Editors’ Note

Dr. Peter Schlegel is also Professor of Reproductive Medicine at the Weill Cornell Medical College of Cornell University; a Staff Scientist at The Population Council, Center for Biomedical Research; and a Visiting Associate Physician at The Rockefeller University Hospital. He is also Urologist-in-Chief and an Attending Urologist at the New York-Presbyterian Hospital. Schlegel has been listed as an expert in nerve-sparing radical prostatectomy techniques as well as male infertility by Castle Connolly’s “Best Doctors” Guide since 1999. His expertise in urology has been recognized by national and international authorities with invitations from the National Institutes of Health and The American Urological Association. Schlegel is a former Co-Editor of the Journal of Andrology, and previously on the Board of Directors of the American Society for Reproductive Medicine. He is a board-certified Urologist who served as a Senior Consultant in Imaging after working as Task Force Chairman on the American Board of Urology/AUA Examination Committee and is currently a trustee of the American Board of Urology. He graduated near the top of his class from the University of Massachusetts Medical School and received training at Johns Hopkins Hospital in Urology. He became Chairman of the Department of Urology in November of 2003 .

organization Brief

The Urology Department at Cornell continues to be a leader in the treatment of all urologic conditions in men and women. Expansion of the area of urologic oncology has allowed the Weill Cornell Medical Center to be nationally and internationally recognized as a site for outstanding care in robotic prostatectomy. In addition, the Urologic Oncology group also provides optimal care of patients with bladder, prostate, kidney, and other urologic cancers. The Weill Cornell Center of New York-Presbyterian Hospital is the most advanced center in the region for minimally invasive treatment of kidney tumors as well as removal of kidneys for transplantation.

Founded in 1898, and affiliated with what is now New York-Presbyterian Hospital since 1927, Weill Cornell Medical College (www.med.cornell.edu) is among the top-ranked clinical and medical research centers in the country. Weill Cornell Medical College is divided into 24 basic science and patient care departments that focus on the sciences underlying clinical medicine and/or encompass the study, treatment, and prevention of human diseases. Weill Cornell Medical College is accredited by the Liaison Committee on Medical Education of the American Medical Association and the Association of American Medical Colleges.

What should someone know as they grow older to help protect themselves against prostate problems?

People should have an awareness of what issues or problems can occur, particularly with men and urination and with their prostate health.

So if men are noticing a change in their urinary pattern that is affecting their lifestyle, it’s something that should be evaluated, because it’s usually a benign problem that can be treated.

If men have a family history of prostate cancer or they’re of African-American descent, it’s very important for them to have their prostate followed very closely for the risk of developing prostate cancer.

All men should have some awareness that prostate cancer can develop and that early treatment may help them.

In terms of diet, what can one do to work towards preventing kidney stones and various cancers like prostate?

The vast majority of people who develop kidney stones have urine that is too concentrated and materials precipitate out as stones. So if you drink more fluids, you will prevent kidney stones, or at least prevent the further development of kidney stones in the vast majority of cases.

It’s best to drink a large glass of water or two before going to bed, and if you get up at night, drink more water – that prevents dehydration while you’re asleep, which can contribute to stones forming.

Prostate cancer is one of the more genetically-based cancers that we know of. The environmental factors that promote the risk of prostate cancer are probably related to fats in the diet and amount of vitamin D in the body. You can take more vitamin D and get some production of vitamin D from sun exposure. And if you limit fats in your diet, particularly fats from red meat, that appears to dramatically decrease your risk of developing prostate cancer.

If you take an Asian man, who genetically has a low risk of prostate cancer, and he moves to the U.S., his risk of prostate cancer goes up substantially, typically because of dietary changes.

Is there anything else that someone should know to prevent having to see you?

One of the important things to remember is that most of the things that give you risk for prostate cancer are the same things that give you risk for heart disease and other conditions.

All the things you do to be heart healthy – modest doses of antioxidants, decreasing the amount of fats in your diet – are prostate healthy and help to prevent problems.

In terms of benign problems, like urinary problems that occur because the prostate is enlarging, we don’t have much insight into how to prevent those issues, but we have a lot of medications that can be used to reduce the progression of symptoms and prevent the need for surgery or development of infections.

In terms of prostate cancer, there is a class of drugs (5-alpha-reductase inhibitors, finasteride, and dutasteride) that helps to shrink the prostate that may also reduce the risk of prostate cancer and for people that are at high risk, that might be something to consider taking earlier in their lives.

What frustrates you the most from a professional standpoint?

We have interventions to detect and treat prostate cancer, and they will help a large proportion of men, and the suffering from prostate cancer is now dramatically less than it was before, but we still have debates over how much we should spend to prevent prostate cancer death and how many people we should evaluate and screen to provide those treatments. And we are not effectively getting the message out about what people can do to help themselves prevent prostate problems that can affect up to 10 or 15 percent of men during their lives.•