Show #492 Airs Sunday 9/6/09
It is the most common cancer in men – prostate cancer. But the diagnosis isn’t the only thing men fear - treatments can worry them almost as much. Dr. Anthony Avallone is here to dispel myths about treatments for prostate cancer. Dr. Avallone is with Fairview Hospital.
Question: Before we get into the treatments, tell us how prostate cancer is detected.
Answer: One in every six men will have prostate cancer sometime in his lifetime. Early detection is key because, when caught early, it is almost always highly curable.
There are two ways we test for prostate cancer:
- One is a rectal exam that takes 10 seconds
- The other is a PSA blood test. The PSA means prostate specific; just because you have an elevated score does not necessarily mean you have cancer. If it is elevated we would do further testing to determine if it is cancer.
Doctors like the PSA test because early prostate cancer doesn’t really have any symptoms, so an elevated PSA can help us find the cancer earlier which allows for a better probability of a cure.
Question: But to get the cure, you have to go through some type of treatment - which a lot of men are fearful of.
Answer: In general, men are concerned about loss of urinary control and loss of erection.
The truth is there are a lot of men who get prostate cancer who don’t need treatment.
We do an ultrasound and a biopsy in the office – takes 10 minutes.
If it is a small amount of cancer, and depending on its type, it may not need treatment.
Prostate cancer cells can take up to two to four years to double, so in this case, we would do “watchful waiting” or “active surveillance” – we’d keep an eye on the patient and monitor to see if there was any progression of the disease.
Question: What happened to "when in doubt, cut it out"?
Answer: For those who do require treatment, surgery is one option. But, while it is still major surgery, the complications from the operation are very low compared to years ago.
Radiation is another option but, again, compared to years ago, the side effects are much lower and the effectiveness is much higher.
And finally, there is also the option of freezing the prostate.
The patient is under anesthesia and probes the size of a ball point pen refill are inserted to freeze the prostate.
The freezing kills all the cancer cells.
The procedure is highly effective with a low risk of side effects.
While loss of erection may occur for some patients no matter which option they choose, we can help with that.
And all three of these options are available as long as the cancer is contained in the prostate and hasn’t spread.
Question: So, which option is the best?
Answer: It truly depends on the patient, their cancer, their age, health, etc.
That’s why I’m excited that we have a multidisciplinary approach at Fairview. The patient is offered all the options by the different doctors – the radiologist, the oncologist. Everyone is in one institution and the patient sees all of them in one place.
And, as part of this approach, we also have the patient see a nutritionist.
It’s been shown that that areas of the world where diets are low in saturated fats have a low incidence of prostate cancer.
And we’ve also seen that, even if you’ve been diagnosed with a slow growing form of prostate cancer, if you change your diet to one low in saturated fats, there’s improvement.
Men, don’t let the fear of prostate cancer keep you from getting tested – and, if necessary, treated. My thanks to Dr. Avallone for sharing this important information.
