Back in 1996, I watched my steadfast father’s quality-of-life crumble as he descended into the world of prostate cancer (PC). Treatments (castration, radiation, etc.) rendered a once proud man a shadow of his former self, which was the result of gruesome side effects. Consequently, when I was diagnosed in 2005 at the age of 55...
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Every year’s Conference presents recurring themes. This year’s focus was prevention, combination treatment and timeliness were emphasized. We live in an era of exploding technological progress. It is a delightful problem to have a wealth of new treatment options and diagnostic tools. However, just like buying a new car or a new smart phone, it takes a little time to learn the ropes and fully exploit the complete range and capabilities of the new technology. A short blog can’t cover everything from a three-day conference. Here are a few comments.
In my last blog I contended that of all the different ways to treat cancer—hormone therapy, chemotherapy, radiation or surgery for example—immune therapy has the greatest potential to save lives: Only the immune system, by its very nature, has the ability to adapt to the many thousands of varieties of cancer. Also, new breakthroughs in understanding how it works have led to real progress inharnessing the immune system to fight cancer.
Despite the significant advances in treatment options, there is still considerable uncertainty—even among doctors—about how or even whether to treat prostate cancer. The treatment controversy is the prostate cancer equivalent of a Dempsey-Firpo fight: the proponents of surgery slugging it out with those who favor some form of radiation.
The surprising finding, after 12 years, was that there was no difference in survival between surgery and watchful waiting in the Low-Risk or in the Intermediate-Risk group. On the other hand, men who were in the High-Risk category did benefit with improved 12-year survival when treated with immediate surgery compared to the men with High-Risk disease who did watchful waiting.
The stress of a diagnosis of cancer can throw patients into an “altered state” in which they are particularly vulnerable to suggestion—good or bad. And because most of us, as children, are taught to believe in the infallibility of doctors, the manner in which a doctor delivers a life-threatening diagnosis has a profound effect, and actually has the power to influence the course of the disease.
One of the unique characteristics of prostate cancer is its responsiveness to the withdrawal of testosterone. This “Achilles Heel” of prostate cancer was discovered in the 1940’s when surgical removal of the testicles was shown to induce cancer remissions. In 1985, Lupron, an injectable medication that works by tricking the testicles into ceasing testosterone production, was FDA approved. Orchiectomy, or surgical removal of the testicles, has been declining in popularity ever since.
“No More Unnecessary Biopsies . . . ” The first four words of the sub-title of our book, Invasion of the Prostate Snatchers,” are a clear statement of our objective. I am no fan of biopsies. At the same time I know that a biopsy is an essential diagnostic tool when appropriately used. The problem is that too many doctors schedule an immediate biopsy if there is only a slight rise in PSA, when it would be more appropriate to explore less invasive diagnostic methods first.
Prior to being biopsied, you need to be aware that almost half of all men diagnosed with prostate cancer have a chronic Low-Risk type, a condition which, according to my writing partner, prostate oncologist Mark Scholz, doesn’t really deserve to be called “cancer” and can be safely monitored without immediate treatment. This reassuring knowledge helps to diffuse the inevitable fear that comes with a cancer diagnosis.