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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
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The New Year’s Cleanse

With the beginning of a new year, our resolutions to live the most vital and healthiest life are often renewed. The most common resolutions are to lose weight, assume healthier eating patterns, and get back in the gym. These are all great resolutions, and everyone should strive to be a better version of themselves. However, there can be a sneaky roadblock you might not even notice that increases the difficulty in achieving these goals – environmental toxicants.

Over the holidays, we often stray from our typical diet: eat less vegetables, drink more alcohol, exercise less, and eat so much more sugar than we usually do. We are also cooped up inside, often with fireplaces. All of these factors, and more, can overburden your body’s ability to eliminate waste from the cells and also from our environment. These toxicants are often stored in fat and can hijack our best attempts to lose weight.

So how do we overcome this hurdle and feel better, gain more energy, and achieve the most weight loss? We can do a short detox once life is a little more settled. Our detox involves a few facets to make sure your body has the proper tools it needs to clean out the toxicants, eliminate them, and start with a clean slate moving forward.

Step one is to give your body high quality nutrients and ingredients. We want to give your body the best, most efficient fuel we can provide for the energy needed to keep our brains healthy and cells clean. We also will use food to decrease inflammation (step 2), which can gum up the works and make the body work sluggish. We’ve found that just by decreasing the amount of inflammation in the body, a person can lose up to 10 pounds.

Step 3 involves making sure we can properly and efficiently eliminate the toxicants. If we skip step three, it is like we are cleaning out a closet without trash bags. You can get it done, but the room will be a mess for much longer while you slowly work to eliminate the junk. Our plan involves giving your body the nutrients, natural medicines, and the tools necessary to package up the toxicants and efficiently eliminate them.

Most people on our detox program notice vast improvement in brain function, energy, skin vibrancy, and overall well-being – all while being several pounds lighter. So instead of just working yourself to death to lose some weight, let our alternative medicine clinic in Sonoma County partner with you to help clean out your body’s closet, find sustainable healthy living practices, and lose some weight in the process.

We wish you a peaceful, prosperous, and healthy 2019!

 

 

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Keys to Maximize Exercise Recovery

Keys to Maximize Exercise Recovery

By Dr. Michaela Falkner

Exercise in some form is always an essential part of any health regimen. But, how do you keep at it when you are sore from your last gym session? The very physiology of exercise involves inflammation, muscle breakdown, and lactic acid buildup. So, how do you get back at it sooner and safer than before?

Before starting any regimen, its best to talk with your doctor and discuss options for faster recovery and a healthier you. Here are some quick tips by alternative medicine physicians in Sonoma County help to alleviate muscle soreness, decrease inflammation, and keep you at your peak:

Magnesium Gel
  • Magnesium is great at increasing blood flow, decreasing cramps, and helping your mitochondria (powerhouses of your cells). We can only absorb so much magnesium through our gastrointestinal tract before it can cause diarrhea. A way to concentrate magnesium to a specific area is magnesium gel. This can decrease inflammation and alleviate cramps and soreness when applied topically. Magnesium can also be optimally absorbed through vitamin injections, such as our Active Body vitamin injection.
Contrast showers
  • Many athletes swear by ice baths after a tough workout. There are increasing studies showing that muscles recover faster and performance increases when contrast baths are used. Contrast showers are easy to do at home. You run a hot shower and stand in it for about 5 minutes. Turn the water to cold and stay under it for 30 seconds. Repeat this 3 times. A study of rugby players showed that athletes performed better and reported being less sore the day after contrast baths versus 5-minute ice baths.
Castor oil
  • Topical castor oil is amazingly anti-inflammatory and can be used for everything from detox, to hormone balancing, to aching joints and muscles. Just be careful, it stains!
Herbal formulations
  • There are many herbal formulations you can make yourself and find that offer great relief from muscle soreness. Some examples are passionflower, Siberian ginseng, Cramp bark, and cordyceps. Let us know if you would like us to custom formulate for you.
Proper Nutrition: Protein, Branched Chain Amino Acids (BCAAs)
  • Don’t forget to give your muscles the building blocks to repair and grow. A good protein powder and BCAAs are integral to fast recovery and muscle repair. Feeding your body is one of the most important things to do in helping to build muscle and alleviate soreness. Other amino acids that aid in increased blood flow, increased growth hormone secretion, and muscle building are: choline, glutamine, and arginine.
Mitochondrial Support
  • The mitochondria are the powerhouses of the cell. These little organelles (organs within the cell) need the proper nutrition to function properly and make the proper “juice” to make your muscles go and recover. Carnitine and acetyl L-Carnitine have been shown to decrease inflammation and carnitine is one of the key components in energy synthesis of cells, including muscle cells. B-vitamins are also imperative to make those powerhouses run. Hill Park offers a few customized nutrient injections that target mitochondrial support like Active Body or Performance Enhancer.
Hormone Optimization
  • Make sure your testosterone and DHEA levels are optimal so you can grow your muscles and recover faster. Also making sure your thyroid and adrenals are in tip top shape will also help to recover and get the most from your workout. Also, try our Hormone Balance nutrient injection to boost levels faster!
SLEEP!
  • Sleeping at least 8 hours a night will not only help you wake rested and energetic for another gym session, but also helps to increase growth hormone. Growth hormone is secreted by your anterior pituitary gland mostly at night during deep, restful sleep and while doing strenuous exercise while fasting. Growth hormone production is interrupted by EMF (electromagnetic fields). So, make sure to keep that alarm clock and your phone, at least 6 feet away from your bed.
Massage and Homeopathy
  • All of these are great for maintaining health, balance, and alleviating soreness. See your practitioner for help with these different modalities.

All of our vitamin injections are available on a walk-in basis, no appointment is necessary.

As a doctor and a fitness enthusiast, I’d love to help you recover faster from workouts and keep your nervous and endocrine system healthy while you gain strength, endurance, and health!

I offer complimentary 15-minute introductory consults to learn who I am as a doctor, my approach, and if our Hill Park Integrative Medical Center is the right direction for you.

Call our team to schedule at 707-861-7300.

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Protecting Our Health After the Fires: Tools for a toxic environment

Protecting Our Health After the Fires: Tools for a toxic environment

Our bodies mirror what is happening in the environment. Here in health-conscious Sonoma County, we’re pretty good about avoiding known toxins such as BPA in water bottles and pesticide use. We’re now in uncharted territory in the aftermath of the North Bay wildfires, which have had inevitable toxic impact on our air, soil, and water quality.

Persistent organic pollutants (POPs) are dangerous hormone-modulating and potentially carcinogenic toxins that can remain residual in our environment for weeks to years.These pollutants include the daily use products in every household that burned as well as fire-specific chemicals such as polycyclic aromatic hydrocarbons—some are benign, some carcinogenic, several can stick around for a long time. Flame retardants (PBDEs) are being phased out of California, but how many older sofas burned out there? Heavy metals such as cadmium and mercury are also a big post-fire toxin concern.

Molecular-sized toxins, either brought in from the outdoors or emitted from our household furniture and belongings, settle with the dust in our home which we, our children, and our pets then ingest.

Here are some ways that you can improve your internal and environmental landscape to protect your health:

Food is Medicine

Include these naturally-detoxifying foods in your diet to promote optimal liver function:

  • Cruciferous vegetables such as broccoli, kale, cauliflower, brussel sprouts, collard greens
  • Water-soluble fibers such as: pears, oats, apples, and legumes (beans)
  • High sulfur-containing foods such as: garlic and onions
  • Artichokes, beets (tops and bottoms), carrots, dandelion (tops and bottoms), parsley, cilantro, turmeric root, sweet potatoes, and squash
Herbal Support
  • Liver support: Milk Thistle, Artichoke, Burdock Root, Dandelion root and leaf, Schisandra
  • Turmeric (fresh root or Meriva SF): enhances detoxification, anti-carcinogenic, anti-inflammatory
  • Mushrooms: Reishi, Turkey Tail, Shitake, Maitake, Cordyceps—these are nature’s potent detoxifiers and immune protection for the earth and our bodies
Supplement Support
  • A high-potency multivitamin and mineral can help protect against toxin exposure. Antioxidants like vitamin C, beta-carotene, and vitamin E protect the liver against damage, as well as aiding in the liver’s detoxification process. B vitamins, calcium, and trace minerals also play a role in the elimination of heavy metals and other toxic compounds.
  • Lipotropic nutrients (compounds that stimulate the flow of bile and fat to and from the liver) such as choline, betaine, methionine, vitamin B6, folic acid, and vitamin B12 have a “de-congesting” effect on the liver, promoting both improved liver function and fat metabolism.
  • N-acetyl cysteine (NAC), alpha lipoic acid (ALA), chlorella, and modified citrus pectin all serve to substantially increase liver detoxification thru direct liver function enhancement and/or capturing toxins for proper elimination.
  • Blue Heron: GI support and detoxifying binders for proper elimination
Gentle Regular Detoxification
  • Regular weekly hyperthermia treatments such peat baths (see our New Year newsletter) and infrared sauna therapy are excellent ways to routinely enhance toxin elimination.
Lifestyle
  • Clothing, pets, cars, and outdoor recreational items can be a passive collection of toxic chemicals in our day to day lives.
  • Regularly wash your clothes, wash your bodies, wash your pets, and have shoe-free home.
  • Consider HEPA air filtration systems and indoor plants for clean air quality in your home.
  • Environmental Working Group: find the cleanest products possible at www.ewg.org
Stress

We’re exposed to toxins on a daily basis, external and internal, in many forms. Chemical exposure has its highest impact when we are vulnerable, such as in time of stress and fear. Take good care of yourself with adequate stress support including:

  • Therapy as needed for support of life’s abundances and relationships
  • Finding the right exercise routine that works for you
  • Adaptogenic herbs
  • Adequate quality sleep
Compassion

Surround yourself with souls you love who love you in return—this is in many forms: friends, chosen family, pets, neighbors. Our quick smiles, nods, or waves in brief encounters. We’re all in it—life’s absurdities. Let’s have some ease on our soul’s journey with a quick smile for one another.

Please check in with your physician about starting any treatment in case you may be allergic or have a need for a personalized program. Heavy metal and toxin analysis is provided at our center and our Natural Remedy Store staff are available to assist with any of the supplements or herbs mentioned in this article to best support you and our community.

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Dispensary Discount: 10% off Meriva SF

Dispensary Discount: 10% off Meriva SF
Curcumin: An “All in One” Solution

We have found Meriva SF to have great outcomes for reducing joint pain, relief of stiffness and soreness, improving immune health, detoxification, improving digestive function, and as an important part of cancer prevention and treatment.

Humans have benefited from the anti-inflammatory and immune-modulating effects of curcumin for centuries. Curcumin is the orange pigment in turmeric root that contains potent antioxidant, anti-inflammatory, immune enhancing, and anti-cancer effects.

There is amazing work being done in the science community around the benefits of this herb, from it’s anti-allergy effects to its advanced use in cancer treatment. Curcumin has been the subject of hundreds of research studies published in the last several decades. Research of particular interest to our cancer patients is its potential to enhance the positive actions of chemotherapy in cancer treatment while protecting our tissues from the negative side effects of chemotherapy.

Eating turmeric in its powdered or whole root form is a great inclusion to a healthy diet, though research has shown that there is low bloodstream absorption in this form to provide sufficient systemic levels for all our tissues to benefit.

As medical technology has evolved, we’ve been able to bind curcumin to phospholipids, which are the essential components of human cells. This maintains the natural plant based effects while permitting a highly effective absorption to access all it’s potent benefits.

As many of you know, we are regularly prescribing curcumin for our patients – and – there are numerous curcumin
products on the market. We have found Meriva SF to have great outcomes for reducing joint pain, relief of stiffness and soreness, improving immune health, detoxification, improving digestive function, and as an important part of cancer prevention and treatment.

Many of our patients are picking up Meriva this spring for allergy treatment and refills for ongoing maintenance use of various health concerns. We’d like to support your use of this herb with a 10% discount from our dispensary on Meriva SF through May 1st, 2018.

Updated April 2023 Great Practice Opportunity!
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