Articles

10 Questions Men Must Ask About Their Urinary Symptoms

Lower urinary tract symptoms in men are amongst the most common reasons for urological visit. In this blog, I explore 10 questions that every man must ask when seeking urological help for these symptoms. Are my symptoms related to my prostate? The natural assumption is that urinary symptoms in men are related to a growing...
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Large Tumor in a Horseshoe Kidney

    80 year old gentlemen who had a CT scan done by his GI physician for nausea and vomiting Found to have a 9 cm tumor in his right kidney, but his kidneys were both joined together in the middle of his body, something we describe as a “horseshoe kidney Ordinarily, such large tumors...
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“The Tumor” By Noor Rahman

There was too much chaos and all I heard are battle cries. I couldn’t see or think.  It was all around me and there was no escape, but the thing is, I couldn’t tell the difference between my own voice and the others. I was trying to be louder than the crowd, but it was...
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THE THRILL OF A MISDIAGNOSED CANCER

“Dr. Rahman, can you squeeze in this patient today, she has kidney mass and is having fevers, and they really want to be seen today by you?” Already facing a full day, I advised my triage nurse that if the patient could be in the office before 4:30 I would see her. She obliged and...
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WHAT’S AILING US? FATIGUE AND THE TESTOSTERONE MYTH

    “I am tired all the time and my primary care doctor found my testosterone is low” I deal with some variation of this chief complaint several times per week.  As urologists, we deal with the many endocrine abnormalities involving the testosterone axis. The more I’ve encountered and studied this clinical theme in my...
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10 Essential Questions When Diagnosed With Bladder Cancer

Over 80,000 new cases of bladder cancer are diagnosed every year.  Of the new cases, over 62,000 are men, and over 18,000 are women.  Whites have higher incidence rates than blacks, although black patients have higher mortality rates, particularly black women.  The majority of cases are found with painless gross hematuria (although most patients with...
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WHEN CANCER ISN’T REALLY CANCER

One of the hardest jobs as a physician is to tell a patient and family that they have been diagnosed with cancer. As a urologist dealing with prostate, bladder and kidney cancer, I often give potentially life-threatening diagnosis while simultaneously reassuring hope and optimism, a skill that requires a deft mastery of the art of...
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CORPORATIZATION OF MEDICINE: TRADING EXCELLENCE FOR MEDIOCRITY

Have you ever been to a doctor’s office and felt that your evaluation was rushed? Have you been seen in the emergency room and felt that you were just a number in a long series of patients? Have you ever seen the same doctor for years and felt like the doctor just met you for...
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RELATIONSHIP STATUS: IT’S COMPLICATED

The operative word describing the relationship between pharmaceutical companies and physicians is“complicated”.  These companies are responsible for innovative medicines, including cancer therapies providing hope to patients where none previously existed.  For example, when I started nearly 15 years ago very little could be offered to prostate cancer patients when hormonal therapy failed.   In the last...
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Medicine and Racial Bias: The Patient Experience

“Yolanda’s biggest problem is she needs to stop doing drugs,” exclaimed one of the doctors as he was talking to a nurse about Yolanda’s pain, implying that Yolanda was an addict to street drugs. In the early stages of my private practice career, I was shocked as I heard him utter these words, as she...
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A Case of a Uterovaginal Fistula

“Dr. Rahman, this is the nurse in OR 12, Dr. H is doing a robotic/laparoscopic hysterectomy, he thinks he’s injured the ureter, and is requesting help. Are you available?” There was a surge of adrenaline in my system as I answered this call in my office, as I know what came next was going to...
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I HAD RADIATION TREATMENT FOR PROSTATE CANCER. HOW DO I KNOW IF MY CANCER HAS RETURNED, AND WHAT DO I DO?

As I have highlighted in other posts, prostate cancer is heterogeneous and often lethal with more than 30,000 deaths per year. Whether surgery, radiation, cryosurgery, chemo or hormonal ablation therapy, treatment for cancer is challenging, and it takes patience and support, from healthcare providers and family, for patients to get through treatment. Fortunately, patients and...
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CAUSATION VS. CORRELATION: THAT IS THE QUESTION!

In the early 1990s large scale studies demonstrated that patient’s undergoing vasectomies had a higher risk of prostate cancer. The common explanation was that there was some statistical correlation between these two findings (perhaps stemming from a younger population exposed to a urologist, i.e. those undergoing vasectomies, were more likely to engage in prostate cancer...
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10 QUESTIONS TO ASK WHEN DIAGNOSED WITH PROSTATE CANCER

Prostate cancer often presents unique challenges to patients and physicians alike. It can be indolent and non-aggressive, or life-threatening, and everything in between. With the multiple treatments (surgery, radiation, hormonal ablation, HIFU, cryoablation) that are available, patients, family members, physicians and even the non-expert urologist are often confused and frustrated. Unlike most cancers that have...
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FROM THE TRENCHES: SATISFACTION IN SIMPLICITY

“I am really uncomfortable and in pain,” said Elaine, tearfully as I met her in the preoperative area for the first time. She had a very sad and difficult history, dealing with complications from childbirth nearly two years ago. She had developed a communication between her rectum and vagina, which allowed feces to come out...
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AGING GRACEFULLY AND LONGEVITY: PEOPLE, PURPOSE, PLANTS AND PEDESTRIAN

I am often amazed at how some patients have aged so gracefully well into their 80s and 90s, active with a sharp memory, fully ambulatory and self-sufficient, while others (often quite younger), seem so debilitated.  While good genes and family history are important, disposition and lifestyle influence these outcomes as well.  Social scientists have studied...
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Fallacies and Pitfalls: The Prostate Cancer Narrative

  “My doctor never checked, and he said that no one ever dies from it,” was Robert’s response when I asked him why he had never been screened for prostate cancer. At age 66, he had just retired 1 year ago from his construction job. He had recently started having right leg pain which would...
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"It's time for medicine to return to
its roots. A respectful relationship
between doctor and patient."