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Why is it so hard to urinate?

STEP 1

1. Straining : Straining when he urinate.2.

Terminal dribbling : A condition when urin still dripped even the urinate was done.3. Frequent :Increase of the urinate intensity.

4. Nocturia : Is a condition when you wake up during the night because youhave to urinate. Its normal when the urinate is less than twice.

STEP 2

1. Why the man couldnt urinate since this morning (hesitancy), how and thepatophisiology? And why one month ago, the man had a weak strain when he urinate

and have to push quite hard in the beginning of urinate process?

2. Why the man still felt that there was still some urine left in his bladder in the end ofurination?

3. Why the doctor decided to do catheterization to him?4. Why the doctor concluded there was straining, terminal dribbling, nocturia, and supra

pubic mass

5. What we can get in rectal touch examination?6. DD?

STEP 3

1. Why the man couldnt urinate since this morning? and Why one month ago, the manhad a weak strain when he urinate and have to push quite hard in the beginning of

urinate process ( hesitancy), and how the patophisiology?

Maybe, there was an obstruction because the hyperplation of the prostate then it

press the lumen of urethra then the urine cannot flow normally and it makes the urine left

in the baldder so he cant urinate.

In the early stage, human body can compensate it with the harder contraction of

the bladder and then it caused the hypertrophy of detrussor muscle to against the

obstruction to push the urine out from the bladder.

But when it left without an medication the hyperplation can be worse and make

the urine cannot flow at all because the weakness of detrussor muscle.

In the early stage because the hiperplasion of the prostate can increase the

intravesical pressure so the bladder contracted

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Because the hiperplasion of detrussor muscle make some sensation of incomplete

urination somehow the bladder is empty.

3. Why the doctor decided to do catheterization to him?To flow out the urine from the bladder. And its a first line medication.

4. Why the doctor concluded there was straining, terminal dribbling, nocturia, andsuprapubic mass

Supra pubic mass: caused by the prostate hyperplation or there are some tumor in

that supra pubic organ. It can be benign or malignant.

5.

What we can get in rectal touch examination?We can make sure the enlargement of the prostate by palpate the surface of the

prostate. If the surface have a hard consistency and irregular mass, it might be a prostate

cancer. But if the surface have a elastic consistency it might be benign prostate

hyperplasion.

6. DD?a. BPHb. Ca Prostate

STEP 4

STEP 5

STEP 6

STEP 7

1. Why the man couldnt urinate since this morning? and Why one month ago, the manhad a weak strain when he urinate and have to push quite hard in the beginning of

urinate process ( hesitancy), and how the patophisiology?

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Many symptoms of BPH stem from obstruction of the urethra and gradual loss of bladderfunction, which results in incomplete emptying of the bladder. The symptoms of BPH vary, but

the most common ones involve changes or problems with urination, such as

a hesitant, interrupted, weak stream urgency and leaking or dribbling more frequent urination, especially at night

The size of the prostate does not always determine how severe the obstruction or the symptoms

will be. Some men with greatly enlarged glands have little obstruction and few symptoms while

others, whose glands are less enlarged, have more blockage and greater problems.

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Sometimes a man may not know he has any obstruction until he suddenly finds himself unable to

urinate at all. This condition, called acute urinary retention, may be triggered by taking over-the-counter cold or allergy medicines. Such medicines contain a decongestant drug, known as a

sympathomimetic. A potential side effect of this drug may prevent the bladder opening from

relaxing and allowing urine to empty. When partial obstruction is present, urinary retention also

can be brought on by alcohol, cold temperatures, or a long period of immobility.

It is important to tell your doctor about urinary problems such as those described above. In eightout of 10 cases, these symptoms suggest BPH, but they also can signal other, more serious

conditions that require prompt treatment. These conditions, including prostate cancer, can be

ruled out only by a doctor's examination.

Severe BPH can cause serious problems over time. Urine retention and strain on the bladder can

lead to urinary tract infections, bladder or kidney damage, bladder stones, and incontinence-the

inability to control urination. If the bladder is permanently damaged, treatment for BPH may beineffective. When BPH is found in its earlier stages, there is a lower risk of developing such

complications.

http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/


As the prostate enlarges, the layer of tissue surrounding it stops it fromexpanding, causing the gland to press against the urethra like a clamp on a garden

hose. The bladder wall becomes thicker and irritable. The bladder begins to

contract even when it contains small amounts of urine, causing more frequenturination. Eventually, the bladder weakens and loses the ability to empty itself, so

some of the urine remains in the bladder. The narrowing of the urethra and partial

emptying of the bladder cause many of the problems associated with BPH.
http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/http://kidney.niddk.nih.gov/kudiseases/pubs/prostateenlargement/

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3. Why the doctor decided to do catheterization to him?First action must to do relieve urin retention to this patient so decrease complication.

4. Why the doctor concluded there was straining, terminal dribbling, nocturia, andsuprapubic mass?

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5. What we can get in rectal touch examination?Clasification :

Grade 1 : mass 0-1 cm from the rectum.

Grade 2 : 1-2 cm from the rectum

Grade 3 : 2-3 cm

4: >3 cm.

Digital Rectal Examination (DRE)

This examination is usually the first test done. The doctor inserts a gloved finger into the rectum

and feels the part of the prostate next to the rectum. This examination gives the doctor a generalidea of the size and condition of the gland.

6. DD?

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a. BPHb. Ca Prostate

BPH

Benign Prostatic Hyperplasia (BPH)

Benign prostatic hyperplasia (BPH), or what is commonly known as an enlarged prostate gland,is a non-cancerous growth of prostate tissue. The chance of developing BPH increases with age.

More than half of men over age 50 have BPH. By age 80, about 80 percent of men have enlargedprostates. However, only 40 to 50 percent of men actually develop any symptoms due to BPH.

BPH affects the inner part of the prostate first - the part that encircles the urethra as it leaves the

bladder. (The urethra is the tube that carries urine and semen through the penis and out of thebody). As the prostate grows, it may begin to squeeze the upper part of the urethra and restrict

the flow of urine. BPH generally does not interfere with sexual functioning.

Can BPH become prostate cancer?

Whether treated or untreated, BPH is not cancer, nor does it lead to cancer. However, it is

possible to have both BPH and prostate cancer at the same time.

Symptoms of BPH

Early on in BPH, men experience few symptoms because the bladder muscles are strong enough

to push urine through a narrowing urethra. However, as the prostate grows and BPH begins to

restrict urine flow, men may experience the following symptoms:

weak flow a need to push or strain to start urine flow intermittent urine stream (starts and stops several times) difficulty stopping urination "dribbling" or leakage after urination a feeling of being unable to empty the bladder completely.

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As the bladder muscle works to push urine through a narrowed urethra, the bladder wall thickens

and is less able to stretch. As a result, the bladder can't hold as much, causing a need to urinatemore often. These symptoms can include:

frequent urination, especially at night, disrupting sleep

an urgent need to urinate that can't be postponed urge incontinence: an inability to get to a bathroom in time when the urge to urinate

occurs.

American Urological Association Symptom Score

TheAmerican Urological Association (AUA)Symptom Score Index is a questionnaire that

evaluates the severity of urinary difficulties that may occur with BPH and is a useful tool in

determining treatment. The seven questions about urinary function are answered on a 0 to 5scale; the higher the total score, the more severe the symptoms.

Complications from BPH

Severe BPH can cause serious problems over time, including the inability to completely emptythe bladder during urination. Urine retention and strain on the bladder can lead to recurrent

urinary tract infections. A small percentage of men suddenly become unable to urinate, develop

bladder stones, or suffer gradual bladder and/or kidney damage. If the bladder is permanently

damaged, treatment for BPH may be ineffective. When BPH is found in its earlier stages, there isa lower risk of developing such complications.

Transurethral Resection of the Prostate (TURP)

Transurethral resection of the prostate (TURP) is a surgical procedure used most often to treat

men with BPH. The operation removes part of the prostate gland surrounding and constrictingthe urethra (the tube that takes urine from the bladder through the penis and out of the body). A

tool with a wire loop on the end is passed into the penis and through the urethra to the prostate

gland. Electricity is then passed through the wire to heat it and cut the tissue. A representativesample of the prostate tissue removed during TURP is examined by a pathologist to determine

whether any cancer is present.

TURP is also used to treat men with prostate cancer who can't have aradical prostatectomy, or

to relieve symptoms caused by prostate cancer before other treatments begin.

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What is the chance you may develop prostate cancer?

There are both age-related and genetic reasons why you might develop prostate cancer. Prostate

cancer is characterized by the malignant growth of tumors in the prostate gland. With this in

mind, it is a good idea to have regular prostate examinations and PSA tests if you

have family members who have been diagnosed with prostate cancer are a 40+ year old African-American are age 50 or older

The following chart underscores the fact that the risk of having prostate cancer increases as yougrow older.

Source: American Cancer Society

Additionally, prostate cancer is the most commonly diagnosed cancer among American men.

One out of six men in the U.S. will develop this form of cancer during their lifetime. In the

United States, every 18 minutes someone dies of prostate cancer. Prostate cancer also accountsfor 33% of all new cancer cases in American men.

FACT: Lifetime risk of developing prostate cancer is 1 in 6 in the U.S.

Globally speaking, there are 700,000 cases of prostate cancer diagnosed each year, resulting in

221,000 deaths. This is the equivalent to 1 death from prostate cancer every 2.5 minutesworldwide.

Understanding cancer

Cancer is a serious health reality that all of us should be aware of. However, having a goodunderstanding about the effects of cancer is the first step for you to know how to stay healthy and

prevent this disease from causing serious complications.

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FACT: 96% of prostate cancer deaths occur in men over 60.

What is cancer?

Your bodys cells normally grow and divide in an orderly manner, permitting you to replace lost

cells and remain healthy. Sometimes genetic imbalances cause cells to reproduce in anuncontrolled way and spread abnormal cells throughout the body; when this happens cancer

develops. These abnormal cells can produce a mass, or tumor. Tumors are responsible fordestroying normal, healthy body tissue. When these cancer cells spread, tumors may grow

throughout the body, this is called metastasis. When prostate cancer metastasizes, it typically

spreads first to the lymph nodes and bones.

With genetics playing a key role in developing cancer, prostate or otherwise, you should find out

if there has ever been a family member of yours who has had cancer. And while genetics are animportant factor in determining the possibility of you developing cancer, other factors such as

the environment and your diet may also play a part in developing the disease.

FACT: If one close relative, say a father or brother, has prostate cancer, your chance of

getting prostate cancer doubles.

Since you can never be certain how fast or slow cancer grows and spreads, the earlier cancer is

detected by your doctor and treatment for the disease begins, the better your chance for survival.

Top of page

What symptoms indicate that you may have a prostate problem?

Through regular Digital Rectal Examinations (DRE) and Prostate Specific Antigen (PSA)testing, prostate problems are more likely to be detected early and you are less likely toexperience serious prostate-related health issues. Some men, however, may experience the

following symptoms indicating prostate problems:

A need to frequently urinate, especially at night Weak, interrupted or uncontrolled urine flow, or incontinence Painful urination or a burning sensation during urination Difficulty in achieving an erection, or impotence Painful ejaculation Blood or pus in urine or semen Weight loss Pelvic discomfort Persistent back, hip and spine pain

If you are experiencing any of these symptoms, make an appointment to see your doctor

immediately. Your doctor can perform additional examinations and tests to determine the

underlying cause of these symptoms. Keep in mind that these symptoms may indicate diseases ordisorders other than prostate cancer.
http://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#top

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FACT: African-American men are more likely to be diagnosed with advanced prostate

cancer and their death rate is 2.5 times greater than Caucasian men.

Top of page

How do you find out if your prostate is healthy?

The two most common early testing procedures that doctors perform to assess prostate health arethe Digital Rectal Examination (DRE) and the Prostate Specific Antigen Blood Test (PSA or

Total PSA Blood Test).

Digital Rectal Examination

The first of these prostate-testing procedures is called the Digital Rectal Examination or DRE(see Figure 2). The DRE is a simple examination your doctor can give you during

an annual physical. Using this examination technique your doctor will insert a lubricated, gloved

finger into your rectum and feel the surface of your prostate in order to see if thesize and shape of the prostate is normal and free of abnormalities such as hard nodules or lumps.

An abnormal DRE, it should be remembered, is not a definitive indicator of prostate cancer. An

abnormal DRE can be caused by infections, the presence of stones or other non-cancerousconditions.

Figure 2: Digital Rectal Examination (DRE)

U.S. National Cancer Institute

Even if your prostate shows all signs of being normal, for a more complete and accuratediagnosis the DRE should be combined with the Prostate Specific Antigen Blood Test.

Total PSA Blood Test

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Performing a Total PSA test significantly increases your doctors ability to detect prostate cancer

early, and early cancer detection always translates to a better prognosis. Available worldwide,the PSA test measures the level of a protein produced by the prostate called prostate specific

antigen, or PSA, that is in your blood.

Some health conditions and drug substances can affect PSA levels, so be sure to discuss yourcurrent health status and all medical treatments with your doctor at the time you have a PSA test.

When certain abnormal prostate conditions arisesuch as BPH, prostatitis, infection or cancer

an increased amount of the PSA protein is released into your bloodstream.

Measuring PSA

PSA levels are measured in nanograms per milliliter (ng/mL). As your doctor will explain to

you, PSA levels under 4 ng/mL are usually considered normal. If your PSA levels are greaterthan 10 ng/mL it is considered abnormal. With levels between 4 and 10 ng/mL your status may

be borderline abnormal. Increased PSA levels can indicate inflammation, infection or simple

enlargement of the prostate, stones within the prostate, urinary tract infection, other non-cancerous disorders or possibly prostate cancer.

Normal PSA levels can also vary due to your age or race. It should also be noted that cancerhas been detected in cases where PSA levels were less than 4 ng/mL, so a thorough examination

and discussion with your doctor should occur before reaching any conclusions. (see Table 1)

Table 1: General PSA Guidelines

PS Level ng/mL Condition

10 Abnormally High

NACB: Practice Guidelines and Recommendations For Use of Tumor Markers In the Clinic,

Prostate Cancer

Recent studies have also found that the year after year rate of increase in your Total PSA has

predictive value in detecting life-threatening forms of prostate cancer. This concept, called TotalPSA velocity, underscores the benefit of tracking your annual Total PSA result, which is easy todo with the tear-out PSA tracking card located on this booklets back cover, and regularconsultation with your doctor.

A valuable early detection tool

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The Total PSA test is not considered conclusive to detect the presence of prostate cancer. It does

provide a valuable early detection tool to assist you and your doctor in assessing your risk ofhaving the disease. The PSA test combined with the DRE is considered the most effective

method to determine your cancer risk and the possible need for further

investigation.

FACT: 21% of all cancer deaths in men over 80 are from prostate cancer.

Top of page

What other tests let you know if you are at risk for prostate cancer?

There are other tests to help determine if you may have prostate cancer, including Free PSA (to

allow for calculation of % Free PSA) and Biopsy.

% Free PSA

Your doctor will calculate your % Free PSA using your Total PSA and Free PSA values. As

mentioned earlier, Prostate Specific Antigen, or PSA, is a protein found in your blood and

produced by the prostate gland. PSA appears in two major forms, bound to other proteins andunbound from other proteins. Unbound PSA is called Free PSA. Comparing your amounts of

bound and unbound PSA can help doctors differentiate between prostate cancer and other

prostate health issues (see Table 2).The comparison can also assistyour doctor in evaluating the aggressiveness of cancer if it has been identified.

When you have borderline Total PSA test results (4 - 10 ng/mL) the use of % Free PSA aids indistinguishing between benign conditions and prostate cancer. These test results therefore assist

you and your doctor in determining if a biopsy is appropriate.

By helping doctors get a clearer picture of your prostate health, the % Free PSA test may

eliminate up to 40% of unnecessary biopsies and enables the accurate identification of 90% of

patients with cancer.

FACT: Lower % Free PSA = Higher Probability of prostate cancer.

Higher % Free PSA = higher probability of BPH or another benign condition.

Table 2: Percent Free PSA and Cancer Probability

% Free PSA Probability ofProstate Cancer*

0-10% 59%

>10-15% 40%

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>15-20% 24%

>20-26% 13%

>26% 7%

*Based on prevalence rate of 25% for prostate cancer (screening population) Vessella, et al.

Urology 2000;55;909-914

Biopsy

When prostate abnormalities are suspected (as a result of abnormal DRE, a high total PSA and a

low % Free PSA value) your doctor may request a prostate biopsy. Biopsy is the surgical

removal of small amounts of tissue from your body for diagnostic examination.

Urologists usually perform this procedure. Urologists are doctors who specialize in the treatmentof urinary disorders and problems with the male reproductive system. Your urologist will

perform a biopsy when he believes the risk of cancer is high.

During a biopsy, your urologist uses a device to provide a video image that helps him guide an

instrument called the biopsy gun into the prostate gland. The procedure to surgically remove

tissue from your prostate gland takes about 15 minutes and is usually performed in your

urologists office. The sample is then sent to a laboratory to be studied under a microscope.

Although a biopsy sounds painful, it usually only causes brief discomfort. In the event yourequire a biopsy, you may want to ask your doctor about numbing the area with a harmless

anesthetic.

Follow-up to biopsy

While biopsy is regarded as the only conclusive method for detecting prostate cancer, it is notaccurate 100% of the time. This means that even if prostate cancer is present, it is not always

detected in an initial biopsy. In the event an initial biopsy is negative, % Free PSA can help

determine if an increased risk of prostate cancer still exists, and whether a second biopsy isappropriate to ensure that cancer is not present.

Top of page

If your test results are positive for Prostate Cancer, what is the next step?

If your biopsy results confirm that you have prostate cancer, the extent of the cancer is

determined through a process called Staging. Staging provides your doctor with information

regarding the severity of the cancer and your prognosis. Staging separates cancer into four stages

(T-1 to T-4) based on how far cancer cells have spread throughout

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your body and can also indicate the treatments that are most appropriate for you. % Free PSA

may also indicate how far the disease has progressed.

The Clinical Stage

The Clinical Stage is based on all of the available information obtained before a surgery toremove the tumor, and is often the result of physical examination (DRE), radiologic examination

(Ultrasound, Computed Tomography [CT] or Magnetic Resonance Imaging [MRI]) andendoscopy. Information from the clinical stage is also used to determine your initial treatment.

Biopsy results do not affect the clinical stage.

The Pathological Stage

Since clinical staging by DRE alone can be inaccurate, the Pathological Stage of cancer is

determined mostly by biopsy or prostatectomy, or the surgical removal of all or part of the

prostate gland. The Pathological stage adds additional information gained by examination of the

tumor microscopically by a pathologist. Pathologists are responsible for processing and reportingon all specimens generated during surgery. The pathological stage is used to determine the need

for additional treatment after surgery.

Other Staging Procedures

In addition to biopsy, other diagnostic tests for cancer staging include

Computed tomography (CT or CAT scan): A test that makes pictures of the inside ofyour body using a rotating X-ray beam.

Magnetic resonance imaging (MRI): A test that makes pictures of the inside of your bodyusing magnetic fields.

Radionuclide bone scan: A scan that produces images of your bones using a smallamount of radioactive material.

ProstaScint Scan: A test to find cancer that has spread beyond your prostate that useslow-level radioactive material.

Lymph node biopsy: This procedure involves the removal of small amounts of tissuefrom the lymph nodes for evaluation.

The last form of staging is called the Gleason Grading System.

Gleason Grading System

Cancer grading estimates how fast the cancer is likely to spread. The Gleason grading system

rates the cancer cells on their difference from normal cells on a five-point scale. Because cancerscan have different grades in different areas of the same tissue, a grade is assigned to two major

areas of the tissue. These two scores are added together to make the Gleason score, which ranges

from 2 to 10. Higher scores indicate that cancer may grow and spread rapidly.

Top of page

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If you have Prostate Cancer, what are the available treatments?

If indeed you need to be treated for prostate cancer there are a variety of treatments available.

Selecting the best course of treatment for you is a decision that you and your doctor can make

together. The surgical and non-surgical treatments for prostate cancer are listed immediately

below.

Surgery

The following two common prostate cancer surgical procedures are used to remove your entire

prostate gland and any other local area cancer you may have.

These procedures are:

Radical Prostatectomy: This treatment involves removal of your entire prostate gland andsurrounding tissue through open surgery.

Laparoscopic Prostatectomy: This treatment involves removal of your entire prostateusing a laparoscope and done through a small two-tothree inch incision.

There are also two other surgical procedures for prostate cancer that do not involve the totalremoval of your prostate gland. These procedures are:

Orchiectomy: This treatment involves the surgical removal of your testicles, a mansmain source of testosterone. Prostate cancer usually needs testosterone in order to grow.

Transurethral Resection of the Prostate, or TURP: This treatment involves removing thepart of your prostate gland that surrounds the urethra to restore a normal urine flow out ofthe bladder.

As you work with your doctor to select the surgical treatment that will best serve your health andlifestyle, discuss what side effects and lifestyle changes you can expect during each of these

procedures surgical recovery periods.

FACT: 75% of men who undergo surgery never experience a reoccurrence of prostate

cancer.

Radiation

Prostate cancer cells can be destroyed by periodic exposure to radiation. The two types of

radiation treatment available to you are:

Radiation therapy (External beam radiation): Treats your prostate and other selectedissues with a targeted beam from a machine outside of the body.

Brachytherapy (Internal radiation therapy): In this form of radiation therapy, while underanesthetic, 40 to 120 small radioactive seeds are implanted directly into your prostate todestroy cancer cells.

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Chemotherapy

This treatment employs the use of powerful drugs to destroy cancer cells in your prostate.

Hormone Therapy

Also known asAndrogen Deprivation Therapy, this is the use of drugs or surgery to decrease theproduction of male hormones, or androgens, in order to stop or limit the growth of prostate

cancer.

Cryosurgery

This treatment uses extremely low temperatures to freeze your prostate, destroying cancer cells.

All prostate cancer treatments available to you have potential advantages and disadvantages.Your doctor will have the most up-to-date knowledge of the actual treatment and possible side

effects. Given this, you should decide the best treatment schedule together. Being an activeparticipant in your treatment selection is important because whatever treatment you end up

choosing needs to work well with your lifestyle.

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Is there a circumstance when you may not need to move quickly with prostate cancer

treatment?

There are circumstances when your doctor may suggest Watchful Waiting as your best course of

action to deal with your prostate cancer. Watchful Waiting involves careful, active observation

without immediate prostate cancer treatment. This may be an appropriate therapeutic course formen who

are found to have less aggressive tumors, which often tend to grow slowly. Remember, tohelp determine a tumors aggressiveness, doctors can use the Free PSA test.

have a life expectancy less than 10-15 years. have significant coexisting illnesses.

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How do you know if prostate cancer treatment has been successful?

There is a method your doctor can use to determine if prostate cancer treatment has beensuccessful and what the prognosis will be. At an appropriate time following prostate cancer

therapy another PSA blood test is performed. Successful treatment may be indicated by a

decrease in PSA levels. An increase in PSA levels may indicate

a reoccurrence of prostate cancer. If there is an increase, your doctor will do additional testing inorder to determine the best course of action.
http://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#top

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Top of page

If you have prostate cancer, what are your chances for survival?

If the disease is detected early, chances for surviving prostate cancer are very good. The fiveyear

relative survival rate for those whose tumors are diagnosed at the local and regional stages is99%. A five-year survival rate refers to the number of men surviving five years after they are

diagnosed with cancer.

Over the last 20 years, the five-year survival rate for all stages combined has increased from 67%

to 92%. Survival rates beyond five years are also increasing. According to recent data, 67% ofmen diagnosed with prostate cancer survive 10 years and 52% survive 15 years beyond

diagnosis.

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Unless you have noticeable symptoms, why should you participate in a prostate cancerscreening?

It is important to have regular prostate examinations and tests such as the DRE, Total PSA and

Free PSA because roughly half of all men may have some type of prostate abnormality by age50. Early detection of these abnormalities is critical in both treating and curing the ailment. Talk

to your doctor about your prostate health, as physicians

remain the best resource for information regarding early detection and treatment for prostate-related disorders and prostate cancer.

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What are the best ways for you to take charge of your prostate health?

Have regular prostate exams and PSA tests. Because symptoms of prostate cancer maynot occur until the disease is advanced, the best prevention against advanced prostate

cancer is to detect it early through DRE and PSA tests. To help you remember to bescreened for prostate cancer, have the tests done at the same time as other important

calendar events such as the date of your annual physical, your birthday, around FathersDay or during Prostate Cancer Awareness Month which occurs in the United States

during September.

Listen to the women in your life. As many as 60% of men screened say that their wives,girlfriends or another female encouraged them to have it done.

Diet can make a difference. A Harvard study showed that a diet high in dairy and fattyfoods, particularly those of animal origin, increased the risk of developing prostate cancerby 80%. Supplements and food sources rich in antioxidants (vitamin E and selenium)

have been shown to control cell damage and may prevent prostate cancer.

Stay fit and active. A healthy exercise program will increase circulation, lower stressand possibly decrease hormones that can increase the risk of cancer. Several studies also

suggest a possible connection between obesity and more aggressive prostate cancer.
http://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#top

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Learn more. The more you know and the earlier you know it, the more control you haveover your outcome. Read, ask others and search the Internet to educate yourself aboutprostate health.

Use theProstate Health Tracking Card. TheProstate Health Tracking Cardwill helpyou monitor your prostate health and act as a reminder to have a PSA test every year. The

card is designed so you can keep it in your wallet.

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Glossary of Relevant Terms

Benign Prostatic Hyperplasia, or BPH

Noncancerous enlargement of the prostate that may cause problems with urination such

as trouble starting and stopping the flow.

Benign Tumor

A tumor that is noncancerous.

Biopsy

The removal of small amounts of tissue from the body for diagnostic examination.

Biopsy Gun

A special instrument that inserts and removes a needle in a fraction of a second during

biopsy.

Clinical Stage

A rating system that tells the doctor about the size and spread of the tumor. Tools used to

determine the clinical stage include physical exam, DRE and PSA Testing.

Digital Rectal Examination, or DRE

A common screening procedure for prostate cancer in which the physician inserts a

gloved, lubricated finger into the rectum in order to feel the size and shape of the prostate

through the rectal wall.

Ejaculation

A sudden release of fluid, especially of semen, from the body.

Frequent Urination

The need to go to the bathroom often, to urinate.

Gleason Grade
http://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/pdf/cancer_prostate_card.pdfhttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/pdf/cancer_prostate_card.pdfhttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/pdf/cancer_prostate_card.pdfhttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/Prostate.cfm#top#tophttp://www.abbottdiagnostics.com.au/Your_Health/Cancer-Oncology/pdf/cancer_prostate_card.pdf

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A numerical grade designating the degree of aggressiveness of a particular tumor based

on the appearance of the tissue under the microscope.

Impotence

Inability to have an erection.

Incontinence

Loss of urinary control.

Laprascopic Surgery

A minimally invasive surgical technique in which operations in the abdomen/pelvic area

are performed through very small incisions, as opposed to larger incisions used in more

traditional surgery.

Lymph Nodes

Small bean-shaped structures of the lymphatic system that produce white blood cells and

filter bacteria and cancer cells that may travel through the system.

Malignant Tumor

A tumor that is cancerous.

Metastasis

The spread of disease from one part of the body to another.

Orchiectomy

Surgical removal of the testicles.

Pathological Stage

The evaluation of the prostate tissue removed after surgery to determine how far the

cancer has spread.

Prognosis

A prediction of the course of disease; the outlook for cure or long-term survival.

Prostate Gland

Organ of the male reproductive system located below the bladder and in front of therectum.

Prostate Specific Antigen or PSA

A protein made only by the prostate gland.

Prostate Specific Antigen Test

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A blood test that measures a patients level of prostate specific antigen.

Prostatitis

Inflammation or infection of the prostate.

Rectum

The last five or six inches of the intestine leading to the outside of the body.

Semen

A thick, whitish fluid secreted by the prostate to carry sperm.

Stage

Term used to describe the extent of cancer.

Testosterone

Male sex hormone produced mostly by the testicles; a small amount is produced by theadrenal glands. It stimulates a mans sexual activity and growth of other sex organs,

including the prostate.

Tissue

A group of cells organized to perform a specialized function.

Transrectal Ultrasound (TRUS)

The use of sound waves to create a picture of the prostate on a screen. This test may be

used for screening or helping to guide the needle for a biopsy.

Tumor

A mass of cells resulting from abnormal, uncontrolled cell growth.

Urethra

Canal that carries urine from the bladder and semen from the sex glands to the outside of

the body.

Urologist

A doctor who specializes in treating problems of the urinary tract in both men and

women, and disorders of the genital area in men.

When it comes to Prostate Cancer, whos at risk?

If you have family members who have been diagnosed with prostate cancer, are a 40+ year-old

African-American or more than 50 years old, you are at a higher risk of developing prostate

cancer.

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Prostate Cancer

is diagnosed every 3 minutes in the U.S.

is the most commonly diagnosed cancer among American men.

is projected to take the lives of 27,350 American men yearly.

takes 1 life every 18 minutes in the U.S.... is treatable, especially when detected early.

Top of page

What are the prostate disease warning signs?

A need to frequently urinate, especially at night Difficulty starting urination, or holding back urine Weak, interrupted or uncontrolled urine flow, or incontinence Painful urination or a burning sensation during urination Difficulty in achieving an erection, or impotence Painful ejaculation Blood or pus in urine or semen Weight loss Pelvic discomfort Persistent back, hip and spine pain

If you have experienced any of the above-mentioned symptoms, make an appointmentimmediately to see your doctor and ask for a PSA test and prostate examination.

Early stage prostate cancer patients often exhibit no visible symptoms, so consider

participating in a PSA screening.

And, dont forget to ask if % Free PSA is appropriate for you.

Prostate Cancer

More than 234,000 men will be diagnosed with prostate cancer this year and of these, more than

27,000 will die from the disease. For men 4059, one in 38 will contract the disease and for

men 6069, one in 14 will learn they have prostate cancer. Sixty-five percent of all prostate

cancers are found in men ages 6569. Below is vital information and links to help you

understand benign prostate changes and symptoms to report to your physician.

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If you have already been diagnosed with

prostate cancer, youll want to know

about the best treatment for your

individual case. The links to staging and

treatment that follow will give you ageneral idea of treatments available for

different stages of the disease.

US TOO International, Inc is an

organization offering education and

support to prostate cancer patients and

their families. Barton Wachs, M.D. is a

urologist who moderates this monthly

group here at Long Beach Memorial

Medical Center. If you are newly

diagnosed, this is the perfect place to meet

other men who are under treatment or

have completed treatment. See below for further details.

At the Todd Cancer Institute, we specialize in the treatment of prostate cancer. Surgery, radiation

and hormone therapy are the most common treatment modalities and are often used in

combination. Theda Vinci Systemutilizes the newest technology and is part of Long Beach

Memorials Robotic Surgery Program, which is overseen byDavid K. Ornstein, M.D., medical

director.Surgical Servicesutilizes the newest technology including the da Vinci Robot.

Patients with high-risk, non-metastatic prostate cancer should find out if they are a candidate to

receive combined modality treatment using low-dose chemotherapy, radiation and hormone

therapy. For more information, callCancer Answersat (562) 933-0900 to speak with a registered

oncology nurse.

TomoTherapy is a highly advanced form of external radiation therapy that uses computerized

scanning to precisely locate and provide a beam of concentrated radiation to a specific area. Why

should you consider TomoTherapy? Besides having peace of mind knowing that 100 percent ofthe radiation is going exactly where your physician and therapists want it to go, most men

experience a reduction in side effects because adjacent tissues such as the bladder and rectal wall

receive a limited dose of radiation. For more information on TomoTherapy, visit our

TomoTherapy information page.

Male Anatomy
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We are internationally known for hyperthermia and high-dose-rate brachytherapy treatments.

We use these technologies to treat recurrent or hard to treat cancers of the prostate, head and

neck and gynecologic cancers. To read more about brachytherapy and hyperthermia, select one

of the following articles:

HDR Brachytherapy in the Treatment of Carcinoma of the Prostate Prostate Cancer Brachytherapy Hyperthermia as Cancer Therapy

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ices/todd_cancer/images/tci_prostate_caner.jpg&imgrefurl=http://www.memorialcare.org

/long_beach/services/todd_cancer/services_prostate.cfm&h=335&w=300&sz=35&hl=id

&start=7&um=1&tbnid=JdvnMGisxlBtFM:&tbnh=119&tbnw=107&prev=/images%3Fq

%3DPROSTATE%2BCANCER%26um%3D1%26hl%3Did%26sa%3DN

Prostatitis.

Definiton

Prostatitis is an infection or inflammation of the prostate that can occur in men who are middle-aged or older. Symptoms of the condition include frequent urination, painful ejaculation and painin the back or rectum.

Etiology

PatophysiologiClinical features

therapy
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