The Record Special Sections Health Quarterly 02-15-2018 - Page 4

4 Thursday , February 15 , 2018 The Record
HEALTH QUARTERLY / ADVERTISING SECTION

Prostate Cancer – Does It Always Need to Be Treated ?

Options Tailored to Needs of Patients

Prostate cancer is the second most common cancer for men — one in every seven men will be diagnosed with the disease . Most patients have an excellent prognosis , with five-year survival rates exceeding 98 percent .

Treatment options for early stage prostate cancer include surgery , radiation and hormonal therapies but emerging data shows that some men may undergo active surveillance , a process of careful observation without treatment . In certain patients , active surveillance has been shown to be just as effective and provide a better quality of life than either radiation or surgery .
“ We have a multidisciplinary team of prostate cancer experts who provide carefully crafted treatment plans that are tailored to the needs of each patient ,” said Dr . Elan Diamond , medical director of Urologic Oncology at the Patricia Lynch Cancer Center at Holy Name . “ Through careful consideration of a variety of markers , we determine which men may be suitable candidates for active surveillance and which men may require more aggressive treatment . For those patients considered to be “ low-risk ,” active surveillance provides outcomes that are equivalent to surgery or radiation .”
Patients are considered low risk based on their Gleason score , a standard measure of the aggressiveness of the cancer cells obtained from a prostate biopsy . Patients with a low Gleason score — six or less — have prostate cancer cells that closely resemble normal prostate tissue . The likelihood of this type of cancer spreading beyond the prostate is extremely low . Patients that are also considered in a low risk group include those men with a small volume of low-grade cancer in the biopsy sample .
Active surveillance is a method of close observation to carefully monitor a patient for signs that their prostate cancer is becoming more aggressive . This includes blood work every three to six months , regular physical examinations , and a repeat prostate biopsy within a year of diagnosis .
Holy Name ’ s medical oncologists use several guidelines to help determine which patients are most likely to do well with active
Dr . Elan Diamond , medical director of Urologic Oncology at the Patricia Lynch Cancer Center , discusses the stages of prostate cancer with a patient at Holy Name Medical Center in Teaneck .
surveillance , including recommendations from the National Comprehensive Cancer Network ( NCCN ), the Cancer Care Ontario ( CCO ) and the American Urological Association .
“ These guidelines were formulated from an ever-growing body of evidence showing that among properly selected men with prostate cancer , active surveillance results in a survival rate that is the same as men who are treated more aggressively , but without the long-term side effects associated with treatment ,” said Dr . Diamond . “ These may include urinary incontinence and sexual dysfunction . Active surveillance represents a way for men with prostate cancer to avoid these complications while still undergoing careful observation by their physician and enjoying excellent clinical outcomes .”

HNMC Physician Promotes New Treatment for Fibroids

It ’ s a condition that is so prevalent that more than 70 percent of women have uterine fibroids by the time they are 50 . Many are unaware , suffering no symptoms , while others double over in pain , experience long excruciating periods or have trouble with fertility . Treatment options are often invasive or ineffective .

But a new oral medication may be available this spring . Ulipristal acetate ( UPA ) has shown significant results in shrinking uterine fibroids and alleviating the symptoms that affect 26 million American women .
“ It ’ s a great new option for women suffering from uterine fibroids ,” said Dr . Payal Shah , the director of the Department of Obstetrics and Gynecology at Holy Name Medical Center . “ It ’ s exciting to see how it can change the way we treat this condition .”
Uterine fibroids are noncancerous muscle tumors that develop in the uterus . They most often appear during childbearing years and can range in size from a barely visible fleck to a basketball . Some women have one , while others have multiple fibroids . The cause
is still unknown but genetics may play a role . “ At Holy Name , we are always looking for the latest advances to provide our patients with the best possible care ,” she said . “ After eval-uating each woman , we can decide which treatment is best for her . We explain all the benefits and side effects of each option and if UPA seems like it is a good fit , I will certainly be prescribing it .”
Fibroids are fueled by hormones , so current treatments include birth control pills , hormone blocking injections or a vascular procedure to block blood flow to
PHOTO COURTESY CBS NEW YORK / HNMC
Dr . Payal Shah , director of the Department of Obstetrics and Gynecology at Holy Name Medical Center , was recently featured on CBS NewYork .
HOLY NAME MEDICAL CENTER the uterus . But all of these approaches only help shrink the fibroids and reduce the severity of the symptoms , not eliminate the tumors .
The only way to remove fibroids is through invasive surgical procedures such as a hysterectomy , which isn ’ t an option for women who want to have children .
“ The pharmaceutical options all have significant side effects that some women can ’ t tolerate ,” Dr . Shah said . “ One medication basically puts patients in pseudo-menopause and women can ’ t take it if they ’ re trying to get pregnant .”
UPA works by blocking progesterone , a hormone that fuels fibroids . It is expected to be approved by the Food and Drug Administration in the spring . One of its biggest benefits is that it doesn ’ t cause the same side effects as the other medications used to treat the condition .
“ UPA is the first significant change in the treatment of fibroids in many years ,” Dr . Shah said . “ It ’ s an important development in the field of gynecology .”
4 Thursday, February 15, 2018 The Record H E A L T H Q U A R T E R L Y / A D V E R T I S I N G S E C T I O N Prostate Cancer – Does It Always Need to Be Treated? Options Tailored to Needs of Patients mine which men may be suitable candidates for active surveillance and which men may require more aggressive treatment. For those patients considered to be “low-risk,” active surveillance provides outcomes that are equivalent to surgery or radiation.” Patients are considered low risk based on their Gleason score, a standard measure of the aggressiveness of the cancer cells obtained from a prostate biopsy. Patients with a low Gleason score — six or less — have prostate cancer cells that closely resemble normal prostate tissue. The likelihood of this type of cancer spreading beyond the prostate is extremely low. Patients that are also considered in a low risk group include those men with a small volume of low-grade cancer in the biopsy sample. Active surveillance is a method of close observation to carefully monitor a patient for signs that their prostate cancer is becoming more aggressive. This includes blood work every three to six months, regular physical examinations, and a repeat prostate biopsy within a year of diagnosis. Holy Name’s medical oncologists use several guidelines to help determine which patients are most likely to do well with active P rostate cancer is the second most common cancer for men — one in every seven men will be diagnosed with the disease. Most patients have an excellent prognosis, with five-year survival rates exceeding 98 percent. Treatment options for early stage pros- tate cancer include surgery, radiation and hormonal therapies but emerging data shows that some men may undergo active surveillance, a process of careful observation without treatment. In certain patients, active surveillance has been shown to be just as effective and provide a better quality of life than either radiation or surgery. “We have a multidisciplinary team of prostate cancer experts who provide care- fully crafted treatment plans that are tailored to the needs of each patient,” said Dr. Elan Diamond, medical director of Urologic Oncology at the Patricia Lynch Cancer Center at Holy Name. “Through careful con- sideration of a variety of markers, we deter- Dr. Elan Diamond, medical director of Urologic Oncology at the Patricia Lynch Cancer Center, discusses the stages of prostate cancer with a patient at Holy Name Medical Center in Teaneck. surveillance, including recommendations from the National Comprehensive Cancer Network (NCCN), the Cancer Care Ontario (CCO) and the American Urological Association. “These guidelines were formulated from an ever-growing body of evidence showing that among properly selected men with prostate cancer, active surveillance results in a survival rate that is the same as men who are treated more aggressively, but without the long-term side effects asso- ciated with treatment,” said Dr. Diamond. “These may include urinary incontinence and sexual dysfunction. Active surveillance represents a way for men with prostate cancer to avoid these complications while still undergoing careful observation by their physician and enjoying excellent clinical outcomes.” HNMC Physician Promotes New Treatment for Fibroids I the latest t’s a condition that is so prevalent advances to that more than 70 percent of women provide our have uterine fibroids by the time they patients with the are 50. Many are unaware, suffering no best possible care,” symptoms, while others double over in pain, she said. “After experience long excruciating periods or eval-uating each have trouble with fertility. Treatment options woman, we can are often invasive or ineffective. decide whi 6'WBWr&VF6F&RfЧG&VFVB2&W7@&RF27&rVƗ&7F6WFFRU0f"W"vRW6v6vf6B&W7VG26&涖rWFW&PFR&VVfG0f'&G2BWfFrFR7F2F@B6FRVffV7G0ffV7B#b֖ƖW&6vV( ėN( 2w&VBWrFf"vVbV6F7VffW&rg&WFW&Rf'&G2( 6BG"BbU6VV0ƖRB2v@6FRF&V7F"bFRFW'FV@fBv6W'Fǐb'7FWG&72BwV6wBǒP&R&W67&&rB( ФVF66VFW"( ėN( 2W6FrF6VRr@f'&G066vRFRvvRG&VBF26FF( Ц&RgVVVB'WFW&Rf'&G2&R66W&W2W66PD4U%DU54%2Ur$0&W26GV'2FBFWfVFRWFW'W2FW7@G"6F&V7F"bFRFW'FVBb'7FWG&72BwV6w7W'&VBG&VFVG0gFVV"GW&r6F&V&rV'2@BǒRVF66VFW"v2&V6VFǒfVGW&VB4%2Wu&খ6VFR&'F6Ц6&vR6Rg&&&Vǒf6&RfV6F&6WF&6RvVfRR27FVv'WBvVWF72&RG&2&R&6rV7F2 vRFW'2fRVFRf'&G2FR6W6P( BǒRvR&Rv2rf"f67V"&6VGW&RF&6&BfrFFRWFW'W2'WBbFW6R&6W0ǒV6&FRf'&G2B&VGV6PFR6WfW&GbFR7F2BVƖ֖FPFRGV'2FRǒvF&VfRf'&G20F&Vvf6fR7W&v6&6VGW&W27V627FW&V7Fגv66( BFf"vVvvBFfR6G&V( FR&6WWF6F2fR6rЦf6B6FRVffV7G2FB6RvV6( @FW&FR( G"66B( RVF6F&66ǒWG2FVG26WVFVW6PBvV6( BFRBbFW( &RG'rFvWB&VvB( ХUv&2'&6r&vW7FW&R&RFBgVV2f'&G2B2WV7FV@F&R&fVB'FRfBBG'VpF֖7G&FFR7&rRbG0&vvW7B&VVfG22FBBFW6( B6W6RFP6R6FRVffV7G22FRFW"VF6F0W6VBFG&VBFR6FF( U2FRf'7B6vf6B6vPFRG&VFVBbf'&G2V'2( ФG"66B( ėN( 2'FBFWfVV@FRfVBbwV6w(