Thursday, August 14, 2014

Why Men Avoid Prostate Exams

The answer to the question of why  men avoid prostate exams isn't as simple as the obvious answer that no man in their right mind wants to feel a physician's finger go deeply into their rectum.  It's an uncomfortable and potentially embarrassing exam, but let's put that aside and look at other reasons.

Unfortunately,  men are less likely to seek out medical attention. According to The Center For Disease Control men are 80% LESS likely than a women to use a regular source of health care. It takes an illness to get the majority of men to visit a doctor and even then many men resist. Prostate cancer is a silent disease. By the time there are symptoms it's usually too late for a cure.

Thoughtful men who research the topic will find many powerful voices  stating that prostate exams will do more harm than good.The U.S. Preventative Task Force  and  the American Academy of Family Physicians came out against prostate cancer screening in men without symptoms. Even the American Urological Association came out against PSA screening in men under 40  and doesn't recommend screening between the ages of 40 and 54 for men at average risk. Visit Prostate Cancer Under 50 if you want to connect with a group of men whose lives were saved due to earlier than recommended prostate cancer screening.

It appears the medical profession wants to protect men from making bad decisions once they are given the news they have prostate cancer. According to the Mayo Clinic, somewhere between 17-50% of men who are diagnosed with prostate cancer over treat their cancer and end up suffering with a lifetime of symptoms such as the loss of urinary control or a lifetime of erectile dysfunction.

I don't understand how or why doctors would recommend that men be kept in the dark about a potentially fatal disease.  If men are making bad decisions after they are given the news they have prostate cancer, the right question to ask is: What can be done to help men make the best treatment decision based on their diagnosis rather than their fear of cancer?

Before men began to celebrate they can avoid a digital rectal exam and\or or a PSA test I believe men need to know there's been a significant jump in the number of YOUNG men dying of prostate cancer which means the Incidence of young men with aggressive prostate cancer is on the rise..

Here's  what needs to be done in order for men to do all they can so they won't die from prostate cancer. First, men need to overcome their resistance to avoid medical care when they are symptom free. Second, men need to cope with the discomfort, embarrassment, and/or  aversion to a digital rectal exam. Third, all of us lean toward  following advice you already agree with. So if you are against prostate exams you'll be glad to follow this advice:  Say Goodbye to Prostate Exams.

The only problem following that advice is that it's  possible  you could be one of those men who have an aggressive form of prostate cancer  early in your life. Therefore, skipping out on your prostate exam could be a fatal decision. That's why I believe all men should have their first PSA and prostate exam at age 30. If you are in a high risk group or have a history of prostate cancer in your family I suggest your first exam  and PSA  at age 20. I strongly prefer the adage "better safe than sorry" applies to prostate cancer screening. Here's the bottom line: Prostate Cancer Screening Saves Lives

If  you happen to be one of the 233,000 men who will receive a diagnosis of prostate cancer this year, use caution. Don't  panic and  rush into aggressive treatment. Take the time to find out whether or not your cancer is aggressive and whether you need aggressive treatment. For many men Active Surveillance is all the treatment you'll need.

Yearly Prostate  cancer screening saved my life. It could save yours.

If your cancer is aggressive and your considering surgery check out my award winning book:
I Left My Prostate in San Francisco-Where's Yours?









Friday, August 8, 2014

Keeping Men In Dark About Their Prostate Cancer

According to the American Cancer:

Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society’s estimates for prostate cancer in the United States for 2014 are:
  • About 233,000 new cases of prostate cancer will be diagnosed
  • About 29,480 men will die of prostate cancer
About 1 man in 7 will be diagnosed with prostate cancer during his lifetime.
Prostate cancer occurs mainly in older men. About 6 cases in 10 are diagnosed in men aged 65 or older, and it is rare before age 40. The average age at the time of diagnosis is about 66.
Prostate cancer is the second leading cause of cancer death in American men, behind only lung cancer. About 1 man in 36 will die of prostate cancer.
The number of younger men diagnosed with aggressive cancer is increasing. Unfortunately  there is a new threat that's emerging for men with prostate cancer. This threat comes from an unexpected source.....the medical community. 
A recent study concludes that prostate cancer screening saves lives, but casts doubt on the benefits of early screening. The U.S  Preventative Task Force came out against prostate cancer screening.
Here's the problem: Too many men are choosing to threat their cancer aggressively and suffering from unnecessary and very unpleasant life long consequences as a result of their treatment choice. In order to protect men from making bad decisions, there is a growing number of medical professionals who believe keeping men in the dark and allowing men to die unnecessarily  from prostate cancer is the solution to the problem of over treatment. From my perspective this is insanity. 
Why are too many men choosing to over treat their cancer? There is a one word answer: FEAR. When I was diagnosed with prostate cancer powerful images of pain, suffering and death came to my mind. If that's how and when men are asked to make a treatment decision they will go for the most aggressive treatment available. That's no reason keep men in the dark and permit other men to die unnecessarily of a disease that could be treated. Yet that's exactly what many in the medical community are proposing.  

As a prostate cancer survivor, I believe the right thing to do is to help men manage their fears and misconceptions about cancer,]. This will empower men  to make best treatment decision based on facts and their diagnosis rather than their fears.  Why is this so difficult for the medical community to understand? Could it be there is widespread ignorance about the emotional aspects of receiving the diagnosis of cancer? 

 In an article I wrote for Alternative Medicine Magazine I propose a way to help men get past their fears in order to make the best treatment decision. This makes infinitely  more sense than keeping men in the dark and allowing others to die. If you are considering surgery as a treatment choice or experiencing difficulty adjusting to life without a prostate check out my book I Left My Prostate in San Francisco-Where's Yours?








Thursday, July 31, 2014

Are Kegels The Magic Bullet For Developing Urinary Control After A Radical Prostatectomy?

I'll start with the bad news first, Kegels are not a magic bullet.That said, men who do Kegels before and after surgery do better with regaining urinary control than men who do no Kegels or men who begin Kegels after surgery.

After surgery I had severe urinary incontinence. I was going through 15 diapers a day. It was both physically and emotionally draining. I hated the quality of my life and more than anything I wanted to regain urinary control as quickly as possible.  Before and after surgery  I was told to do  6 sets of ten Kegels a day.

I have a philosophy in life that''s probably caused as much trouble as it's relieved. It goes like this, if 20 is good, then 200 is ten times better. I figured I could regain urinary control much faster if I went from 60 Kegels a day to a few hundred a day.

With a misplaced confidence in my philosophy and without discussing my plan with my Doctor I began my plan of performing hundreds of Kegels a day. It didn't take me long to realize I began leaking worse than before I started performing hundreds of Kegels a day. I got so discouraged and depressed I went from doing hundreds of Kegels a day to quitting completely. In other words, I gave up on Kegels.

I learned the hard way that performing hundreds of  Kegels  causes fatigue and increased leakage.  I learned this after discussing my failure with my Doctor. Based on his experience and advice, I went back to performing 60 Kegels a day.

On my  Website Survey 32% of 300 men said urinary issues were the worst part of coping with life without a prostate.

I discovered the hard way it's not possible to cut your recovery time half by doubling the amount of Kegels you perform. Here's one out of  many life issues where more is harmful rather than helpful.

I hope by reading this you are spared from the trouble and healing delay this misplaced philosophy caused me.

Here's a link to a good article about Continence After A Radical Prostatectomy

If you want more tips and insights with regard to coping with life without a prostate, check out my book on Amazon.com





Tuesday, July 22, 2014

Double Nerve Sparing Surgery-Hope or Hoax?

I believe the overwhelming majority of men who undergo double nerve sparing surgery are set up for long term disappointment. Disappointment is an understatement. In fact I'm beginning to wonder whether the expectations men are given post surgery could be considered a hoax.

A  hoax is defined as: something intended to deceive or defraud. So my question is whether or not men are receiving accurate information about the return of their erectile functioning post-surgery.

I'm aware that many men never loose their erectile abilities. As soon as the catheter is removed, they are capable of achieving an erection.  I also know of men who after a period of weeks, months, or years regained their pre-surgery levels of their erectile abilities.

I'm also aware there is a very large group of men who are either disappointed, angry, depressed or devastated by their lack of erectile abilities after double nerve sparing surgery.  Every man who is offered double nerve sparing surgery should be told the following:

"Double nerve sparing does not necessarily mean a return of erectile functioning. Even if there is a return, in all probability it will not be comparable to your preoperative abilities." 

If you received that information, you were provided with accurate information.  I believe far too many men went into surgery expecting a return to preoperative erectile functioning. There are a few reasons why this could have happened.

It's possible you were given inaccurate information. It's also possible you were told but didn't remember. Another possibility is the  issue was never discussed. Whatever the caused this gap between what you expected vs what actually happened doesn't matter in terms of the devastation men experience post-surgery.

Men who experience this expectation gap experience anger, depression, bitterness, a loss of self esteem or manhood, and relational  problems. Too man men suffer emotionally, sexually, physically, and relationally as a result of the gap between what was expected and what actually happened with regard to erectile abilities.

Make sure you understand ALL the effects that surgery will have on your sexuality. For example a man will no longer ejaculate. Spontaneous erections may be a thing of the past. No amount of visual auditory or physical stimulation will result in an erection without the use of ED medication, penile injections or a vacuum pump. Orgasms may be less intense. It's possible you'll leak urine before, during or after an orgasm.

Far too many men are choosing aggressive treatment and unnecessarily suffering some of these consequences when aggressive treatment may not be necessary.  My advice is this: Don't let fear determine how you treat your prostate cancer. Get all the medical tests necessary to give the most information possible about your cancer. If it's life threatening treat your cancer aggressively. The risks and consequences of surgery may cause you to consider other forms of aggressive treatment. If your cancer is not aggressive, seriously consider active surveillance.

If you want more information about the surgical option check out my book:
I Left My Prostate in San Francisco-Where's Yours?











Friday, July 18, 2014

Conflicting Advice For Men Regarding Prostate Cancer

Men can and should be confused about the advice and warning they receive about prostate cancer. On the one hand there is  The United States Preventive Services Task Force who recommends that regardless of age, men without symptoms should not routinely have the prostate-specific antigen (PSA) blood test to screen for prostate cancer. The logic behind this decision comes from the fact that too many men are choosing to aggressively treat their prostate cancer when aggressive treatment isn't necessary.

In other words men are basing their choice of treatment on their fear of cancer rather than the specifics of their diagnosis.  That's definitely a problem that needs to be addressed. That said, keeping men ignorant about the possibility of prostate cancer is equally dangerous.

Here's another fact men need to know before they blindly follow the recommendations of the U.S Preventive Services Task Force:
 The number of younger men diagnosed with prostate cancer has increased nearly 6-fold in the last 20 years, and the disease is more likely to be aggressive in these younger men, according to a new analysis. Typically, prostate cancer occurs more frequently as men age into their 70s or 80s. However, the researchers found that when prostate cancer strikes at a younger age, it's likely because the tumor is growing quickly.

To read the article where this quote is taken from click on this link:
Incidence of Aggressive Prostate Cancer Increasing In Young Men

I don't know about you, but when it comes to making life and death decisions I prefer to error on the side of caution. That's why I believe it's important for men, especially those men who have a family history of prostate cancer to begin screening as early as in their twenties and thirties.

The incidence of aggressive  prostate cancer found in young men is on the rise. Men need to based their decision making based on reality rather than the  ridiculous  recommendations from the Task Force. That's my take away from this, what's yours?

Saturday, July 12, 2014

Where's God When I Have Cancer?

This is in rough draft, but I wanted to post it before it's in it's finished form.

Vikor Frankl was no stranger to suffering. He survived many years in Nazi concentration camps. He witnessed and personally experienced man’s cruelty, and brutality. He noticed something different about those who gave up, or became as cruel as the Nazi’s vs those who remained kind and caring, and who fought to live under terrible circumstances. What he learned is found in some quotes from his book- Man’s Search For Meaning:

1. “In some ways suffering ceases to be suffering at the moment it finds a meaning, such as the meaning of a sacrifice.”
2. “Life is never made unbearable by circumstances, but only by lack of meaning and purpose.”
3. If there is meaning in life at all, then there must be meaning in suffering".

Frankl witnessed first hand the outcome of those in the concentration camps who found meaning and purpose to suffering vs those who gave in to their suffering by experiencing despair.  Frankl’s discovery confirms what was written centuries before he was born:

To everything there is a season,
A time for every purpose under heaven:
(Eccl 3:1)

Frankl's observation reflects a Biblical truth which applies to those  with no faith or those of any faith. Everyone has the potential to discover meaning and purpose in their suffering. That said,  the God of this universe offers some very specific ways to grow and mature though suffering. Those who choose to suffer without God will miss out on many blessings from the hand of  God.

God does not want us to waste our suffering or giving into despair. Therefore, He seeks to give our suffering meaning and purpose. A purpose that’s laid out in these two Bible verses:

My brethren, count it all joy when you fall into various trials, knowing that the testing of your faith produces patience. But let patience have its perfect work, that you may be perfect and complete, lacking nothing. (James 1:2-4)

And not only that, but we also glory in tribulations, knowing that tribulation produces perseverance; and perseverance, character; and character, hope (Rom 5:3-4)

God is working His purpose in the worst of our suffering, IF we allow Him to do so. Do not think for a moment I under estimate or make light of the suffering and pain that comes from cancer. I know the suffering can become so overwhelming, it can drive the one who is suffering or the healthy person witnessing the suffering  away from a belief in God.

 A reasonable question is what is God doing while I’m suffering?
 Believe it or not God offers you comfort. Comfort directly from heaven, and comfort through an army of comforters who've had Divine training and experience with suffering. Here's the Bible verse that confirms this:
 Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and God of all comfort, who comforts us in all our tribulation, that we may be able to comfort those who are in any trouble, with the comfort with which we ourselves are comforted by God. (2 Cor 1:3-4)

A skeptic might ask: How can I know this is real?

Paul was a man who knew all about suffering and listed some of his experiences when he wrote:
 From the Jews five times I received forty stripes minus one. Three times I was beaten with rods; once I was stoned; three times I was shipwrecked; a night and a day I have been in the deep;  in journeys often, in perils of waters, in perils of robbers, in perils of my own countrymen, in perils of the Gentiles, in perils in the city, in perils in the wilderness, in perils in the sea, in perils among false brethren;  in weariness and toil, in sleeplessness often, in hunger and thirst, in fastings often, in cold and nakedness-- (2 Cor 11:24-27)

In spite of all his suffering he wrote these words:
For I consider that the sufferings of this present time are not worthy to be compared with the glory which shall be revealed in us. (Rom 8:18)

In other words our hope is in a future what begins after we die. Death is the vehicle, which transports us to a new life and a new world.

 So we are always confident, knowing that while we are at home in the body we are absent from the Lord. For we walk by faith, not by sight.  We are confident, yes, well pleased rather to be absent from the body and to be present with the Lord. (2 Cor 5:6-8)

Those who will inhabit this world have this promise:
And God will wipe away every tear from their eyes; there shall be no more death, nor sorrow, nor crying. There shall be no more pain, for the former things have passed away."  Then He who sat on the throne said, "Behold, I make all things new." (Rev 21:4-5)

Suffering isn't meant to turn you away from God, it’s purpose is to draw you closer to God. A God who gave his only Son to die on cross, in order to pay the price for your sins and mine. By doing this, Jesus cleared the way for us to enter into a new world without sin, suffering, and death.

You can go though your experience with cancer with God or without God. You can experience meaning and purpose from your suffering or give in to despair. You can accept or reject His comfort. You can accept His offer to enter into a new world without suffering, pain and death, or reject that world.

We choose what meaning and purpose we will give to our suffering once we receive the news we have cancer. I decided to join the army of Divine Comforters. What will you do?

Wednesday, July 9, 2014

How to Cope With Life & Love Without a Prostate


I've heard from thousands of men who've had their prostate removed. I've learned where you land post-surgery in relation to urinary control and erectile functioning are not the deciding factors with regard to whether or not you wind up bitter and/or angry about the quality of your life. I've known men who never regain urinary control or erectile functioning who are grateful to be alive. They state they are closer than ever to their partners. As a couple they've explored and discovered alternative ways to have a mutually satisfying sexual life together, that does not depend on erections.

Then there are men who've lost their relationships. They have given up on sex.
Many of these men despise and blame their surgeon for ruining their lives. These men frequently state they would have preferred to die of prostate cancer than live the quality of life they have. Even though they are currently cancer free, they remain angry and bitter.
As a Medical Social Worker I was trained to look at a number of factors such as:
1. The couple's previous history of resolving crisis.
2. The current state of the couple's relationship.
3. The couple's support systems.
4. The couple's sexual history and their level of satisfaction with that prior to the dx of cancer.
5. A couple's willingness and flexibility to try different ways to satisfy each other.
6. How much of the man's erectile abilities determine how he feels about himself as a man.
7. How realistic their expectations are about life  without a prostate.
8. The couple's previous experiences with cancer.
9. The role of faith or the absence of faith in coping with prostate cancer.

These are a few of the issues that impact how well a couple will do post-surgery.
My wife and I believe hearing from couples who've walked this walk and are willing to share the tough and intimate realities of life without a prostate is very important. It's the reason we were willing to overcome our shame and  embarrassment in order to share our journey with you. From receiving the news I had prostate cancer, to the hospital and into our bedroom we share intimate details of our success, failures, and life lessons we learned along the way so other couples will  successfully cope with life and love without a prostate. You can check out our book and read a few chapters FREE by clicking this link:
http://www.amazon.com/gp/aw/s/ref=is_box_?k=i+left+my+prostate