Wednesday, January 02, 2008

Prostate cancer treatment

Tough choices to make when prostate owners are diagnosed with cancer of the gland. Pesky thing is prone to cancer--in autopsy studies of older men who no longer need their prostates nor much of anything else, nearly 1/3 demonstrate microscopic cancer of the prostate. Because of this high incidence of latent, asymptomatic cancer, urologists comment that more men die with it than of it.

As a result, one possible treatment choice for prostate cancer is to do nothing at all. One of my sixty-something year old patients went this route 4 years ago and continues to do well. Brachytherapy is another option; radioactive 'seeds' are implanted into the gland, and over time the prostate shrivels up and scars down. Several of my patients have chosen this route, and they too are doing well. The most radical route to a prostate cancer cure is the piecemeal removal of the whole darned thing which is inconveniently located beneath the bladder encased in important nerves in charge of urinary continence and other important male functions.

Only one of my patients opted for this choice. Now, a year later, he is also doing well, continent, potent, and cancer-free. He did his Internet homework, discovering a premier uro-oncologist at the University of Colorado Health Sciences Center. Dr. Shandra Wilson is not only superbly trained, per Mr. M, she's as nice as she can be. As I reread his consultation report from his initial evaluation at the UCHSC Urology Clinic, I was as impressed by the report from the dietician on the case as I was my Dr. Wilson's credentials. Epidemiological studies suggest that a diet high in animal fat contributes to prostate cancer, and this energetic dietician managed to enumerate all of Mr. M's favorite sources, including Popeye's, Red Lobster, and White Fence Farms.

Planting a radioactive field in the pelvis, hacking the gland out piecemeal with efficient little robotic arms, doing nothing at all, difficult choices for men and the people who love them. If you're in Denver and worrying about your own prostate or that of someone near and dear to you, consider a consultation with Dr. Wilson and company--they are most thorough and caring.


JeanMac said...

Is the deciding age about 60 for no treatment?

KGMom said...

A timely and helpful post.
My office mate at my community college learned about a month ago that her husband has prostate cancer--he is early 50s, so a bit risky. And the cancer is a bit more advanced than early stage. So they have opted for the 3rd option with surgery at Johns Hopkins.

Mauigirl said...

Of the two male friends I have who were diagnosed with prostate cancer, one chose the surgery - he's African-American and at the time was only 51, so the more aggressive approach was recommended for him. The other is going the radioactive seed route.

#1 Dinosaur said...

I have an 89 y/o patient with prostate cancer being "treated" with observation for several years; his PSA is now down to 3.5. He also has a mass in his kidney growing very slowly, if at all. Due to his precariously compensated cardiac status, I keep the urologists from going after the kidney thing more invasively. Recently he developed a symptomatic inguinal hernia that was (appropriately) fixed without incident, but it led me to mock the surgeons with the following declaration (which wasn't all that accurate clinically, but really funny):

"We're ignoring his prostate cancer; we're ignoring his kidney cancer, but by God we're going to fix his hernia!"