November 11, 2013 • An Advertising Supplement to the Los ... · November 11, 2013 • An Advertising Supplement to the Los Angeles Business Journal Heart Health, Prostate, Stroke

FocusonMen’sHealth

November 11, 2013 • An Advertising Supplement to the Los Angeles Business Journal

Heart Health, Prostate, Stroke Prevention and General Wellness

This special advertising supplement did not involve the reporting or editing staff of the Los Angeles Business Journal.

By DAVID JOSEPHSON, MD FACS

SEPTEMBER is the official Prostate CancerAwareness month, however November hasbecome equally if not more effective in driv-

ing the message home thanks to the Movembermovement. Millions of men worldwide (known asMo Bros) will start the month clean-shaven andthen grow a mustache to raise awareness, fundresearch and combat men’s health related issuesincluding prostate and testis cancer.

Prostate cancer is the second most commoncancer diagnosed in American men after skin can-cer. This year, the American Cancer Society esti-mates 238,000 cases will be diagnosed in theUnited States with about 30,000 deaths related tothe disease. About one in six men have the risk ofbeing diagnosed in their lifetime.

The prostate is a walnut-sized gland locatedbetween the bladder and rectum that produces sem-inal fluid to protect sperm and is needed for fertilitypurposes. Contrary to a common misconception,the prostate is not required for the production ofmale hormones such as testosterone. It isn’t entirelyknown what causes prostate cancer. Some prostatecancers may be inherited and caused by DNA muta-tions while others may be related to hormones,environment, or diet. The older a man is, the high-er his risk of prostate cancer. African-American menhave higher incidences of the disease thanAmerican men of other ethnicities. Rates for gettingprostate cancer increase if a person’s father or broth-er has the disease. In addition, some researchershave linked the cancer to a high-fat diet.

Prostate cancer develops slowly and may causefew, if any, symptoms. Most urinary symptomsrelated to prostate growth are due to benignenlargement occluding the flow of urine and notcancer per se but if a tumor does enlarge rapidly itcould also cause difficulty with voiding. Othersymptoms include painful ejaculation, and lowappetite/weight loss. When prostate cancer spreadsoutside the prostate, there can also be continualbone pain due to the spread of cancer to areas out-side the prostate such as bone or lymph nodes.

Prostate cancer is diagnosed through a biopsy,or the extraction of tissue with a needle. They areindicated if a man has an elevated blood test forprostate specific antigen (PSA) or an abnormal dig-ital rectal exam (DRE). There has been great con-troversy on the utility of PSA and DRE utilized in

population based screening because of conflictingresults in the pivotal trials studying their effective-ness in reducing death. What is known for sure isthat thanks to the efforts of early screening, inmore than two-thirds of men diagnosed with thedisease, the cancer is confined to the prostate.Furthermore, prostate cancers found through com-mon screening tests are, on average, smaller andmore contained than cancers discovered when thepatient notices symptoms.

We believe that men should be well informedof the risk for having prostate cancer and the asso-ciated potential side effects from work-up andtreatment. Through a informed decision makingprocess we recommend annual PSA tests for menstarting at age 50 (or at age 40 if any of his closerelatives have had prostate cancer or if they are ofAfrican American descent). Since it may takemany years to see the benefits of screening andtreatment of prostate cancers, we usually do notrecommend screening for men who have a lifeexpectancy of less than 12-15 years.

The treatment (if any) depends on many factorsincluding their age, life expectancy, extent of dis-ease, other health conditions, and the patient’sexpectations from therapy. Although there arenumerous options, the mainstay of therapy for dis-ease that is confined to the prostate includes active

surveillance, surgery and radiation while therapyfor more advanced disease involves hormones toblock the body’s testosterone and/or chemothera-py. In the area of active surveillance, we now uti-lize updated MRI technologies and molecularmarkers analyzing genetic changes in the biopsy tobetter decide who is an ideal candidate for contin-ued surveillance versus proceeding with definitivetreatment. Advancements in radiation therapy uti-lizing shorter courses/image guided therapy andthe use of minimally invasive robotic assisted sur-gery have both lead to significant reduction andprevention of some of the side effects associatedwith conventional treatment including inconti-nence (loss of urine control) and impotence.

While the challenges for us as physicians takingcare of patients with this cancer remain how toaccurately identify and cure aggressive diseasewhile avoiding over-treatment of indolent or non-significant disease, the continued advancements inresearch and the advent of new technologies havecertainly lead to great reduction in morbidity andovertreatment associated with this disease.

David Josephson, MD FACS is a Robotic Surgeon andUrologic Oncologist with Tower Urology Institute ofMinimally Invasive Surgery at Cedars Sinai MedicalOffice Towers.

The Importance ofUnderstanding Prostate Cancer

SPONSORED BY

Prostatecancer is thesecond mostcommoncancerdiagnosedin Americanmen afterskin cancer.About 1 in 6men have therisk of beingdiagnosed intheir lifetime.

23_28_menshealth.qxp 11/7/2013 3:55 PM Page 23

24 AN ADVERTISING SUPPLEMENT TO THE LOS ANGELES BUSINESS JOURNAL NOVEMBER 11, 2013

W HEN a newly diagnosed cancerpatient is considering treat-ment options, proton radia-

tion therapy might not be the first choicethat comes to mind. Yet over the pasttwo decades, proton therapy has contin-ued to evolve as a viable alternative toother therapies, and a less-invasive proce-dure than traditional radiation or surgery.Today many doctors and patients consid-er proton therapy is a preferred course oftreatment for cancer.

The James M. Slater, MD, ProtonTreatment and Research Center at LomaLinda was the first in the world to treatpatients and conduct research in a hospi-tal setting. As a result of its pioneeringefforts and proven expertise, it has treatedmore patients with proton therapy thanany other center of its kind. Proton radia-tion is so precise in treating many types ofcancer that doctors can target the radia-tion directly at cancerous tissue whileminimizing damaging side effects to sur-rounding healthy cells, tissues, and organs.

The pinpoint accuracy of the protonbeam makes it a highly effective form oftreatment for many types of tumors,including those often considered difficultto treat with standard therapies. Theseinclude cancers found in the head andneck, lung, and breast. Proton therapyhas also been shown to be the preferredmethod of treatment for many types ofchildren’s tumors, given that it deliversless damage to surrounding healthy tis-sue. This tissue-sparing capability isimperative to protect a child’s growthand development. Finally, proton therapyis a highly effective treatment for prostatecancer: in the Loma Linda experience,thousands of patients have been able tocontinue normal activity with minimalside effects, during and after treatment.

“Continuing research findings, cou-pled with advancements in technologyand improved outcomes over the pastquarter century, have resulted in expand-ing proton therapy’s applications to thepoint where it is now highly successfulfor many types of cancer,” said Jerry D.Slater, M.D., chairman of the Departmentof Radiation Medicine and director of theproton treatment facility at Loma LindaUniversity Medical Center (LLUMC).LLUMC was not only the first; it contin-ues to be the leading hospital-based pro-ton treatment center for cancer.

Since LLUMC introduced the treat-ment into the mainstream in 1990, pro-ton therapy has been refined and, cou-pled with leading-edge technology, hasbecome one of the best treatmentoptions for doctors and patients. Indeed,patients travel from around the world tovisit a proton treatment center wheretheir cancers can be effectively treated.

Palm Springs Man Swam and Golfed

Through Fight Against Prostate Cancer

Palm Spring resident Hilton Whittakeris the picture of good health. He enjoyshiking, swimming, playing golf and help-ing his wife Marianne with her retailstore. However just six months ago, the70-year-old wasn’t sure what the futurewould look like when he was diagnosedwith prostate cancer.

Like many prostate cancer patients,Hilton Whittaker didn’t want his lifestyle tochange and did not want to endure sideeffects including incontinence and impo-tence. As he searched for a less invasivetreatment option he learned about the

advantages of proton therapy offered lessthan an hour away at Loma LindaUniversity Medical Center. Hilton liked howProton therapy precisely targets canceroustissue without spilling over into healthy tis-sue, minimizing potential side effects.

According to Hilton, his treatment notonly was painless but was a “non-event.”

“I would wake up every morning andafter taking my five-mile walk woulddrive to Loma Linda for my 30-minuteappointment and get home with enoughtime to take a swim or play golf in theafternoon. The treatment never interrupt-ed my life.”

After three months of treatment,

Hilton Whittaker’s future looks great. HisPSA (prostate specific antigen) is downand he is still as active as ever.

More information about proton therapy maybe obtained at protons.com or by calling1-800-PROTONS.

Exploring the Proton Therapy Option

MEN’S HEALTH

23_28_menshealth.qxp 11/7/2013 3:55 PM Page 24

When Gary was diagnosed with prostate cancer, he chose the place with the most experience, Loma Linda University Medical Center. Gary chose proton therapy over other types of radiation — like IMRT, Seeds, CyberKnife or TomoTherapy — because protons can directly target the tumor sparing surrounding healthy tissue. As the nation’s first hospital based proton treatment center and with over 17,000 patients treated, Loma Linda University Medical Center’s expertise in proton technology is unsurpassed.

Take it from an old fisherman like Gary, experience counts.

Cyberknife and TomoTherapy are trademarks of Accuray Incorporated. Loma Linda University Health is not affiliated with Accuray Incorporated.

Loma Linda University Medical Center has been using protons to fight prostate cancer for over twenty years.

protons.com | 1-800-PROTONS

NOVEMBER 11, 2013 AN ADVERTISING SUPPLEMENT TO THE LOS ANGELES BUSINESS JOURNAL 25

23_28_menshealth.qxp 11/6/2013 3:16 PM Page 25

26 AN ADVERTISING SUPPLEMENT TO THE LOS ANGELES BUSINESS JOURNAL NOVEMBER 11, 2013

HEART disease and stroke are anepidemic in the United Statestoday. Many of the people who

are at high risk for heart attack or strokedon’t know it. The good news is thatmany of the major risk factors for theseconditions can be prevented and con-trolled. Talking to your health care pro-fessional about your heart health and get-ting your blood pressure and cholesterolchecked are important first steps toreduce your risk. Many other lifestylechoices—including eating healthy, exer-cising regularly, and following yourhealth care professional’s instructionsabout your medications—can all helpprotect your heart and brain health.

Remember Your ABCS

Keep the ABCS in mind every day andespecially when you talk to your healthcare professional:• Appropriate Aspirin Therapy for thosewho need it• Blood Pressure Control• Cholesterol Management• Smoking Cessation

Talk to Your Health Care Professional

Share your health history, get yourblood pressure and cholesterol checked,and ask if taking an aspirin each day isright for you.

Control Your Blood Pressure and Cholesterol

High blood pressure is one of the lead-

ing causes of heart disease and stroke.One in three U.S. adults has high bloodpressure, and half of these individuals donot have their condition under control.

Similarly, high cholesterol affects onein three American adults, and two-thirdsof these individuals do not have the con-dition under control. Half of adults withhigh cholesterol do not get treatment.

If your blood pressure or cholesterol ishigh, take steps to lower it. This couldinclude eating a healthier diet, gettingmore exercise, and following your healthcare professional’s instructions aboutmedications you take.

Eat Healthy for Your Heart

What you eat has a big impact onyour heart health. When planning yourmeals and snacks, try to:• Eat lots of fresh fruits and vegetables.• Check the labels on your food andselect those with the lowest sodium. Too

much sodium can increase your bloodpressure. • Limit foods with high amounts of satu-rated fat, transfat, and cholesterol. Youcan find this information on theNutrition Facts label.• Cook at home more often. Wheneverpossible, select foods that are low in sodi-um or have no salt added. Limit sauces,mixes, and “instant” products, includingflavored rice and ready-made pasta.

Get Moving

Obesity can increase your risk for heartdisease and stroke. To keep your body at ahealthy weight and to fight high bloodpressure and cholesterol, make physicalactivity part of your daily routine. Try tofit in 2 hours and 30 minutes of moder-ate-intensity exercise every week.

Quit Smoking

Cigarette smoking greatly increases your

risk for heart disease. If you’re a smoker,quit as soon as possible, and if you don’tsmoke, don’t start. You can also supportsmoke-free policies in your communityand try to avoid secondhand smoke.

Barriers to Effective Heart Disease & Stroke

Prevention

Many people with key risk factors forheart disease and stroke—such as highblood pressure and high cholesterol—donot know that they have these condi-tions, what blood pressure or cholesterolnumbers are best for them, or how theirhigh blood pressure or cholesterol couldbe more effectively controlled. Other bar-riers include:• Access to convenient, consistent, andaffordable monitoring of blood pressureand cholesterol• Lack of continuity of care• Inadequate time with healthcare profes-sionals to ask important questions andreceive personalized advice• Medication expense, side effects, andhabits around daily use• Need for community based strategiesfor healthier lifestyle choices such asreduced sodium and transfat and smokefree air policies.

Information for this article was provided bythe US Centers for Disease Control andPrevention. Visit the MillionHearts.hhs.govwebsite for more information.

Heart Disease and Stroke Prevention Facts That Could Save Your Life

MEN’S HEALTH

Many of the major risk factors for heart disease and stroke

can be prevented and controlled. Talking to your health care

professional about your heart health and getting your blood

pressure and cholesterol checked are important first steps

to reduce your risk. Many other lifestyle choices can all help

protect your heart and brain health.

23_28_menshealth.qxp 11/7/2013 3:56 PM Page 26

THEY might be considered the “manin charge” in the boardroom orthe “man about town” on the

social scene, but when it comes to takinga personal stake in their own health,men’s behavior is more marked by reluc-tance than that signature bravado. Thesemen, who ignore symptoms or whodon’t regularly schedule doctor’s visits,are taking a gamble with their health, asthey put the early detection of severalconditions and diseases and the availabil-ity of treatment options into peril.Northwestern Memorial Hospital expertsrecently explored the trend’s culturalroots, and offered tips for how men cankeep their health in check.

“Women recieve encouragement to benurturers,” said Robert Sobut, MD, a psy-chiatrist at Northwestern MemorialHospital and clinical instructor of psychi-atry at Northwestern University FeinbergSchool of Medicine. “A woman is so usedto giving and taking care of others it’snot too much of a leap for her to takecare of herself. For men the act of nurtur-ing can be an unfamiliar concept, there-fore they tend to be more neglectful ofthemselves.”

Sobut believes women and men getvery different messages early on inregards to their health. “A man is accli-mated from an early age to tough it out,so they tend to not like to ask for help,”said Sobut. “When they start to feel ill, itconflicts with their masculine identity.

For women their gender role has muchmore fluidity.”

“Men will take their car in for generalmaintenance when nothing is glaringlywrong, yet many men won’t show thatsame attention to detail and care when itpertains to their own health,” said EricMizuno, MD, an attending physician atNorthwestern Memorial Hospital and anassistant professor of medicine atNorthwestern University Feinberg Schoolof Medicine. “Much more so thanwomen, who schedule appointments ona more regular basis, men seem to onlyrespond to catastrophic events or uponthe recommendation of a third party.”

Mizuno sees potential danger in thisdismissive attitude toward regular check-ups. “Men won’t be able to prevent theonset of a health issue or have as manytreatment options available if they onlycome in when it’s catastrophic or com-pulsory, such as when they’re starting anew job or going out for a sports team.”

Experts say there are several ways toimprove a man’s care for and attention tohis own health.

Sobut thinks Mizuno’s reference to carmaintenance is a fitting metaphor forhow healthcare professionals should con-front the fear, denial and embarrassmentmen often face over health issues. “If welet men know up front, at the beginningof appointment, what they’ve signed upfor and how long they can expect to bethere, this type of transparency will foster

a greater level of comfort for them.”Mizuno also cites the healthcare pro-

fessional’s relationship with his malepatient as key to increasing a man’sawareness of health problems. “Once aperson develops a relationship with adoctor, often through repetitive visits, thecomfort level that develops allows mento more freely express themselves.Doctors can also make men aware of theappropriate timeframes for schedulingappointments and routine tests.”

Sobut believes that with society’srelaxation of stereotypical gender rulesand roles, men feel like they have more

permission to give into their health con-cerns. “In general men are getting theokay from society to be more in touchwith their feelings, which will figureprominently into their ability to identifyand share health problems.”

Mizuno advises healthcare profession-als to involve the entire family whentreating a man. “Healthcare professionalshave to appeal to men’s sense of familialduty and responsibility when talking tohim about his own health,” said Mizuno.“Maybe the man hasn’t made regularappointments of his own volition before,but if you start talking to him aboutbeing around for his wife, for his chil-dren’s graduations and weddings, youmight find greater success. A man can’tbe expected to be that pillar of strengthfor his family if he’s not taking care ofhimself from the inside out.”

Mizuno says the first step men shouldtake is to make an initial appointmentwith a doctor to discuss family historyand get a thorough physical exam. “Fromthere, you can work with your doctor onan individual plan for monitoring andstaying proactive about your health.”

Information for this article was provided byNorthwestern University Feinberg School ofMedicine.

Men’s Dismissive Attitude TowardOwn Health Can Prove Dangerous

NOVEMBER 11, 2013 AN ADVERTISING SUPPLEMENT TO THE LOS ANGELES BUSINESS JOURNAL 27

MEN’S HEALTH

TAKE CHARGE

OF YOUR HEALTH

Dr. Eric Mizuno recommends the

following health screenings for men:

• Full physical exams every one to three

years based on family history and per-

sonal health

• Testicular cancer screening: starting at

age 18

• Cholesterol screening: starting at age

20

• Blood pressure: beginning at age 21

• Colonoscopy: beginning at age 50

• Prostate cancer screening: beginning

between age 40-50 based upon family

history and ethnicity

23_28_menshealth.qxp 11/7/2013 3:56 PM Page 27

28 AN ADVERTISING SUPPLEMENT TO THE LOS ANGELES BUSINESS JOURNAL NOVEMBER 11, 2013

BY substituting healthy vegetablefats – such as olive and canola oils,nuts, seeds and avocados – for ani-

mal fats and carbohydrates, men with thedisease had a markedly lower risk of devel-oping lethal prostate cancer and dyingfrom other causes, according to the study.

The research, involving nearly 4,600men with non-metastatic prostate cancer,could help with the development ofdietary guidelines for men with the dis-ease. While prostate cancer affects mil-lions of men around the world, little isknown about the relationship betweenpatients’ diets following their diagnosisand progression of the disease.

The study was published online onJune 10 in JAMA Internal Medicine.

“Consumption of healthy oils and nutsincreases plasma antioxidants and reducesinsulin and inflammation, which maydeter prostate cancer progression,” saidlead author Erin L. Richman, ScD, a post-doctoral scholar in the UCSF Departmentof Epidemiology and Biostatistics.

“The beneficial effects of unsaturatedfats and harmful effects of saturated andtrans fats on cardiovascular health arewell known,” Richman said. “Now ourresearch has shown additional potentialbenefits of consuming unsaturated fatsamong men with prostate cancer.”

Analyzing Intake of Fats

from Various Sources

Nearly 2.5 million men in the United

States currently live with prostate cancerand another quarter-million men areexpected to be diagnosed this year. Onein six men in the U.S. will be diagnosedwith the disease during their lifetime.

In recent years, evidence has indicatedthat diet might be an important way formen with prostate cancer to take anactive role in determining their diseaseoutcome and overall health. Research onadvanced prostate cancer has suggestedthat fat intake may be relevant to diseaseprogression, but this is the first study toexamine fat consumption post-diagnosisin relation to risk of lethal prostate can-cer and overall survival.

The new paper analyzed intake of sat-urated, monounsaturated, polyunsaturat-

ed and trans fats as well as fats from ani-mal and vegetable sources.

The data were derived from the HealthProfessionals Follow-up Study, whichbegan in 1986 and is sponsored by theHarvard School of Public Health and isfunded by the National Cancer Institute.

The fat intake study involved 4,577men who had been diagnosed with non-metastatic prostate cancer between 1986and 2010. During the study timeframe,1,064 men died, primarily from cardio-vascular disease (31 percent), prostatecancer (21 percent) and other cancers(nearly 21 percent).

The authors uncovered a striking ben-efit: Men who replaced 10 percent oftheir total daily calories from carbohy-

drates with healthy vegetable fats had a29 percent lower risk of developing lethalprostate cancer and a 26 percent lowerrisk of dying from all causes.

More Study Needed on Potential

Benefits of Healthy Fats

Adding a single serving of oil-baseddressing a day (one tablespoon) was asso-ciated with a 29 percent lower risk oflethal prostate cancer and a 13 percentlower risk of death, the authors found.And adding one serving of nuts a day(one ounce) was associated with an 18percent lower risk of lethal prostate can-cer and an 11 percent lower risk of death.

The study adjusted for factors such asage, types of medical treatment, bodymass index, smoking, exercise and otherdietary factors, elevated blood pressure,cholesterol at the time of prostate cancerdiagnosis and other health conditions.

The researchers say further research isneeded on the potential benefits of healthyfats among prostate cancer patients.

“Overall, our findings support coun-seling men with prostate cancer to followa heart-healthy diet in which carbohy-drate calories are replaced with unsaturat-ed oils and nuts to reduce the risk of all-cause mortality,” said Richman.

Information for this article was provided byUCSF Department of Epidemiology andBiostatistics and the Department of Urology.

Simple Changes in Diet Can ProvideDramatic Benefits for Men with Prostate Cancer

REAL ESTATEAWARDS

COMMERCIAL

The Los Angeles Business Journal is proud to announce the 2014 Commercial Real Estate Awards.We are accepting nominations for the biggest, best, and most notable commercial real estateprojects of 2013. We’ll be honoring the developer, architect and general contractor of eachaward winning project. In addition, we’ll recognize the most successful broker/broker teams in themarket! Winners will be announced at the Commercial Real Estate Awards and published within theLos Angeles Business Journal in February 2014.

Nomination forms available at: www.labusinessjournal.com/bizevents

CALL FOR NOMINATIONS

Nomination Deadline: Friday, January 10, 2014

We’re accepting nominations in the following categories:

• Hospitality • Industrial • Medical • Mixed-Use • Multi-Family • Office

• Public • Redevelopment • Retail • Sustainable • Tenant

Improvement

PROJECTS OF THE YEAR

• Largest Single Sale

• Largest Single Lease Deal

• Annual Sales by Revenue

• Annual Sales by Volume

• Rookie of the Year

BROKERS OF THE YEAR

For more information, please contact Breanne Kamai at 323.549.5225 ext. 203 or [email protected]

2013 HONOREES

MEN’S HEALTH

23_28_menshealth.qxp 11/7/2013 3:56 PM Page 28