Published: May 29, 2007 04:36 pm            

Understanding Urinary Health with Dr. Ruby

Somerset — Men often don’t talk about prostate cancer, but, in some cases, what you don’t know could kill you.

Prostate cancer has long been a taboo subject for most men that would rather ignore the symptoms than go to a doctor. Burying your head in the sand can be potentially life-threatening.

According to the American Cancer Society, prostate cancer is the third leading cause of cancer death in men, after lung and colorectal cancer. Based on ACS statistics, 234,460 new cases will be diagnosed nationwide in 2007 and 27,350 men will die of this disease.

The good news is, early detection can spot cancer at its earliest stages before symptoms develop and new advanced treatments make it easier to treat prostate cancer.

Cryotherapy: A revolutionary

new treatment

Dr. Eric Ruby, a Somerset urologist, is among a handful of physicians in Kentucky to offer cryotherapy as a treatment option. This is a revolutionary new treatment that freezes prostrate cancer without major surgery and radiation.

While cryotherapy is not a new procedure, it is new to this area. Ruby has treated 30 cases in the last two years he has performed the procedure.

Cryotherapy is used as a primary treatment for localized prostrate cancer or when radiation treatments fail.

Lake Cumberland Regional Hospital in Somerset and its medical staff offer some of the latest procedures in the field of urology.

With Cyrocare TCAP (Targeted CryoaAblation of the Prostate), a minimally invasive procedure, a physician inserts six to eight slender probes into the prostate gland. Each probe contains argon gas cold enough to freeze the entire prostate. A warming catheter protects the urethra from the cold temperatures. Ultrasound images allows the doctor to guide the probes to the best possible positions for destroying the cancer. Temperature sensors carefully monitor the process and precisely determine when target temperatures have been reached.

Benefits of this procedure include:

• a choice of general or local anesthesia;

• no radiation beams;

• no permanent radiation seeds and no radiation exposure;

• is not major surgery;

• and fast and easy recovery times with lower risk of potential side effects.

Radioactive seed implant:

Another choice

Another new treatment option is radioactive seed implant therapy, or “brachytherapy,” which is used in conjunction with radiation.

“This is a minimally invasive way to deliver radiation therapy for prostate cancer patients,” explained Ruby, who has been practicing urology in Somerset for the last eight years.

Radioactive seed implant therapy puts radiation at the site of the cancer. Tiny radioactive seeds (about the size of a grain of rice) are implanted into the prostate, where the radiation kills the cancer cells.

There are many different options available for the treatment of prostate cancer and patients should consult with their physician to determine a recommended course of treatment that’s appropriate for their needs.

Prostate cancer is the most common form of cancer in men, most prevalent in men over age 65 and fairly common in men 50-64 years old.

Men, age 50 and over, are encouraged to have an annual screening before they wait for symptoms to develop. African-Americans and men who have a family history of cancer should be tested around age 40, according to Ruby.

Screening for prostate cancer can be performed in a physician’s office using two tests: The PSA (prostate-specific antigen) blood test, and the digital rectal exam (DRE).

PSA is a protein produced by the prostate and released in very small amounts into the bloodstream. When there’s a problem with the prostate, such as when prostate cancer develops and grows, more and more PSA is released, until it reaches a level where it can be easily detected in the blood.

Benign prostatic hypertrophy

Elevated PSA levels can indicate other possible problems, including the presence of a medical condition known as benign prostatic hypertrophy (BPH), or an enlarged prostate, Ruby said.

“The prostate gland is at the base of the bladder and is normally the size of a walnut,” he said. “As a man grows, the prostate enlarges and can develop a condition known as BPH.”

Enlarging prostate is not a cancerous condition, Ruby said, and does not lead to cancer.

BPH is normally treated with medication, but if that fail, your urologist may recommend a procedure to relieve the obstruction. Transurethral resection of the prostate (TURP) has historically been the treatment of choice. However, Ruby said, newer laser treatments give patients another choice and, to a large degree, have replaced the TURP procedure. Laser treatments are less invasive, reduce bleeding and require minimal hospitalization.

Symptoms of BPH include: Reduced urine flow, increased frequency and urgency, dribbling, hesitancy, incontinence and excess urination at night.

Kidney stones:

Lithotripsy treatment

Switching subjects, Ruby said, a new spin has been put on the standard treatment for kidney stones with the addition of a new piece of equipment in the operating room.

The movement of a Lithotripter machine into the OR now allows physicians “to treat the site (of the kidney stone) more quickly and efficiently,” Ruby said.

A Lithotripter is a device that pulverizes kidney stones by passing shock waves through a water-filled tub in which the patient sits. In the past, a mobile Lithotripter was brought to the Somerset hospital once a week for the procedure.

Lithotripsy, a procedure that uses high energy shock waves to crush the stone into tiny pieces, is the recommended treatment for patients who have a single stone, or those who have had ongoing problems with kidney stones.

A kidney stone is a hard mass developed from crystals that separate from the urine and build up on the inner surfaces of the kidney. Stones can vary in size from a grain of sand to more than an inch in diameter. They build up gradually and can be found anywhere in the urinary tract.

In lithotripsy, the stone to be treated is targeted with the use of x-ray or ultrasound. Multiple high-energy pressure waves are then focused on the stone until it breaks into tiny particles, which can be passed naturally from the urinary system.

Mild soreness may occur at the treatment site, but most patients report little or no problems. n

        

• Click to discuss this story with other readers on our forums.