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Facebook Fans Learn About Prostate Health

Posted: September 28, 2016

From the effectiveness of herbal remedies to the latest studies on prostate cancer survival rates, followers of NorthBay’s Facebook page were given the latest information on prostate health during the Sept. 21 #OurDocTalk with urologist Herkanwal Khaira, M.D.

#OurDocTalk is a live Facebook chat in which interested followers who visit NorthBay’s Facebook page (Facebook.com/NorthBayHealthcare) post their questions and comments and a NorthBay doctor replies.

Dr. Khaira focused on prostate health for a half an hour during the chat.

When asked about the herbal remedy saw palmetto, for example, Khaira laid out the facts.

“Saw palmetto has been used as an herbal remedy for prostatic problems for many, many years. It is available in numerous formulations; typically you would find it in a health food store or in the ‘Men’s Health’ section of a pharmacy,” he explained. “Many of my patients swear by saw palmetto and feel that it has greatly impacted their urinary function. However randomized, placebo controlled studies have not been able to detect any significant improvement with the use of saw palmetto for prostatic symptoms. The supplement is generally safe and side effects/complications of treatment are not widely reported. The supplement is not regulated by the FDA, so there is less regulation and monitoring of manufacturers.”

Dr. Khaira was also quizzed on a recent study that grabbed headlines regarding prostate cancer survival rates, and noted that some of the reporting could be misleading.

“Certainly there has been some over-diagnosis and treatment of prostate cancer in the past 30 years. But prostate cancer remains the second leading cause of cancer-related deaths of men in America and we should not disregard screening or treatment of the disease,” he wrote. “The Urologic Oncology community has been focusing efforts on identifying the patients who would most likely benefit from treatment (thereby treating the prostate cancers which show more aggressive profiles), while monitoring prostate cancers which appear less likely to cause problems.”

Here is an edited transcript of the chat which is still posted on NorthBay’s Facebook page as well:

Q: I've heard a lot about a plant called Saw Palmetto being used for treatment of all sorts of prostate issues. What are your thoughts, Dr. Khaira? Is it safe? Effective?

Dr. Khaira: Saw Palmetto has been used as an herbal remedy for prostatic problems for many many years. It is available in numerous formulations; typically you would find it in a health food store or in the "Men's Health" section of a pharmacy. Many of my patients swear by saw palmetto and feel that it has greatly impacted their urinary function. However randomized, placebo controlled studies have not been able to detect any significant improvement with the use of Saw Palmetto for prostatic symptoms. The supplement is generally safe and side effects/complications of treatment are not widely reported. The supplement is not regulated by the FDA, so there is less regulation and monitoring of manufacturers.

Q.: Is there a home test for a mans PSA levels?

Dr. Khaira: Presently there is no FDA approved home PSA or prostate screening test. But it is the 21th century so bigger and better things cannot be far off!

Q.: A new study grabbed a lot of headlines recently after researchers reported that they followed patients for 10 years and found no difference in death rates between men who had surgery or radiation and those who relied on "active monitoring" of early stage prostate cancer, with treatment only if it progressed. What are your thoughts?

Dr. Khaira: Unfortunately this study has captured a lot of headlines lately and the articles are at times misleading. Certainly there has been some over diagnosis and treatment of prostate cancer in the past 30 years. But prostate cancer remains the second leading cause of cancer related deaths of men in America and we should not disregard screening or treatment of the disease. The Urologic Oncology community has been focusing efforts on identifying the patients who would MOST LIKELY benefit from treatment (thereby treating the prostate cancers which show more aggressive profiles) while monitoring prostate cancers which appear LESS LIKELY to cause problems.

Q.: At what age should men get their PSA level checked? How often should they do this? What is the risk if they don't do anything?

Dr. Khaira: There are numerous different PSA screening guidelines; different organizations' guidelines have gained more or less press in the past few years. The American Urologic Association Guidelines recommend for routine screening for men between ages 55-69. Men with higher risk of disease such as African American men or family history of prostate cancer should start routine screening at an earlier age typically 45-50 years. Of course this is screening for asymptomatic men. If a man has any prostatic problems or complaints, screening for prostate cancer should obviously start earlier. Screening should be annual or every other year based on the PSA number and individual patient factors. Failing to screen for prostate cancer risks allowing potentially treatable, curable disease becoming locally advanced, metastatic, incurable and possibly causing death.

Q.: I know someone with a kidney stone, not causing any problems. They do always have +2 blood in urine always. Are they connected?

Dr. Khaira: Microscopic blood in the urine can at times be related to the presence of asymptomatic kidney stones. However one should not attribute the blood to the stone without adequate workup from his/her doctor.

Q.: I've hear about a procedure called urolift. What is it and how can it help with prostate issues?

Dr. Khaira: Urolift is a newer procedure which uses minimally invasive techniques to alleviate prostate obstruction. The procedure is relatively painless and provides near immediate improvement in voiding symptoms. The procedure does not use any cutting or destructive mechanisms. Patients interested in prostate problem solutions without surgery or medicines should talk to their doctor about the Urolift procedure.