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Advancing Care - November/December 2022

advancing care
 

Do you really need a prostate exam? 

Prostate cancer is the second-leading cause of cancer death in American men, behind only lung cancer. Michael Leapman, MD, a urologist at Yale New Haven Hospital and an assistant professor of urology at Yale School of Medicine, sees patients with urologic cancers in collaboration with Smilow Cancer Hospital. Here he offers advice about the importance of rectal exams, PSA (prostate-specific antigen) blood tests and screenings for prostate cancer. 

  • Who is most at risk for prostate cancer? 
    Prostate cancer is incredibly common. The biggest risk is age, as older men are more likely to be diagnosed with the disease. However, many of these patients may have low-grade prostate cancer, which means it’s very slow growing, unlikely to spread and doesn’t require treatment. 

    Patients at risk of more aggressive disease include those with a strong family history and those who are African American. There is also an association with the BRCA gene, so patients with a strong family history of breast cancer should also be monitored closely.
     
  • At what age should men consider getting a prostate check?
    The American Urologic Association recommends prostate cancer screening starting at age 55 for men who are at average risk. Screening is generally not recommended in men over age 75 as the potential benefits are outweighed by the risks in this population. Men who are at high risk should begin screenings at age 45. 
     
  • What does a prostate screening or test involve?
    Prostate cancer screening includes a digital rectal exam (DRE) and PSA blood test. Depending on the results, your physician may recommend additional blood urine tests or a prostate MRI. 
     
  • Where should men go for a prostate check? 
    Your primary care provider should initiate most prostate cancer screenings. They will refer you to a urologist if the initial screening detects any abnormalities. Certain high-risk individuals may benefit from establishing care with a urologist early on. 
     
  • What would you say to men who are hesitant about a prostate exam?
    Many men are reluctant to be screened for prostate cancer, specifically when it comes to a rectal exam. It’s true that this exam is somewhat invasive; however, it is quick and usually fairly painless. And while many prostate cancers can be detected by the PSA blood test, there are those that are sometimes only detected by rectal exam. Screening allows for earlier detection of the disease, making treatment much more straightforward. Once prostate cancer metastasizes and spreads to other areas of the body, it generally cannot be cured. 
     
  • What are signs/symptoms of prostate cancer?
    One challenge with prostate cancer is that the early stages often present without any symptoms – which is why regular screening exams are important. Occasionally a patient will complain about urinary symptoms such as urgency, frequency, slow flow or incomplete bladder emptying. However, these signs are much more commonly associated with benign prostate growth. While usually not related to prostate cancer, these symptoms warrant an evaluation by a urologist if they are severe or impacting your lifestyle. 

    Advanced prostate cancer symptoms may include bone pain, blood in the urine, weight loss, kidney failure or urinary retention. 

  • What do you tell patients who are diagnosed with prostate cancer? 
    The first thing is that prostate cancer is treatable and usually curable if detected at an early stage. Second, most prostate cancer is fairly slow-growing, relative to other cancers. This gives patients time to consider the options and allows us to develop the best plan for their situation because the appropriate management really depends on the specifics of a patient’s case. Low-risk patients are often managed with surveillance alone, which allows us to monitor the disease without subjecting the patient to the potential side effects of treatment. Patients with more aggressive disease or those who are at higher risk find themselves in an era of evolving technology which has improved outcomes while minimizing side effects through robotic surgery, targeted radiation therapy and other treatments.

    Patients in Connecticut who are diagnosed with prostate and other urologic cancers have access to the Prostate & Urologic Cancers Program throughout the Smilow Cancer Hospital Network. Yale Cancer Center’s designation as a National Cancer Institute Comprehensive Cancer Center brings the most advanced access to clinical trials to our patients throughout the entire network.

  • What other health issues should men be aware of in “Movember” besides prostate cancer? 
    While Movember started as a prostate cancer awareness movement during the month of November, it has turned into so much more. Men’s health has become an important buzzword that includes both physical and mental health. It’s also important that men — and those who love and care about them — consider other health issues including low testosterone (low T), erectile dysfunction (ED) and fertility. Men may be reluctant to discuss these issues but addressing them may reveal silent health concerns. Erectile dysfunction may indicate a heart condition; low T can be associated with depression. 

    That’s why men should make an appointment with their primary care provider. During the visit, the provider will check blood pressure, record weight, and may order blood tests to review cholesterol, blood sugar and other levels that could indicate urological, cardiac and endocrine conditions. Excessive weight is a concern, because it is often related to degenerative, arthritic changes in men, especially in their hips and knees

Good health should be a year-round concern for men – not just in November. This time of the year should be a time for men to reflect on things in their life that they can change to impact their overall health for the better. 

Talk to your doctor. If you don’t have one, call 888-700-6543 or visit Find a Doctor for a referral to a primary care physician near you. 

 

Why you should get a flu vaccine this year  

For almost three years now, the news has focused primarily on COVID-19 and the coronavirus. But healthcare professionals want people to remember another respiratory virus: seasonal influenza. 

Influenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza is commonly called the “flu,” but it's not the same as stomach "flu" viruses that cause diarrhea and vomiting. Common signs and symptoms of the flu include: fever, aching muscles, cough and sore throat, headache and fatigue. Influenza and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses.

Learn more about the differences between flu and COVID-19.

Flu viruses are most common during the fall and winter. The exact timing and duration of flu seasons can vary, but influenza activity often begins to increase in October. Most of the time flu activity peaks between December and February, although it can last as late as May. 

“We usually say that flu is predictably unpredictable,” said Richard Martinello, MD, medical director of Infection Prevention at Yale New Haven Health. “However, we are already seeing an uptick in influenza circulating in our area, so people should get vaccinated as soon as possible.” 

Nearly 10 percent of the U.S. population gets sick from flu each season, according to the Centers for Disease Control (CDC). The CDC estimates there were a record-high 61,000 flu deaths in the U.S. during the 2017-2018 season. 

Over the past few years, the U.S. experienced relatively mild flu seasons. That’s because people were wearing masks, maintaining physical distance, avoiding mass transportation and generally staying home to prevent the spread of COVID-19. Many people were continuing to work remotely, students were not in school and there wasn’t much travel. These prevention tools help to stop both COVID-19 and the flu viruses from spreading, according to Dr. Martinello. 

“We need people to be attentive. Flu is still a major public health threat and poses a risk to everyone, including healthy children, teens, adults and pregnant individuals,” Dr. Martinello said. 

Another concern this year, said Dr. Martinello, is respiratory syncytial virus (RSV). RSV is a common seasonal virus that poses particular risks to pregnant women, immunocompromised children and adults, and adults older than 65. It is a leading cause of infant mortality around the globe and is especially dangerous to prematurely born babies. “We are also seeing an unusually early and significant RSV season,” he said. “Hospitals across the U.S., including Yale New Haven Children’s Hospital, are inundated with children with RSV right now. And among older adults, RSV causes about 14,000 deaths per year.”

So what should you know about this coming fall and winter? Dr. Martinello recommends the following safety measures: 

  1. Get a flu vaccine. Dr. Martinello said the best way to protect yourself from the flu is to get your yearly flu shot. It’s safe and recommended for everyone six months or older, including pregnant women, unless you’re known to have a severe allergy to the flu shot.

    “Contact your primary care provider or local walk-in care location for more information and to schedule your flu vaccination as soon as possible,” he said. “After you get your flu vaccine, your body takes about two weeks to build immunity to flu.” 

    Dr. Martinello adds that you can get your flu vaccine at the same time as a COVID-19 vaccine or booster. It’s recommended you get them in different arms.

  2. Continue to practice physical distancing and wearing masks. “COVID-19 and influenza are both viruses that spread through respiratory droplets. So, the strategies people can employ to minimize the spread of the influenza virus are very similar to the practices used to control the spread of COVID-19,” he said. 

  3. Wash your hands. Frequently and thoroughly washing hands with soap and water removes or greatly reduces the likelihood of transmitting viruses. At minimum, hands should be washed before preparing or eating food, after using the bathroom and after touching surfaces that others have touched (like doorknobs and light switches in public places).

  4. Stay home if you feel sick. People who feel unwell or who have symptoms of influenza such as fever, body aches, sore throat or coughs should stay away from others to avoid transmission.

  5. Get tested if you are sick. Because some symptoms of flu and COVID-19 are similar, people may need to be tested to tell what virus is causing their illness. People can be infected with both a flu virus and the virus that causes COVID-19 at the same time. 

One thing Dr. Martinello knows for sure: it’s best to be prepared. Take the proper precautions, be alert and consult a physician or health professional if symptoms are concerning. "Every flu season is unique. Every time we think we know what will happen, it will do something totally different,” he said.

 

2023 YNHCH Wish Book for pediatric patients is now online

The annual Wish Book, a gift list for Yale New Haven Children’s Hospital patients, is now available online. 

The online catalog includes items hospital staff have suggested to help keep young patients’ spirits up through play and entertainment. Many Wish Book gifts are items families can’t purchase themselves. The items in the latest catalog are designed for gift-giving throughout the year, not just the holidays. View this year’s Wish Book to order an item online or make an online donation and make a difference in the lives of our pediatric patients and their families. 

 

Are you living with Parkinson's Disease?

Join our beneficial exercise program for those living with Parkinson's Disease. This class is held on Tuesdays and Thursdays from 10:30 am - 12 pm via Zoom and in-person in the Wellness Center at Home Care Plus Community Healthcare & Hospice, 753 Boston Post Road, Guilford. The cost is $6 per class. 

A free support group is held on the first Tuesday of each month immediately following class. Please call Bobbi Dunne at 866-474-5230 for more information and to register. 

A virtual Parkinson’s Caregiver Support group is also available; call 866-474-5230 for a link. No registration is required.

 

Got a health question? Ask the Nurse

A registered nurse with Yale New Haven Health’s Home Care Plus can check your blood pressure, heart rate and weight, and work with you to set health goals at one of our free “Ask the Nurse” clinics held throughout the greater New Haven area. The nurse can also help you create a medication list and discuss how you can prepare for a medical appointment. There is no cost for this service and appointments are not required. 

“Ask the Nurse” clinics are available monthly on the following dates and locations:

East Haven: 

  • 2nd Wednesday, 10 - 11 am at East Haven Senior Center, 91 Taylor Ave. (available to East Haven residents only)

Hamden:

  • 3rd Tuesday, 11 am - 1 pm at Miller Senior Center, 2901 Dixwell Ave. (available to Hamden residents only)

North Haven:

  • 2nd Thursday, 10:30 - 11:30 am at Joyce Budrow Senior Center, 189 Pool Road (available to North Haven residents only)

To learn more, call the Home Care Plus - Community Healthcare & Hospice helpline at 866-474-5230.

 

Need to visit the ER? Find out how long you might wait  

Need care right away? We can help with everything from allergies and sprains to emergency symptoms for heart attack and stroke. 

If you are headed to the emergency department, our wait time clocks help make sure you get the care you need as quickly as possible.

While emergency departments provide care for life-threatening injuries or illnesses, walk-in/urgent care centers offer convenient, professional medical attention for non-life-threatening conditions including the flu and common cold to broken bones, sprains, cuts, allergic reactions, and minor burns, and many other conditions. Avoid long wait times at the emergency department and get the care you need at one of our walk-in or urgent care centers located throughout Connecticut.

For minor medical concerns, you can receive care online using Video Care OnDemand

Not sure where to go? Find out how to Get Care Now.

 

Find a Doc at YNHH

Are you looking for a physician? Call 888-700-6543 or visit our Find a Doctor feature for information on physician specialties, office hours and locations as well as insurance plans accepted. Many of our physician practices offer telehealth video visits for your convenience.

 

Billing questions? 

Yale New Haven Health offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.