Cranberry juice and urinary infections

Cranberry Juice May Prevent Bacteria From Developing In The Urinary Tract.

WebMD (8/23, Woznicki) reported, "Scientists report that within eight hours of drinking cranberry juice, the juice could help prevent bacteria from developing into an infection in the urinary tract." Scientists at the Worcester Polytechnic Institute made that observation after growing "strains of E. coli in urine collected from healthy people before and after they drank cranberry juice cocktail." In short, investigators "discovered that in petri dishes, cranberry metabolites in the juice prevented E. coli from sticking to other bacteria, limiting its ability to grow and multiply."

Occupational risk for bladder cancer

Something I suspected all along (see article below)

Painters Found to Have Increased Bladder Cancer RiskAnd risk appears to increase along with more time in occupation

TUESDAY, July 20 (HealthDay News) -- Occupational exposures in painters are associated with an elevated risk for bladder cancer, a risk that increases with years on the job, according to research published in the August issue of Occupational and Environmental Medicine.

Neela Guha, Ph.D., of the International Agency for Research on Cancer in Lyon, France, and colleagues conducted a meta-analysis of 41 studies encompassing more than 2,900 incident cases or deaths from bladder cancer, including two cohort studies, nine record linkage studies, and 30 case-control studies. The researchers pooled data and adjusted for smoking and other occupational exposures. Results were stratified by study design, gender, and study location.

Compared to unexposed subjects, the researchers found that painters had an overall 25 percent increase in bladder cancer risk (based on all 41 studies), a 28 percent increased risk after adjusting for smoking (based on 27 studies), and a 27 percent increased risk after adjusting for other occupational exposures (based on four studies). After the researchers stratified by gender, study design, and study location, the results were still robust. They also found that bladder cancer risk was higher for those employed as a painter for longer periods of time.

"Because several million people are employed as painters worldwide, even a modest increase in the relative risk is remarkable. It is important for cancer control and prevention to design studies with more specific exposure assessment that quantifies individual agents or classes of agents to identify the underlying carcinogenic agents encountered in painting," the authors write.

PCA3

The PCA3 urine test is becoming a useful test for the diagnosis of prostate cancer. See article below. Refer to the website www.PCA3.org for the most up-to-date information.

Cleveland Clinic To Use Progensa PCA3 Test For Prostate Cancer Screenings.

The Cleveland Plain Dealer (7/20, Townsend) reports that even as "the quest for a better, more accurate prostate cancer screening test continues," the Cleveland Clinic "is the latest of a dozen centers across the country to offer the Progensa PCA3 test," which is "one of the latest, more accurate, such tests." PCA3 detects the presence of the gene of the same name, "which shows up in urine only when a man has prostate cancer." The gene is found "in more than 90 percent of prostate cancer cases," the paper says. Over 30 men have received the test and "about half of those tests" have indicated the need "for a follow-up biopsy." Clinical trials for the test "have ended," and Gen-Probe Inc., one of the developers, is preparing to file its regulatory application with the FDA by fall.

provenge

Several patients have inquired about Medicare coverage for the recently approved drug, sipuleucel-T(Provenge) for the treatment of metastatic castrate-resistant prostate cancer. The Centers for Medicare and Medicaid is performing a "national coverage analysis to determine whether autologous cellular immunotherapy is reasonable and necessary under certain sections of the Social Security Act". More information will be forthcoming as it becomes available

TOP DOC

Dr. Frank was recently named one of New Jersey's Top Doctors in the urology category by New Jersey Monthly magazine. Watch for the listing in the November 2010 edition.

NEW for 2010 continued

PCA3 urine test A specific urine test to stratify patients having elevated PSA's at risk for prostate cancer. The specimen is collected and prepared in the office before it is processed at a specialized laboratory. The results are returned to our office usually within 48-72 hours.

Gardasil vaccine for men. In 10/09, the FDA approved Gardasil for boys and men 9-26 years of age for the prevention of genital warts. The vaccine is available in our office for administration.

Greenlight laser for BPH (benign prostate enlargement) The numbers of procedures for this successful outpatient modality continue to increase as patient satisfaction and "word of mouth" are the guiding forces directing patients away from the traditional TURP (transurethral resection of the prostate).

Bladder outlet and prostate enlargement Medications to treat the prostate continue to enter the market offering patients more options to treat non-invasively. Flomax, Uroxatral and now Rapaflo, a new entry is available in the pharmacological treatment of poor urinary flow secondary to prostate enlargement.

Urgency incontinence The market is flooded with a range of choices. Older medications include ditropan, oxytrol, enablex and detrol. Newer entries include Vesicare, Sanctura and now Toviaz and Gelnique offer patients more options.

NEW for 2010

It is clear that the overall trends in urology continue in the direction of non-invasive, in-office and outpatient treatment of many urologic conditions.

Vasectomy My personal observation is that there is a definite increased interest in couples choosing vasectomy as a mode of permanent contraception. I suspect this may be partially impacted by the economy and the expense of having additional children.

Prostate cancer screening The recommendations for an annual PSA have been revised. A baseline PSA is now recommended in men beginning at age 40 (formerly a PSA blood test was performed on men starting at 50 years of age). Our in-office blood test can provide a result in an astounding 11 minutes.

NMP22 urine test The only non-invasive, in-office urine test approved by the FDA for the diagnosis of bladder cancer in patients with blood in the urine. The result is obtained in 30 minutes.