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Dr. Manny: Expert Advice on Prostate Cancer

As men get older they start to pay more attention to their health. In recent years, prostate health has become a focal point for many men.

In the U.S., prostate cancer is the second leading cause of cancer death among American men. So no wonder more and more research is being done on this subject. Some researchers have found a protective effect associated with a high intake of fish oils--eicosapentaenoic (EPA) and dorosahexaenoic acid (DHA).

At least five studies have linked selenium with a reduced risk of prostate cancer.

And now a new report finds that curry --yes, the spice -- might also have a preventative effect. Curry contains the chemical curcumin, a yellow pigment which has demonstrated significant cancer preventive qualities, according to studies done at Rutgers University.

Since 1994, the rate of prostate cancer diagnoses has increased by 2-3 percent a year, although death rates have declined. Coincidence, or are these therapies working? Or is raising awareness-- educating men about risks, detection, treatment, etc. -- finally paying off? Are men finally getting over the embarrassment of asking questions about their prostate?

(By the way, to all of you men out there, you should not be embarrassed to ask about anything that has to do with your health. Whatever it is you may be embarrassed to ask about, just get over it! You are not the only one... there are others out there... )

We asked an expert for her thoughts on the subject. Dr. Debra L. Fromer, M.D., is chief of the Center for Bladder, Prostate, and Pelvic Floor Health at Hackensack University Medical Center in Hackensack, N.J.

What are the latest screening tools for prostate cancer in 2006?

Dr. Fromer: There has been nothing this year that has supplanted the "gold standard" in prostate cancer screening: PSA and digital rectal examination. Newer variations of the PSA test are available and show promise, as do urine screening tests for prostate cancer, but none of these have been shown to be more effective in screening that PSA and DRE.

Are there any alternative treatments or natural medicines that would treat an enlarged prostate?

Dr. Fromer: There are plant extracts, such as Saw Palmetto, that have been proven effective in treating the symptoms of prostatism.

Patients complain that as they get older, they have to urinate in the middle of the night. Is this a sign of prostate disease?

Dr. Fromer: Nocturia may be a sign of an enlarged prostate and/or overactive bladder in aging men.

What are the pros and cons of prostate surgery?

Dr. Fromer:

BPH Surgery:

1. TURP (Transurethral Resection of the Prostate) is a procedure whereby the obstructing prostatic tissue is removed through a scope using electrocautery.

PRO: Highly effective in treating the symptoms of enlarged prostate-"gold standard." Enables tissue diagnosis

CON: Usually requires overnight stay, general or spinal/epidural anesthesia; Potential of bleeding, excessive fluid absorption, retrograde ejaculation

2. LASER TURP: obstructing prostatic tissue is ablated using laser (Holmium or PVP)

PRO: Also highly effective in treating symptoms; Less risk of bleeding; Patients can be discharged home on day of surgery without catheter

CON: No tissue diagnosis; Requires general/spinal/epidural anesthesia

3. OFFICE-BASED PROCEDURES (TUNA, TUMT, ILC): ablation of obstructing prostatic tissue using a variety of energy forms (Microwave, Radiofrequency, LASER)

PRO: Can be done under local anesthesia in office without admission to hospital

CON: Not as effective as TURP in long-term outcomes; many procedures require prolonged catheterization (3-7 days)

4. PROSTATE CANCER SURGERY: Radical Prostatectomy (can be done laparoscopically and/or robotically)

PRO: Tissue diagnosis, can evaluate pathologic stage. Depending on stage, can have excellent cancer-free survival rates, which may be superior to radiotherapy in the long-term.

CON: Requires general anesthesia, with 1-3 day hospital stay; Catheter required for 5-10 days after surgery; Risk of incontinence, erectile dysfunction, urethral stricture, bleeding

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Do you have a question or comment for Dr. Manny? Email him at drmanny@foxnews.com, and he may answer you in this column or on the air. Don't forget to watch Dr. Manny on the Fox News Channel.

FOX News medical contributor Dr. Manny Alvarez is the Chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in Hackensack, N.J., and is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City. He appears on FNC's daytime programs FOX & Friends and Dayside.

Dr. Manny Alvarez serves as FOX News Channel's (FNC) Senior Managing Editor for Health News. Prior to this position, Alvarez was a FNC medical contributor.
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