer diagnosis, the urologist will want to identify what kind of prostate cancer it is in order to develop the best treatment plan. Non-aggressive cancers may not necessarily need treatment and can be monitored with active surveillance, which means watching the cancer to make sure it doesn’t turn aggressive and spread. In cases where the cancer is of intermediate or high risk, early identification from a screening test can help make sure that the treatment used on the cancer has the best chance for success.

If you believe it is time for you to start being screened for prostate cancer, then you should have a conversation with your urologist. Early detection can be a life saver. For men who are concerned about prostate cancer, the Advance Urology Institute is an excellent place to begin screening.

I’ve got prostate cancer. Now what?

Being diagnosed with prostate cancer is a painful reality that can happen to any man. As Dr. Paul Arnold states, “Being diagnosed with prostate cancer is a very alarming, shocking, and scareful diagnosis.” A patient diagnosed with prostate cancer may experience a flood of thoughts, emotions and questions. For men recently diagnosed with cancer, the first step to a successful outcome will be having a trusted urologist answer questions and suggest treatment options.

Men recently diagnosed with prostate cancer will find there are many treatment options available to them. A trained and experienced urologist will be able to offer a number of treatment options tailored to their patient’s specific cancer type and circumstance. In some cases, when a cancer is not aggressive, a urologist may recommend staying away from treatment and instead monitor the cancer with the patient using active surveillance.

In cases where the cancer is more aggressive and the patient is healthy, a urologist may recommend surgery. Depending on how far the cancer has spread, the surgery could remove the entire prostate or just the prostate tissue where the cancer is found. In some cases, robotic surgery can be used for more precise procedures that cause less pain and quicker recovery times. Some of the common side effects of surgery are bladder incontinence and erectile dysfunction, although both usually go away with time.

Radiation therapy is an option for older patients, those who have other health problems, and patients who may have difficulty recovering from a surgery. For this treatment, radiation is used to kill the cancer cells. It also targets cancer that may have spread to bone. Although effective, the side effects of radiation therapy can be strenuous.

One newer option for prostate cancer treatment is High Intensity Focused Ultrasound (HIFU). This is a cutting-edge treatment option has been approved by the FDA since 2016 with exciting success. HIFU works by sending intense ultrasound waves directly to the area of the prostate that has cancer cells and these waves destroy the cancer cells. This is a minimally invasive treatment option with few side effects; however, only certain sizes and types of cancers can be treated in this way.

The fear and uncertainty caused by a cancer diagnosis is serious. Fortunately, experienced urologists at Advanced Urology Institute can help men find treatment options and guide them through this difficult time. For more information about prostate cancer, visit the Advanced Urology Institute website.

What happens when a man’s testosterone is low?

Testosterone is a male sex hormone that plays an important role in a man’s life. It is important to normal sex drive, energy and even mood. However, testosterone levels normally tend to decrease in men as they age. Although these decreases are generally normal and may even go unnoticed, they can also be severe and cause symptoms that are problematic.

Symptomatic low testosterone is a real problem that men can face when low levels of the hormone result in negative side effects. One of the most prominent symptoms is low energy and tiredness to the point of fatigue. A patient with low testosterone can also experience decreased libido or sex drive, or even erectile dysfunction. Personality can also be affected by low testosterone for those who experience moodiness, anxiety, and differing levels of stability.

Dr. Paul Arnold of Palm Harbor, FLThere are many causes of low testosterone, with simply aging being the most common reason. Men can also experience low testosterone after an injury to the testicles, chemotherapy, certain types of infections, or autoimmune diseases. In addition, there are also medications that can lower testosterone levels.

Many men with low testosterone experience no symptoms at all and, for these men, a urologist would not recommend treatment. For men who do experience the negative symptoms, one option is testosterone replacement therapy.

With testosterone replacement therapy, the hormone is brought into the body through gels, patches, or injections. The supplemental hormone brings testosterone back to normal levels and, in most cases, the patient will notice the change quickly. Energy levels, mood, and libido see quick improvements. And when testosterone replacement therapy is closely monitored by a urologist, the risks are minimal.

According to Dr. Paul Arnold, for patients receiving testosterone replacement therapy, “It’s like a light switch from their symptoms prior to treatment to post treatment.” Symptomatic low testosterone can be a difficult and depressing condition for those who miss the active life they once had. Fortunately, the urologists at the Advance Urology Institute can help you feel better and live with energy and a positive outlook again. For more information about testosterone replacement therapy, visit the Advanced Urology Institute website.

Symptoms and Treatment of Low Testosterone

The level of testosterone hormone in the body naturally declines as a man grows older. In fact, up to 40% of all men aged 45 years and older experience the effects of low testosterone. The symptoms of low testosterone may appear even earlier in some men.

Also called hypogonadism or low-T, low testosterone is characterized by a variety of symptoms such as:

  • Low libido (decreased sex drive)
  • Fatigue and lethargy
  • Erectile dysfunction (impotence)
  • Reduced testicle size
  • Breast growth in men (gynecomastia)
  • Loss of body and facial hair
  • Muscle weakness
  • Thinning of bones (osteoporosis)
  • Moodiness, irritability and depression
  • Decreased sense of well-being
  • Increased body fat or reduced muscle mass
  • Difficulties in concentration
  • Memory loss and sleep disturbances
  • Decreased hemoglobin level and mild anemia
  • Skin changes such as fine wrinkles
  • Diagnosis of low testosterone

Dr. Amar Raval of Palm Harbor, FLLow-T is diagnosed by measuring the quantity of testosterone in the blood. To clearly assess the level of testosterone, a urologist will request blood tests for both total testosterone and free testosterone. Often, it takes several measurements to confirm that a man has low-T because the levels tend to change throughout the day, with the highest levels occurring in the morning. Testosterone levels are also affected by body mass index (BMI), alcohol consumption, nutrition, age, illness and certain medications. Additional tests for sex hormones such as follicle stimulating hormone (FSH) and luteinizing hormone (LH) may also be requested by the urologist for a better picture.

Treatment of Low Testosterone

If low-T is diagnosed, the missing hormones may be replaced through hormone replacement therapy, restoring the body’s testosterone levels to normal. In some cases, however, particularly when low-T is diagnosed but no troublesome symptoms are noted, the urologist may not administer any treatment.

For men with bothersome symptoms, the therapy is administered to remove the symptoms and associated sexual problems. Testosterone replacement therapy can be given in different forms and the urologist will discuss options with the patient before deciding on the most appropriate method. After the treatment begins, testosterone levels are monitored to ensure the most effective dose is given.

The different ways of administering testosterone include:

  1. Injections – The urologist gives regular injections deep into a muscle (intramuscular injection) every 2-3 weeks to 3 months depending on the type of injection chosen. When appropriate, the urologist may delegate the task of injecting testosterone to a nurse or teach the patient how to self-inject. When done correctly, the injections are not painful.
  2. Testosterone Implants – Cylindrical pellets are inserted into the abdomen, thigh or buttock by the urologist under local anesthetic, once every 3-6 months.
  3. Testosterone Patches – Used every day and applied on different areas of the body, including arms, back, buttocks and abdomen, the patches work similarly to nicotine patches used by people trying to quit smoking. They deliver testosterone hormone gradually through the skin.
  4. Testosterone Gel – These gels are applied to clean dry skin, usually on the arm, shoulder, back or abdomen. They should be applied after showering to prevent the gel from washing off too quickly.

There are several benefits that can be derived from testosterone replacement therapy. They include:

  • Improved sexual function
  • Enhanced mental sharpness
  • Increased bone density and protection against osteoporosis
  • Increased muscle mass and loss of body fat
  • Greater strength and improved physical performance
  • Enhanced mood and better sense of well-being

Are you experiencing any bothersome symptoms and suspect you could be having low testosterone? Speak with your doctor as soon as possible about the problem. You do not have to live with these symptoms when effective treatment is available. For more information about testosterone replacement therapy, visit the Advanced Urology Institute website.

What are the treatment options for erectile dysfunction?

Erectile dysfunction is a common disorder that affects men of all ages. It is a man’s inability to get and maintain an erection. There are many different causes of ED and in many cases there is more than one underlying cause. All a urologist needs is a physical exam and a few questions answered in order to diagnose erectile dysfunction in a patient.

Dr. Brian Hale - Urologist at Palm Harbor, FLFor urologists like Dr. Brian Hale, treatment for erectile dysfunction begins with trying three different medications. The medications are generally oral and easy to take. The urologist will monitor the results of the oral drugs with the patient. Very often, at least one of the oral drugs prescribed will resolve the issue. For these cases, the urologist will write a prescription for the drug and continue to monitor its effectiveness through routine appointments.

If the urologist and the patient are unable to find an oral medication that works effectively, there are other options to consider. One possibility is injection therapy. Small injections into the shaft of the penis are used to dilate the penile arteries, helping increase blood flow, causing an erection. For most men who do not see results with the oral medication, injection therapy is their next best option.

For many men, injection therapy can seem a bit overwhelming at first, maybe even frightening. But in reality, the injections are easy to administer and are relatively painless. The urologist and the patient will begin the injection therapy with a teaching session at the urologist’s office. The urologist may use an ultrasound to monitor the reaction of the blood vessels to the injection to help determine the right dosage for the patient. The patient is also taught how to administer the injection on his own.

Patients are generally pleased after they start injection therapy. The teaching session at the office helps the patient see that the injections are not painful and can easily be done at home. It is very rare that a patient cannot do the injection therapy himself. For those who did not respond positively to the oral drugs, injection therapy is an ideal treatment to produce the desired results and overcome the erectile dysfunction.

Treating erectile dysfunction is an important part of a patient’s well being, both personally and within his relationships. The urologists of the Advanced Urology Institute offer many options for treatment and remain committed to finding the best one for each patient. For more information, visit the Advanced Urology Institute website.

Patient Communication: COVID-19

Coronavirus

Reschedule Appointment if you have Flu Symptoms

For patients who are experiencing flu symptoms: please reschedule your appointment for another time.

Please stay home if you are experiencing flu symptoms including fever, cough, sore throat, runny nose, aching, headache, fatigue, or have recently traveled out of the country or been on a cruise ship. The flu virus can spread very easily from person to person.

For the safety of patients, employees, and physicians, we will be implemented visitor restrictions to our facilities effective Wednesday, March 17th.

Patients who are minors, have disabilities, or need a translator will be allowed 1 companion. All other parties will be asked to wait outside of the facility. Please call to reschedule your appointment today if you are having any of the above stated symptoms. We are happy to reschedule you for a later date without penalty.

Becoming a Urologist with Paul Arnold, MD

From a young age, Dr. Paul Arnold knew he wanted to become a physician. Growing up as an athlete, he had to deal with many broken bones and made frequent visits to the doctor’s office. ”I found the physician as a healer,” he explains, “and wanted that as my path and destination from [when I was] very, very young. Didn’t know what kind of doctor, but my idols were my orthopedic surgeons that I would see all the time.”

Dr. Paul Arnold of Palm Harbor, FLAs a student at the University of Florida, Dr. Arnold became even more interested in scientific subjects, particularly in biology. He earned his undergraduate degree in zoology before moving on to the University of South Florida, where he attended medical school. During his surgical rotations, he realized that his interest was in the field of urology. He continued to research urology while in medical school and completed his residency in this field at Ohio State University. He holds certifications with the American Board of Urology and the American College of Surgery, in addition to a specialization in laser BPH surgery.

Having grown up in Miami, it made sense for Dr. Arnold to choose to practice urology in his home state. In addition to his work with AUI in Palm Harbor, Dr. Arnold has served as the assistant chief of staff at Helen Ellis Memorial Hospital since 2008; prior to that, he was the chief of surgery at Helen Ellis for two years. He is also an active member of the urological community. He participates in research for medical device and pharmaceutical companies and has published multiple papers on topics related to the diagnosis and treatment of urological issues. He specializes in the treatment of impotence and incontinence for both men and women. He also is experienced with the use of GreenLight Laser therapy and lectures internationally on the subject.

Part of the appeal of urology for Dr. Arnold is that it has a high patient success and recovery rate. As he puts it, “With urology, there is definitely a problem and a solution to it, and so you definitely have a high rate of accomplishment.” Like all physicians with the Advanced Urology Institute, Dr. Arnold’s goal is to diagnose and treat urological issues as quickly and effectively as possible in order to help his patients live the lives they deserve. For more information, visit the Advanced Urology Institute website.

Kidney Stone Surgery and Removal Procedures

Kidney stones can be stubborn and painful. In many cases, patients rely on a urologist for help removing these painful obstructions. Kidney stones are hard deposits of minerals that form in the body and can cause blockage in the urinary tract. Urologists will decide how to treat the stone based on factors like its size, the patient’s health and the amount of pain it’s causing.

Dr. Brian Hale of Palm Harbor, FLOne cutting-edge and noninvasive method for treating kidney stones is called shock wave lithotripsy. Board-certified urologist Dr. Brian D. Hale describes it as using water waves to break up the stone. A machine is put against the patient’s body and creates small explosions. The water waves from the explosions target the stone. As many as 2,500 water waves are directed at the stone during a single treatment.

These waves break the stone into small pieces similar to sand. The patient will be able to pass these much smaller pieces with greater ease. The whole treatment takes about 25 minutes. The procedure is mostly pain free but does require the patient to go under general anesthesia. In the early 2000s, patients were not required to go under anesthesia for this procedure. However, it was found that natural movements from the patient made it difficult to concentrate the water waves on the stone, so putting patients under anesthesia is now the general practice.

Each case of kidney stones is different, and noninvasive measures are not always an option. An alternative procedure for stone removal is to use a scope to go up the patient’s penis through the urethra to the kidney and then use a medical laser to break up the stone and pull out the fragments. This is the preferred method for some of the smaller stones that cannot be broken up with shock wave lithotripsy.

For larger stones in the kidney, urologists may recommend a more invasive form of surgery called percutaneous nephrolithotomy. In these cases, the urologist will make a small incision in the patient’s back to reach the kidney directly. The urologist then will use a scope and either a laser or ultrasound energy to break up the stone. This procedure also requires general anesthesia and the patient may need to stay in the hospital for one to two days to recover.

There are many options for patients suffering from painful kidney stones. The many urologists of the Advanced Urology Institute have committed to finding the best options to relieve the pain of kidney stones. For more information, visit the Advanced Urology Institute website.

Kidney Stones Pain, Symptoms and Treatment

Kidney stone disease is a common issue that affects men and women alike. There are many factors that can be attributed to developing kidney stones. According to Dr. Amar J. Raval, “Kidney stone disease is very prevalent in Florida because of heat and lack of hydration.” The state’s warm climate helps induce sweating and makes it easier to dehydrate, putting people who live there at a higher risk of developing stones.

In addition to climate, there are several other factors that can increase kidney stone likelihood. Family history is one factor. If someone in your family has a history of developing stones, you are at greater risk of developing them as well. Diets high in protein, salt and sugar also increase the risk. Salt especially is known to increase the amount of calcium your kidneys must filter, raising the chances of stone development. Certain conditions like irritable bowel syndrome and urinary tract infections are also known to increase kidney stone risk.

Urologist Dr. Amar Raval of Palm Harbor, FLThere are numerous symptoms associated with kidney stones and they can vary in seriousness and pain level. Doctors often see patients with acute onset pain in the upper abdomen that does not resolve with medication, nausea, fever, chills, difficulty urinating and even blood in the urine. The symptoms of kidney stones may present themselves differently depending on many different factors. It is important to know when something is not right and when it may be best to see a urologist for help.

Luckily for people suffering from kidney stones, there are many treatments doctors can use to help them. Many of the treatments are endoscopic, not requiring incisions and are minimally invasive. For instance, doctors may insert a stint into the urinary tract to allow the patient to pass the stone. Shock waves also can be used to break large stones into smaller more easily passable pieces. The shock wave treatment also is not invasive. Doctors can use lasers to break off a piece of the stone for a biopsy to determine exactly what kind of stone it is and what the best treatment may be.

Consulting a trusted urologist for diagnosis and treatment options for kidney stones is very important. Like many conditions, kidney stone treatment is easiest when caught early. Urologists like Dr. Amar J. Raval at the Advanced Urology Institute help many patients with kidney stones. They are familiar with kidney stone disease as well as the latest medical technology, and can provide the most advanced treatment options for their patients. For more information, visit the Advanced Urology Institute website.