Naturopathic Medicine Archives - Page 2 of 2

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.”

Naturopathic Medicine

Functional Medicine vs. Naturopathic Medicine: Which Alternative Medicine Doctor to Choose?

When making an appointment at Hill Park Integrative Medical Center, one of the first choices you will make is the choice of which doctor to schedule an appointment with. While all the doctors practicing at Hill Park are alternative medicine doctors, meaning they do not subscribe to the traditional medical model of illness management; the docs here instead stress the return to vitality and the goal to thrive as naturally as possible. However, there are subtle differences between the two types of alternative medicine doctors you find at Hill Park: Functional vs Naturopathic.

Functional doctors have graduated from an accredited medical school for Medical Doctors (MDs) and have chosen to pursue post graduate training in functional medicine. Dr. Johnson is a functional medicine doctor. Naturopathic doctors have graduated from an accredited naturopathic medical school for Naturopathic Doctors (NDs) and have had an overlapping education, but also are trained in multiple treatment modalities such as homeopathy, herbal medicine, and possibly even acupuncture from alternative medicine clinic in Sonoma County. Both often are well versed in primary care and specialties like SIBO, bioidentical hormone replacement, and adrenal dysfunction.

Overall, I believe that functional and naturopathic doctors share more similarities than differences. They both are patient centered rather than disease centered. They focus on treating a patient as a whole person and believe a patient is more than just a sum of their parts. They deviate away from viewing a patient as a collection of body systems that needs to be managed by multiple specialties such as gastroenterology, neurology, etc. Both types of alternative medicine doctors look for underlying causes and individualize treatment based on their findings. Both types of doctors use cutting edge specialty lab testing to dive deeper into your condition. They focus treatment on lifestyle medicine and nutrition and reserve medications for cases that are particularly advanced or complex. They both utilize science-based medicine to achieve goals of vitality, not merely the absence of disease. Neither follows a rote standard of care, but adjusts treatment to the needs and wants of the individual. They take often-ignored factors into account, such as environment, genetics, your existing lifestyle and diet, and emotional state of health in their treatment plans. Often, patients walk away with a few supplements and many suggestions for diet, exercise, and mind/body practices such as meditation!

The differences between functional doctors and naturopathic doctors are subtle and tend to be slight. While both use lifestyle and nutrition medicine extensively, naturopathic doctors also tend to heavily use other natural modalities such as herbal medicine and homeopathy. Functional MDs are very science based, as are NDs, but NDs also appreciate time honored traditional medicine practices such as hydrotherapy that might not have as many double blind placebo controlled studies behind them. The other main difference is insurance coverage. While Hill Park does not accept insurance for visits, oftentimes labs can be covered by your insurance. In most cases, this is no different between an MD and an ND. However, in the case of Medicare, only labs ordered by an MD might be covered.

Overall, if you are looking for a doctor that focuses on vitality and optimal health, sees you as a whole person, and takes your whole environment into account, you can’t go wrong at Hill Park, an alternative medicine clinic in Sonoma County. If you prefer a certain treatment style, check with our staff to see which doctor might be right for you. All the doctors here are well-versed in lifestyle and nutrition, care about you as a person, and want you to live optimally.

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.