Author Archives: Joe Hilbert

  1. Does Gum Disease Increase the Likelihood of Alzheimer’s Disease?

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    A diagnosis of dementia or Alzheimer’s disease is enough to scare anyone. With more than 5.5 million Americans over the age of 65 currently diagnosed with Alzheimer’s disease, and that number is expected to double by the year 2050 according to the Alzheimer’s Association. Understandably, people are desperate to find causes, treatments and cures which despite ongoing research remain elusive.

    When studies seem to yield any solid data, the media is quick to splash headlines that grab the attention of families hopeful for better understanding of who at risk of getting the disease or if there is a way to treat or minimize the effects of Alzheimer’s. A May 2018 study published online in the Journal of Alzheimer’s Disease linked periodontal disease and an increased likelihood that gum disease may play a role in predicting Alzheimer’s disease.

    Size of the Study Does Matter

    Neurologist Dr. Joshua Daniel of Shore Physicians Group, said unfortunately the sample study was too small to establish a definite link between periodontal health and the likelihood that people with gum disease are at a greater risk to develop Alzheimer’s disease.

    Researchers in England, Drs. John Crean and Sim K. Singhro, examined brain tissue samples donated by 10 patients without dementia and 10 patients with dementia. They found gum disease bacteria, lipopolysaccharides, in the sample from four of the people with dementia and none of the people who did not have dementia. Bacteria can enter the bloodstream through everyday activities such as eating, chewing and brushing teeth and once in the bloodstream, the bacteria can be carried to other parts of the body. The researchers hypothesized that when the bacteria reaches the brain, it may trigger an immune system response (like it does in the mouth), killing brain cells. This immune response could be one mechanism that leads to changes in the brain, which is typical in Alzheimer’s disease. It could play a role in causing symptoms such as confusion and deteriorating memory.

    Study Linking Biomarker to Alzheimer’s Disease

    One recent study Dr. Daniel thought may show promise looks for a protein in the blood, a neurofilament light, which could be a biomarker for Alzheimer’s disease. A paper published in March 2018 supports the idea that dying neurons release a slew of proteins into the brain and traces of those neurofilament proteins make their way into the blood.

    In the largest study to date on neurofilament light proteins in people with dementia, Swedish scientists at the University of Gothenburg reported high levels of this protein in the blood of people with Alzheimer’s disease and mild cognitive impairment. Neurofilament light was also associated with worsening cognitive scores over time and with brain atrophy. While it is not sensitive or specific enough to stand alone as a diagnostic marker, the protein distinguishes Alzheimer’s disease and mild cognitive impairment from healthy control patients who do not have a diagnosis of Alzheimer’ about as well as the presence of tau in cerebrospinal fluid from a spinal tap. Tau is a normal protein in the brain that changes and may damage brain cell structures in patients with Alzheimer’s disease, and is identified through a spinal tap. Blood neurofilament light would be a more easily accessible biomarker for prognosis and progression. Washington University researcher Anne Fagan reported in Alzforum, a news website and information resource for Alzheimer’s disease and related disorders research, that the work with the neurofilament light plasma marker needs to be replicated, but if the blood testing performs as well as the cerebral spinal fluid then it could have a huge impact.

    Dr. Daniel said that while the studies are encouraging and may help with early diagnosis they still need more data and more information. Having a path to cover the expense of the testing could be difficult, adding that getting the insurance companies to cover it will be the biggest challenge.

    Neurofilament light research is not limited to Alzheimer’s disease and mild cognitive impairment. It is also suggested as a marker for neurodegeneration in everything from amyotrophic lateral sclerosis (ALS) to traumatic brain injury and atypical Parkinson’s disease. Research is ongoing.

    To make an appointment with Dr. Joshua Daniel at Shore Physicians Group, located at 649 Shore Road, Suite O in Somers Point, call 609-365-6202.

  2. 4 Nutrient Deficiencies that Could be Causing your Headaches

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    “Oh, my head is pounding.”

    We have all muddled through days when a headache gets in the way of what may have been planned. Before you grab that over-the-counter remedy to silence the drum banging in your head, experts say there could be several deficiencies that are contributing to your headache.

    Dehydration

    Water, water everywhere, but yet if we fail to drink enough it can spark a headache. According to the National Headache Foundation, even mild dehydration can cause a dehydration headache or even a migraine. Since it’s often not clear what is causing a headache, drinking a full glass of water and continuing to sip more fluids during the day is a simple way to ease the pain.

    Magnesium Deficiency

    Neurologist Dr. Joshua Daniel of Shore Physicians Group said many migraine headache sufferers are found to be deficient in magnesium when they have blood work done. He instructs patients to take magnesium not only to prevent the onset of future migraines because it stops the transmission of pain but also because there are no side effects. Magnesium is affordable and available over the counter, according to the physician.

    Magnesium is abundant in the body but for some, it is not absorbed readily. It can be a genetic deficiency that keeps a body from absorbing sufficient magnesium or it could be inherited renal magnesium wasting where the magnesium is lost through the kidneys, excretion of excessive amounts of magnesium, stress, low nutritional intake or several other factors, according to information provided by the National Institute of Health.

    Dr. Daniel said he includes magnesium with the IV fusion therapy to treat migraines that has proven to be very helpful with patients. He added that it is safe and has no contraindications for patients.

    Fight Deficiency with Diet

    Low levels of magnesium may contribute to migraines, according to Chris Kozmor, RN, M.Ed., director of the Shore Medical Center Cardiac and Pulmonary Rehabilitation Center. Kozmor suggests including plenty of magnesium-rich foods like spinach, avocado and almonds into a well-rounded diet to keep those headaches at bay.

    Vitamin D Deficiency

    Why does that sun (in moderation) feel good on your skin? While it warms you on a chilly day, it is also supplying vitamin D to your body. Most of us get an ample supply through our diets with fatty fish and dairy products, orange juice and cereals, and just by being outside. Vitamin D deficiency can cause a number of side effects, but recent studies have also shown a possible link between the deficiency and headaches. On the flip side, too much vitamin D can have its own problems. Follow the recommended daily allowance for vitamin D according to age to help cut down on the frequency of headaches. The National Institutes of Health recommends 600 IU of vitamin D for adults ages 19 to 70. Adults 71 and older need 800 IU.

    Vitamin B2 Deficiency

    The B vitamins help to protect from headaches, according to the National Headache Foundation, but it is B2 (riboflavin) that really stands out and where a deficiency may lead to headaches. Eating foods high in vitamin B2 or supplementing with a quality vitamin may help improve energy metabolism and decrease the incidence of migraine headaches. Foods high in B2 include eggs, lean meats, green vegetables along with fortified grains and cereals. The NIH recommends 1.3 mg for males and 1.1 mg for females.

    Each of the B vitamins (B1, B2, B3, B5, B6, B12, biotin, and folic acid) have a recommended daily allowance according to the National Institute of Health.  https://ods.od.nih.gov/factsheet 

  3. Shore Physicians Group Surgeons Announce Affiliation with Penn Medicine

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    Shore Physicians Group, a multi-specialty medical group based in Somers Point, NJ, announced today that its surgery division is now an affiliate of Penn Medicine. Now rebranded as Shore Physicians Group Surgeons, an Affiliate of Penn Medicine, the Shore Physicians Group’s surgical division will collaborate with Penn Medicine in an effort to provide even more high quality, cost-efficient care.

    Mark Stephens, chief administrative officer of Shore Physicians Group, says this affiliation sets its surgical division apart from others in our region.

    “In order to become an affiliate, our surgeons and practice went through a rigorous review, and we have met the specified standards and qualifications set for all Penn Medicine physician practices. This affiliation also provides our patients with a direct connection to the University of Pennsylvania Health System, when needed, and the confidence that we are all working together in their best interest,” Stephens said.

    This partnership will also establish standards and protocols for Shore Physicians Group Surgeons to efficiently and effectively diagnose patients, treat their conditions, and ensure the best continuum of care.

    “Speaking on behalf of the surgeons of Shore Physicians Group, we are excited to bring this level of expertise in collaboration with the Penn Medicine Specialty Network to our area by becoming a local affiliate,” said David P. May, MD, FACS, President, Shore Physicians Group. “This relationship will bring the knowledge and protocols of Penn Medicine to the patients of Shore Medical Center and Shore Physicians Group, and will foster a closer working relationship with our colleagues in Philadelphia. This is an important development for the residents of Cape May and Atlantic counties that we serve.”

    The office is located at 649 Shore Road, Somers Point, NJ and includes general surgeons David May, MD and John Millili, MD; reconstructive surgeon Mohit Sood, MD; neurosurgeon Francis Kralick, DO; urological surgeon Dr. Meredith Perry; and general surgeons Leonard Galler, MD and Gary Feinberg, MD.

  4. Seven Reasons to Stop Ignoring this Silent Killer

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    At Shore Physicians Group’s Mays Landing office, Family Nurse Practitioner Cindy Nunan, DNP, has a lot to share with her patients who have high blood pressure, but one of the most important pieces of advice she has for them? “Just check it!”

    Unfortunately, one in three Americans has high blood pressure (see chart) but only a third of those individuals are aware of it. Nunan can’t stress enough the importance of checking your blood pressure regularly. That means at least once a year if you’re low risk, and every few months if you have high blood pressure or it runs in your family. You can have your blood pressure checked at your provider’s office, using an at-home machine, or even using the free machines at pharmacies and grocery stores.

    “High blood pressure is called a ‘silent killer’ because it usually exists without any symptoms, but it’s slowly taking its toll on your body over time,” Nunan says. “As a clinician, high blood pressure is not something that I take lightly, nor should you. If you don’t know your blood pressure, it’s time to find out.”

    Nunan works with her patients who have high blood pressure to help them make lifestyle changes to bring their blood pressure down, from recommending smoking cessation and nutrition counseling to encouraging exercise and weight loss.

    “My goal is to ultimately help people realize how serious high blood pressure is and motivate them to act so we can help to prevent heart attack, stroke and even death,” Nunan says.

    Wondering what can happen if you ignore your high blood pressure for too long? According to the American Heart Association, here are some of the most serious possible outcomes:

    1. Heart Attack: High blood pressure strains the arteries and can cause blockages, which starves it of oxygen and nutrients and results in damage or death of part of the heart muscle. Approximately 735,000 people have a heart attack each year, and 17 percent of those people will die.
    2. Stroke: Stroke occurs as the result of weakened blood vessels in the brain that burst or clog from prolonged high blood pressure, preventing oxygen from flowing to the brain, which can cause serious disability and even death.
    3. Heart Failure: Prolonged high blood pressure overworks the heart, causing it to enlarge and fail to supply adequate blood to the body.
    4. Kidney Disease or Failure: Arteries carry blood from the heart to the rest of the body, including the kidneys, where damaged arteries can interfere with the kidney’s ability to filter blood. High blood pressure is the second leading cause of kidney failure. Kidney failure could require dialysis or even a kidney transplant.
    5. Vision Loss: Blood vessels in the eyes can become damaged from high blood pressure, causing blurred vision or loss of sight. It can also lead to fluid buildup under the retina, or nerve damage, both of which can cause impaired vision.
    6. Sexual Dysfunction: Damage to blood vessels means reduced blood flow to the pelvic region as well, which can cause erectile dysfunction in men and a lower libido in women. If you’re experiencing these symptoms, it’s important to have your blood pressure checked right away
    7. Dementia: There has long been a correlation between high blood pressure and dementia, but a recent study in the European Heart Journal says that even an elevated systolic blood pressure of just 130 mm Hg in middle age can increase your risk for developing dementia in middle age by 38 percent, even though 140 mm Hg is typically the level when medications are prescribed.

    While some high blood pressure can be caused by genetics, far more people have it as a result of unhealthy lifestyle choices, including smoking, heavy drinking, lack of exercise and obesity.

    “One way or another, high blood pressure will catch up to you if you don’t address it,” says Nunan. “It’s not so much a matter if you’ll develop one of the serious conditions caused by high blood pressure, but when. The good news is that you can start today to lower your risk by making healthy lifestyle choices.”

    Cindy Nunan practices at Shore Physicians Group’s Mays Landing office located in the Shore Health Park at 5401 Harding Highway, Suite 3. Her hours are Monday through Thursday, 8:30 a.m. to 5:00 p.m. To make an appointment, call 609-365-6217. Learn more about Cindy Nunan at https://www.shorephysiciansgroup.com/providers/cindy-l-nunan-dnp-fnp-bc/

  5. What Your Stomach Pain Could be Telling You

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    “It must have been something I ate”, is usually the first reaction we have when our stomachs hurt.

    While a recent meal may indeed be the culprit, the cause of abdominal discomfort can be as simple as a digestive problem caused by overeating, eating too late at night, having too much fat in one’s diet, an allergy or intolerance to lactose, fructose and/or gluten. Whether it’s mild abdominal discomfort, cramping or severe abdominal pain there can be many causes.

    We spoke with Dr. Judith Genova, Nurse Practitioner with Shore Physicians Group who has been treating patients with gastrointestinal problems for 15 years. As Dr. Genova explained, most causes of abdominal discomfort lasting 12-24 hours are not worrisome and are often associated with stomach virus, indigestion, constipation, food allergies/intolerance or gas.

    However, it becomes important to seek medical advice from a health care provider when any of the following conditions occur:

    • Severe abdominal pain lasting more than a few hours and associated with fever
    • Inability to keep food or liquids down for 2 days
    • Inability to urinate or have a bowel movement

    There are many causes of abdominal pain including irritable bowel syndrome (IBS), gallstones, kidney stones, appendicitis, diverticulitis, gastroesophageal reflux, Crohn’s disease, or in the case of women, endometriosis. When being evaluated for abdominal pain a health care provider will ask questions and perform a thorough physical examination. Patients may be asked to describe their pain (dull/stabbing/cramping/burning). Other questions relating to abdominal pain may include: is pain associated with eating, is it more noticeable in morning or evening, what eases the pain, and how long has pain been occurring? Based upon patient response to questions and physical examination, testing might be recommended. Diagnostic tests that aid in determining the cause of abdominal pain include: blood, urinalysis, stool samples, x-ray, ultrasound or CT scan.

    Based upon testing, symptoms and physical examination, your health care provider may refer you to a gastroenterologist for further evaluation with colonoscopy and/or endoscopy.

    Symptoms such as uncontrollable vomiting, vomiting blood, black/tarry/bloody bowel movements and/or skin yellow cannot be ignored. Any of these symptoms could signal a serious health problem that would require immediate evaluation and treatment by an emergency room physician.

  6. What You Need to Know if You’re Considering Back Surgery

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    People with debilitating, chronic back pain often understandably wish for a quick and permanent fix, and many turn to surgery hoping for that result. However, while over 90 percent of all Americans will experience back pain at some point in their lives, in most cases, pain is not cured by surgery.

    Before you rush to visit a neurosurgeon, it’s important to determine whether surgery is right for you. Dr. Francis Kralick, a neurosurgeon with Shore Physicians Group, offers the following advice to consider when you’re seeking treatment.

    1. Surgery should be appropriately timed. Dr. Kralick says that while he is certainly happy to see anyone seeking help for their back pain, he never recommends surgery as a first option, even for those he feels will benefit from it.
      “There are many things you should try to alleviate your back pain before you turn to spine surgery. It’s important to first speak with your primary care doctor about these nonsurgical options. Your doctor may recommend physical therapy, acupuncture, or a visit to a pain specialist,” Dr. Kralick says. “In the cases where surgery may have a benefit, we have to first attempt to get you better without an operation, because all operations have risks – especially spine surgery.”
    2. Surgery is only effective for 20 percent of back pain sufferers. Approximately 80 percent of people with back pain will not benefit from surgery. Often the cause of pain cannot be identified. “Pain is a feeling. It cannot be extracted or imaged. I can operate on something that I think may be causing the pain, such as an instability, but if we can’t prove the exact cause of the pain, then the surgery may not work,” says Dr. Kralick. “I have strict parameters for recommending spine surgery to my patients.”
    3. Skip the MRI. When it comes to spinal imaging, MRIs provide such detailed images of your spine and surrounding tissue that it can send physicians down a wild goose chase and lead to unnecessary surgery. “Everyone’s spine begins to age around 20-years-old. MRIs are the test of choice for leg pain, but back pain is better evaluated with X-ray in flexion and extension.”
    4. Spondylolisthesis is usually the only condition that benefits from lower back surgery. Spondylolisthesis is when a vertebra slips over the one below it, and represents an instability. In these cases, when a patient has tried all other treatments, Dr. Kralick will recommend spinal fusion. Spinal fusions essentially join two vertebrae together to provide stability to slipped vertebrae. “My job as a neurosurgeon in performing spine surgery is to relieve pressure on nerves and stabilize an instability. We’ve had great results from spinal fusions in patients.”
    5. A spinal stimulator may be the answer to your back pain relief. One of Dr. Kralick’s preferred devices to help reduce back pain is a spinal stimulator known as HF10, developed by Nevro. HF10 is a small device implanted under the skin at the beltline or in the buttocks that delivers mild electrical pulses to the nerves, interrupting the transmission of pain signals to the brain, thus reducing pain. After a pain specialist performs a trial with you and determines HF10 is effective, Dr. Kralick will perform the minimally invasive insertion at Shore Medical Center. Spinal stimulators have been on the market for 30 years, but HF10 is the only one designated as superior by the FDA for providing significant relief.
      “Spinal stimulators provide us with a way to treat patients without major surgery or getting them on pain medication and creating a situation where they could develop an opiate addiction. We can also use HF10 to wean them off of pain medication.”
    6. Always get a second opinion. If a doctor recommends back surgery, always get a second opinion. “I even tell my own patients to get a second opinion. We care about people and doing the right thing, and part of that means making sure they have a second opinion before they make the commitment.”
    7. If you are a candidate for surgery, you probably don’t need to travel to a major city for it. “All spine surgery can easily be performed at Shore Medical Center in their modern and well-equipped operating rooms located in the Surgical Pavilion,” says Dr. Kralick. “In fact, I recently had a patient referred to me from Philadelphia, and I had incredible results with him.”

    As a neurosurgeon who practiced from 2002 to 2015 at Hahnemann University Hospital in Philadelphia, a level I trauma center, Dr. Kralick brings university-level expertise to the Jersey shore. He also served as chief of the Department of Neurosurgery and Director of Complex Spinal Surgery at Hahnemann. Dr. Kralick is an expert in performing complex, minimally invasive brain and spine surgery with endoscopic and microsurgery techniques. Conditions he treats include degenerative disease of the spine, spine and brain tumors, cerebrospinal fluid anomalies, hydrocephalus, normal pressure hydrocephalus, Chiari malformations and neurosurgical oncology.

    If you would like to schedule an appointment with him, please contact his office at 609-365-6241.

  7. 10 Reasons to Schedule this Important Cancer Screening Today

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    Yes, we know. Getting a colonoscopy isn’t your idea of a good time, but then again, neither is paying bills, taking out the trash or doing the laundry – but you do it anyway, right? When it comes to your recommended colonoscopies, it’s important to take the same approach in order to prevent colorectal cancer or to catch it early. In this article, we share top reasons why if you’re due for a colonoscopy, you should set your fears aside and schedule it today.

    1. You don’t want colorectal cancer. According to the American Cancer Society, colorectal cancer is the third leading cause of cancer-related deaths in men and women in the United States. However, colorectal cancer deaths overall have been declining for decades thanks to colonoscopies, a procedure conducted by a gastroenterologist which detects abnormalities in the colon. During a colonoscopy, if a polyp is found, it will be removed through biopsy and tested for cancer. This both prevents precancerous polyps from turning into cancer, and screens for cancer.Dr. John Millili, a general surgeon with Shore Physicians Group’s Surgical Division at 649 Shore Road in Somers Point, knows first-hand what can happen when people don’t get their recommended colonoscopy. He sees patients when they’ve developed colorectal cancer and are in need of a colectomy, or the removal of part or all of the colon.“Some of the most difficult situations I see are people in their 60s and 70s who neglected to have their colonoscopy and now have colorectal cancer that has spread,” says Dr. Millili. “They could have avoided this with a simple colonoscopy procedure, but now they are faced with a far more serious situation. While surgery can be minimally invasive and lead to good results for many, it’s far better to catch it early in a colonoscopy. If I never had to do another colectomy for cancer again, that would make me very happy.”
    2. You can survive the prep. “Everyone says the prep is the worst part of a colonoscopy, and that’s probably true,” says Dr. Millili. “However, it’s not painful. You just go to the bathroom a lot, kind of like the stomach flu without the pain and cramping. It’s not fun, but you can certainly handle it.”
      Dr. Millili says that following all instructions is the most important thing when prepping for a colonoscopy. “A colonoscopy on a poorly prepped colon is likely to miss abnormalities. If you’re going to do it, it has to be done right or you’ll need another one.”
    3. Colonoscopies don’t hurt. You won’t feel a thing during your colonoscopy because it is conducted under sedation. It’s a same-day outpatient procedure with minimal side effects, even if you have a polyp removed.
    4. You have risk factors for colorectal cancer. People who are at greatest risk for developing colorectal cancer include those who are overweight or obese; lead a sedentary lifestyle; eat a lot of red or processed meats; drink excessively (more than 1 glass a day for women, 2 for men); or are or have been a heavy smoker. Type 2 diabetes is another condition that could increase a person’s risk of developing colorectal cancer.
    5. You have an Inflammatory Bowel Disorder (IBD). People with Crohn’s disease or ulcerative colitis have an increased risk of developing colorectal cancer and follow different screening guidelines than those without IBD. Colonoscopies for this population are recommended every 1 to 2 years, regardless of age.
    6. You have a family history. Colorectal cancer and polyps run in families. If you have a parent, sibling or child with a history of colorectal cancer, your doctor may want you screened before you reach the recommended age of 50.
    7. You may not need another colonoscopy for five to ten years. Precancerous polyps take approximately ten years to develop into cancer. For that reason, if your colonoscopy is normal with no polyps, you’re likely off the hook for a decade. If you do have polyps removed, your doctor may recommend another one in five years.
    8. Colorectal cancer typically only has symptoms when it’s advanced stage. Typically you won’t notice any symptoms of colorectal cancer until it has spread. “Once symptoms appear, your risk from dying of it goes way up,” says Dr. Millili.
    9. Colonoscopies are still the gold standard. Other tests for colorectal cancer are available on the market, but they are less effective and cannot prevent cancer. For example, an at-home stool test like Cologuard, which may be appealing because it doesn’t require a prep, only checks for colorectal cancer DNA and blood in the stool. It won’t remove polyps. There is also a 13% chance your test will be a false positive or false negative. If your test is positive, you will need a colonoscopy anyway. Virtual, or CT, colonoscopies are a relatively new procedure you may have heard about that don’t require sedation, but they do require a full bowel prep. They also don’t remove polyps during this procedure, so if any are discovered, you will need a colonoscopy.
    10. You are uninsured or underinsured. If the cost of a colonoscopy is a problem and you are uninsured or underinsured, you may qualify for financial assistance through the NJ Cancer Education and Early Detection (NJCEED) program. Shore Cancer Center is the lead agency for NJ CEED in Atlantic County. To learn more and find out if you qualify, call 609-653-3484 (Atlantic County) or 609-465-1047 (Cape May County).

    If you are concerned about colorectal cancer, you can take steps today to lower your risk. Make sure you are eating a healthy diet, exercising regularly, and limiting your use of alcohol and tobacco. Ultimately, following the recommended guidelines for colonoscopy screening is your best bet for preventing colorectal cancer. Talk to your doctor today about your risk factors and when you should be screened.

  8. Is This Common Male Problem Keeping You Awake at Night?

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    When you drift off to sleep at night, your body and mind are preparing to be healed and repaired, especially during the deepest sleep stages known as REM. Getting consistent, uninterrupted sleep allows your body to reach this restorative stage of sleep, which helps prevent obesity and chronic illnesses including heart disease and diabetes.

    Often, sleep apnea is the cause of sleep disruptions, but for men 50 and over, there is another prime suspect: benign prostatic hyperplasia (BPH), also known as an enlarged prostate.

    We checked in recently with urologist Dr. Meredith Jankowski, DO to learn more about BPH, its symptoms and treatment options. Dr. Jankowski joined Shore Physicians Group in January in affiliation with Jersey Urology Group and sees patients at SPG’s office located at 649 Shore Rd. in Somers Point.

    Symptoms of an Enlarged Prostate
    The prostate is a walnut-sized gland that sits below the bladder and plays an important role in sexual function. At around age 25, the prostate gland begins to slowly grow. By around age 50, half of men will have a prostate gland large enough to interfere with their ability to urinate – and their quality of life.

    “Symptoms of BPH including frequent urination, difficulty starting urination, a weak or slow flow, difficulty or strain with urination, and a feeling that the bladder is never fully emptied,” says Dr. Jankowski.

    “A lot of the men I treat have been struggling with their BPH symptoms for quite some time, but only come to see me at the urging of their spouse because the symptoms interfere with their lives as well.”

    Dr. Jankowski says in addition to interrupted sleep from frequent awakenings, there are many other ways BPH interferes with patients’ lives.

    “Many patients are reluctant to go on car rides because of the need to stop frequently to use a restroom. When they do go out, they have to constantly be aware of where the restrooms are located. It can also take ten minutes to use the bathroom due to the weak flow, which is disruptive as well. My goal as their urologist is to provide patients with an effective treatment that can help them get their quality of life back.”

    Treatment Options
    Dr. Jankowski first course of action for patients with BPH is to start them on a medication. There are many medications out there that either relax the muscles in the bladder and prostate, or stop prostate growth and reduce its size and help relieve symptoms. However, Dr. Jankowski is quick to note that these medications do not fix the problem. The patient will need to take the medication daily for the rest of their life. There are also unwanted side effects, so it is important patients are aware of this.

    “Medications are really just a Band-Aid, but what BPH patients really want is a fix. Luckily, there are procedures that can actually fix the problem.”

    Dr. Jankowski says the size of the prostate will dictate which procedure is best for the patient. For prostates on the smaller end of the spectrum, there are minimally invasive options that can have the patient back to their normal lives in a day or two. These procedures are called UroLift® and Rezūm. Another procedure, known as a resection, is slightly more invasive but has almost immediate results. For the largest prostates, however, Dr. Jankowski recommends a prostatectomy, or removal of the prostate. While the previously mentioned procedures can be performed at Shore Medical Center, Dr. Jankowski prefers to send her patients in need of a prostatectomy to Penn Medicine because they perform these procedures more frequently.

    Although there are side effects and discomfort from these procedures, Dr. Jankowski says most do not last long and are a small price to pay in order to get their freedom back.

    “An enlarged prostate really can hinder a man’s ability to enjoy life fully,” says Dr. Jankowski. “The good news is that we can treat it, and get them back to the life they enjoyed before BPH.”

    Risks of Not Treating an Enlarged Prostate
    While BPH is by definition ‘benign’ in the sense that the overgrowth is not cancerous, an enlarged prostate can be dangerous if left untreated.

    “The longer the bladder pushes against an outlet obstruction, the greater the risk is that the patient will experience bladder failure in the future. That’s when the bladder basically gets tired and shuts down. This can lead to kidney failure over time, as well as a need for permanent catheterization in order to empty the bladder,” says Dr. Jankowski.

    “Another reason to see a urologist when you have BPH symptoms is that prostate cancer can present like BPH. That’s why it’s important to come see me as soon as possible – nobody wants that outcome.”

    About the Appointment
    In addition to addressing a patient’s BPH concerns at the visit, Dr. Jankowski also takes the opportunity to perform a prostate cancer screening for men age 55 or older. Prostate cancer is the most common cancer in men, but it is also treatable when discovered in its early stages.

    “I understand visiting a urologist is not everyone’s favorite thing, so I like to address prostate cancer at the appointment as well, killing two birds with one stone. I encourage anyone who is experiencing BPH symptoms or age 55 or older to schedule an appointment with me,” says Dr. Jankowski.

    To schedule an appointment with Dr. Jankowski, call 609-365-6241.

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