Joaquin Carballido

1. Lately they have increased my desire to urinate, where until recently could stand for hours without going to the service. Is it a symptom of something?

To properly answer this question is very important to know the age of the person who raises, because the symptoms when urinating, and specifically the increased frequency may be due to many causes. Prominent among them the benign growth of the prostate, urinary infections, some processes associated with aging itself and, less commonly, diseases tumorales. Tampoco forget that if the disturbance is transient may be related to some change in habits life or drug therapy initiated

2. Good afternoon, Joaquin. My CONCERN WITH RESPECT TO THE PROBLEMS OF MY FATHER IS THE FOLLOWING: A few days ago, the urologist who follows him told him he had to do a biopsy, AND it had detected a lump in IT. OTHERWISE, THE PSA MY FATHER IS LESS THAN 4 (slightly more than 1, as I recall). DO YOU BELIEVE, THAT THE FOLLOWING THAT MY FATHER MUST BE SUBMITTED prostate operation?

In the diagnosis of prostate cancer, and more specifically the opportunity for biopsy or not, poses many difficulties in practice. Urologists are accustomed to handle primarily PSA figures, your changes with the passage of time, the volume of the prostate, rectal and data coming from other imaging tests. The combination of all this is what has greater diagnostic yield. In the specific case that you raise is probably the most appropriate information that comes from own digital rectal examination, and experience of the urologist who treated his father. Probably the instruction he provides is based on touch and for that reason, being pathological, the indication for biopsy is appropriate, despite normal PSA. Obviously, the biopsy does not mean surgery on the prostate.

3. Hi very good, I'm 26 years old and it follows that I have been diagnosed chronic prostitis. It seems that for an infection I had. I worry about his development and a possible complication, type prostate cancer. How can I improve the state of my prostate? Thanks

The care of young patients with regard to the pathology of the prostate is associated mainly with chronic prostatitis. Should be noted that not all are infectious and inflammatory nature that are more common, in terms of frequency. Therefore, linking chronic prostatitis with bacteria infection is not always correct. When diagnosed properly, the evolution is favorable but not immediate and therefore we must be prudent and consistent with the treatment prescribed by the urologist. At present, need not bear any relation to their condition with a complication of tumor type.

4. GOOD AFTERNOON, how does a double COMBINED RADIATION THERAPY AND CHEMOTHERAPY? THANKS

At this time, the evolution of some prostate cancers may require treatments which exhaust all the possibilities of arrest of the tumor process and for that reason may be that a patient receives hormone therapy, radiotherapy and chemotherapy. However, the most important message in these circumstances is that the treatments are usually staggered, and adapt to changes (in most cases lso chronic) disease. Options Association avant-garde since the beginning of the disease are not yet sufficiently developed.

5. at end of urination, a little blood stain every time 80 days

Any presence of blood in connection with urination should be properly valued, but the significance can be very variable. In his case, it is noteworthy that the emergence periods are long, and seems to only happen at end of urination. The suggestion is that from analytical determinations in urine can indicate whether this blood is present more frequently and from that data, initiate a study to rule out pathology in the urethra or the prostate itself.

6. Dr.Carballido, it is true that cyclists are more prone to prostate cancer?

There is enough scientific evidence to support this statement concluded. What is certain is the theoretical relationship between practice, both cycling and mountain-bike, with the possible appearance of discomfort in the anatomy of the perineum, which runs from the scrotum to the anus, and is secondary to minor knocks and injuries eproducen s over the area to make the aforementioned sports. These symptoms can mimic or even lead to congestion and inflammation in the prostate gland.

7. Doctor, what are some beneficial properties of the pumpkin seed or its oil to treat prostate tumors or prevention?.

This question leads to express the importance that the future will have the prostate cancer prevention. This prevention hypothetically be achieved through diet, lifestyle and drugs with hormonal mechanisms of action. At present, especially in American societies, there is an unusual interest in developing epidemiological studies that highlight the prevention of disease. Fortunately many of them have scientific designs well suited to draw valid conclusions, but as it is easy to guess, the time for these demonstrate effective preventive strategies must be long and therefore must be cautious with the information that exists about but it is certainly encouraging.

8. What is the hope of survival for a patient being treated with chemotherapy because the tumor has spread to bones and lymph and hormonal therapy did not work? Thank you very much.

Treatment options exhausted hormonal manipulation are rare, yet currently are developing new strategies with proven drugs on bone metabolism and also on the rate of tumor growth. These drugs, mainly bisphosphonates and taxanes, are changing the course of the disease at the stages you mention and wait for them better than traditional ones so far and more effectively on the possible complications of the disease.

9. Good afternoon: I'm 40 years old, my father had prostate cancer and his brother 3 years ago también.Tengo diagnosed prostatitis and I recently conducted a vasectomía.Con this picture What do you advise to prevent prostate cancer? Thanks

The challenge would be if early diagnosis, but relating it exclusively with family history. The history of prostatitis and vsectomía not be regarded as something that overshadow what you call the "big picture". In any case, without magnifying the importance of family background, it is advisable that after 45 years appropriate revisions start with a urologist who will guide you on time.

10. is rectal PRARE TACRO idispensable be verified prostate after age 55, or only need the PSA blood sample

It depends on the clinical scenario in which you raise this question. The highest diagnostic yield is obtained with the combination of DRE and PSA. Two separate tests have limitations for diagnosis, but if the PSA data is from an analytical and is routinely performed in the normal range, your doctor may direct you to complete and timely information, since PSA values should be interpreted within the own normal ranges.

11. Dr what people are more prone to prostate cancer? (if it is hereditary, triggers testicular cancer operation ..?) Many thanks and a greeting from a congressman.

Risk factors for prostate cancer are mainly family history and race (blacks have a higher risk than white). Other cultural factors have less relevance in our environment. A history of testicular surgery in any case do not increase the likelihood of prostate cancer.

12. Hello doctor. My grandfather died of prostate cancer. I'm 35 now. When should begin monitoring the issue on my part? It is convenient to measure PSA in the annual analysis of my business? Thank you.

At his age should not worry about the possibility of having prostate cancer. From 45 and with the aim of establishing an early diagnosis is no exaggeration to include the PSA in their corporate annual checkups. The background tells you referred to his grandfather and not his father, and this should help to reassure him.

13. What are the first affected by a noticeable symptoms without medical knowledge, and from what age sulen occur?

Interestingly, in the initial phase of the disease, it is usually not have any symptoms, and therefore a suspected diagnosis can not be established unless prodigue clinical examinations (DRE) or analytical (PSA). At this point we can say that in the absence of risk factors, screening in healthy male population is not justified. There are interesting epidemiological studies with long follow-up and large population of Europeans, who help in the future to further clarify this issue.

14. Good afternoon, doctor. My father was taking medication for a year because I had trouble urinating. After seeing it did not work you have done further testing and have been told they need surgery because it appears to have a tumor. My question is if after all this time can be extended and the tumor or even being on time to cure. My father is 67 and healthy.

Would need to know what kind of "tumor" is you refer. The explanation is as follows: prostate, when it grows, and its benign nature, is called benign prostatic hyperplasia and this is the most common benign tumor of the male over 50 years lso. In this case, the only thing his father that there had been a progressive growth of this benign tumor, a circumstance that occurs in a group of patients and may require surgery. On the other side of the spectrum is the "tumor" malignant or prostate cancer, which in most cases is slow growing and progressive, and therefore with good medical supervision is usually predict or prevent what you fear, ie the extent of the tumor. Treatment options are varied and not both cure and control of the disease may raise his father (67 years) for relatively long periods.

15. For BPH, the urologist has prescribed me 1 tablet daily of a beta blocker, are there any contraindications? Which ones? "If one day something happens does not take the capsule? Are there alternative non-surgical treatments? Thanks and best regards from Cordoba

In this case we speak of benign prostatic hyperplasia and prostate cancer not. What you been prescribed by a urologist is a blocker and contraindications are minimal. Different alpha-blockers and a blanket the only complication that should be considered is the slight modification of the figures for blood pressure (orthostatic hypotension) and according to which patients may be more or less sensitive to the onset of symptoms. Are treatments where compliance is important, and should not forget your daily dose. Precisamete and according to your question, these and other pharmacological treatments are those that are considered alternative to surgery.

16. Until now I have operated my prostatic hyperplasia by the consequences it entails, essentially powerless. A few months ago my PSA went up and I had to do a biopsy whose result was positive but I've heard of green laser operation what you think about this intervention? Is it true that no side effects?

The information you have of powerlessness in relation to surgery for benign prostatic hyperplasia is not consistent with reality as it occurs in percentages are not representative and also do not know exactly the mechanism by which it occurs. This information has nothing to do with what happens in the case of radical surgery for prostate cancer, a condition in which the appearance of impotence deserves further discussion. Now you have been diagnosed with prostate cancer and should follow the signs to timely apprise his urologist, based on clinical data such as PSA level, gland volume, tumor type, age and so on. The operation "green laser" to which you refer, is considered within the new treatments for BPH, as emerging therapy. And to give my impression of this technique I would like to have more information regarding the monitoring of patients operated in this way. I encountered more at the recent congress of the American Urological Association and I think actually it is a treatment modality that deserves close seguimieto by some of the virtues attributed to him because it would expand treatment options for these patients although the long term monitoring are essential.

17. Why that occurs in most prostate cancer in the testes and these were to have greater role?

The theories that relate to the greater or lesser incidence of tumors are not related to the degree of organ function. Testicular tumors and prostate stem cell clusters from morphological and functional characteristics are radically different, and the biological behavior of their tumors as well.

18. At what age must be the first review?

In the presence of risk factors or urinary symptoms, it is appropriate to consider revising from 45-50 years. As a rule, this statement is prudent and timely manner, never forgetting that the epidemiological significance and impact of prostatic disease on quality of life and the welfare of patients are omnipresent current and ongoing review.

Farewell

Traditionally, it is true that the man did not like talking about his prostate pathology. this concept must change and it is doing. There is a dimension of prostate pathology hitherto unappreciated, but which undoubtedly has a transcendent social or health impact. The strategies of early diagnosis and recognition of the biology of advanced prostate cancer significantly. In this sense, prevention, optimization of tratameitnos currently available and early identification of malignant tumors with the highest potential within individual prostate cancers, can look to the future with optimism concerning a condition whose incidence and prevalence is increasing . The information generated by good health care at all echelons of care and commitment to growing traditional and urologist are improving substantially the "prostate health" of our boys.