Prostate Cancer
Urologist Dr. Edwin Youngstrom explains the risk factors, diagnosis and treatment of prostate cancer.
Featured Speaker:
Currently, the Chief of Surgery at Memorial Hospital, Dr. Youngstrom uses a personalized approach to patient care. Specializing in men’s health, urinary issues in both men and women, prostate cancer, kidney stone disease, and sexual dysfunction, Dr. Youngstrom builds an individualized care plan for each patient. He is current with the newest advances in surgical technology, performing robotic surgery with the DaVinci robot and using the latest minimally invasive techniques for common urologic issues, including GreenLight laser and shockwave lithotripsy.
In his spare time, he enjoys golfing, playing his saxophone, and most importantly spending quality time with his wife of over 10 years and four children.
Edwin Youngstrom, DO
Dr. Youngstrom is a board-certified urologist with the Dignity Health Medical Foundation. He began serving the Bakersfield community in 2016 after finishing his Urological Surgery residency at Michigan State University/Sparrow Hospital. Prior to residency, he attended the University of Pennsylvania for his Bachelor’s degree and received his Doctor of Osteopathic Medicine degree at Midwestern University’s Chicago College of Osteopathic Medicine.Currently, the Chief of Surgery at Memorial Hospital, Dr. Youngstrom uses a personalized approach to patient care. Specializing in men’s health, urinary issues in both men and women, prostate cancer, kidney stone disease, and sexual dysfunction, Dr. Youngstrom builds an individualized care plan for each patient. He is current with the newest advances in surgical technology, performing robotic surgery with the DaVinci robot and using the latest minimally invasive techniques for common urologic issues, including GreenLight laser and shockwave lithotripsy.
In his spare time, he enjoys golfing, playing his saxophone, and most importantly spending quality time with his wife of over 10 years and four children.
Transcription:
Prostate Cancer
Bill Klaproth: (Host) According to the American Cancer Society, prostate cancer is the leading cause of cancer among men after skin cancer. But it can often be treated successfully. So let's learn more with Dr. Edwin Youngstrom, urologist at Dignity Health. Dr. Youngstrom, thank you so much for your time. So prostate cancer is the most common solid organ malignancy in men, and the second leading in cancer deaths. Can you first give us some background on prostate cancer?
Dr. Edwin Youngstrom: (Guest) Well, prostate cancer does happen to be one of the more common cancers in men. One of the biggest advantages that we've had in recent years is the advent of PSA testing. Fortunately, with PSA testing, men are able to diagnose their prostate cancers much earlier and with routine testing and with early treatment the risk of death from prostate cancer has been lowered very significantly in recent years.
Host: And that PSA tests it's good to start that early so you have a baseline to go off of?
Dr. Youngstrom: Exactly. Yeah. PSA testing is recommended in all men between the ages of 55 and 70 and then certainly earlier, in men who have a family history of prostate cancer or in men who have other risk factors for prostate cancer.
Host: So as a man gets screened for prostate cancer, at what point when he needed to go see a urologist?
Dr. Youngstrom: Trigger to see a urologist is when the PSA rises above four. At that point, it's considered elevated and it's definitely worthwhile getting evaluated because there can be a lot of reasons why the PSA could be elevated. It doesn't necessarily mean that it is cancer, but certainly, cancer needs to be ruled out.
Host: So then what are the risk factors of prostate cancer?
Dr. Youngstrom: Prostate cancer tends to run in families. So the biggest risk factors are people who've had close family members with prostate cancer. Or anyone in the family who's had prostate cancer earlier than the age of 50, both of those, the number of close relatives, as well as relatives with early-onset, prostate cancer. Predisposed anyone to have prostate cancer earlier and more aggressive.
Host: So then when someone does have a history of prostate cancer in their family, when should they start to get screened versus someone who doesn't. Can you explain that to us?
Dr. Youngstrom: Sure. And the average man, without any risk factors known in the family with prostate cancer, for instance, the recommendation is to start screening at the age of 55. However, in people, with close family members with prostate cancer, the recommendation is to start at 50 or five years earlier than the age of onset of the earliest family member to get prostate cancer. So if someone in the family had prostate cancer diagnosed at the age of 50, we recommend starting PSA screening at the age of 45.
Host: That makes sense okay. And then can you explain the screening process to us, what is all involved in that?
Dr. Youngstrom: Well, the screening process is pretty simple. The most important test is the PSA blood test, which is just a routine blood draw. as well as the prostate exam. at your doctor's office, just to feel the contours of the prostate, make sure that the prostate's feel smooth and symmetric, and that there aren't any lumps and bumps or nodules, which may suggest the presence of prostate cancer.
Host: And then Dr. Youngstrom, I'm wondering about the treatment options for prostate cancer. I've heard that there's various ways to treat this. Can you explain those options to us?
Dr. Youngstrom: Absolutely, the favorable aspect of management of prostate cancer is that there are various different treatment modalities for prostate cancer, and that allows the patient to really direct his own care. The first option offered to patients, especially patients who have low-risk prostate cancer or in men who, elect not to actually treat the prostate cancer is something called active surveillance. This allows the doctor and the patient to closely monitor the patient's PSA and symptoms if any and to determine whether or not this patient can get by without actually treating prostate cancer. There is a subset of men with prostate cancer where that cancer will never progress or in men who have other health conditions that are competing for attention. That need to take precedence prior to treatment of prostate cancer and active surveillance can be a very good option for some of these men. Another option for prostate cancer is radiation. There are two different types of radiation generally, and, that includes radiation from outside the body delivered toward the prostate. That's called external beam radiation therapy or seed implantation, which is a short, one-time surgical procedure where radioactive pellets are implanted within the prostate for treatment of prostate cancer. A third option is also prostatectomy, and this is a surgical procedure where the entire prostate is removed and the benefit to that in some men's eyes is that the whole prostate is removed, limiting the need for future treatments.
Host: Let me ask you this. And I've heard this and you can certainly clarify that sometimes it's better to be under active surveillance. You just don't want to go in and go, okay, we're going to cut it out because that could be worse for the patient then just watching it through active surveillance, if it is a low risk and really not growing, is that true?
Dr. Youngstrom: Yeah, that is true. like any treatment option, there are always side effects. Those side effects for treatment of prostate cancer, whether it's radiation or surgery include primarily, urinary pattern changes as well as erectile dysfunction. And while that these side effects aren't necessarily guaranteed and even if they exist, that can often be treated, they can be bothersome. Active surveillance allows the patient the opportunity to just keep an eye on this low-risk disease, which may end up not having any real impact on their day to day life and therefore they avoid the side effects for treatment of prostate cancer.
Host: Okay, well, that makes sense. So thank you for explaining that to us. So it's really on an individual basis and how aggressive the cancer is and you and your physician would have a discussion to approach this the best way possible for that particular patient. And let's talk about the importance of routine follow-up. It sounds like you don't want to have that PSA done and then wait 10 years to have it done again, it sounds like routine follow-up to monitor that PSA level is a good idea is that right?
Dr. Youngstrom: Yeah, it's generally recommended that the PSA test is repeated yearly with the physical exam, the prostate check, because although the number of four is what we use as our cutoff, generally speaking, certainly patterns of change in the PSA or, the prostate exam can also trigger further evaluation and management and not to mention once treatment for prostate cancer has begun we still follow the PSA blood test after treatment, just to keep an eye on the levels, keep an eye on the trend and make sure that the cancer stays away.
Host: So regular follow-up is very important. And then last question, Dr. Youngstrom, and thank you for your time. Anytime you get a cancer diagnosis, that is very frightening, but it sounds like when it comes to prostate cancer, there are treatment options available. So it's best to take a deep breath and have that conversation with your doctor is that the important message I'm getting from you?
Dr. Youngstrom: Yeah, that was the most important thing I think when being diagnosed with any major medical problem, but certainly with prostate cancer is to take a deep breath and have a good conversation with your doctor. As it pertains to prostate cancer, specifically, there are a lot of different treatment options, and prostate cancer in general, even the more aggressive types tend to be slower growing than other types of malignancies, other types of cancers. It's good to take a deep breath, bring a notebook and a pen and really work on the different options because, on one hand, it's great that there are so many options, but that also brings up a lot of questions and a lot of comparisons. So you need to really understand what you're dealing with.
Host: Yeah, that's really good advice and certainly a great recommendation to do that. Dr. Youngstrom this has really been informative. Thank you so much for your time today. We appreciate it.
Dr. Youngstrom: Thank you very much. It was my pleasure to be here.
Host: That's Dr. Edwin Youngstrom. And for more information, please visit dignity health.org/bakersfield. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is Hello Healthy, Dignity Health podcast. I'm Bill Klaproth. Thanks for listening.
Prostate Cancer
Bill Klaproth: (Host) According to the American Cancer Society, prostate cancer is the leading cause of cancer among men after skin cancer. But it can often be treated successfully. So let's learn more with Dr. Edwin Youngstrom, urologist at Dignity Health. Dr. Youngstrom, thank you so much for your time. So prostate cancer is the most common solid organ malignancy in men, and the second leading in cancer deaths. Can you first give us some background on prostate cancer?
Dr. Edwin Youngstrom: (Guest) Well, prostate cancer does happen to be one of the more common cancers in men. One of the biggest advantages that we've had in recent years is the advent of PSA testing. Fortunately, with PSA testing, men are able to diagnose their prostate cancers much earlier and with routine testing and with early treatment the risk of death from prostate cancer has been lowered very significantly in recent years.
Host: And that PSA tests it's good to start that early so you have a baseline to go off of?
Dr. Youngstrom: Exactly. Yeah. PSA testing is recommended in all men between the ages of 55 and 70 and then certainly earlier, in men who have a family history of prostate cancer or in men who have other risk factors for prostate cancer.
Host: So as a man gets screened for prostate cancer, at what point when he needed to go see a urologist?
Dr. Youngstrom: Trigger to see a urologist is when the PSA rises above four. At that point, it's considered elevated and it's definitely worthwhile getting evaluated because there can be a lot of reasons why the PSA could be elevated. It doesn't necessarily mean that it is cancer, but certainly, cancer needs to be ruled out.
Host: So then what are the risk factors of prostate cancer?
Dr. Youngstrom: Prostate cancer tends to run in families. So the biggest risk factors are people who've had close family members with prostate cancer. Or anyone in the family who's had prostate cancer earlier than the age of 50, both of those, the number of close relatives, as well as relatives with early-onset, prostate cancer. Predisposed anyone to have prostate cancer earlier and more aggressive.
Host: So then when someone does have a history of prostate cancer in their family, when should they start to get screened versus someone who doesn't. Can you explain that to us?
Dr. Youngstrom: Sure. And the average man, without any risk factors known in the family with prostate cancer, for instance, the recommendation is to start screening at the age of 55. However, in people, with close family members with prostate cancer, the recommendation is to start at 50 or five years earlier than the age of onset of the earliest family member to get prostate cancer. So if someone in the family had prostate cancer diagnosed at the age of 50, we recommend starting PSA screening at the age of 45.
Host: That makes sense okay. And then can you explain the screening process to us, what is all involved in that?
Dr. Youngstrom: Well, the screening process is pretty simple. The most important test is the PSA blood test, which is just a routine blood draw. as well as the prostate exam. at your doctor's office, just to feel the contours of the prostate, make sure that the prostate's feel smooth and symmetric, and that there aren't any lumps and bumps or nodules, which may suggest the presence of prostate cancer.
Host: And then Dr. Youngstrom, I'm wondering about the treatment options for prostate cancer. I've heard that there's various ways to treat this. Can you explain those options to us?
Dr. Youngstrom: Absolutely, the favorable aspect of management of prostate cancer is that there are various different treatment modalities for prostate cancer, and that allows the patient to really direct his own care. The first option offered to patients, especially patients who have low-risk prostate cancer or in men who, elect not to actually treat the prostate cancer is something called active surveillance. This allows the doctor and the patient to closely monitor the patient's PSA and symptoms if any and to determine whether or not this patient can get by without actually treating prostate cancer. There is a subset of men with prostate cancer where that cancer will never progress or in men who have other health conditions that are competing for attention. That need to take precedence prior to treatment of prostate cancer and active surveillance can be a very good option for some of these men. Another option for prostate cancer is radiation. There are two different types of radiation generally, and, that includes radiation from outside the body delivered toward the prostate. That's called external beam radiation therapy or seed implantation, which is a short, one-time surgical procedure where radioactive pellets are implanted within the prostate for treatment of prostate cancer. A third option is also prostatectomy, and this is a surgical procedure where the entire prostate is removed and the benefit to that in some men's eyes is that the whole prostate is removed, limiting the need for future treatments.
Host: Let me ask you this. And I've heard this and you can certainly clarify that sometimes it's better to be under active surveillance. You just don't want to go in and go, okay, we're going to cut it out because that could be worse for the patient then just watching it through active surveillance, if it is a low risk and really not growing, is that true?
Dr. Youngstrom: Yeah, that is true. like any treatment option, there are always side effects. Those side effects for treatment of prostate cancer, whether it's radiation or surgery include primarily, urinary pattern changes as well as erectile dysfunction. And while that these side effects aren't necessarily guaranteed and even if they exist, that can often be treated, they can be bothersome. Active surveillance allows the patient the opportunity to just keep an eye on this low-risk disease, which may end up not having any real impact on their day to day life and therefore they avoid the side effects for treatment of prostate cancer.
Host: Okay, well, that makes sense. So thank you for explaining that to us. So it's really on an individual basis and how aggressive the cancer is and you and your physician would have a discussion to approach this the best way possible for that particular patient. And let's talk about the importance of routine follow-up. It sounds like you don't want to have that PSA done and then wait 10 years to have it done again, it sounds like routine follow-up to monitor that PSA level is a good idea is that right?
Dr. Youngstrom: Yeah, it's generally recommended that the PSA test is repeated yearly with the physical exam, the prostate check, because although the number of four is what we use as our cutoff, generally speaking, certainly patterns of change in the PSA or, the prostate exam can also trigger further evaluation and management and not to mention once treatment for prostate cancer has begun we still follow the PSA blood test after treatment, just to keep an eye on the levels, keep an eye on the trend and make sure that the cancer stays away.
Host: So regular follow-up is very important. And then last question, Dr. Youngstrom, and thank you for your time. Anytime you get a cancer diagnosis, that is very frightening, but it sounds like when it comes to prostate cancer, there are treatment options available. So it's best to take a deep breath and have that conversation with your doctor is that the important message I'm getting from you?
Dr. Youngstrom: Yeah, that was the most important thing I think when being diagnosed with any major medical problem, but certainly with prostate cancer is to take a deep breath and have a good conversation with your doctor. As it pertains to prostate cancer, specifically, there are a lot of different treatment options, and prostate cancer in general, even the more aggressive types tend to be slower growing than other types of malignancies, other types of cancers. It's good to take a deep breath, bring a notebook and a pen and really work on the different options because, on one hand, it's great that there are so many options, but that also brings up a lot of questions and a lot of comparisons. So you need to really understand what you're dealing with.
Host: Yeah, that's really good advice and certainly a great recommendation to do that. Dr. Youngstrom this has really been informative. Thank you so much for your time today. We appreciate it.
Dr. Youngstrom: Thank you very much. It was my pleasure to be here.
Host: That's Dr. Edwin Youngstrom. And for more information, please visit dignity health.org/bakersfield. And if you found this podcast helpful, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is Hello Healthy, Dignity Health podcast. I'm Bill Klaproth. Thanks for listening.