Diagnosed with prostate cancer? Know your options.

Prostate cancer is the second leading cause of cancer death in men in the U.S., but many men never know they have it. That’s why screening is so important.

“Some prostate cancers are slow growing and low risk. It may be years before they cause any symptoms or health problems,” says Cleveland Clinic urologist Ryan Berglund, MD, who treats patients at Hillcrest Hospital, Willoughby Hills Family Health Center and main campus. “For some men with these low-risk cancers, the potential side effects are enough reason to hold off on any treatment. They choose to practice active surveillance, closely monitoring the cancer’s progress over time.”

For prostate cancers that are more aggressive, treatment may be needed sooner than later. An imaging study will likely be done to determine the extent of the cancer, and if it has spread.

The type of treatment is largely the choice of the patient, his family and physician. Treatment options include: • Surgical removal of the prostate and lymph nodes. • External beam radiation – high-energy rays are emitted

from a machine outside the body.

• Brachytherapy – small “seeds” that release radiation

when inserted into the prostate.

• Cryotherapy – a probe is used to freeze and kill

cancer cells.

• High-intensity ultrasound – high-energy sound waves

kill the cells.

• Focal therapy – destroys small tumors in the prostate

using different noninvasive techniques.

“Men diagnosed with prostate cancer should know that advances in treatment have resulted in one of the highest survival rates of any type of cancer,” says Sam Haywood, MD, a Cleveland Clinic urologist who treats patients at Hillcrest Hospital and main campus.

To make an appointment with a Cleveland Clinic urologist on the East Side, call 216.444.5600. Walking is something we take for granted. But when foot or ankle cartilage breaks down from arthritis, just a few steps can be painful. Cleveland Clinic orthopaedic surgeon Sara Lyn Miniaci-Coxhead, MD, shares the latest procedures that can give you relief.

Relief for big toe arthritis

Synthetic cartilage implant uses a contact lens-type material to replace the cartilage (cushioning material) that’s worn away in the great toe.

Pros and cons of cartilage replacement include: • Maintains range of motion. • 92% success rate after five years. “For most patients, success means pain relief,” says Dr. Miniaci-Coxhead. • Can be converted to a great

toe fusion if necessary. • May not work for those with

bunions.

The alternative is to fuse the big toe to the adjacent bone. Fusion has a 95% success rate but limits range of motion.

Options for arthritis-related ankle pain

“The first replacement ankle joints, designed in the 1970s, were less successful,” says Dr. Miniaci-Coxhead. “But newer devices are more successful.”

Pros and cons of ankle replacement include: • Alleviates pain in 80–90% of cases.

• Maintains range of motion.

• Not an option for patients with nerve damage in

their feet.

The alternative, ankle fusion (permanently connecting the bones at the point where cartilage has worn away), has similar success.

“If you have pain or difficulty walking, talk to an orthopaedic specialist,” says Dr. Miniaci-Coxhead. “There is always something we can do!”