PROSTATE CANCER
Title: PROSTATE CANCER , By: Simmons, Judy Dothard, Crisis (The New), 00111422, Sep/Oct98, Vol. 105, Issue 4
Section: HEALTH WATCH
It Doesn’t Have To End Your (S-x) Life
Last April, Harold Dudley, a mortgage loan officer in Birmingham, Alabama, celebrated his forty-eighth birthday twenty-eight months after he underwent radical surgery to remove a cancerous prostate gland.
“After they took out as much tissue as they could, they were still afraid some cancer cells had gone into the bladder,” said Dudley. The prostate gland’s location allows malignant cells to migrate easily around the pelvic area. “Over the next six weeks I had thirty short-duration radiation treatments. It was low-dose, so it wasn’t painful.”
Dudley mentioned that prostate cancer survivors include such prominent men as Harry Belafonte, General Norman Schwarzkopf, and Louis Farrakhan. “I read a lot about it once I was diagnosed and realized I could die,” Dudley said. After lung cancer, prostate cancer is the leading cause of cancer deaths for men in the U.S.
Dudley was 45 and living in Hempstead, New York, when the cancer was detected. He had a standard yearly digital rectal examination (DRE) and a blood test that measures the level of prostate-specific antigen (PSA), a protein made by prostate cells. The test has been in widespread use for just about a decade.
“Anybody over forty, with a family history of prostate cancer should have a yearly exam and PSA,” said Dr. Manoj Subudhi, the Garden City, New York, urologist who operated on Dudley. Subudhi explained that irregularities in the gland’s texture and/or higher antigen levels can indicate other problems like prostatis (inflammation) or benign prostatic hypertrophy (enlargement), not always cancer.
An internal scan with a rectally inserted ultrasound wand is the next step. Following that, if necessary, is a needle biopsy that samples tissue from several different areas of the gland. It takes about a half hour in the office, Dr. Subudhi said, admitting that it is somewhat uncomfortable. Dudley said, “It felt like a nail. I was wounded. Then I had to lay there knowing he was going to do it five more times.”
Dudley’s age, condition, and stage of cancer called for a retropubic prostatectomy–removing the gland through an incision from the navel to the base of the penis. Treatment of prostate disease can include: waiting and watching; undergoing radical surgery; seeding the tumor with radioactive material; and/or using external radiation therapy. If the lymph system or bones are affected, hormones may be used to reduce testosterone.
Dr. Subudhi didn’t bite on the gee-whiz figure that black men here have the world’s highest prostate cancer rate. “We don’t know what the rate is everywhere, not in India or Africa.” He said race is less important than age. A PSA level of 2.5 at age 50 may indicate as serious a condition as a PSA of 5 for a 70-year-old. But National Cancer Institute data show that prostate cancer occurs among black men at a higher rate than in the general U.S. population. A similar discrepency occurs with several other serious diseases among black people.
“We still are very slow about our medical health and getting regular exams,” said Dr. J.W. Pitts., Jr., an internist with Acipco, a major Birmingham manufacturer. Yet prostate cancer, like hypertension, often lacks symptoms. “It’s a silent problem,” Pitts warned. Black men are advised to begin yearly screening at age 40 rather than 50, and to make their doctors aware that black men may be in more trouble at lower PSA levels than white norms predict.
Dr. Pitts mentioned men’s fears about impotence and urinary incontinence after prostate treatments. ‘”My sex life is over’ is often their first comment, but then they want to know how far along it is and what their options are. Surgery is the least popular,” Dr. Pitts said, “but I have had a number of guys who opt for it because it gives them some confidence that their cancer is cured.”
Loss of function can occur, but in most instances it is reversed through healing time and various therapies. Doctors Subudhi and Pitts, and survivor Harold Dudley, urge that men not let fear and ignorance snatch away their mellow years with their loved ones. For more information, call 800-4-CANCER.
S (COLOR): Survivors of prostate cancer: Norman Schwartzkopf Harry Belafonte and Louis Farrakan
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By Judy Dothard Simmons
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Source: Crisis (The New), Sep/Oct98, Vol. 105 Issue 4, p19, 1p
