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.

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.

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.

Becoming a Urologist with Amar Raval, MD

A urologist plays an important role in healthcare. The field of urology encompasses many issues that people face throughout their lives, especially as they start to age. As urologist Dr. Amar Raval notes, urology allows him the opportunity to “provide a service to others.” As a urologist he gets to make a positive impact on his patients’ lives by helping them with many of the common issues that prompt people to seek medical help.

Dr. Amar Raval from Palm Harbor, FLOne common problem is kidney stone disease. Kidney stones form for a variety of different reasons. They are particularly common in warm climates, like Florida. Symptoms can vary, but they include severe abdominal pain, nausea, fever, chills, difficulty urinating or blood in the urine. Kidney stones can be very painful and some people need assistance to pass them. A urologist can assess the stones and determine the best way to remove them. In some cases, experienced urologists can break up the stones using a shock wave treatment that is totally noninvasive.

Urologists also frequently see cases of prostate cancer, one of the most common cancers for men. The disease comes in many different forms, making each case unique. While some need to be treated with surgery, chemotherapy or radiation, other forms are non-aggressive and can be left alone. Urologists also may recommend cutting-edge technologies like HIFU. Whatever the diagnosis, it is important to work with your urologist to monitor your prostate and find the best treatment plan for you.

Urinary incontinence is a common problem that many patients are embarrassed to discuss with their doctor. A urologist deals with many patients experiencing urinary incontinence and is accustomed to having in-depth conversations with their patients about incontinence. They know how to discuss the problem with patients so they feel comfortable while also finding the underlying issue causing the incontinence. Whether it is caused by stress, infection, lifestyle or another issue, a urologist can find the best solution and help a patient maintain a healthy and confident life.

There are countless other issues that bring patients to see a urologist for help. Dr. Amar Raval at the Advanced Urology Institute is one of many dedicated urologists improve their patients’ quality of life. For more information, visit the Advanced Urology Institute website.

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.

Are Medications Effective in Treating Erectile Dysfunction


Erectile dysfunction occurs to some degree in about 50 percent of men 40-70 years old. But only 10 percent of men report a total inability to have erections. For 70 percent of men with ED, taking an erectile dysfunction drug can produce an erection sufficient for intercourse. The drugs typically improve the supply of blood to the penis and, together with sexual stimulation, they produce an erection that is hard enough to begin and complete intercourse.

What ED pills are available?

The first ED drug commonly offered is sildenafil (Viagra). It has been on the market for the longest time and its side effects and the foods it interacts with are well known. Other ED drugs available in the U.S. are tadalafil (Cialis), avanafil (Stendra) and vardenafil (Levitra). Another option is Staxyn, the fast-dissolving form of Levitra that is placed under the tongue.

How well do these drugs work?

In those who are otherwise healthy, ED drugs produce an erection sufficient for sexual intercourse in at least 70 percent of men. Although the results vary slightly with each person, 70-80 percent of men will respond well to these medications. In fact, the majority of men with ED are pleased to use these medications. And while there are some who may not have the desired effect from any of these drugs, including men with damaged arteries or nerves after prostate surgery, cardiovascular disease, or diabetes, a larger number will find them quite effective.

How quickly do the pills work?

The pills may not work if they are not used correctly. These drugs are not an on-and-off switch for erections. So they won’t work well if there is no sexual stimulation. After taking the drugs, it is important for a man to be with his sexual partner and have foreplay. Likewise, Viagra and Levitra do not work if taken after a meal and must be taken before eating. But Stendra and Cialis do not interact with food and can be taken after a meal. When used properly, it takes about 15-60 minutes for the pills to start working.

Which drug works best?

There is no specific ED drug that is the best. Studies have shown that all ED pills have similar efficacy and safety. So the best drug depends on the man’s body chemistry, lifestyle and needs. That is why men should consider their and their partners’ preferences and the cost of their preferred medications. For instance, they may consider how spontaneous their partners are when it comes to sexual activity.

Nevertheless, studies have shown that about 52 percent of men with ED prefer tadalafil (Cialis), 28 percent prefer sildenafil (Viagra) and about 20 percent prefer vardenafil (Levitra). Tadalafil is more popular because it offers a 36-hour window of opportunity to have an erection while the other pills offer a much shorter period.

What are the alternatives to ED drugs?

For men not satisfied with the pills or who have conditions that make these drugs ineffective, shockwave lithotripsy is a great alternative to explore. During this treatment, waves are delivered to the penis to create or improve vascularity. Even if shockwave lithotripsy does not work, the urologist may request a test to measure the rate of blood flow to the penis. The test can help the doctor determine if there are underlying issues that ought to be addressed.

Even though ED drugs are generally safe, they should not be taken by men with certain conditions. For example, men with heart disease should not take these drugs. ED patients should always tell their doctors about all their health issues and the medications they are taking during their consultations. With this information, doctors can recommend the right pills or treatment for each patient. For more information on treatment of erectile dysfunction, visit the “Advanced Urology Institute” site.