In a new twist on telemedicine during the COVID-19 crisis, the actor Dax Shepard removed a pin from his broken hand from home, while his doctor guided him through the procedure by phone. "Yep, that feels weird,” he said, as he wiggled a 5-inch metal pin out of his hand, which is still in a cast.
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Read Morefollow-up plans to see the doctor on Friday before asking, “Am I the worst patient you've ever had?” he adds. “I'm texting you nonstop, now I'm pulling pins out?”
Known for his role in “Parenthood” and his hit podcast, “Armchair Expert”, Shephard’s other TV role is spokesperson for the Prostate Cancer Foundation (PCF). "Prostate cancer has tragically affected my life. My stepfather passed away from late-stage disease and since we became aware of his diagnosis, my wife and I have been doing whatever we can to support the great work the PCF is doing, and bringing awareness is the first step," said Shepard.
His wife, Kristen Bell’s role has included her annual TRUE Love contest. In the video (above), Shepard ironically says “Don’t DIY Your Health.”
After skin cancer, prostate cancer is the second most frequent cause of cancer death in America. The disease begins when cells in the prostate gland start to grow out of control. In 2020, about 191,930 new cases of prostate cancer were diagnosed and 33,330 men died from the disease.
Prostate Cancer: Are You At Risk?
A man with a family member who had prostate cancer is twice as likely to develop the disease. Two or more relatives with prostate cancer quadruples the same man’s change of being diagnosed. If the relative was under age 65, the risk goes even higher, according to the Prostate Cancer Foundation. A strong family history of other cancers — including breast cancer, ovarian cancer, colon cancer, or pancreatic cancer — can also put a man at increased risk and highlights the genetic component.
Researchers have identified specific genes that carry a known risk of prostate cancer. Men with these genes may need to be screened differently or consider changes in treatment.
A 2019 Harvard study found that men who ejaculate frequently throughout adulthood are less likely to be diagnosed with prostate cancer. "The hypothesis is that ejaculations, by helping the prostate to empty regularly, prevent clogging of the ducts in the prostate, which can lead to inflammation,” says Dr. Stephen Freedland, Urologist and Director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai Medical Center. “Therefore, by preventing
Dr. David Wise, a medical oncologist at NYU’s Perlmutter Center explains how the Gleason Score helps determine treatment for prostate cancer.
inflammation, it would lower prostate cancer risk."
But a healthy lifestyle to reduce your risk, says Dr. Freedland: "We have clear evidence that avoiding being obese and more physical activity can prevent death from prostate cancer. That is what I would focus on," he says. "Likewise, we know getting regular screens with PSA reduces the risk a man will die of prostate cancer. The role of ejaculations is less clear. If there is a link, this most recent paper suggests it is only for low-risk disease.”
A Prostate Cancer Diagnosis During COVID-19?
As with any cancer diagnosis during the coronavirus outbreak, the matter of treating newly-diagnosed prostate cancer has become more complex for both doctors and patients, says Dr. Freedland: "The question is ‘What is the risk of doing surgery now, in this environment, versus waiting until some future time point?’" he explained in an interview with SurvivorNet.
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Dr. Freedland stresses the importance of weighing the risks and benefits of prostate cancer surgery now. It’s a conversation your doctor should be willing to have as you collaborate on a treatment plan.
Dr. Stephen Freedland, Urologist and Director of the Center for Integrated Research in Cancer and Lifestyle at Cedars-Sinai Medical Center spoke to SurvivorNet about prostate cancer surgery during the COVID-19 outbreak.
He cites the risks of exposure to the virus in a hospital environment and limitations on protective gear and equipment for hospital staff: "It really is a discussion with the patient," Dr. Freedland says. "Can this safely be delayed for a period of time? I think the challenge is, if we knew this would be two or three months, it would be one discussion, but we don't know how long this will be delayed."
While aggressive tumors typically need surgery immediately, with many prostate cancers, surgeries can wait a few months, Dr. Freedland says. If surgery can be postponed, active surveillance — or closely monitoring the cancer while waiting — is an option.
Active Surveillance In Prostate Cancer
While some patients may be pushing for surgeries, monitoring a diagnosis can sometimes be just as effective for patients with early-stage prostate cancer. With active surveillance, patients will be watched to see if the cancer changes while in the prostate, and if it does then it will be treated.
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"With active surveillance, you preserve your normal functioning," Dr. James Brooks, a urologic oncologist at Stanford Hospital & Clinics, tells SurvivorNet. "You don't have to suffer some of those potential side effects of sexual dysfunction or urinary dysfunction."
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