A monthly health newsletter for patients |
September 2018 |
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New prostate cancer screening guidelines released
Explains Dr. Elias Hyams, a urologist with ColumbiaDoctors, the faculty practice of Columbia University Irving Medical Center. “Urologists interpret PSA levels in the context of other risk factors such as age, ethnicity, family history, and the prostate exam. From there we determine the need for additional testing.” While a high PSA level can be the first sign of prostate cancer, there are other, less threatening conditions that can produce elevated test results. “As men age and the prostate grows, the PSA typically rises, separate from risk of cancer,” says Dr. Hyams. “This can cause false alarms.” Other benign conditions that can affect PSA include urinary tract infections, procedures on the urinary tract, certain medications, and swelling of the prostate gland (prostatitis). “Fortunately, we have a growing repertoire of tools to clarify risk in men with elevated PSA – blood, urine, imaging, and other tests to determine who truly needs a biopsy, versus reassurance.” A doctor/patient partnership Earlier this year, The United States Preventive Services Task Force (USPSTF) updated its recommendations for prostate cancer screening, saying that men should discuss PSA screening with patients in a “shared decision-making” approach, incorporating medical judgment and patient preferences. The American Cancer Society (ACS) concurs, advising that men have the opportunity to make an informed decision with their health care provider about whether to be screened for prostate cancer. The decision should be made only after examining the uncertainties, risks, and potential benefits of the screening particular to each patient. Says Dr. Hyams, “While it’s true that there are downsides to screening, we are thoughtful in how we interpret screening results, and rely on validated follow-up tests before pursuing invasive testing. Furthermore, through improvements in biopsy techniques, specifically MRI-fusion biopsy, and observational management of ‘low risk’ prostate cancers, we reduce the likelihood of over-diagnosis and over-treatment of cancers that are slow growing and not likely to cause harm.” When to start the conversation According to the American Cancer Society, age recommendations for men to initiate a discussion with their doctor about PSA screening are as follows:
If there is sufficient concern, a prostate biopsy can be performed in the doctor’s office. This is a 10-15 minute procedure done with local anesthesia. If a diagnosis of prostate cancer is made, follow-up discussions determine whether the cancer needs to be treated (slow growing cancers can often be safely monitored), and if so what type of treatment would be appropriate (often surgery or a form of radiation therapy). To find a prostate cancer specialist, call 877-697-9355 or visit doctors.nyp.org. To learn more about how NewYork-Presbyterian treats prostate cancer, visit nyp.org/cancer. |
Prostate cancer is the second most common cancer among men, and one in seven men will be diagnosed with it during his lifetime. Screening, or early detection in men without symptoms, can identify men who are at risk for problems related to prostate cancer and may benefit from additional testing. ‘PSA’ (Prostate-Specific Antigen) remains the primary screening tool, which is a blood test that measures the level of a specific protein produced by cells of the prostate gland. But many considerations come into play on whether a man should have PSA screening at all.|
For older adults, exercise can be a life extender
What should come to mind when you think of exercise is “extension”— as exercise helps extend the wellbeing of both body and mind. The best part about exercise is that it can easily be tailored to benefit people of all ages, shapes, sizes or physical limitations. Exercise is important at any age. It helps to keep our cardiovascular system healthy, improves our blood pressure, lowers risk of developing diabetes and certain cancers and also helps to improve our overall stress level and immune system. Even for those who haven’t been physically active for years, it’s never too late to start. Many older adults have medical conditions to consider, such as arthritis, high blood pressure, diabetes or heart disease. That’s why the first step is to get advice from the experts: your doctor to make sure an exercise program will be safe and beneficial for you; and perhaps a certified fitness professional who can customize an exercise plan that is right for you. So important is physical activity that it negates the commonly held notion that older adults should “take it easy” and save their strength. There are exceptions, of course, but most of the time it’s best for seniors to get out there and move around. Strength training is great because it helps to keep bones, ligaments, and tendons nice and strong. Cardio conditioning is also important because it improves energy levels and helps to improve confidence levels. Watching your diet and focusing on eating healthy may help with some weight loss but exercise will aid in losing weight faster. The fact remains that eating healthy is important but you still need to burn calories and maintain better body tone through exercising. How much physical activity do older adults need? According to the American College of Sports Medicine, the exercise standards for the adult population over 60 is to get at least 150 minutes of moderate intensity exercise per week. This can be met through 30-60 moderate intensity exercises (5 days a week) or 20-60 minutes of vigorous intensity exercise 3 days per week. Gradual progression of exercise time, frequency and intensity is recommended for best adherence and to avoid risk of injury. Exercise: good for the mind and body
In order to get the maximum benefits, it’s recommended you have to treat exercise like it is an appointment with your doctor. Physical activity needs to be done on a regular basis or else it will not work for you. Setting goals can help to be a motivator for exercising consistently. And then there’s the camaraderie factor that often builds when people exercise in groups or at clubs. It helps them stay committed and active, which is what it’s all about. For articles on fitness, visit our health library. To find a primary care doctor or weight management specialist, please call 877-697-9355. |
What comes to mind when you think of exercise? Discomfort? Sweat? Maybe you think of athletic, toned bodies lifting weights or spending serious time on a treadmill.|
Six tips to combat fall allergies
“While spring allergies are caused by tree pollen, fall allergies are caused by weeds, with ragweed being the biggest culprit,” says Dr. Soo Kwak, an allergy and immunology specialist with NewYork-Presbyterian Hudson Valley Hospital. “Ragweed season starts mid-August, with pollen counts rising throughout the course of the fall. Symptoms of ragweed allergy are similar to those caused by tree pollen — runny nose, itchy eyes, sneezing, scratchy throat and nasal congestion. The most symptomatic patients may not experience relief until after a hard frost.” In addition to ragweed pollen, there are some lesser-known triggers for fall allergies. Unseasonably warm temperatures can make allergy symptoms last longer. Mold spores can be released when humidity is high, or if the weather is dry and windy. Many patients also find that their allergies are exacerbated by mold growth after leaves have fallen. According to the American College of Allergy, Asthma and Immunology, allergies (also known as allergic rhinitis) are the sixth leading cause of chronic illness in the United States, with an annual cost in excess of $18 billion. More than 50 million Americans suffer from allergies each year. Ways to get relief There are a host of simple steps one can take along with medications designed to help alleviate the symptoms associated with allergies, regardless of the season. Advises Dr. Kwak, “Preemptive use of OTC or prescription medications early on in the season is more effective than playing catch-up after the season is in full swing.”
Finally, people should see an allergist when their quality of life is so impaired that they are unable to fully function and/or enjoy their normal lifestyle. Allergy injection therapy, also known as immunotherapy, can be very effective in preventing allergy symptoms and may decrease the need for daily medications. Says Dr. Kwak, “Patients with significant symptoms of allergies, allergic asthma and eczema, can benefit from allergy shots. Allergies can be very debilitating, but fortunately there are effective therapies available.” Think you know a lot about seasonal allergies? Test your knowledge with our seasonal allergy quiz! Find an allergist by visiting doctors.nyp.org or by call 877-NYP-WELL. |
Just when you thought it was safe to go outside more hazards await: fall allergies. While most people associate allergies with springtime, the other peak season is right around the corner.
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