Integrative Medicine

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Alternative Cancer Care, Integrative Medicine, Men's Health, Naturopathic Medicine, Uncategorized

Prostate Biopsy: Is it Necessary? How to Decide and What to Do

by Eric Yarnell, ND

If you have an elevated PSA level and it has been recommended that you have a biopsy, consider these important tips before you do.

First, it is becoming more and more clear that a prostate MRI should be done before any biopsy. There are several reasons why:

    1. Many MRIs show there is no cancer, and thus a biopsy would be a waste of time.
    2. If an MRI does show a spot that might have prostate cancer, the biopsy can be targeted to that area instead of being somewhat random.
    3. Almost always, this means a prostate biopsy can be limited to just 1–3 samples being taken, instead of the standard of 12 or more.
    4. The MRI can also show other important information such as the size of the prostate, if the seminal vesicles, urinary bladder, lymph nodes, or bones in the area are being affected.

Overall, prostate MRIs help reduce the number of prostate biopsies, which is a very good thing, while providing lots of other information ultrasound-guided biopsies can’t deliver, or aren’t as good at assessing.

It is crucial that the MRI is done on a 3 Tesla strength machine (older MRI machines had 1.5 Tesla magnetic fields and are not sufficient for seeing the prostate). If you have concerns about the contrast material used in MRIs, we have natural therapy options to help counter the low risk of side effects they may cause.

A proper MRI will give what is known as PI-RADs score. This is a standardized assessment of how likely it is that serious prostate cancer would be found on a biopsy. Generally speaking only PI-RADS 4 or 5 lesions should be biopsied, and sometimes even these prove not to be cancer. If there is only a PI-RADS 3 lesion, then usually it means no biopsy is needed and a repeat MRI should be done in a year (almost always without contrast on this follow-up imaging). PI-RADS 1 and 2 lesions never need to be biopsies.

There are other tests Dr. Yarnell can discuss with you as well to help determine if a prostate biopsy is necessary in the first place.

Second, if the MRI shows an issue or a prostate biopsy is going to happen, it is imperative that it be a transperineal, not a transrectal biopsy. Currently over 90% of prostate biopsies are done through the rectal wall, which does provide good and fairly easy access to the prostate. However, this brings with it a quite high risk of infection, including potentially deadly sepsis. This risk is so high, that the entire country of Norway has essentially abandoned transrectal prostate biopsies, and in 2021 the European Association of Urology agreed, saying only transperineal biopsies should be done. In this type, the needle or needles are placed through the skin between the base of the penis and the anus. While a bit more challenging for the urologist, it provides just as good information and is dramatically safer.

Dr. Yarnell can help explain all these options to you, and help advocate with your urologist to make sure you get an MRI when appropriate. If it appears a biopsy is recommended, Dr. Yarnell will help support you getting a transperineal prostate biopsy focusing only on problem lesions, and not a transrectal prostate biopsy or a fishing expedition all over your prostate. Furthermore, he can provide natural treatments to go with the biopsy to reduce the already very low risk of side effects even further.

Some patients are concerned that a biopsy will spread cancer. Two studies have looked into this concern with prostate biopsies. One found that while very rarely you could find evidence of prostate cancer cells in the blood after a biopsy (just 4 cases out of 42 studied). This supports the long-held naturopathic notion that the immune system can take out a few errant cells that might escape during a biopsy. Another study found that in just 2% of prostate biopsies was there any evidence of cancer cells being pushed around inside the prostate by the needle. Given that the rate of prostate cancer mortality has gone down despite the near tripling of the number of prostate cancer biopsies being performed, it is highly unlikely that prostate biopsies cause any significant amount of cancer spread. Again, Dr. Yarnell can recommend some supplements to help reduce this already extremely low risk if you wish.

If you want a forward-thinking doctor who really puts patients first, stays up-to-date on the latest findings, and can implement a science-informed natural approach to prostate problems of all kinds, then call and make an appointment to see Dr. Yarnell.

 

References

Bastacky SS, Walsh PC, Epstein JI (1991) “Needle biopsy associated tumor tracking of adenocarcinoma of the prostate” J Urol 145(5):1003–7. 

Midiri F, Vernuccio F, Purpura P, et al. (2021) “Multiparametric MRI and radiomics in prostate cancer: A review of the current literature” Diagnostics (Basel) 11(10):1829.

Moreno JG, O’Hara SM, Long JP, et al. (1997) “Transrectal ultrasound-guided biopsy causes hematogenous dissemination of prostate cells as determined by RT-PCR” Urology 49(4):515–20.

Wolinsky H (2023) “Death Spurs Country’s Shift to Safer Prostate Biopsies” Medscape Medical News, March 15, https://www.medscape.com/viewarticle/989696

Alternative Cancer Care, GI Health, Integrative Medicine, Men's Health, Naturopathic Medicine, SIBO

Gastroenterology Specialty at Hill Park

We hope this finds you well and enjoying the final days of summer. We’re reaching out with some exciting news that Dr. Eric Yarnell, ND is now seeing patients for gastroenterology concerns!

As the author of the definitive textbook of naturopathic Gastroenterology, The Natural Approach to Gastroenterology, he is one of the preeminent practitioners and teachers of gastroenterology in the naturopathic profession. As a professor to medical students and doctors for over 20 years, he is much sought after for his expertise from the medical community.

Dr. Yarnell’s specialization includes Small Intestinal Bacterial Overgrowth (SIBO), IBS, gallbladder/liver, intestinal parasites and microbiome imbalance with additional focus in identifying the underlying concerns of chronic diarrhea/constipation, gas/bloating, and abdominal pain. He is uniquely specialized in difficult cases of inflammatory bowel disease (Crohn’s disease and Ulcerative Colitis) and undiagnosed digestive problems.

Dr. Yarnell is a noted authority specializing in men’s health, gastroenterology, and herbal medicine. He is known for his extraordinary, compassionate, and personalized care for his patients. As a highly awarded and beloved doctor, mentor, researcher, and professor of Naturopathic Medicine and Botanical Medicine, it’s truly an honor and privilege to have him serve our community.

Dr. Yarnell is currently accepting new patients and will be doing in-person patient care this September.

Alternative Cancer Care, GI Health, Integrative Medicine, Men's Health, Naturopathic Medicine, SIBO

Eric Yarnell, ND at Hill Park Integrative Medical Center

Eric Yarnell, ND, RH(AHG) (Bastyr University, 1996) is a researcher and professor at Bastyr University and has been in practice for 25 years, focusing on and mentoring student doctors in men’s health, urology, gastroenterology, and nephrology, with a heavy emphasis on herbal medicines. Dr. Yarnell works to find the underlying causes of conditions and to use whatever tools are needed (preferably natural ones, saving conventional approaches only for those few cases where they are truly necessary) to support healing. 

Dr. Yarnell is chief creative officer of Wild Brilliance Press, president of Heron Botanicals, and CEO of Red Root Pharmaceuticals. He is a co-founder of the Boucher Institute of Naturopathic Medicine in Vancouver, BC. He previously served as chair of the department of botanical medicine at the Southwest College of Naturopathic Medicine. 

He has over 150 published medical articles and is the author of many of the definitive textbooks used to teach naturopathic doctors including Natural Approach to Urology 2nd ed, Natural Approach to Prostate Conditions 2nd ed, Natural Approach to Gastroenterology 2nd ed, and the forthcoming Naturopathic Nephrology.

He is a highly desired keynote speaker at educational seminars and has been the recipient of four distinguished lifetime awards in the Naturopathic Profession in recognition for his outstanding contributions to the field of natural medicine, research, botanical medicine, and education.

American Association of Naturopathic Physicians Vis Award (2014)
Naturopathic Medical Student Association Faculty of the Year (2018 and 2020)
Gastroenterology Association of Naturopathic Physicians Borborygmus Award (2020)

“Nothing is more satisfying than really listening to someone’s whole story, and helping them discover and fix the underlying cause of their problem.”

BioIdentical Hormone Therapy, Hormone Balance, Integrative Medicine, Menopause, Natural Immune Health, Naturopathic Medicine, Peri-menopause, Women’s Health

Understanding Perimenopause

Information about Perimenpause

Perimenopause is the window of time before menopause, which can be as long as a decade or more of changes prior to having a last period. The symptoms of perimenopause are often totally unrecognized by the general medical community, even though it is a time when women are seeking the most medical care. The hormonal fluctuations during this time influence change in our physical, mental, and emotional health that can significantly alter a woman’s sense of well-being as well as her relationships.

Many women are quite familiar with the symptoms of perimenopause: changes in her menstrual cycle: either heavier/lighter flow or more irregular than they have been, hot flashes or “warm rushes”, brain fog, difficulty losing weight, night sweats, joint pain, tendonitis, vaginal discomfort during intercourse, anxiety, depression, fatigue, palpitations, emotional lability, loss of libido, and a whole lot more.

One of the more challenging issues of perimenopause is that our brain can become like a “sieve” where words and tasks are easily lost, making multi-tasking a really difficult course of the day, at one of the busiest times of our lives.

Stress plays a significant role in the early onset and rapid progression of perimenopause. It is common that women will have hormone imbalance due to chronic stress while entering perimenopause, possibly worsening the symptoms and adding momentum to the process, which can have a negative impact on our fertility, and overall health.

Along with the overt symptoms, there are risks to the decline in hormones: bone thinning and osteoporosis, alzheimer’s disease, insulin resistance/diabetes, high blood pressure, and arthritis. This is an important window of time to examine a personalized “risk reduction” approach to hormone fluctuations such as family history or existing conditions so that the transition toward menopause does not have a cost on the decades of health ahead.

While some women are just moderately inconvenienced by these symptoms, they can be quite severe for other women. Often times the medical messaging is to just “live with it”, but this is pretty dated, and frankly… not sufficient. There are many treatment options that integrative medicine and naturopathic doctors offer to effectively balance hormone fluctuations and minimize symptoms while not interrupting the natural process of perimenopause.

Women have been finding their own medicines to balance their health since the beginning of time, but sometimes we need help when our own approach is not quite enough, or uncertain. After a detailed medical interview, if necessary, one of our doctors can help to test your hormones levels, along with thyroid and adrenal hormone levels, or any additional tests that may be important for you. We can then formulate a treatment course that will be personalized to your symptoms, hormone balance, and overall wellness.

Perimenopause and hormone health can be a smooth, safe, and even enjoyable experience with the support of nutrition, herbal medicine, bioidentical hormone therapy, self-care, acupuncture, and an experienced doctor to help find the right course for you. Contact us at 707-861-7300 to reach out to the office staff.

Alternative Cancer Care, Integrative Medicine, Natural Immune Health

Acupuncture & Chinese Medicine for Cancer Care

Acupuncture & Chinese Medicine for Cancer Care

Acupuncture is a beneficial and very important part of cancer care in all its stages. Chinese medicine, alone or when integrated with conventional care, can amplify the desired benefits of current treatments, prevent recurrence and metastasis of early tumors, promotes foundational health, improves quality of life, and may prolong life even in advanced stages.

Some of the successful alternative cancer care methods in Sonoma County such as acupuncture and other ChineseAcupuncture and Chinese Medicine for Cancer Care -Hill Park Medical Center medicine methods can further optimize conventional treatment outcomes by limiting side effects of surgery, radiation and chemotherapy, enhance immune function and extend one’s life. Jennifer’s experience in preventing and lessening side effects such as nausea, vomiting, fatigue, alopecia, anxiety, depression, insomnia, mouth ulcers, cystitis, skin rash, diarrhea, cardiac toxicity, hepatic toxicity, immune suppression have brought numerous patients much relief and support along their path toward healing.

Fu Zheng Therapy

Chinese Medicine has been used for the treatment of tumors for over 3,000 years. In regards to cancer care: Fu Zheng therapy is specifically applied in cancer care, which translates as “to strengthen what is correct and to secure the root”. This results in enhancing immune fortitude and preserving the function of the internal organs. This also counters chemotherapy-induced immune suppression or the decrease in red blood cells, white blood cells, and platelets.

Guiding Qi through its channels, acupuncture aims to achieve continuous balance and harmony. Over the course of time, various treatment protocols have been developed to:

  • Reduce tumor size, pain, swelling and inflammation
  • Prevent the initiation, formation and development of cancer
  • Increase the function and activity of the immune system
  • Enhance the regulating function of the endocrine system
  • Enhance and protect the structure and function of the organs
  • Strengthen digestion and absorption of nutrients
  • Improve metabolism
  • Protect bone marrow and generation of new blood cells
  • Increase effectiveness of surgery, radiation and chemotherapy and hormonal therapy
IV Therapy Support

Acupuncture can greatly augment the benefits of IV therapy, especially High Dose Vitamin C treatment. Acupuncture works synergistically with IV therapy in the overall desired effect, as well as allows each individual to relax and fully receive the benefits. Jennifer Monin provides a unique service at Hill Park Medical Center in supporting patients with nurturing and strengthening acupuncture treatments in conjunction with their IV therapy for cancer care.

Pre and Post Surgical Support

Therapeutic and reconstructive surgery often introduce a variety of unwelcome conditions including pain, anesthesia-induced nausea, bruising, anxiety, fatigue, constipation, and scarring that can be relieved with Chinese Medicine. Treatments can increase peripheral blood circulation to increase nutrient supplies, hasten wound healing, assist nerve regeneration, minimize scarring, enhance immunity, and prevent lymphedema.

Hormonal Therapy Support

Chinese medicine can support the side effects of early menopause and night sweats, decreased libido, vaginal dryness, osteoporosis, cardiovascular health.

Individualized Treatment Plans

Treatments are targeted to be effective regardless of the stage a patient is in: immediately upon diagnosis, before or after surgery, in conjunction with chemotherapy and radiation or in the following years as a supportive preventive therapy. Dietary and lifestyle suggestions are provided to promote better general health and improve long-term optimal health.

Jennifer MoninLAc has been practicing acupuncture for the past 20 years. She has extensive experience supporting individuals with cancer – including work at the National Institute of Oncology and Radiology in Havana, Cuba and as a long-time volunteer at Charlotte Maxwell Complementary Clinic in Oakland, CA. She is honored to support patients in all stages of cancer at Hill Park and is also available for treatments pre and post IV therapy.