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Posts Tagged ‘ProstRcision’

Easing Side Effects Of Cancer Treatment With Diet

Tuesday, August 2nd, 2011

When facing a cancer diagnosis, whether for yourself or a loved one, you know that cooking healthful, delicious food is not always easy. The body goes through various changes from the side effects of cancer and treatment that can affect taste buds, including a diminished appetite, limited foods that are appealing and changes to your taste and smell. Although the goal of cancer treatment is to destroy the cancer cells, normal cells can be damaged in the process, affecting how you feel. When going through treatment, each hour, each day and each week you can feel differently. As a person experiences these side effects, it is important to know the foods that are better tolerated and help to ease the symptoms.

The most common side effect of chemotherapy is loss of appetite, or anorexia, which can be a result of radiation, stress, depression and the cancer itself. Taste changes may also be an issue caused by treatment, resulting in flavor changes and or no taste at all.

  • Eat by the clock at regularly scheduled times. Your appetite signal may not be intact.
  • Eat between meals with high calorie, high-protein diet snacks and supplements, like cheese or peanut butter and crackers, hard boiled eggs or a nutritional energy drink supplement.
  • Add cream or butter to soups, cooked cereals and vegetables to increase calories. Add gravies and sauces to vegetables, meat, poultry and fish until weight loss is no longer a problem.
  • Try things to enhance smell, appearance and texture of food. Be creative with desserts.
  • Tart flavors such as lemon wedges and tart candies, peppermint or lemon drops may reduce the sensations of bitter or sour taste. Try choosing sugarless kinds. Try drinking lemonade. (If you have a sore mouth or throat, do not use this tip.)
  • If you experience that “metallic” taste in meat, try marinating it in a reduced sodium soy sauce or fat free Italian dressing to intensify the flavor. If red meat doesn’t work, try eating chicken, seafood or beans for protein.
  • Add extra seasonings to give the food more flavor such as onion, garlic, chili powder, basil, oregano, rosemary, tarragon, barbecue sauce, mustard, ketchup or mint. The rule of thumb is to add a little at a time to see if you can perk up those taste buds.
  • Rinse your mouth with tea, ginger ale, salted water or water with baking soda before eating to help clear your taste buds.
  • Use plastic utensils if you’re bothered by a bitter or metallic taste.
  • Marinate meats or cook them with sauces or tomatoes to help improve the flavor. Meats that are cold or at room temperature may be more palatable.

Neutropenia, or low white blood cell count, occurs after chemotherapy treatments for most patients. Neutropenia normally lasts for three to seven days. As soon as your counts have returned to normal, you can return to a regular diet.

To decrease your risk of infection, avoid fresh fruits, vegetables, raw meat or fish during the time your blood counts are low.

  • Avoid crowds and anyone who is ill until your blood counts are normal.
  • Always wash cooking utensils and surfaces that contact food well with soap and hot water.
  • Avoid uncooked herbs and spices and honey — use molasses.
  • Processed cheese, canned or cooked fruits, cooked or baked goods, jello, syrup, ice cream and sherbet made from pasteurized products are acceptable.

A dry or sore mouth, caused by chemotherapy or radiation, can get sore seven to 10 days following certain chemotherapy treatments. Precaution and care in choosing foods must be taken to sooth this sensitive side effect. Practicing good oral hygiene can help tremendously. Soft foods should be readily available, while avoiding rough textured, spicy, pain inducing foods.

  • With a sore mouth, avoid spicy, coarse textured foods, very hot or cold foods and beverages, citric juices or foods containing citric acid (tomatoes, oranges, lemon, etc.)
  • Limit alcohol, caffeine and tobacco, as they can dry out your mouth and throat and promote further irritation.
  • Cut food into small pieces.
  • Softer and easy to swallow foods include soft, creamy foods such as cream soups, cheeses, mashed potatoes, pastas, yogurt, eggs, custards, puddings, cooked cereals, ice cream, casseroles, gravies, syrups, milkshakes and nutritional liquid food supplements.

The gastrointestinal tract is often affected by cancer treatments, which can bring nausea, vomiting, diarrhea and constipation along with it. Healthy well-tolerated high fiber foods are important for alleviating constipation, while low fiber foods are helpful for vomiting and diarrhea relief.

  • Try eating foods that don’t have strong odors to reduce feeling nauseous.
  • When stomach is upset, eat foods at room temperature. This can decrease the food tastes and smells.
  • Save your favorite foods for times when you feel well. Try not to eat one to two hours before treatment or therapy. If you no longer enjoy beef or pork, you may find chicken, fish, eggs, milk products or legumes more appealing.


  • Eat high-fiber foods, such as whole grain breads and cereals, fruits and vegetables (raw and cooked with skins and peels on), popcorn and dried beans.
  • Try adding shredded veggies into other casseroles or recipes.
  • Bran (such as wheat bran) may be added to baked goods or casseroles. By consuming two tablespoons of wheat bran, your stools will be softer and easier to pass.
  • Remember when you increase bran intake; increase your water intake also.


  • Eat smaller mini meals throughout the day to see what you can tolerate.
  • Avoid raw vegetables and fruits, and high fiber foods, nuts, onions, garlic
  • Avoid spicy food and greasy, fatty or fried foods.
  • Limit caffeine intake and milk.
  • Ginger can be soothing to the stomach: gingersnaps, ginger candy
  • Drink and eat high-potassium foods, such as fruit juices and nectars, sports drinks, potatoes without the skin and bananas.
  • Be sure to sip fluids throughout the day to prevent dehydration
  • Soluble fiber can be used to relieve mild to moderate diarrhea. Soluble fiber soaks up a significant amount of water in the digestive tract causing stool to be more firm and pass slower.
    Soluble fiber sources include: Legumes, oats, bananas, apples, berries, broccoli, carrots, potatoes and yams (without skins).

Maintaining adequate calories and nutrition during this time can be a difficult task, however it is very important to keep nutrition a priority for optimal health and strength, while incorporating nutrition therapy to help ease the side effects of your treatment.


Integrative Oncology

Tuesday, June 14th, 2011

Integrative Oncology is an important part of patient care at Radiotherapy Centers of Georgia.

10 Myths and Misconceptions About Prostate Cancer

Tuesday, May 24th, 2011

With the identification of more than 25 types of prostate cancer by PCF-funded scientists in the past 24 months, and the fact that it remains one of the least talked about cancers, it’s no wonder there remains a great deal of confusion surrounding this disease.

Ask any group of men about prostate cancer. If they don’t abruptly change the subject or take the opportunity to crack a few wise remarks, chances are you will get a wide variety of answers when it comes to what it is, how it should be treated and whether or not (and when) one should be screened for this disease. Against this reality, it is always a good idea to review some of the more popular myths and misconceptions about this disease that claims the lives of more than 32,000 men in the U.S. each year.

Myth #1: Prostate cancer is an old man’s disease.

While it may be true that the older you are, the more likely you are to be diagnosed with prostate cancer (65% of cases are diagnosed in men who are 65 or older), the fact remains that 35% of those diagnosed, or more than 76,000 each year, are diagnosed at an earlier age. I was diagnosed at age 51 and I have met many men who were diagnosed in their early 40s. Although only 1 in 10,000 men under age 40 will be diagnosed, the rate skyrockets up to 1 in 38 for ages 40 to 59, and 1 in 15 for ages 60 to 69.

There are many risk factors to consider. Your race, family history, physical health and lifestyle—even geographic location—are all factors that can increase your likelihood of developing prostate cancer.

Myth #2: If you don’t have any symptoms, you don’t have prostate cancer.

Wrong. Prostate cancer is one of the most asymptomatic cancers in oncology, meaning not all men experience symptoms. Many times symptoms can be mistaken or attributed to something else. Signs of prostate cancer are often first detected by a doctor during a routine check-up. Common symptoms include a need to urinate frequently, difficulty starting or stopping urination, weak or interrupted flow of urination, painful or burning urination, difficulty having an erection, painful ejaculation, blood in the urine or semen, or frequent pain and stiffness in the lower back, hips or upper thighs. If you experience any of these symptoms, be sure to tell your doctor.

Myth #3:  Prostate cancer is a slow growing cancer I don’t need to worry about.

The answer to this one is sometimes, yes. Sometimes, no. With the 25 types of prostate cancer discovered by PCF-supported researchers, we can confirm that there are those prostate cancers a man may die with and not of, while others are very aggressive. Once a biopsy confirms the presence of cancer in the prostate, a physician uses the data contained in the pathologist’s report to characterize the potential aggressiveness of the cancer and make recommendations for treatment based on many factors, including a patient’s age and health status. There are many treatments available for patients and one approach does not fit all cases. Patients need to understand the complexity of this disease and make treatment decisions that are right for them in consultation with a trusted medical professional.

The good news is that we believe, with the accelerated pace of scientific discovery, we will soon be able to identify the specific cancer a patient has at time of their diagnosis and match the most effective treatments for their prostate cancer and their biological makeup. This will enable us to cure more and overtreat less.

Myth #4:  Prostate cancer doesn’t run in my family, so the odds aren’t great that I will get it.

Wrong. While a family history of prostate cancer doubles a man’s odds of being diagnosed to 1 in 3, the fact remains that 1 out of 6 American men will be diagnosed with prostate cancer in their lifetime. This compares to 1 in 8 women who will be diagnosed with breast cancer. African-American men are 60% more likely to be diagnosed with prostate cancer and 2.4 times more likely to die as a result.

Family history and genetics do, however, play a role in a man’s chances for developing prostate cancer. A man whose father or bother had prostate cancer is twice as likely to develop the disease. The risk is further increased if the cancer was diagnosed in a family member at a younger age (less than 55 years old), or if it affected three or more family members.

In 2010, approximately 218,000 new cases were diagnosed in the U.S. and more than 32,000 men died as a result of this cancer. The number of new U.S. cases could exceed 300,000 per year by 2015.

Myth #5:  The PSA test is cancer test.

Incorrect. The PSA tests measures levels of prostate-specific antigen in the prostate, not cancer. PSA is produced by the prostate in response to a number of problems that could be present in the prostate including an inflammation or infection (prostatitis), enlargement of the prostate gland (benign prostatic hyperplasia) or, possibly, cancer. Think of it as a first alert smoke alarm, instead of a fire alarm. The PSA test is the first step in the diagnostic process for cancer. It has made detection of cancer in its early stages, when it is best treated, possible. Experts believe the PSA test saves the life of approximately 1 in 39 men who are tested. Personally, I believe the PSA test saved my life and will continue to save it as we track my response to treatment.

Myth #6: A high PSA level means that you have prostate cancer and a low PSA means you do not have prostate cancer.

Although prostate cancer is a common cause of elevated PSA levels, some men with prostate cancer may even have low levels of PSA. PSA can also be diluted in men who are overweight or obese, due to a larger blood volume, and a biopsy should be considered at a relatively lower number (i.e. 3.5 instead of 4). Again, elevated levels can be an indication of other medical conditions.

Myth #7:  Vasectomies cause prostate cancer.

Having a vasectomy was once thought to increase a man’s risk. This issue has since been carefully researched by epidemiologists. Vasectomy has not been linked to increasing a man’s chance of getting prostate cancer but has led to the prostate being checked by the urologist more often and prostate cancer consequently being detected in the clinic.

Myth #8: Treatment for prostate cancer always causes impotence or incontinence.

While erectile dysfunction (ED) and urinary incontinence are possibilities following surgery or radiation therapy for prostate cancer, it is not true that all men experience complications. These side effects can also be highly dependent on age and physical condition. Numerous therapies and aids can improve erectile function and limit incontinence following treatment and nerve sparing surgical procedures have improved outcomes for patients as well. When selecting a surgeon, patients should inquire about the surgeon’s outcomes for ED and incontinence as well as the number of surgical procedures (open or robotic) performed.

Myth #9: Sexual activity increases the risk of developing prostate cancer.

High levels of sexual activity or frequent ejaculation were once rumored to increase prostate cancer risk. In fact, some studies show that men who reported more frequent ejaculations had a lower risk of developing prostate cancer. Ejaculation itself has not been linked to prostate cancer.

Myth #10: You can pass your cancer to others.

Prostate cancer is not infectious or communicable. This means that there is no way for you to “pass it on” to someone else.

What men can do about prostate cancer.

The first step in dealing effectively with prostate cancer is knowing the facts and eliminating confusion. Recent studies have shown that lifestyle decisions such as maintaining a healthy diet and regular exercise, such as walking 30 minutes a day, may also play a pivotal role in reducing the risk of getting prostate cancer and surviving it if you get the disease. Talk to your family and friends about prostate cancer and, if you are over 40, talk to your physician to develop a prostate health and screening plan that is right for you.
By Dan Zenka


Prostate Cancer Survivors — RC Cancer Centers

Thursday, May 12th, 2011

More Good News for Patients

Monday, May 2nd, 2011

Abiraterone, 4th New Drug for Prostate Cancer is Approved in 12 Months

In the past few months I have often said there is no better time to be a prostate cancer patient than now. In my position here at the Prostate Cancer Foundation, I have uttered this statement with enthusiasm and a bit of pride. As a patient, I have said it with a healthy portion of relief and a prayer of thanksgiving for progress. Not that I want to ever need any of these new drugs, but, as I grapple with my disease and the ever present possibility of recurrence, I am reassured that these new treatments will be ready and waiting for me and my medical team if and when I need them.

To recap, the four new drugs are: Provenge (the first ever immunotherapy for the disease); Cabazitaxel, an advanced chemotherapy agent also known as Jevtana; Denusomab, marketed as Xgeva for bone health during androgen dperivatrion tehrapy;  and now, Abiraterone (Zytiga).  Approved just yesterday by the FDA, Abiraterone has been in development since the 1990s and will be utilized for the treatment of castration-resistant, metastatic prostate cancer following docetaxel chemotherapy. It’s a clinical break-through for patients who previously had few good clinical therapies available to them.

During Phase III clinical studies, patient response was so encouraging that those patients who were taking the placebo were given the option of switching to the drug. Good news indeed for so many.

You can read more about Abiraterone here.

Here’s to progress. Here’s to better outcomes.


Half of men feel worse after prostate removal

Wednesday, April 27th, 2011

A new study shows nearly half of men feel worse after having their prostate gland removed due to cancer, although three-quarters would do it again given the same circumstances.

Tens of thousands of men each year undergo the surgery, called prostatectomy, and may suffer long-term consequences to their quality of life, in particular sexual function.

In the current study, published in the Journal of Urology, researchers asked 236 men how they were doing up to 1 year after surgery.

Three out of four had regained their physical and mental well-being and had no more problems with incontinence than before the operation. But just one out of four had recovered his ability to have intercourse.

The research team, led by Dr. Adrian Treiyer at St. Antonius Hospital in Eschweiler, Germany, also teased out the circumstances that were tied to better recovery.

Men were more likely to get their quality of life back if they had a type of surgery that leaves the nerves controlling erection intact, for instance, and if they participated in a rehabilitation program.

While the study doesn’t prove that rehab is helpful — men who did better might be likely to join such a program, for example — the possibility is worth noting, said Dr. Mark Litwin, a urologist at the University of California, Los Angeles, who was not involved in the study.

Rehab programs, which are relatively new in prostate cancer care, can include talk therapy or a drug regimen to treat erectile dysfunction.

“It’s not just about recovery of the penis and its ability to become erect, but helping men come to terms with being a cancer survivor,” Litwin told Reuters Health.

Both physical well-being, such as experiencing less pain, and mental health, including feeling good and functioning well socially, were tied to remaining continent and not encountering any complications after surgery.

“Some of these things, no one can control, such as baseline PSA,” Litwin said. “But some they can. Patients can doctor-shop and find the best care.”

In the type of surgery the patients had, surgeons make a cut between the belly button and the pubic bone to get to the prostate, which is then removed entirely — so-called radical prostatectomy.

About one in six American men get prostate cancer at some point in their life, according to the American Cancer Society. But they don’t necessarily have to have their prostate removed because of it.

Some may get radiation treatment instead, or they may have their tumor destroyed by a kind of surgery that uses freezing liquids. Others may choose just to be monitored — so-called watchful waiting — to see if the cancer grows slowly enough to be safely ignored.

All of these strategies have problems of their own, and the right option depends on both the cancer and the patient’s values.

Litwin said most studies have focused on the drawbacks to prostate cancer surgery, and indeed, the new findings confirm that most men have worse sexual function after the procedure.

“Quality of life definitely takes a hit, both physically and emotionally,” Litwin added, “but ultimately, it tends to go back to normal.”


Footloose and cancer-free: What’s a 2,650-mile hike after beating 3 types of cancer?

Tuesday, April 19th, 2011

By: Kate Santich, Orlando Sentinel

JOHN CASTERLINEAt 68, John Casterline has beaten advanced-stage lung cancer, prostate cancer and throat cancer. Last month, he finished radiation treatments. Just one week ago, his doctors pronounced him cancer-free.

So what is he doing to celebrate?

Forget Disney World. Starting April 28, this Orlando retiree will be hiking 2,650 miles, from Canada to Mexico, along the Pacific Crest Trail — a route that will climb above 13,000 feet elevation and require him to average 20 miles a day.

“I expect that I will experience weather that is too cold, too hot, too wet, too dry and too perfect,” he wrote in his journal a year ago, when he began training seriously for the hike. “I will encounter rattle snakes, bears, and maybe even mountain lions. … The mosquitoes will be horrendous at times, the hills steep, the rocks sharp, the trail blocked, the wind very strong. [Sleep will be] occasionally fitful and I’ll be carrying a backpack with 30-plus pounds.”

But if you have to ask why he’s doing it, he wrote, you wouldn’t understand.

It is not simply that he hopes to raise $26,500 for the dramatically underfunded battle against lung cancer, a disease expected to claim the lives of 160,000 Americans this year — more than colon, breast and prostate cancers combined.

Nor is it about creating some kind of legacy. Though followers can read his ongoing exploits on, the website is intended to give fellow cancer survivors hope — and to collect donations for the American Lung Association — not to brag.

“John is the guy you want with you in a foxhole,” said Eric Gray, an executive director at the American Lung Association of Florida. “He’s the guy who makes you believe anything is possible.”

Casterline is a favorite at Orlando lung-cancer support-group meetings, and Gray often uses him as a beacon of hope when counseling the newly diagnosed.

“In years past, there hasn’t been a lot to say to people other than, ‘I’m so sorry,’ ” Gray said. But now I can say, ‘Let me tell you about this guy who had Stage 4 lung cancer and this remarkable thing he’s doing …”

Casterline was diagnosed in August 2006, a week after he retired from 21 years working for 7-Eleven preceded by 21 years in the Navy. He had quit smoking seven years earlier — 1999, the same year he took up backpacking at the urging of his eldest son. By the time the disease was detected, it was so far advanced he was given a 3.5 percent chance of surviving the next five years.

“You go through these stages of grief,” he said. “For two or three days, I figured I wouldn’t make it a year.”

It may have been the only time his relentless spirit waned, and even then it didn’t last long. He researched exhaustively, interviewed doctors at five hospitals — including Memorial Sloan-Kettering in his birth state of New York — and ultimately selected M.D. Anderson Cancer Center Orlando. He went through surgery, chemotherapy and more than one round of radiation, and by February 2007 he was officially cancer-free.

That lasted a blissful 3 1/2 years, until he developed prostate cancer. He had just finished surgery for that in November last year when, one month later, doctors discovered the earliest stage of throat cancer.

“He exercised all through chemotherapy and radiation,” said Dr. Jennifer Tseng, his medical oncologist, who counts herself a fan. “Probably the only time he didn’t exercise is when he was in the hospital after surgery. And even then, he was back on his feet in no time. He’s got an amazing spirit and willpower.”

The average person undergoing radiation would still be trying to eat solid food at this point, she said. Casterline, who began competing in marathons 10 years ago, has been out hiking 14 miles a day wearing a 35-pound backpack. Within the past week, all three of his doctors have given their blessing to the upcoming hike.

In fact, in some ways, Casterline’s wife of 41 years, Sue, has been the toughest sell.

“When he first told me about this trip, I thought, ‘You’re out of your mind,’ ” she admits. “It was just surreal. But he’s a force of nature, and he’s going to do what he’s going to do. I mean, I can’t stop him.”

She did, however, make him update his will.

As she says this, the family room has turned into a staging area with 13 cardboard boxes of food due to be shipped to various post offices near the Pacific Crest Trail. Those are for the times when the nearest store is 20 miles away. Casterline has the spots numbered on spreadsheets that detail his mileage, route-elevation changes, meet-ups with his wife and two grown sons, and notations on the hazards du jour.

“Water supply contaminated — dead rodents,” he notes for Day 5, a 20-mile stretch through the scrub oak and chaparral of Southern California. “Poison oak about mile 105.”

His gear has been weighed to the nearest tenth of an ounce. All his clothing comes in at 2.56 pounds. His tent, sleeping bag, backpack, ground cover and pad: 7.66 pounds. Total, with cooking and hygiene supplies, medications, emergency whistle, duct tape, bug repellent, iodine tablets, reading glasses and playing cards: 15.97. It’s the food and water that will add an additional 20 or so pounds. Plus there’s the 1-pound ice axe he can ditch after the halfway point.

He has coaxed sponsorships from Nestlé, which owns PowerBar energy products, and Mango International, which sells a small solar panel to recharge his iPhone. He’ll also carry a pocketknife and perhaps a 6-ounce Kindle reader. But he’s still on the fence over a distress signal that alerts rescue workers you need to be airlifted to a hospital.

“It’s 8 to 10 ounces,” he said, frowning.

Though Casterline feigns fearlessness most of the time, he admits one enormous worry: failure.

“I’m very determined, mentally and physically, and I know I’ve already been tested pretty hard,” he said. “But that’s one of my greatest fears: that I won’t make it.”

On bad days — and there will be bad days — he will remember to look at the names his granddaughter has printed on his backpack in ink. “Alysan F.,” “Judy C.” and “William R.,” they read. There are 100 names in all: lung-cancer patients or their loved ones. Some he has only met online. If not for himself, then at least for them, he must try to persevere.

No one is betting against him.

“Short of getting eaten by a bear,” his wife said, “he’s going to do it.”


When Does One Become A Survivor?

Tuesday, April 12th, 2011

Survivorship. It’s what every cancer patient is striving for…, to know that they’ve clinically defeated their cancer…, to believe that it’s behind them and incapable of making another assault…, to feel healthy and unburdened once more.  To be worry free of the disease. But in order to enjoy survivorship, one has to first become a survivor. Trying to decipher exactly when a patient passes this magic milestone and qualifies as a survivor is, in my opinion, the moving target.

Most medical studies classify any patient who has been treated and is still living as a survivor. Technically, I qualify for the title. Personally, I do not feel as if I can wear it yet. Yes, I survived surgery and radiation. And, for the next two and a half years, I will be surviving the side effects of ADT on a regular basis. But, have I survived cancer? That jury is still out and will be for quite some time. In my mind, the act of surviving is vastly different from having survived a threat to one’s well being. Marooned passengers may have survived the shipwreck, but I don’t consider them survivors until the whole of their ordeal is behind them.

In the past twelve months, I have talked with many fellow patients in the halls of treatment centers and in waiting rooms. It is interesting to hear how they view their place on the survivor scale. Some adhere to the concept that having been treated, they are indeed survivors. Others, like me, are waiting and hoping to hear those magic words, “you are cancer free…” in a few years.  One patient (who has been treated for multiple cancers) even advised me to never label myself as a survivor. While I never had an opportunity to press this person for the reasoning behind his thinking, that statement still sticks in my memory.

I have come to believe that, scientific classifications aside, there is no right or wrong answer to this question. While our journeys have many shared experiences, we remain individuals. When one decides to consider him- or herself a survivor, is a matter of personal preference. (Of course, one’s staging must also play a role in their point of view.) If the title supplies comfort when applied early on, excellent. If it supplies motivation to press on, that’s wonderful too. Whatever it supplies to patients, if it’s positive, they should go for it when it’s meaningful for them.

All of this, of course, raises today’s question for readers: When were you, or are you, willing to consider yourself a survivor?


A Question on PSA Testing and Older Men

Tuesday, March 29th, 2011

We Often Consider at What Age a Man Should Consider PSA Screening, But We Rarely Ask When Do Individuals Stop?

I just had an interesting conversation with an individual who asked me at what age do most men start thinking about NOT having an annual PSA test? To be honest, I didn’t have an immediate answer. It’s a complicated question and I am, to be honest, stumped. Age is certainly a factor as is the reality that there exist 24 types of prostate cancer that range from indolent to very aggressive.

We frequently read about suggested guildelines for PSA screening. I personally like the AUA recommendation that suggests a man should talk to to his doctor about a first screening to establish a baseline when he enters his 40s. From there, based on a man’s general state of health and family history, he can decide on a screening approach that is right for him.  But in the almost twelve months that I have been writing this blog and the years that I have been meeting fellow patients, I can’t remember a discussion that addresses the other end of the spectrum. I would think that a vibrant, active 78-year-old man with a form that appears to be aggressive would be grateful to have the data and take some sort of action. Of course, a man of the same age could be pleased to live out his life with little or no intervention if his numbers indicated a slower growing form of cancer that he could quite possibly live with.  But, how many give up, for whatever reason, wanting to know at all?

So, I have to ask four questions:

1.) Are there men out there in their 70s and 80s who choose to no longer have annual PSA screenings and why?

2.) Are there men out there in their 70s and 80s who insist on annual PSA screenings?

3.) Are there men in this age group who have been screened and diagnosed with cancer?

4.) If you were given a diagnosis of cancer in your 70s or 80s, what course of treatment did you decide upon?

Thank you to anyone and everyone who can provide some insight.


Treatment is a Complex Issue

Tuesday, March 22nd, 2011

As a patient, I feel for anyone who is given a diagnosis of prostate cancer.  Hearing the “Big-C” word can be upsetting enough. But the complexity of the disease—diagnosing it, trying to characterize it and selecting the appropriate treatment—can feel like insult upon injury.  We need to talk about prostate cancers. With 24 known sub-types of this cancer—from non-life-threatening to very aggressive—it’s no wonder so much time is expended on debating PSA screening and the potential for overtreatment.

While debates continue, more than 32,000 American men die from this disease each year, placing it on par with breast cancer in incidence and mortality.

Oddly, I still contend that when I was diagnosed last year, I was “lucky” enough to have clear diagnostic and prognostic data to inform my decision to have a radical prostatectomy, despite potential side effects .  My PSA had nearly doubled in a year’s time. As my urologist reviewed my biopsy results, the extent of the cancer’s involvement in my walnut-sized gland and my Gleason scores, I knew where I was headed. He dutifully began sketching out all treatment options currently available to patients when I told him to stop and move to the top two options. He gave me a dubious look before I shared with him that I had learned much about the disease in two years of working at the Prostate Cancer Foundation.

I was lucky once again when my surgeon’s professional instincts prompted him to remove some of my lower lymph nodes during my robotic procedure, something that’s not always done.  The post-surgical pathology report upgraded my diagnosis to Stage 4 metastatic disease with single Gleason 5 cells discovered in the nodes. (Not exactly the kind of upgrades I am accustomed to in my life…) As a result, I headed into seven weeks of radiation therapy and three years of androgen deprivation therapy—a palliative treatment that drastically cuts my production of testosterone, a fuel for prostate cancer growth and proliferation.  Today, I have a 60 percent chance that I will have to live with recurrent disease. I look forward without second guessing.

Not all patients have such clarity. Through My New York Minute, I meet many readers who are confused by the complexity of this disease. As a fellow patient who also works for world’s leading private accelerator of prostate cancer research, I remind them:

  1. The PSA test is not a cancer test—it’s a diagnostic tool for identifying potential problems, including cancer, in the prostate
  2. With 24 sub-types of this cancer, one size does not fit all for treatment
  3. Sometimes, the best treatment is no treatment and proactive surveillance
  4. Age and personal preference are important factors in treatment selection
  5. Once committed to a treatment plan, avoid the pitfall of second guessing

Science will someday, sooner than later, enable us to identify which prostate cancer a patient has and prescribe highly personalized treatments that will work best for their case. Until then, an in-depth understanding of the disease and the advice of a trusted healthcare professional remain the best tools for making treatment decisions with confidence.