All material provided is for informational purposes only. It is not intended to be a substitute for a physician's consultation.
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CONTACT INFORMATION
Patrick E. Wherry, MD Inc.
2505 Samaritan Drive
Suite 201
San Jose, CA 95124-4009

Bus: 408.356.7089
Fax: 408.356.0890

Email: Dr Wherry

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REFERENCE LINKS:
 
Vasectomy
Coloplast
American Medical Systems
Auxilium
Northern California Prostate Cancer Center
Urological Surgeons of Northern California
Prostate Cancer

Prostate Cancer ... learn more


Prevention of cancer development and of cancer progression ...these include

  • lifestyle changes such as diet and exercise
    • usually very difficult to implement
    • if followed, do have a major impact
    • that which is “heart healthy is also prostate healthy”
  • nutritional supplements
    • easy to use but often of questionable benefit
      • Selenium
              ...use < 200 mcg/day
              ...most multivitamins contain an adequate dose
              ...can measure via blood test or toe nail clippings
      • Lycopene
              ...benefits and risks remain inconclusive
              ...best obtained from food sources (tomatoes, watermelon)
              ...despite being the best anti-oxidant, probably the least useful
    • ASA
      • commonly known as aspirin
      • probably of some prostatic benefit
      • criteria for use has changed...can increase the chance of a hemorrhagic stroke
    • Some that are in common use may actually increase risk. These should be used only in safe amounts.
      • Vitamin E ...do not exceed 400 IU /day
      • Zinc ...try not to go above 25 mg/day
              ...this may increase the risk of aggressive prostate cancer
              ...it is best if this is not used over what is found in a multivitamin
  • medications
    • the types, and the indications, have changed
    • some have proven to decrease risk of prostate cancer
      • Multi-vitamin ...cheapest is best
      • Vitamin D ...400 IU bid
      • Statins ...they all seem to work about equally.
              ...3 are on patent
              ...3 are off patent and less costly
              ...cheapest may be best

Diagnosis

  • PSA total, free and velocity (rate of change)
    • at present these have proven to be the most effective ways to suspect microscopic prostate cancer
    • however, there are inherent and significant false positive, and false negative, detection errors
    • the end result is a statistical risk-benefit choice
  • Prostatic biopsy
    • it is not possible to diagnose prostate cancer without this procedure
    • is done in the office and is almost painless (local anesthetic is routinely used)
    • most patients are very apprehensive ...if needed appropriate oral sedation can be given
    • does have risks of bleeding and infection ... fortunately both are infrequent and treatable
  • biopsy results
    • these are reviewed in detail, in the office, with the patient and if he wishes any other party
    • a copy of the results, and appropriate ancillary, information will be supplied...this will include data on the Gleason grading scores and the TNM staging system
    • if required, further testing (to complete the staging) and a follow-up visit will be arranged

Treatment

  • the treatment algorithm combines the DRE (digital rectal examination) findings, the PSA (total, free, velocity) serum level, the Gleason grading score and the TNM staging system.
  • The correct treatment choice will maximize cancer free survival while minimizing the side effects of therapy.

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