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This year more than 200,000 men will get a diagnosis of prostate cancer, and about 30,000 men will die of the disease. Screening for prostate cancer with the PSA test has become quite controversial, because so many of the cancers identified would not cause trouble. The most common treatments for prostate cancer may cause men trouble, though, including incontinence and impotence.

There are a number of new approaches that are not well known. Find out why MRIs and focal therapies should be on the radar screen of most men who have received this frightening diagnosis. Why isn’t immediate surgical removal of the prostate gland always the best treatment? Our guests present cutting edge information that could save men from a lot of pain and suffering. 

 Guests: Jay Cohen, MD, is an expert on prescription medications and natural supplements. He has written several books, including Overdose: The Case Against the Drug Companies. His latest book is Prostate Cancer Breakthroughs: New Tests, New Treatments, Better Options. The photo is of Dr. Cohen.

Cary Robertson, M.D., is an associate professor in the Division of Urology at Duke University Medical Center in Durham, N.C.  A board-certified urologist, Dr. Robertson is the director of the Morris Center for Urologic Research at the Duke Cancer Institute and is a leading expert on prostate cancer and its treatments. He is the author of the book  Prostate Cancer: A Guide for Men.

 Thomas J. Polascik, M.D., F.A.C.S., is Professor of Surgery and Director of the Society of Urologic Oncology program at Duke University Medical Center. He is also Director of the Genitourinary program on Focal Therapy at 
Duke Cancer Institute. Dr. Polascik is the founder and director of The International Symposium on Focal Therapy and Imaging of Prostate and Kidney Cancer and Past President of the North Carolina Urological Association. He is editor of the medical book, Imaging and Focal Therapy of Early Prostate Cancer. 

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

 

 

 

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  1. Steve
    Reply

    I just finished Dr. Cohen’s book. It’s worth reading. There are a few issues worthy of comment, however. During his interview on People’s Pharmacy, I think that Dr. Cohen stated that Gleason 6 is the lowest cancer level. Yet his book asserts that there are lower Gleason scores. (see page 23) This adds to the confusion over the Gleason scale.
    Also, Dr. Cohen’s book failed to mention genetic testing of prostate tumor material. This is truly one of the most important “breakthrough” developments. Some companies offer genetic testing now. I had my cancer material sent off, but there was not enough useful material for testing. I understand that is not uncommon. Genetic testing offers great possibility in the near future.
    Finally, my first urologist saw no benefit in prostate MRI or color Doppler ultrasound. The MRI that I obtained from a more progressive urologist showed that there were no tumors in my prostate. Dr. Cohen’s book convinced me on the value of color Doppler.

  2. J David Auner
    Reply

    Dr. Cohen stated that prostate cancer deaths had fallen from 50K to 30K and attributed the decrease to medical diagnosis and treatment. Now that the government works again, please review the National Cancer Institute data. The SEER study reported by NCI, figure 2.7 reports stable prostate cancer deaths in the low thirty thousand level around 1990. The recent numbers are around 37K deaths reflecting the baby boom generation now in the age for prostate cancer death risk but the percentage of deaths is in the same range.
    The prostate cancer story is still unchanged. We need better tests and to figure out how to save some lives while leaving the 95% of men who will not die of their “cancer” alone and unmutilated.

  3. cps
    Reply

    I have been recently examined and have had an increase in my PSA score. The md wants to do a biopsy. I am 75 yrs old and currently in good health otherwise… I had a stroke 4 yrs ago but so far I have had no follow up problems. My Dr. examined my prostate and now wants to do a biopsy. This worries me. What would you recommend before I do a biopsy?
    People’s Pharmacy response: Ask the doctor if you can wait a few months and have another PSA test done then. Usually there is not big urgency to rush to a biopsy. You may also want to read Dr. Cohen’s book.

  4. dg
    Reply

    Because of an elevated PSA I had a biopsy. The urologist found 1 of 12 biopsies positive at 8%. He recommended DaVinci surgery and I spoke to that surgeon who also recommended surgery. Before scheduling I ran across a practice that specialized in prostate oncology. Over the past 2 years I have had several different tests which showed the cancer to be very minor and perhaps getting smaller. My PSA has decreased. My oncologist said that at a prostate cancer conference it had been suggested that my type of prostate cancer should not even be considered a cancer. Too many men are rushed into surgery. There are many options and more coming every day. Many men don’t know that at their first stop at the urologist, they are seeing a surgeon. When you’re a hammer, all the world looks like a nail.

  5. RR
    Reply

    Very pertinent a timely information; however I was disappointed in your guests, especially Dr Cohen. First, he should have mentioned the NATIONAL PROSTATE CANCER INSTITUTE (among many others)–A valuable, vetted source for up to date prostate cancer research and information. He neglected to mention PSAD (doubling time), PSAV (velocity), % free PSA, and PCA3 tests just to name a few relatively inexpensive testing metrics. His MRI testing recommendation, while valuable and point appropriate, is expensive and probably towards the end of the diagnostic investigation. These and other aspects of prostate cancer are covered extensively on the aforementioned organization’s web site/phone hotline and should be exhausted prior to considering a biopsy.
    I know that your on air time is limited and I couldn’t listen to the entire program but your listeners should exhaust as many options as possible prior to making a biopsy/radical surgery decision as they should with any invasive medical procedure.

  6. paulbyr
    Reply

    Is the problem, which caused Steve on Oct 14th to “hate the American medical system” really one of so many people having to take HMO type insurance with the difficulty in changing (i.e., firing) the doctor who tries to play God?
    I have been very fortunate in never having that type of insurance contract and am free to switch doctors whenever I see fit. For me, being a “refusenik” is not hard work at all.

  7. Steve
    Reply

    Prostatitis is what brought me to a urologist. There’s a saying that if you hang out in a barber shop, that sooner or later you will get a haircut. It might be said that if you see a urologist for long enough, you will get a prostate biopsy. And so it was with me. Despite a low PSA, my urologist thought he felt a nodule. The “nodule” was benign, but a small amount of Gleason 6 was found elsewhere in my poor old prostate and that initiated a cascade of events.
    My urologist was emphatic that I should have surgery. I refuse and have gone to other doctors in search for a reasonable treatment plan for my (probably) low risk cancer. By the way, no other doctor has found a nodule on my prostate and an MRI couldn’t find one. I should never have been offered or accepted a prostate biopsy.
    The “protocol” is that patients with prostate cancer should have yearly biopsies. I have refused and as a result, many doctors will not treat me. My PSA is about 1.0 and DREs are unremarkable. If my condition changes, I’m open minded and will consider more aggressive treatment. Yearly prostate biopsies can’t be good for you.
    Being a refusenik is very hard work. Thank you Joe & Terry for your wonderful program. Thank you especially for your rational programs on prostate cancer. I hate the American medical system.

  8. Cindy
    Reply

    My father was diagnosed with prostrate cancer, went through the radiation and died about 10 months later from multiple cancers – brain, liver, bone, and lung. Always super healthy, I feel these other cancers were able to grow unchecked by his compromised immune system. He was 89. In fairness to the medical establishment, I think they were not completely onboard with him getting treatment. But he was of the idea that one “does everything possible”. I tried to plant the seed that “doing nothing” is NOT “doing nothing” if you are eating well, sleeping well, and feeling joy in your life. I think the tide is changing as both doctors and lay people realize there is a significant health “cost” to treatment that must be factored in.

  9. Randolph H.
    Reply

    your show was very helpful. I have a family member who’s in his late 20’s or early 30’s who had his prostate removed about 2 or 3 months ago. I was very disappointed when I heard this (I think he was too young for that). I did not hear you talk about why men get prostate cancer nor did I hear you talk about prevention (sad).
    People’s Pharmacy response: It is certainly possible, though quite uncommon, for such a young man to develop prostate cancer. Unfortunately, we do not know why men develop it, and as a consequence we do not know how to prevent it. We do know that those with a family history are at higher risk, as one of our guests mentioned, and should consider early screening.

  10. William H.
    Reply

    I was diagnosed with prostate cancer in 2009 and was advised by my doctor that I should have surgery as soon as it could be scheduled. My family doctor insisted on a second opinion.
    The second opinion was that I should not have the surgery now, but to just keep a close eye on it. My urologist was adament in his belief that “this will not go away by itself”.
    In early October of 2013 I had a “TURP” done. Lab results came back showing no evidence of cancer at all. Was this evidence of a “false” positive, or did it go away on its own?
    Thanks to my family doctor I am still in one piece and not suffering from the side effects of having my prostate removed. I encourage all men who receive a positive diagnosis of prostate cancer to take a deep breath and not rush into surgery without having this diagnosis verified.

  11. Yvonne W.
    Reply

    My husband has an enlarged prostate and won’t do anything about it except he takes two pills that don’t seem to work. I think he may think if he has an operation that they will tell him it is cancerous. My question: are all prostate problems cancer?
    Yvonne
    People’s Pharmacy response: No. Many prostate difficulties are caused by an enlarged prostate that is not cancerous.

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