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prostate cancer

With prostate cancer again in the news, RRH urologist discusses screening and treatment

By Howard B. Owens
dr. gantz rrh
Dr. Jacob Gantz

The nation's defense secretary's treatment for prostate cancer has put the disease in the public spotlight again, and officials at Rochester Regional Health/United Memorial Medical Center had a specialist talk with reporters on Wednesday to help people better understand detection and treatment.

Lloyd Austin's struggle with prostate cancer and subsequent post-surgery infection led him to seek treatment without alerting the White House.

That, in itself, became a controversy, but as USAToday reports, many men are reluctant to discuss a prostate cancer diagnosis.

 "I find that it's something that a lot of men don't talk about," Dr. Samuel Haywood, a urologist specializing in prostate cancer, says. "Men can be very stoic, and they don't like to talk about their health issues."

But facing up to prostate cancer can help men save their own lives, suggested Dr. Jacob Gantz, a urologist with RRH.

"It's crucial to be screened because by the time the disease, prostate cancer, would develop and cause symptoms, symptoms that the patient would be able to detect, it likely would be a very advanced disease and much more difficult to treat," Gantz said. "Catching prostate cancer early in its disease course makes the treatments much more effective. And it makes the treatments much more manageable and easier to do for the patient."

Screening consists of an annual PSA test (part of blood tests for an annual physical) and a digital rectal exam. Generally, men between 55 and 75 should be screened annually, but that can vary with family history.  A man whose father, or a grandfather, uncle, or brother had prostate cancer is at greater risk of developing the disease. Black men are also at elevated risk for prostate cancer.

"Prostate cancer in its early stages doesn't cause any outward symptoms that a patient would be able to pick up on," Gantz said.

Treatment has evolved and improved over the years, and outcomes are often favorable, Gantz said.

"Treatment of prostate cancer is not one size fits all," Gantz said. "It depends on the patient's age, the stage of the cancer, potentially the degree of spread of the cancer. In some cases (standards of treatment include), watching the cancer, evaluating it over time with biopsies, as well as MRIs and other adjunctive tests to monitor the progression of cancer."

The cancer can sometimes be spot-treated in the prostate instead of treating the whole gland, Gantz said.  That can help reduce the potential side effects of treatment.

Radiation treatment is also an option, he said.

If necessary, the prostate can be removed, called a radical prostatectomy.  This is where advances in technology really make a difference, Gantz explained.

"Robotic-assisted removal of the prostate has kind of revolutionized the treatment of prostate cancer," Gantz said. "Before (robotics), the surgery was much longer. There was much higher blood loss, much more invasive, and it required a hospital stay for at least several days. Since the introduction of the robotic platform, the surgery has become minimally invasive. It usually requires only one night in the hospital and a catheter for a few days, and the recovery is much faster with good cancer outcomes as well. Long-term complications have also improved with the radical prostatectomy being done robotically, such as sexual side effects as well as incontinence due to leaking of urine, has improved as well. But that being said, despite it being minimally invasive, it is still a major surgery."

As with any major surgery, complications are rare, but also an ever-present risk.  It was complications, reportedly an infection, that sent Austin back to the hospital on Jan. 1. 

Gantz said he is, of course, not Austin's doctor, so has no specific information on his treatment or complications, but complications can include, he said, leaking urine (possibly the complication Austin struggled with, according to news reports), which can cause a bowel infection and for the bowels to not function properly. 

"All of these complications, fortunately, as far as I can tell, from what I've read, are reversible and pretty easily reversible with no long-term damage," Gantz said.

Gantz emphasized that while prostate cancer is treatable, it takes a man to regularly see a primary care doctor to ensure it's detected early.  Once discovered, the treatment strategy becomes a discussion for the patient and a urologist.

"Prostate cancer treatment really depends on the patient, the goals of the patient, their age, as well as their health status," Gantz said. "It's very important when deciding what treatments are right for a patient to have a dialogue with their urologist to weigh the pros and cons of each treatment and then, therefore, come to a conclusion about what's right for that patient."

Center for Urology in Batavia is major sponsor of Prostate Walk and Health Fair

By Billie Owens

Information provided by Patrick Fisher, event organizer for Us TOO Rochester:

The Center for Urology in Batavia, a practice of seven urologists in the city, is one of this year's major sponsors of the fifth annual Prostate Cancer Walk and Health Fair on Sunday, Sept. 15 inside The Mall at Greece Ridge.

Us TOO Rochester hosts the event, which is its primary fundraiser and proceeds benefit local patient programs. It is the regional affiliate chapter of Us TOO International, a nonprofit 501c3 organization providing patient support, education and advocacy for those affected by prostate cancer in Rochester and the Finger Lakes Region.

Registration for Sunday's Walk and Health Fair is $30 at the door and includes an event T-shirt while supplies last. All are welcome.

Online registration is only $20 and the last day to register online is Sept. 12. Click here to register online.

On-site registration opens at 8:30 a.m. and the final lap begins at 10 a.m.

Children age 13 and under are admitted free.

This is a family fun event that includes: prize drawings worth hundreds of dollars; DJ Blaze as Master of Ceremony; a collection of classic cars displayed by Street Machines of Rochester; entertainment by mascots for Rochester Red Wings (Spikes) and Amerks (Moose); face painting by Freckles; a performance by Oasis Senior Tappers; free Dunkin’ Donuts (The Luis Ribeiro Group); free Gloria Jean’s Coffee (Rumit Patel, Mgr.); and cookies by Kiss Me Cookie in Webster.

See the '10-foot-tall Enlarged Prostate'

Among the sights will be the region's largest “enlarged prostate” -- a 10-foot-tall educational tool that informs you about how prostate cancer develops and spreads when left untreated.

In addition to educational exhibits, UR Medicine Labs and Urology will conduct free PSA screening on site for qualified men who have no medical insurance.

Ample parking is available at the mall near door #8. For full details about the walk and fundraiser, visit here.

The Mall at Greece Ridge is located at 271 Greece Ridge Center Drive in Greece.

The annual Prostate Cancer Walk and Health Fair is held in September because it is National Prostate Cancer Awareness Month. The disease is the most common non-skin cancer in American men, and the leading cause of cancer death in men second only to lung cancer.

The National Cancer Institute reports that 29,430 men in the United States will die from prostate cancer annually. More than 16,000 men in Rochester and the Finger Lakes region are diagnosed with the disease that left untreated may affect other organs or lead to bone cancer and death.

According to the NYS Department of Health, every year another 42 men from Batavia and Genesee County will be diagnosed with prostate cancer.

African-American men are at even greater risk and from an earlier age than their caucasian counterpart. However, not only men suffer. This cancer has the potential to affect spouses, significant others and relationships in meaningful ways, too.

No Early Warning Signs

While medical research has advanced how prostate cancer is diagnosed and treated, there are no early warning signs. The same BRCA2 gene that contributes to breast cancer in women, may also contribute to prostate cancer in men. Men who have a sister or mother known to have BRCA2 may benefit by being screened for prostate cancer.

Yet, the best outcomes begin with an early diagnosis. This makes it very important that men routinely talk with their provider about being screened for prostate cancer especially as they age.

Batavia's Dr. Anees Fazili, one of the urologists with the local Center for Urology, says he was honored to have helped bring a new exciting procedure to Western New York for the treatment of prostate cancer called High Intensity Focused Ultrasound (HIFU). It reduces some of the usual risks of treatment associated with this disease.

"At Rochester Regional Health we also just purchased the 'FocalOne' HIFU device, which is truly revolutionary and allows for same day focal therapy of prostate cancer, and we are one of only a handful of centers in the entire country offering this amazing treatment option," Fazili wrote in an email to The Batavian.

He operates out of both United Memorial Medical Center and Medina Memorial Hospital, and is working on starting an Us TOO chapter for Genesee County.

A cancer diagnosis can be overwhelming, but the process for men to learn what they need to know in order to make informed decisions is a daunting task that typically requires many sleepless nights and weeks spent conducting research or getting second and third medical opinions.

Us TOO is a good resource for help and information.

Their monthly meetings provide a safe environment where men and their care givers may share about their experience or learn from others regarding current options.

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