““FOR MEN ONLY”FOR MEN ONLY”RetreatRetreat

Prostate HealthProstate Health

““FOR MEN ONLY”FOR MEN ONLY”

RetreatRetreat

The Prostate ?The Prostate ?

Gland in the male reproductive systemGland in the male reproductive system

Makes some of the fluid secreted in Makes some of the fluid secreted in semensemen

Located below the bladder and in front of Located below the bladder and in front of the rectumthe rectum

Surrounds the upper part of the urethra Surrounds the upper part of the urethra (tube that empties urine from the bladder)(tube that empties urine from the bladder)

The ProstateThe Prostate

Benign Prostate HyperplasiaBenign Prostate Hyperplasia

BPH is an enlargement of the prostate gland. BPH is an enlargement of the prostate gland.

After age 50, most men develop enlarged After age 50, most men develop enlarged prostatesprostates

In some men, BPH can lead to serious In some men, BPH can lead to serious problems, including urinary tract infections, a problems, including urinary tract infections, a sudden inability to pass urine (acute urinary sudden inability to pass urine (acute urinary retention), as well as the need for surgery.retention), as well as the need for surgery.

Symptomatic BPHSymptomatic BPH

Affects 5.6 million Affects 5.6 million menmen

Can affect quality of Can affect quality of lifelife– Degree of botherDegree of bother– Interference w/daily Interference w/daily

livingliving– Degree of WorryDegree of Worry– General psychological General psychological

well-beingwell-being

Can be progressiveCan be progressive

BPHBPH

Benign Prostatic HyperplasiaBenign Prostatic HyperplasiaSigns & SymptomsSigns & Symptoms

Poor Stream

Nocturia

Incomplete Bladder Emptying

Hesitancy

Urgency

Post-void Dribbling

BPH DiagnosisBPH Diagnosis

History and symptom scoreHistory and symptom score

Physical exam Physical exam – Digital Rectal Exam (DRE)Digital Rectal Exam (DRE)– Neurological evaluationNeurological evaluation

UrinalysisUrinalysis

Creatinine Creatinine

PSA (when appropriate)PSA (when appropriate)

Benign Prostatic HyperplasiaBenign Prostatic HyperplasiaTreatmentTreatment

Program of monitoring or "Watchful Waiting"

Medication

Surgery (Which procedure is best depends on your symptoms and medical condition.

Prostate CancerProstate Cancer

Prostate cancer is the leading cancer Prostate cancer is the leading cancer diagnosed among men in the United diagnosed among men in the United StatesStates (excluding skin malignancies). (excluding skin malignancies).Second leading cause of male cancer-Second leading cause of male cancer-related deathsrelated deathsMortality rates for prostate cancer Mortality rates for prostate cancer are much lower than the incidence are much lower than the incidence rates, because survival for men with rates, because survival for men with this cancer is generally quite high. this cancer is generally quite high.

Prostate Cancer in 2002Prostate Cancer in 2002USAUSA

Incidence: 189,000Incidence: 189,000

Mortality: 30,200Mortality: 30,200

2001Black Men2001Black Men– Diagnosis Diagnosis 25,300 25,300 – Deaths Deaths 6,1006,100

PROSTATE CANCERPROSTATE CANCER

African American men African American men are twice as likely to are twice as likely to die from prostate die from prostate cancercancer

Black men have Black men have about a 60% higher about a 60% higher incidence rate of incidence rate of prostate cancer than prostate cancer than white menwhite men

Prostate CancerProstate CancerRisk FactorsRisk Factors

Age – more than 75% of cases are Age – more than 75% of cases are diagnosed in men over age 65diagnosed in men over age 65

Family HistoryFamily History

Race – African American men have the Race – African American men have the highest incidence of prostate cancerhighest incidence of prostate cancer

High Fat DietHigh Fat Diet

Environmental CarcinogensEnvironmental Carcinogens

Prostate CancerProstate CancerSigns & SymptomsSigns & Symptoms

Early – No SymptomsEarly – No SymptomsProgressive – Symptoms are same as BPHProgressive – Symptoms are same as BPHWarning Signs:Warning Signs:

--frequent urination, especially at night

- burning with urination - persistent pain in back, hip, pelvis, or thighs - hematuria (blood in the urine) - change in urination patterns lasting 2 weeks

ANY UROLOGIC SYMPTOM ANY UROLOGIC SYMPTOM SHOULD BE EVALUATED BY SHOULD BE EVALUATED BY

A PHYSICIANA PHYSICIAN

Prostate CancerProstate CancerEarly DetectionEarly Detection

Our best defenseOur best defenseThe earlier prostate cancer is detected, The earlier prostate cancer is detected, the better the chance of effective the better the chance of effective treatmenttreatmentLong term survival is good for cancer Long term survival is good for cancer confined to the prostateconfined to the prostateOnce the tumor has spread outside of the Once the tumor has spread outside of the prostate gland, it is much more difficult to prostate gland, it is much more difficult to treattreat

Prostate Cancer Prostate Cancer Early DetectionEarly Detection

Prostate Specific Antigen (PSA)Prostate Specific Antigen (PSA)

Digital Rectal ExamDigital Rectal Exam

PSAPSA

Elevated PSA does not always mean that Elevated PSA does not always mean that cancer is present – It serves as a “red flag”cancer is present – It serves as a “red flag”

Other conditions associated with an Other conditions associated with an elevated PSA: elevated PSA:

- BPH (benign enlargement of prostate)- BPH (benign enlargement of prostate)

- UTI (urinary tract infection)- UTI (urinary tract infection)

- Prostatitis (infection/inflammation of - Prostatitis (infection/inflammation of prostate) prostate)

Recommendations for Prostate Recommendations for Prostate ScreeningScreening

Annual PSA and DRE for men >50Annual PSA and DRE for men >50

Begin at age 40 for high-risk populations Begin at age 40 for high-risk populations (strong family history or African American)(strong family history or African American)

PSA elevations caused by inflammation PSA elevations caused by inflammation sometimes can be restored to normal with sometimes can be restored to normal with antibiotics (25%)antibiotics (25%)

Persistent PSA >2.5ng/ml has >20% Persistent PSA >2.5ng/ml has >20% chance of being cancerouschance of being cancerous

Prostate Biopsy May Be Prostate Biopsy May Be Required To Evaluate An Required To Evaluate An

Abnormal DRE or Elevated PSAAbnormal DRE or Elevated PSA

Prostate CancerProstate CancerProstate BiopsyProstate Biopsy

Small samples of prostate tissue are Small samples of prostate tissue are removed and examined under the removed and examined under the microscopemicroscope

Usually done in physician’s officeUsually done in physician’s office

Needle biopsies are guided by transrectal Needle biopsies are guided by transrectal ultrasoundultrasound

Prostate CancerProstate CancerProstate BiopsyProstate Biopsy

Takes less than 30 minutesTakes less than 30 minutes

Minimal discomfortMinimal discomfort

Biopsies can miss cancers; therefore, Biopsies can miss cancers; therefore, follow-up biopsies may be necessaryfollow-up biopsies may be necessary

Precancerous changes (prostatic Precancerous changes (prostatic intraepithelial neoplasia) have a 50% intraepithelial neoplasia) have a 50% chance of prostate cancer and require chance of prostate cancer and require follow-up biopsiesfollow-up biopsies

Prostate CancerProstate CancerTreatmentTreatment

General Health of the IndividualGeneral Health of the Individual

Stage and Grade of the DiseaseStage and Grade of the Disease

Expected LifespanExpected Lifespan

Anticipated Effects of TreatmentAnticipated Effects of Treatment

Patient and Family PreferencesPatient and Family Preferences

Prostate Cancer Prostate Cancer Treatment OptionsTreatment Options

Watchful WaitingWatchful Waiting

SurgerySurgery

Radiation TherapyRadiation Therapy

Hormone TherapyHormone Therapy

ChemotherapyChemotherapy

““FOR MEN ONLY”FOR MEN ONLY”

Life expectancy for Life expectancy for men 73 years (6 men 73 years (6 years less than years less than womenwomenMen see physicians Men see physicians 28% less often than 28% less often than womenwomen33% of men have no 33% of men have no regular doctor (19% regular doctor (19% of women)of women)

““The best protection is early The best protection is early detection”detection”

&&We are our brother’s keeperWe are our brother’s keeper