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Episode 11

Category: GatekeepersofMen Series

Treatment Options for Prostate Cancer

Prostate Cancer Treatment Options

The purpose of the Movember movement is to create awareness among MEN and women regarding prostate cancer. I want to emphasize how important it is for men to go to their urologist and get their prostates checked.  We all know women tend to be more responsible than their male counterparts when it comes to their medical care and health.   Why?   Us Men feel we are invincible, strong, machos, heroes, the main character in the movie, and silverback gorillas. Moreover, it isn’t until we start feeling very sick or have multiple problems, that we decide to go to the doctor.

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Movember and Prostate Cancer Awareness


Time to create Awareness of Men’s Health Issues!

Movember (from the Australian-English diminutive word for mustache , “mo”, and “November”) is an annual movement involving growing of moustaches during the month of November to create awareness of men’s health related issues including Prostate Cancer, Testicular Cancer, Men’s Health and suicide prevention.

Therefore, I have decided to dedicate this month’s #GatekeepersofMen series to the Movember movement.  Let’s start off with Prostate Cancer.

How common is prostate cancer?

Prostate cancer is the second most common cancer in men (skin cancer being the most common).  The American Cancer Society estimates that about 1 out of 9 men will be diagnosed with the disease during his lifetime.   That number is staggering!  Think about it, if you are in a get-together event with 8 of your male friends, one of you will be diagnosed with prostate cancer!

Moreover, older men and African-American men have a higher risk of developing cancer in their prostate.  60% of cases are diagnosed in men older than 65 years old, and it is extremely rare for men under 40 to be diagnosed.  Regarding race: 1 of every 6 African-American men develop prostate cancer.

Who is at risk?

  1. Age: The risk of developing prostate cancer increases with age.  This is why we encourage men older than 50 years old to ask their doctors about screening.
  2. Family History: If someone in your family (brother, father or son) was diagnosed with prostate cancer you have a 2 to 3 times higher risk of developing the disease.
  3. Race: Studies show that African American are at higher risk of developing prostate cancer.
  4. Smoking: Just as with other cancers, smoking increases your risk of developing prostate cancer.

What are the symptoms of prostate cancer?

Unfortunately, not everyone experiences symptoms. Many of the “signs and symptoms”  coincide with BPH and these include:

  • Urinary frequency, especially during the night
  • Difficulty starting urination
  • Difficulty holding the urge to urinate
  • Weak stream
  • Blood in the urine or semen

One symptom: frequent pain of the lower back, hips or upper thighs, could be an indication that the cancer is already spreading. Therefore, it is crucial that us men start the screening process when indicated.

What does Prostate Cancer Screening involve?

  1. PSA test:  PSA stands for prostate specific antigen. PSA is a chemical that ONLY the prostate produces into the bloodstream.  When PSA is found elevated in a blood test, it indicates that there is increased activity of the prostate. In some occasions, that increased activity may indicate that there is uncontrolled cell growth which means, cancer is growing.
  2. DRE:  DRE stands for digital rectal exam.  Yes. It is a necessary tool that urologists use to help detect the presence and aggressiveness of prostate cancer even though nobody likes this test.  Why?  Not all prostate cancers show an elevated PSA. Therefore, we don’t want to miss a cancer that may be growing even when the PSA is within normal limits.

When should I start screening?

The most common question that I receive from friends, family, and patients is: when do I need to start screening for prostate cancer? Basically, if you are a MALE above 50, talk to your doctor about screening.  Most importantly, if you are African American or have family history of men with cancer in their prostate, you should consider screening starting at 45 years old.

In Conclusion…

If you are a male above 50 years old, are African-American or have a family member with history of prostate cancer, you should visit a urologist.  Early detection is key!  Studies show that more than 98% of prostate cancers are curable if detected and treated early.   If it is detected late, the chance of survival beyond 5 years can be as low as 26%.

In our next post I will be talking about how prostate cancer can be treated. If you are looking for a urologist, come visit us.  We are eager to meet you and help you retake the reigns of your life.  You are in control!

This article was authored by Dr. Jonathan Clavell. Dr. Clavell is an urologist who specializes in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH.

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Penile Implants, 10 Most Common Questions

September is Sexual Health Awareness Month

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For those of you who have been following my most recent posts, this month I have focused on topics related to Sexual Health.  Why?  September is Awareness Month for Sexual Health. And, as an expert in the field of Sexual Medicine and Men’s Health, I wish to help you optimize that very important aspect of your life.  Therefore, today I wish to talk about a very important therapy not many men know or talk about.  I will address the 10 most common questions regarding the penile implant or prosthesis.

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Hey Man, Are you to blame?

Hey Man, Are you to blame?

September is Sexual Health Awareness Month. 

I recently ran into an article published at the NY Times titled “Why a Woman’s Sex Life Declines After Menopause”.

What really caught my attention was the second part of the title “Hint: Sometimes It’s Her Partner”.    Now,  if you are a man above 45 years old, and you are reading this, get ready! This post will create a PARADIGM SHIFT in your relationship and attitude towards not only your partner and sexual health, but your OVERALL HEALTH.    Yes, believe it or not, research proves that sex is a reflection of your mental, cardiovascular and overall health.

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When “Not Lasting Long Enough” is the Problem

Should you be able to “last longer” in bed?

I recently saw an article published in a well-known Men’s magazine which mentioned that one of the most common Googled questions about sex was “how to last longer in bed” with more than 60,000 searches per MONTH.  Suddenly, I knew I had to write about this since there are many things that men should have clear and know.

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Penile Rehabilitation: Life After Prostate Cancer

The American Cancer Society estimates that 1 out of 7 men will be diagnosed with prostate cancer during his lifetime.  Nevertheless, 5-year survival rates after treatment of localized prostate cancer approximate 98%.   Yes, you read it correctly.  When diagnosed early and the cancer is still localized within the prostate, there is almost 100% chance you will be cured. 

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Five Most Common Complications Associated to BPH

How an Enlarged Prostate can affect your overall health

Benign prostatic hyperplasia, also known as BPH, is a prevalent condition that affects approximately 50% of men over 50 years old and up to 90% of men after the age of 85.  Many men with BPH have bothersome symptoms. Others, simply do not have bothersome symptoms, either because of lack of awareness or simply they just get used to them.  Every week I meet men in my office to whom I ask “How is your urination?”  and their response is “Normal for my age, I guess”.  Then, when I keep inquiring they have a wide array of issues and that is why I will focus today on BPH complications.

Middle Aged Man

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hCG and Testosterone levels

hCG and Low Testosterone Treatment in Houston, Texas

Several weeks ago, I had the opportunity to go back to where I grew up:  Puerto Rico.  My younger brother got married in a magnificent place between the mountains and the beach.  While I was there, I had so many memories, one of which was: how good I felt when I used to live there.  I used to travel around the island during the day to explore the different beaches, mountain trails, rivers and rainforests, among other things.  At night, had the energy to be able to go partying with friends and dancing with my then girlfriend (now wife), and then wake up early in the morning the following day, ready for work without feeling exhausted. Why?  I worked out regularly, maintained myself healthy and my testosterone levels were at their highest peak.   

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Finding Optimal Testosterone Levels

Low Testosterone – Finding Optimal Levels

As men, we live in a very interesting time.  Our bodies are aging prematurely and become more fragile by the second.  You might wonder, why is that happening?   With social media, youtube, and TV entertainment at its highest, a sedentary lifestyle is limiting the mobility and exercise that our bodies need.  Then you add the constant assault from our environment and combine it with stress, lack of sleep and poor nutrition, and you end up with a fragile body without energy.   This premature aging, constant fatigue and lack of energy, in some instances, makes us question our own masculinity. Men’s health declines and because we are too busy running our daily lives, we don’t even pay attention to how we feel.  Ten, 15, 20 years pass by and then we realize that we not only feel old, but we ARE old. And all this time, our bodies lived in a desperate silence, longing for you to speak up, talk to someone about it, and look for help.  However,  there is hope.  That lack of sexual desire, loss of energy, constant fatigue has an explanation… Low Testosterone.

The stone-cold hard truth is: without testosterone, a man is not a man.

Man with High Testosterone

What causes low T?

Although there are many organic and pathological causes for low T, one common cause that most do not account for is AGE.  Research studies have shown that once we reach 30 years old, testosterone starts decreasing by 1 to 2% in every man.  However, some men are more sensitive to those decreases than others.

How common is it?

The prevalence of low T varies depending on the research study.  However, there was a recent study that showed that up to 40% of men lived with sub-optimal T levels.

Sub-optimal levels… what do you mean?

Testosterone levels carry a wide range of what is considered “normal levels” according to the laboratory, doctor who is evaluating you and, of course, insurance companies.   This range is, on most occasions, anywhere between 300 and about 1000.  However, imagine a 30 year-old man who used to live 5 years ago at the 700-800 range,  drop to a level of 350. How do you think he will feel?  At the same time, imagine a 65 year-old man with a level of 700…  Even though both are within a “normal level”, who do you think is at an optimal level and who is at a sub-optimal level?  The answer is a bit obvious.  When we try to box everyone within such a wide range, many men end up living in a sub-optimal level with a long list of symptoms.

For this reason, in our office, we do not check to see if you are within the normal range.  We focus on finding what is the optimal level for you.  We help you ‘listen’ to your body. In every visit: I will ask you how is your level of energy, how are your sleeping patterns, how is your sex drive, how are your erections, etc.  This way, together, we help you reach your optimal level to live life at its fullest.

This article was authored by Dr. Jonathan Clavell. Dr. Clavell is a urologist specialized in men’s health including erectile dysfunction, low testosterone, Peyronie’s Disease and BPH.

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