4 • SPRING 1995 ISSUE
■
SINAI HOSPITAL
HealthNews
S PECIAL ADVERTISEMENT
Prostate Cancer More
Common Than You Think
en today are keenly aware
of a small, walnut-shaped
organ that few gave any
,., thought to in previous gen-
erations. Expanding right along with
knowledge about the prostate gland
and its cancer-bearing potential are
male anxiety and confusion.
Prostate cancer is very common in
men over 50, yet "more men will die
with it than of it," says Michael Lutz,
M.D., Chief of the Section of Urology at
Sinai. Sorting out who has prostate
cancer and how it should be treated re-
quires the experience and knowledge
of a urologist.
Sinai Hospital participates in a free,
national early-detection program every
fall. The men who take advantage of it
receive a digital rectal exam and a
serum prostate specific antigen (PSA)
test. These two tests help determine if
further studies should be done.
Because the treatment
for prostate cancer can af-
fect a man's urinary habits
and sex life, it is especial-
ly important for the pa-
tient to be an active
participant in the treat-
ment plan. Once a diag-
nosis is confirmed, the
urologist takes into con-
sideration a man's age,
race, health status, per-
sonal and family histories,
and appropriate test re-
sults that evaluate the
extent of disease when
determining the proper
course of treatment.
The American Cancer
.Society and the American
Urologic Association rec- Patient education
ommend that men should
be evaluated annually between 50 and
• 70 years of age with digital rectal ex-
amination and PSA blood test. In
African-Americans, there is a higher
incidence of aggressive prostate can-
cer. Therefore, these men should begin
annual examinations at age 40, as
should men of any race who have a
close blood relative with prostate can-
cer.
'There are often no symptoms at the
time of diagnosis, so it is essential that
prostate cancer be detected as early as
possible," Dr. Lutz says. "Men are not
doing themselves a favor by skipping
the yearly rectal exam done by their
primary care physician."
If a diagnosis of prostate cancer is
made, Dr. Lutz suggests that the pa-
tient explore all the options with his
physician. These include surgery,
radiation, medical therapy and obser-
vation. Observation may be appropri-
ate for a man whose life expectancy
would not exceed greater than 10 years.
Patients found to have localized dis-
ease will benefit by interventions de-
termined by their unique clinical
situations.
The decision-making, and any pre-
scribed treatment, are expertly guided
by a urologist. "It's very important that
the patient learn all the reasonable
risks and trade-offs," Dr. Lutz says.
Combining more than one mode of
treatment is sometimes recommend-
ed. Also, experimental programs for
treating prostate cancer are available
for men who are not successfully treat-
ed by traditional methods.
"If he opts for treatment, he will
want to be in an atmosphere, such as
at Sinai, where the radiation thera-
pists, oncologists, and urologists all
work together," Dr. Lutz concludes.
Men can take advantage of Sinai's ex-
perience in treating prostate cancer pa-
tients. There are support groups
available too.
Support groups give patients an op-
portunity to voice their concerns with
others who face similar challenges. Peo-
Patient education and emotional support are special features of this program.
Special Program for Breast Care
continued from page 2
is an important component of treatment.
ple get encouragement from one an-
other while learning new strategies for
coping with a multitude of fears and
adjustments an illness can require.
People often develop new friendships
as a result of support groups, cheering
one another on through particularly
difficult times. While support groups
can be a necessary forum for express-
ing sad feelings, overall the message
that patients share is hopeful. Devel-
oping and maintaining a positive
attitude are encouraged.
Groups are important because they
decrease feelings of isolation so fre-
quently experienced with illness.
Advice is often more readily accepted
from someone who has been in the
same boat. When it comes to under-
standing the emotions associated with
illness, patients are often the experts
and need one another as much as they
need their healthcare providers.
"This teamwork offers the best we
have to give," according to Dr. Lutz.
The healthcare team, including med-
ical specialists and the patient, needs
to work together for the optimal ben-
efit of the patient.
cer counselor for emotional support, a
pathologist, cancer specialist nurses with
knowledge of rehabilitation, and the pa-
tient's primary care physician (family
practitioner, internist, or gynecologist).
This program • is currently being
offered at Sinai's Hechtman Health Cen-
ter in Bingham Farms. When the pro-
gram moves to West Bloomfield in July,
it will be expanded to include on-site
mammography.
"A woman will come to a single loca-
tion," Dr. Phillips explains. "We bring
the doctors to her; she doesn't have to
go out to a lot of different offices or facil-
ities. The visit may begin and end with
a screening mammogram and breast
examination. If this breast tissue X ray
is negative, with no suspicion of disease,
she's on her way."
If the mammogram results are ab-
normal or disease is suspected, more
detailed tests can be done on-site. Oth-
er sophisticated testing with minimal
invasion include ultrasound, fine needle
aspiration, stereotactic core biopsies, and
X ray localization procedures.
The team meets to evaluate the re-
sults of clinical examination and test re-
sults, diagnose, and make treatment
recommendations. Treatment may in-
clude surgery, chemo-therapy, and ra-
diation therapy. Physical therapists and
cosmetologists may be consulted and
asked to review the case.
"Within days of her diagnosis, the pa-
tient has had the benefit of learning and
understanding what breast cancer is,
what the available treatment options
are, and has received the support of the
cancer counselor and the team. The plas-
tic surgeon is also available to provide
the best reconstructive procedure for
her." says Dr. Phillips. This means that
she is actively participating in the deci-
sion-making process and it assures that
all of her needs are being addressed. This
translates into superior, user-friendly
healthcare.
With this wealth of information, the
patient can make a reasonable and
truly informed decision about her treat-
ment. "The educational component — in-
cluding lectures and programs to help
people understand breast health — will
make this a very comprehensive breast
care program for this community," Dr.
Schwartz says.
"We're all excited about this," Dr.
Schwartz says of himself and his Sinai
colleagues, "because it combines up-to-
date technology and an integrated team
working together, consolidating efforts
and expertise. This can help make a
better outcome in patient satisfaction,
convenience and, ultimately, results."
The most amazing part, from the pa-
tient's point of view, is the time element.
From the time of diagnosis, through all
the planning, testing and the surgery, to
being back at home, only one to two
weeks have passed. The effort is so well
choreographed at the hospital and the
patient is so well prepared, she will
typically go home within 24 hours of her
surgery.
"There are very few community hos-
pitals which offer anything like this," Dr.
Phillips says. "This approach is usually
only seen in some university settings."
He adds that this program is designed
to serve any breast problem, not just
cancer. Furthermore, patients and their
doctors are free to seek a consultation
for a second opinion. All patients who
consult with this program at Sinai will
return to their own doctors with more
information provided by an impressive,
experienced team of professionals.