Mark Scholz MD Prostate Oncology Specialists Marina del
Rey
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Common Sense Health Advice 1. Prostate cancer screening: PSA
blood test 2. The annual physical exam 3. Physical fitness &
longevity 4. Sexuality and aging 5. Sensible vitamins and
supplements
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Prostate. Produces semen that aids sperm transport Prostate
gland is susceptible to: Infections Enlargement Cancers
Prostate
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Prostate Cancer Most common cancer in men Lifetime risk of
diagnosis = 1 in 6 men 230,000 new cases each year 30,000 men die
each year
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Common Questions about Prostate Cancer What is prostate cancer?
Abnormal cells that replicate within the prostate, and have the
potential to spread throughout the body What are symptoms of
prostate cancer? Generally no symptomsPSA is the only way to detect
prostate cancer early
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PSA Blood Test Since PSA testing started 25 years ago prostate
cancer deaths have decreased 40% What is an abnormal PSA? Greater
than 2.5-8.0, depending on the mans age and the size of his
prostate Problems with PSAabnormality of PSA is not always from
prostate cancer Benign prostate enlargement of aging Prostate
infections Recent sexual activity
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The Good The GoodPSA Blood Test Detects prostate cancer at an
early stage when it is curable Gets men to the doctor for a general
health check ups
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The Bad PSA Causes Too Many Prostate Needle Biopsies
One-million men undergo biopsy every year Biopsy frequently
diagnoses Low-Grade prostate cancer, a harmless condition that does
not require treatment, a condition you would be better off not
knowing about it Abnormal PSA should lead to a prostate scan with
MRI or color doppler ultrasound, not an immediate biopsy
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The Ugly The UglyRampant Overtreatment of Low-Grade Prostate
Cancer 85% of men diagnosed with the Low-Grade prostate cancer
receive treatment with surgery or radiation, even though they dont
need it Treatment with surgery or radiation frequently causes
permanent sexual and urinary problems The prostate cancer treatment
industry is out of control!
Vaccines: Centers for Disease Control Recommendations Flu
vaccine annually 40,000 deaths annually Dont forget the flu
antibioticTamiflu Pneumovax vaccine one time for men over age 65
Pneumonia: 1 million hospitalized and 50,000 deaths annually
Zostavax one time after age 60 Cuts lifetime risk of shingles from
one out three to one out of six
AtherosclerosisHardening of the Arteries Plaque that ruptures
causing heart attacks and strokes Cholesterol Good Cholesterol: HDL
Bad Cholesterol: LDL Triglycerides: Less Important Total
Cholesterol: Almost irrelevant
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ABCs of Primary Prevention A = Anti-platelet Therapy (Aspirin)
30% reduction in cardiovascular death B = Blood Pressure Reduction
25-30% reduction in MI and cardiovascular death C = Cholesterol
therapy (Statin medication: Crestor, Lipitor) 32% reduction in
mortality
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Declining Mortality Rates from Heart Disease and Cancer
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The Challenge in Diagnosis of Coronary Heart Disease The
majority of people destined to die suddenly will not have a
positive exercise test. The likely reason that they will die
suddenly is that only a mild, non-flow - limiting coronary plaque
will have been present before the sudden development of an
occlusive thrombus. - Stephen Epstein New England Medical Journal
1989
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Fast Scan Times Minimal Radiation Instant Results Cardiac
CT
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WHAT DOES CORONARY ARTERY CALCIFICATION MEAN? Atherosclerosis
present in this vessel Higher levels of coronary calcium correlate
with higher risks Zero calcification (none seen) suggests a very
low probability of obstructive disease and less than 1% chance of
heart attack and stroke over the next 5 years
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Who Should Have this Test? Low risk men over 45 Higher risk men
over 35 with one or more of the following: Diabetes High Blood
Pressure Smoking High Cholesterol Family History of Heart
Disease
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Poor Fitness Just as Dangerous As. JAMA Wei Oct 1999 Smoking
Diabetes Hypertension High Cholesterol
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Fitness Reduces. Cardiovascular deaths Cancer deaths Depression
Osteoporosis Fatigue Obesity
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90% 60% 75% Normal 10-year Survival Normal People Over 60
Jonathan Myers NEJM 2002
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Male Sexual Dysfunction Can be an early sign of atherosclerosis
Weight loss Fitness BP control Cholesterol treatment Low male
hormone levelstestosterone deficiency? Genuine proof that God is a
truly loving God Cialis 5 mg daily Viagra 100 mg when the time is
right
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Female Sexual Dysfunction Women lose their testosterone at
menopause (age 50) Libido in women depends on testosterone (like
men) Testosterone helps improve mood, energy and lean body mass
(fat loss) Normal testosterone levels AND LIBIDO can be restored
with bio-identical hormone therapy Joseph Sciabbarrasi MD
310-268-8466 Karen Sun MD 949-768-6780 Nicole Garcia MD
949-491-8312 Uzzi Reiss MD 310-247-1300
Vitamins and Supplements Vitamin D 2000 units daily Fish Oil
Two grams daily Vitamin C 500 mg daily Co-Enzyme Q-10 200 mg daily
(if taking a statin)
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Health Care Pitfalls Doctors that are too busy Necessary tests
never get ordered Information gets lost or overlooked Doctors too
greedyHealthcare gimmicks abound Doctors uninformedMedicine is
evolving so rapidly no one can keep up with all the changes. You
have to be alert and do your own research. Always get a second
opinion before making a major health decision Watch out for doctors
who motivate patients through fear, rather than by providing
sensible explanations Good health is not an end in itself. Medical
care should be only a Pit Stop along the road of life
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Conclusion 1. Properly performed annual physical exam can
detect treatable conditions early and reduce the risk of illness
and untimely death 2. Physical fitness has a far larger impact on
longevity than most people realize 3. Sensible application of
modern medicine used wiselyprolongs life and quality of life
