The American Urological Association Foundation www.KnowYourStats.org 2 Table of Contents About the American Urological Association Foundation The AUA Foundation is the world’s leading nonprofit urological health foundation and the official Foundation of the American Urological Association. Our goal is to promote health, provide hope and promise a future free of urologic disease, including cancer. As the official foundation of the AUA, the professional organization of approximately 18,000 urologists, the AUA Foundation is the trusted public source for the most accurate and current information relating to urological health. Knowledge is power. By reading and learning from this Playbook, you are taking the first step toward your Game Plan for continued urologic health and well-being. Monitor your prostate health with regular exams and a simple blood test. Knowing your “stats” or baseline levels of prostate-specific antigen (PSA) and having regular prostate exams will help you keep track of changes and seek medical care for problems that could put you on the sidelines – or take you out of the game for good. I. Pregame Preparation Pg. 2 II. What is Prostate Cancer Screening? Pg. 4 III. What is Enlarged Prostate? Pg. 7 IV. What is Prostatitis? Pg. 9 V. What is Prostate Cancer? Pg. 10 VI. What are the Treatment Options? Pg. 12 VII. What is Incontinence? Pg. 13 VIII. What is Sexual Health? Pg. 14 IX. Glossary/Definitions Pg. 15 X. Pg. 16 Post-Game Wrap Up www.KnowYourStats.org 1 The Know Your Stats About Prostate Cancer® campaign, a collaboration between the AUA Foundation and the National Football League, has already touched 300 million men and their families. Through a national conversation about prostate cancer risk, diagnosis, treatment, and for some, learning to live with the disease and its aftermath, this campaign is making a difference for the more than 200,000 American men who will be diagnosed every year. Through the example of our favorite heroes of football, these larger-than-life athletes like Pro Football Hall of Famer and prostate cancer survivor Mike Haynes, Know Your Stats has been a lifeline for men who don’t know their risk, or have already learned that they suffer from prostate cancer, a disease that kills more men each year than almost any other cancer. Beginning at age 40, all men should work with their doctor to establish a baseline, and track their risk together. As a national spokesperson for the campaign, Mike participates in media interviews across the country to raise awareness of prostate cancer stats. One in six men will develop prostate cancer in their lifetime (for AfricanAmericans like Mike it’s one in three). Mike’s story gives hope to those diagnosed and in treatment. Mike and his Team Haynes members work together to get this powerful message out to men everywhere. After reading this Playbook, go to KnowYourStats.org to learn more and find an event taking place near you. Throughout the football season, hospitals and doctors’ offices across the country are hosting screenings and educational events to help local families learn about this devastating disease. 2 www.KnowYourStats.org Pregame Preparation: What should you know about your prostate? Prostate health — much like success in football — depends primarily upon key members of the team. In prostate health, the urologist is your head coach, the leader of your healthcare team, which also includes you, your family and your friends working together to design and execute a game plan that best suits your needs. Any football fan or player knows the best offense is a good defense. Learning about your prostate can help you know your opponent and give you the best plays to keep you off the sidelines and in the game — the game of life, that is. Only men have a prostate.* Part of the male reproductive system, the prostate is located just below the bladder and in front of the rectum. It surrounds the urethra, the tube that carries urine from the bladder and semen through the penis and out of the body. The prostate’s main job is to help create semen — the fluid that helps protect and energize the sperm — by producing ejaculatory fluid. Think of semen as the offensive line. As the sperm run into the end zone, where the female egg is waiting, the semen protects the sperm so they can fertilize the egg and form a new life — touchdown! The seminal vesicles, located next to the prostate, also add fluid to semen. The most common prostate health problems are non-cancerous enlarged prostate (benign prostatic hyperplasia, or BPH), inflammatory disease (prostatitis) and prostate cancer. Because of its location inside the pelvis, there are no simple self-exams for men to check their own prostate. Doctors use two tests to monitor prostate health: the digital rectal examination (DRE) and a blood test called prostate-specific antigen (PSA). The American Urological Association (AUA) recommends that early detection and risk assessment of prostate cancer should be offered to men 40 years of age or older. Your baseline PSA value in your 40s can then be used to compare with future PSA tests to help identify life-threatening prostate cancer. *All words that appear in italics are explained in the glossary. More than 33,000 men die each year from prostate cancer in the United States. www.KnowYourStats.org 3 What is the PSA test? This blood test measures the level of prostate-specific antigen (PSA) in the blood. Very little PSA is found in the blood of a man with a completely healthy prostate. Keeping your opponent’s score low is the name of the game and a low PSA is better for prostate health. A rapid rise in PSA (known as velocity) may be a sign that something is wrong. One possible cause of a high PSA level is enlargement of the prostate. Inflammation of the prostate, called prostatitis, is another possible cause. Prostate cancer is the most serious cause of an increased PSA level. You should know your PSA score and discuss changes with your doctor so you can stay on top of your game. The male urinary tract. The prostate surrounds the urethra, through which urine leaves the bladder. Image provided courtesy of National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health What is the DRE? During the DRE, the doctor inserts a lubricated gloved finger into the rectum. He or she feels for abnormal size, shape or consistency in the prostate. The DRE can help the doctor decide if a man has an enlarged prostate or other prostate problems. However, the DRE by itself is not the only way to detect prostate cancer. A man should also have a PSA test. Digital rectal exam (DRE). 4 Image provided courtesy of National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health www.KnowYourStats.org More than 200,000 men in the United States will be diagnosed with prostate cancer this year. AUA International Prostate Symptom Score Index Total score: 0–7 mildly symptomatic; 8–19 moderately symptomatic; 20-35 severely symptomatic. Not at all Less than 1 time in 5 Less than half the time About half the time More than half the time Almost always Incomplete emptying — Over the past month, how often have you had a sensation of not emptying your bladder completely? 0 1 2 3 4 5 Frequency — Over the past month, how often have you had to urinate again less than two hours after you finished urinating? 0 1 2 3 4 5 Intermittency — Over the past month, how often have you found you stopped and started again several times when you urinated? 0 1 2 3 4 5 Urgency — Over the last month, how difficult have you found it to postpone urination? 0 1 2 3 4 5 Weak stream — Over the past month, how often have you had a weak urinary stream? 0 1 2 3 4 5 Straining — Over the past month, how often have you had to push or strain to begin urination? 0 1 2 3 4 5 None 1 time 2 times 3 times 4 times 5 times or more 0 1 2 3 4 5 Delighted Pleased Mostly satisfied Mixed: about equally satisfied and dissatisfied Mostly dissatisfied Unhappy Terrible 0 1 2 3 4 5 6 Nocturia — Over the past month, how many times on average did you typically get up to urinate, from when you went to bed until you got up in the morning? Your score Your score Total IPSS score Quality of life due to urinary symptoms If you were to spend the rest of your life with your urinary condition the way it is now, how would you feel about that? 6 www.KnowYourStats.org Enlarged Prostate The prostate may become larger and start to cause problems as a man ages. Enlarged prostate is also known as benign prostatic hyperplasia (BPH). The prostate of a 50-year-old man weighs about 20 to 30 grams and is about the size of a walnut or golf ball; however, it may grow to 50 to 100 grams (almost the size of a baseball) or more. As the prostate enlarges, it can squeeze the urethra, which can cause some men to experience lower urinary tract symptoms (LUTS), including symptoms from the International Prostate Symptom Score Index on the previous page. Who is at risk for enlarged prostate? Aging is the biggest known risk factor for an enlarged prostate. Clinical trials suggest that family history, obesity and high blood sugar could also be risk factors. How is an enlarged prostate diagnosed? The American Urological Association (AUA) designed a series of questions to determine how often symptoms occur. The International Prostate Symptom Score Index, on the previous page, helps doctors measure the problems caused by an enlarged prostate, ranging from mild to severe. Side view drawing of the male urinary tract, showing the prostate. Image provided courtesy of National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health When a doctor checks a man for an enlarged prostate, he or she takes a thorough medical history. The doctor performs a physical exam, including a DRE. He or she may also ask questions from the AUA International Prostate Symptom Score Index. The doctor will often do a urine test called a urinalysis and may offer to conduct other medical tests, including the PSA blood test, for a man who may have an enlarged prostate. When should a man see a urologist about an enlarged prostate? A man should see a doctor if he has any of the symptoms mentioned previously. In addition, he should see a doctor immediately if he has blood in his urine, pain or burning with urination or is unable to urinate. An enlarged prostate is not cancer and cannot lead to cancer, although both conditions can exist together. There may not be any symptoms during the early stages of prostate cancer; therefore, yearly physical examinations and PSA tests are highly recommended. What is the game plan to treat enlarged prostate problems? As men age, enlarged prostates can get worse. Knowing if you have an enlarged prostate can help your game plan. An enlarged prostate can lead to bladder damage, infection and even kidney damage. A doctor will examine a man with an enlarged prostate to determine the best treatment options. One way to tackle an enlarged prostate may include medication. If medication does not work, some minimally invasive options and surgical procedures may help with the lower urinary tract symptoms. If the symptoms do not improve after treatment, men should consult their doctor to determine if a different issue might be causing their symptoms. www.KnowYourStats.org 7 Researchers estimate that 10–12% of men experience prostatitis-like symptoms. www.KnowYourStats.org 8 Prostatitis Occurring mostly in young and middle-aged men, prostatitis is a common and painful disease of the prostate gland and its surrounding structures. Although prostatitis is not the end of the game, it can put any player on the sidelines. Doctors may have difficulty diagnosing prostatitis because the symptoms are not the same for every man. Many of the symptoms — such as painful or burning urination and incomplete emptying of the bladder — could be signs of another disease. Researchers estimate that 10–12% of men experience prostatitis-like symptoms. How is prostatitis diagnosed? Although the term prostatitis means inflammation of the prostate, doctors use the term to describe four different disorders. It can be chronic, and keep coming back. It can also be acute, and come on suddenly. Some cases of prostatitis are caused by bacteria. For some men, the cause of their prostatitis is not known. What is the game plan to treat prostatitis? The treatment is different for the different types of prostatitis disorders. It is important to make sure other conditions — such as urethritis, cystitis, an enlarged prostate, or cancer — are not causing the symptoms. To help make an accurate diagnosis, several types of examinations are useful. These include a DRE and PSA. A prostate infection can raise your PSA level. The doctor may also analyze samples of urine and prostatic fluid for signs of inflammation and infection. These samples may help the urologist determine whether the problem is inflammation or infection and whether the problem is in the urethra, bladder or prostate. The urologist may use cystoscopy — passing a small telescope through the urethra to see inside the urethra, prostate and bladder. The urologist may also order urine flow studies, which help measure the strength of your urine flow and any blockage caused by the prostate, urethra or pelvic muscles. The treatment recommended often depends on the type of prostatitis a man has. For many men with prostatitis, the urologist may give antibiotics. Depending on his symptoms, a man may receive other treatments as well. Although prostatitis may place you on the sidelines, it is not life threatening. Treatments are available once you are diagnosed. www.KnowYourStats.org 9 Prostate Cancer This year more than 200,000 American men will learn they have prostate cancer — more than twice the number of fans who could fit in FedEx Field, home of the NFL Washington Redskins! Sometimes this cancer can be small, slow growing, and of limited risk to the patient. Other prostate cancers may threaten a man’s well-being or life. More than 33,000 men die each year from prostate cancer in the United States. What are the causes and risks of prostate cancer? Although prostate cancer is rare before age 40, the risk increases with age. One in six men in the United States faces a diagnosis of prostate cancer in his lifetime. Researchers are still studying what causes prostate cancer, but men with a close family member (father, brother, or uncle) and those with a high intake of fat in their diets are at a greater risk of getting prostate cancer. Most doctors agree that, if you do things that are heart healthy, you will also help keep your prostate healthy. Eating right, exercising, watching your weight and not smoking can improve men’s health and help them stay in the game. What are the symptoms of prostate cancer? In the early stage, prostate cancer often causes no symptoms. When symptoms do occur, they may include any of the following: dull pain in the lower pelvic area; frequent urination; problems with urination, such as the inability to urinate, pain, burning, or weakened urine flow; blood in the urine or semen; painful ejaculation; general pain in the lower back, hips, or upper thighs; loss of appetite and/or weight; and persistent bone pain. Some of the symptoms can be similar to those of BPH, so it is very important to have a PSA and DRE when you have such symptoms. How is prostate cancer diagnosed? The PSA and DRE are the main methods for screening for prostate cancer (see page 4). Based on 2009 recommendations from the American Urological 10 www.KnowYourStats.org Association, men should be offered a baseline PSA and DRE starting at age 40. Each man should talk to his doctor about his risk factors and the best screening schedule for him. Just as knowing the score and time in football games leads to a particular game plan, knowing your PSA “score” will help you identify changes in your PSA that may indicate prostate problems — including cancer. If the PSA and/or DRE suggest further testing, a prostate biopsy is the next step for diagnosing prostate cancer. The biopsy removes small pieces of prostate tissue. A pathologist, a physician who examines human tissue to see whether it is normal or diseased, examines the prostate tissue to confirm if cancer is present. If cancer is detected, the pathologist will also grade the tumor. The grade indicates the tumor’s degree of aggressiveness — that is, how quickly it is likely to grow and spread. What is the game plan to treat prostate cancer? There are many treatment game plans for men with prostate cancer. Like going for it on fourth down, you and your healthcare team must examine the risks associated with each treatment and determine the most effective play for you to win. The best option for each man depends on various factors, including age, overall health, stage and grade of the cancer, and personal preferences. Just as a head coach must prepare a separate game plan for every opposing team, prostate cancer patients are treated differently depending upon the characteristics of both themselves and their disease. Once diagnosed, men should discuss their treatment options with their healthcare team. 1 in 6 men will be diagnosed with prostate cancer in his lifetime. Choosing a Treatment Your treatment choice should be based on your personal health and thoroughly discussed with your physician and family. While treatment choices vary, every year more men are surviving prostate cancer and winning back their lives. Prostate cancer can be a manageable disease if caught early and treated appropriately. What is the game plan to treat prostate cancer? Active surveillance, or “watchful waiting,” is monitoring the cancer via PSA, DRE and possible biopsies on a regular basis. Your prostate cancer may never become life-threatening and you may not need immediate treatment. This treatment allows men to maintain their quality of life. It is a suitable option for men not experiencing symptoms, when the cancer is not expected to grow at an aggressive rate and for older men and/or men who have other serious health conditions. Radiation therapy uses high-energy rays or particles to kill cancer cells. An initial treatment for cancer still confined within the prostate or only spread to nearby tissue, radiation therapy is also used if the cancer is not completely removed or returns after surgery. Imaging tests are performed to determine the exact location of the tumor. There are two forms: interstitial brachytherapy and external beam radiation. Radical Prostatectomy is the surgical removal of the entire prostate, the seminal vesicles, the immediate surrounding tissue and some of the associated lymph nodes. Cancer cells may be scattered throughout the prostate gland in an unpredictable way, thus the entire prostate must be removed. There are several types of radical prostatectomy procedures, which include: retropubic open radical prostatectomy, perineal prostatectomy, robotic-assisted prostatectomy and laparoscopic prostatectomy. 12 www.KnowYourStats.org Cryotherapy freezes the prostate to destroy cancer cells. During cryosurgery, your doctor places small needles into the prostate. A cold gas is placed into the needles, freezing the prostate tumor and surrounding tissues. After each freezing process (there are usually two), the tissue is able to thaw; this repeated freezing and thawing cycle kills the cancer cells. Hormonal therapy uses medications to lower testosterone and can stop or slow the growth of prostate cancer in the prostate or other organs in the body. Chemotherapy drugs may destroy prostate cancer cells that have spread. Hormone therapy and chemotherapy are most often used as a method of reducing prostate cancer growth and minimizing prostate cancerrelated symptoms. After treatment, you may feel like you ran into the end zone while scoring the game-winning touchdown – very emotional and potentially exhilarated. You could also feel anxious with thoughts of recurrence. Whatever you’re feeling, talk to your doctor about any issues you may have so you can work together as a team. Now that you know your stats about the disease, and you’ve developed a solid game plan with your doctor, it’s time to plan out your defense for any side effects of treatment. Life After Prostate Cancer Incontinence is the inability to control your urine. After prostate cancer treatment, you may experience leakage or dribbling of urine. While this is very common, being incontinent can affect your physical and emotional recovery. What are the different types of incontinence? There are several types of incontinence. Stress incontinence, the most common, is urine leakage when coughing, laughing, sneezing or even exercising. It is caused by problems with the muscular valve that keeps urine in the bladder (the bladder sphincter). Prostate cancer surgery or radiation may irritate or compromise the muscles that form this valve or the nerves that keep the muscles working. Overflow incontinence occurs when you are not able to empty the bladder completely. You may find yourself taking longer to urinate, and when you do, it is not a powerful stream. This can occur because of a blockage or narrowing of the bladder outlet caused by scar tissue. Men with urge incontinence have a sudden need to go to the bathroom and pass urine even when the bladder is not full because the bladder has become overly sensitive. Mixed incontinence is a combination of stress and urge incontinence with symptoms from both types. While uncommon, some men can experience continuous incontinence, the inability to control urine at anytime. How long can incontinence last after treatment? After surgery or radiation, improvement in urine control can take several weeks to several months. It varies from patient to patient, and your particular recovery could be quick or slow. You should talk to your doctor about what to expect after treatment. What is the game plan to treat incontinence? Treatment is based on numerous factors, including the type and severity of your incontinence. While you may feel embarrassed, it is a common occurrence and can be treated; you can potentially regain complete control and get back into the game. Before and after treatment, you may be told to perform Kegel exercises, which help to strengthen your bladder control muscles. These exercises involve tensing and relaxing certain pelvic floor muscles. You may need to modify your diet, liquid intake and medications to decrease your urination frequency. For more short-term options, your urologist may prescribe medications that affect the nerves and muscles around the bladder, helping to maintain better control. Neuromuscular electrical stimulations can strengthen bladder muscles. A long-term treatment option is additional surgery. Surgery can consist of injecting collagen (a natural protein) into the bladder opening and urethra to tighten the bladder sphincter, surgically implanting a small device called a urethral sling to tighten the bladder neck, or an artificial sphincter, which is a device used to control urination. If your incontinence is not adequately managed with these options, talk with your urologist and create a game plan. There are a wide variety of products such as adult undergarments available to help you cope with this condition. www.KnowYourStats.org 13 Life After Prostate Cancer Now you have completed treatment, and it is time to begin thinking about the post-season. Maintaining a good sexual lifestyle is important not only for your health but also for the health of your relationship with your partner. While erectile dysfunction (ED) is common after treatment, it can be treated. What causes erectile dysfunction after prostate cancer treatment? What is the game plan to treat erectile dysfunction? Surgeries may cause damage to nerve bundles that control blood flow to the penis, causing ED. Nerves that are involved in an erection surround the prostate gland; and, while most surgeons try to perform a nerve-sparing procedure, saving the nerves from damage is not always possible. The cancer may have spread, encompassing the nerves and making it necessary to remove them. Once the nerves are damaged or removed, the signal that is sent from the brain to the penis to stimulate erections is lost. To get the maximum benefit from treatment, it is important to be able to clearly communicate not only with your doctor but your partner, who is an important part of your team. In addition, there could be a decreased amount of blood flowing to the penis post-treatment. During surgery, the blood vessels that supply blood to the penis to help it engorge during arousal are damaged. While blood will still flow to the penis, it may not be enough to create an erect penis for penetration. How long can ED last after treatment? Men can experience ED issues for varying periods of time. However, the ability to recover is partially dependent on sexual performance before surgery, as well as the type of treatment. It is important to know some men may regain full ability after surgery, but many men will not. If you are having trouble, do not feel embarrassed. Your doctor can provide you with a variety of treatment options for your playbook. 14 www.KnowYourStats.org Oral medications are generally the first line of treatment for ED by improving blood flow to the penis. Vacuum pumps are mechanical devices used to create an erection. Medical injections are used to allow for more blood flow, which creates an erection. Your doctor can help you decide which option is best for you. If ED persists, a permanent penile implant may be an option. This surgical procedure places a device in the erectile tissue of the penis. There are two types of implants and, depending on your need, your doctor can help determine which one is best for you. If any of these treatment options are necessary, your urologist will help you decide on the best choice for a game-winning season. What is most important to remember is that there are options that can work for every patient. In order to achieve better sexual health, you should have an open and honest conversation with your doctor. The Prostate Health Playbook Glossary Active surveillance/watchful waiting: Monitoring the cancer via PSA, DRE and biopsies on a regular basis Benign prostatic hyperplasia (BPH): An enlarged prostate not caused by cancer. BPH can cause problems with urination because the prostate squeezes the urethra at the opening of the bladder Biopsy: A tiny piece of prostate tissue is removed for examination under a microscope to determine if cancer or other abnormal cells are present Bladder: The balloon-shaped pouch of thin, flexible muscle in which urine is temporarily stored before being discharged through the urethra Chemotherapy: The use of medications to destroy prostate cancer cells Cystitis: Urinary tract infection that causes inflammation of the bladder and results in pain and a burning feeling in the pelvis or urethra Cystoscopy: An examination using a narrow, flexible tube-like instrument passed through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones Cryotherapy: Destruction of prostate cancer cells through freezing Digital rectal examination (DRE): The insertion of a gloved, lubricated finger into the rectum to feel the prostate and check for any abnormalities Ejaculation: Release of semen from the penis during sexual climax Erectile dysfunction: The inability to achieve or maintain an erection Incontinence: Leakage of urine. There are various types: stress, overflow, urge, mixed and continuous Hormonal therapy: Use of medications to lower testosterone to stop or slow the growth of prostate cancer Kegel exercises: Exercises to strengthen bladder control by tensing and relaxing certain pelvic floor muscles Lymph nodes: Rounded masses of tissue that produce cells to fight foreign agents invading the body Nerve-sparing procedure: Surgical technique to avoid damaging the nerve bundles surrounding the prostate which control blood flow to the penis Pathologist: Scientist skilled in identifying the cause and progress of diseases by examining tissue and fluid from the body Pelvic: Relating to, involving or located in or near the pelvis Penis: The male organ used for urination and sex Prostate: In men, a walnut-shaped gland that surrounds the urethra at the neck of the bladder. The prostate supplies fluid that goes into semen Prostatitis: Inflammation or infection of the prostate. Chronic prostatitis refers to the repeated inflammation of the prostate Prostate-specific antigen (PSA): A protein made only by the prostate. High levels of PSA in the blood may be a sign of prostate cancer Radiation therapy: Use of radiation to treat prostate cancer; two options include brachytherapy (small radioactive “seeds” implanted in the prostate) and external beam radiation (carefully-targeted beams to treat the prostate) Radical prostectomy: Surgery to remove the entire prostate and cancerous tissues; includes two approaches: retropubic and perineal Rectum: The lower part of the large intestine, ending in the anal opening Recurrence: The return of cancer after treatment in the same location or another part of the body Semen: Also known as seminal fluid or ejaculate fluid Seminal vesicles: Produce fluid to provide sperm with a source of energy to help it move. This fluid makes up most of the volume of a man’s semen Sperm: Also referred to as spermatozoa. Male reproductive cells produced by the testicles that are capable of fertilizing the female partner’s eggs Tissue: Group of cells in an organism that is similar in form and function Tumor: An abnormal mass of tissue or growth of cells Urethra: In males, this narrow tube carries urine from the bladder to the outside of the body; it also serves as the channel through which semen is ejaculated. Extends from the bladder to the tip of the penis Urethritis: Inflammation of the urethra Urinalysis: Examination of urine to assess general health of the body Urinary tract: System that takes waste from the blood and carries it out of the body in the form of urine. Passageway from the kidneys to the ureters, bladder and urethra Urinate: To excrete urine Urine: Liquid waste product filtered from the blood by the kidneys, stored in the bladder and expelled from the body through the urethra by the act of urinating (voiding) www.KnowYourStats.org 15 POST-Game Wrap Up Prostate health is important for all men. Winning the battle against prostate diseases involves a team approach. With a solid head coach (urologist) leading the way and a team made up of healthcare workers and your family and friends, you will be on the path to victory. When a prostate problem arises, be sure to huddle up with your entire team, move into formation, and keep your head up as you advance toward your ultimate treatment option, leading to a cure … touchdown and the extra point! The American Urological Association Foundation The AUA Foundation provides this information based on current medical and scientific knowledge. This information is not a tool for self-diagnosis or a substitute for professional medical advice and should not be used or relied upon for such purposes. Please see your urologist or other healthcare provider regarding any health concerns, and always consult a healthcare professional before you start or stop any treatments, including medications. Please go to our Web site — www.KnowYourStats.org — or call the National Urology Health Line at 1-800-828-7866 for more information about prostate or other urological health concerns. 16 www.KnowYourStats.org Notes www.KnowYourStats.org 17 Any football fan knows the best offense is a good defense. The American Urological Association Foundation Prostate Health PLAYBOOK Now that you have been informed, please help us get the word out in your community! The AUA Foundation is committed to helping the one in six men who will develop prostate cancer in their lifetime. One in six — that means that one of your friends may already be facing a future with prostate cancer. Please help today by making a donation in support of this vital educational outreach program. For more information, contact the AUA Foundation 1000 Corporate Blvd. Linthicum, MD 21090 Urology Health Line: 1-800-828-7866 www.UrologyHealth.org The NFL has teamed up with the AUA Foundation to bring you the Know Your Stats About Prostate Cancer® campaign. Your teammates are counting on you. Log on to KnowYourStats.org to make a donation today. 1 © 2011 AUA Foundation. All rights reserved. The American Urological Association Foundation is a 501(c)(3) nonprofit organization. Donations made to the foundation are tax deductible to the fullest extent of the law. Patient resources supported by an educational grant from American Medical Systems, Inc.
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