Urologists specialize in conditions of the female and male urinary tract system, as well as those of the male reproductive organs—including kidney stones, kidney cancer, bladder cancer, prostate cancer, and erectile dysfunction.
We sat down with urologist Gerald Portman, MD, to discuss the field of urology and, in particular, prostate cancer.
What conditions might a urologist treat with surgery?
Dr. Portman: Urologic surgery, especially with the assistance of robotic laparoscopy, can be used to treat many malignant conditions. With kidney cancer that was detected early, we are regularly able to successfully treat patients and preserve kidney function. Using the latest robotic techniques, we are able to successfully treat prostate cancer, while maintaining erectile function and urinary continence. We also have the latest technologies in our office for the detection of bladder cancer, including narrow band cystoscopy. Our use of robotics allows us to perform more surgeries laparoscopically. For patients, this means shorter hospital stays, less blood loss, and faster recovery. At Englewood Health’s urology department, we specialize in urologic oncology, including cancer treatments for the kidney, bladder, and prostate. We also treat a host of benign conditions. For example, we perform minimally invasive procedures for the treatment of kidney stones and prostate enlargement.
What signs and symptoms warrant a trip to a urologist?
Dr. Portman: You might need to see a urologist if you have blood in your urine, experience pain in your flank area (upper abdomen or back and sides), have difficulty getting or maintaining an erection, or have kidney stones or an enlarged prostate. If you are considering getting a vasectomy, or if your primary care doctor detects an elevated PSA level, you would be referred to a urologist, as well.
Do urinary irregularities in men indicate prostate cancer?
Dr. Portman: Irregular urination does not mean you have prostate cancer. What you could have is an enlarged prostate and—while it should be seen by a doctor if it negatively affects your life—that alone is not a sign of cancer. In fact, you can have an enlarged prostate with no presence of cancer, and you can have a small prostate and still have prostate cancer; there is no correlation.
Is it true that people urinate more often as they get older?
Dr. Portman: It is common for both women and men to urinate more frequently with age. With men, this is typically a sign of benign prostatic hyperplasia (BPH), or enlarged prostate.
What does the term “active surveillance” mean in relation to prostate cancer?
Dr. Portman: Many patients diagnosed with prostate cancer qualify for what we call active surveillance. This means that the person has been diagnosed with cancer that is so low grade that treating it with radiation or surgery would do more harm than the cancer itself. We follow up with these patients regularly, doing blood work and biopsies, to make sure the cancer hasn’t advanced to the point where it requires treatment. In this way, we prevent the harms and side effects of the treatments themselves.
How are more advanced cases of prostate cancer treated?
Dr. Portman: Prostate cancer that is intermediate or high grade warrants a discussion with the patient about radiation and surgery. Radiation and surgery are equally effective in treating prostate cancer, so deciding which treatment is better depends on the patient’s preference, risk factors, and urinary symptoms.
Posted September 2019
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