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E-mail to a friend | Updated Wednesday, December 01, 2010 7:57 PM Prostate cancer: A silent danger
When a blood test turned up a moderately-high PSA (Prostate Specific Antigen) level, Don Riedl made an appointment with a urologist. when the doctor told him to return in a year for another test, Riedl essentially blew it off.
“I was an ignorant male, thinking nothing would ever be wrong with me,” said Riedl, now a 10-year survivor of prostate cancer. Measuring the amount of PSA, a protein produced in the prostate, is currently the best method to detect prostate cancer. when the prostate is healthy, the protein remains in the organ, said Dr. Steve Johnson, a local urologist.
Johnson said a response like Riedl’s is common. “People have the rationale if it isn’t broken, don’t fix it,” he said. “If they’re not having problems, don’t go to the doctor.”
Two years after Riedl’s first visit, a second PSA test came back with even higher levels. Riedl’s urologist worked to eliminate other possible causes and eventually ordered a biopsy.
The results came back and Riedl had prostate cancer. There were no symptoms; there rarely are with prostate cancer. “If you wait until you have symptoms, you’re very unlikely to be curable,” Johnson said.
That’s why testing is so important. Men should begin yearly prostate screenings at 40.
In his 50s, Riedl had never had a prostate screening. Luckily, the cancer was not aggressive, which is common for prostate cancer. Still prostate cancer is the second leading cause of cancer death in the United States, and one in six men will be diagnosed with it during their lives, according to us TOO International, a prostate cancer education and support network.
Johnson said the high mortality, in large part, is likely because men don’t understand there are rarely symptoms with prostate cancer and don’t get tested. “Men are just reluctant to go to the doctor if they’re not sick,” he said.
For those like Johnson who are diagnosed with the disease early, they’re faced with three treatment choices. Johnson said the choices are surgery, radiation or cryoablation — using extremely cold tubes to kill cancerous tissue. the outcomes are essentially the same, Johnson said. for patients with advanced or recurrent cancer, the choices of hormone therapy or chemotherapy offer less promising outcomes.
For Riedl, the final decision was surgery. he said he wanted the assurance that comes with physically removing the cancerous tissue. the potential side effects he faced were erectile dysfunction and incontinence.
Johnson said incontinence is something that’s rare, but erectile dysfunction is more common. However, Johnson said, when patients are facing prostate cancer the focus first must be on treatment. after successful cancer treatment there are a number of treatments for erectile dysfunction.
“The most important influence on outcome is a positive mental outcome,” he said. Patients that tackle the cancer head on do best. “They handle treatment well,” Johnson said. “They don’t let the cancer dictate their future — they deal with it just like they would any other stresser in life.”
Patients who focus on quality nutrition also tend to do better in treatment, Johnson said. Overall wellness also has some effect — though unmeasurable — on prevention.
Increased body fat or obesity is a risk factor, Johnson said. “One of the things we’re challenged with in the Western Hemisphere is our diet,” he said. “We tend to eat a very fat-rich diet.”
Now 10 years after his bout with the disease, Reidl has taken the importance of nutrition to heart. though he began exercising regularly before he was diagnosed, Reidl has focused more on regular exercise and resistance training.
“It’s becoming more and more obvious that general health is pretty important,” Reidl said after returning from a recent conference on prostate cancer. “I don’t know why it’s taken this long for people to understand that.”
Besides just a greater focus on early detection and good health, Johnson said the future of medical science seems promising for prostate cancer patients. Research is examining how to decide what patients have prostate cancer that will respond to treatment and what patients have cancer that even requires treatment.
In some case, Johnson said, the cancer is so non-aggressive that a patient would do fine without treatment. In others, the cancer is so aggressive that treatment will be ineffective.
Johnson said as understanding of the disease advances, doctors are moving toward “active surveillance.” if a patient’s case doesn’t have indicators that it is aggressive, the doctor may recommend simply monitoring the disease with regular screenings. at the time, if ever, that the disease does appear to be becoming more aggressive the doctor and patient will move toward one of the traditional treatments.
Johnson said the approach has two advantages. for some patients, they may discover they never need treatment. for those that do, they’ve enjoyed a “honeymoon period” from treatment, and, based on current science, the treatment is equally as effective as it would have been initially.
Outside the doctors office, patients are also seeing increased availability of support groups for survivors and patients.
In Texoma, patients and survivors like Riedl, who is an active member of the group, can find support in the local us TOO chapter. Johnson called it a strong group where many of the long-time members “know almost as much about the disease as doctors.”
“It just very valuable as a patient to be able to relate to other patients that have had cancer,” Johnson said.
For more information about the local us TOO group visit ustoo-texoma.org or contact Managing Director Jerry Bylander at 903-893-6437 or .