Overview

This brief is intended to summarize the important points of prostate cancer so that all men may have a better understanding of the problem and can ask their doctors effective questions. As a group, the retired military men are older and should pay attention to this health problem to collect on their well deserved retirement.

Prostate cancer is common in men. Science has discovered that about a third of the men around age 50 have some microscopic cancer. At age 75 around a half or more have cancerous changes in the prostate. These are important mileposts of health.

The following historical outline tells the story of the development and solution to my cancer problem. After my story, I have reviewed significant points of this cancer problem guided in part by the book, The Prostate, by P.C. Walsh, M.D., Urologist-in-Chief at Johns Hopkins Hospital. I strongly believe this book should be in possession of men with a prostate problem to determine a course of action. I have found a used medical dictionary helpful to decipher medical jargon, but Dr. Walsh’s book is very basic with terms.

Personal History With Prostate Cancer

This brief tells the progress and solution of a deadly disease illustrating that knowledge may save your life.

1. April 1995 – Naval Hospital, Guam – Physical exam showed my PSA (a prostate problem indicator) to be 2.05, this number was in a blood test; an enzyme made by the prostate. Under 4.0 is satisfactory in the younger men. Over this number and up to 6.0 is accepted by doctors in old men. Why? I do not get a good answer. About one-quarter of the men with a low PSA level (less than 4.0) have been found with prostate cancer. This Guam number was excellent for age 74 – so why worry?
2. August 2000 – Clinic at Pinedale, Wyoming – A senior citizen test showed a PSA number of 38; the message said to see the doctor now. I was 79 and in deep trouble.
3. August 2000 – Clinic at Pinedale, Wyoming – Later tests showed a PSA of 25. I had begun to take Vitamin C, but there were no facts for the drop in PSA. I was still in trouble. The doctor felt with the finger. There was a tumor (enlargement) on the prostate. I needed a biopsy. The country doctor said the "watch and wait" approach was valid for older men like myself. Somehow, this approach lacked reason in the case of cancer. It does not go away.
4. November 2000 – Salt Lake City, Utah – Doctor’s office; a biopsy was done. It showed one of six needles held cancer cells with a Gleason score of 6. The Gleason score shows growth rate of the cancer (2, 3, or 4 is good; 5, 6 and 7 is moderate; 8, 9 or 10 is bad). Not good news. The doctor also asked for a bone scan; no cancer in the bones appeared.
5. November 2000 – Dr. Mangelson, my Salt Lake doctor, decided that a Lupron shot (hormone) would contain the cancer, and the action was taken. As a back-up (second opinion) I asked an oncologist (cancer specialist) to review the biopsy report. He recommended treatment with radioactive seeds; seeds placed in the prostate.
6. December 2000 – Bought Dr. Walsh’s book, The Prostate, on my Christmas vacation in Washington, D.C. and read it from cover to cover. It was a wake-up call showing I needed knowledge to solve this cancer problem and possibly save my life.
7. January 2001 – The PSA dropped to 1.5 about three months after the Lupron shot. It was expensive (about $3,000) but a powerful detergent which to a degree can shrink the prostate. I believe using Lupron before the operation helps contain the growth. I went on vacation thinking about my next move.
8. March 2001 – The follow-up PSA test was 0.6 – good news? From what I read in Dr. Walsh’s book, the cancer was still there which would begin to grow in time. I am in trouble.
9. April 2001 – I thought long and hard, reviewing the information on cancer, and during the vacation decided the only way out was to face the music and have the cancerous prostate removed. On my follow-up PSA test, the number dropped further to 0.5. Good news? Not so fast, as the cancer was still there – just not as active as before. Some might assume that because the PSA number was so low, I would be cured of the disease. I knew that science showed the proper direction which was to have my prostate removed. I asked Dr. Mangelson to perform the task. He mentioned that doctors do not operate on 80-year old men, but, I was in good health and he would operate.
10. April 30, 2001 – The Operation

Dr. Mangelson, at the LDS Hospital, removed my prostate and during the operation found that the cancer had spread to the seminal vesicle gland and one lymph gland which were also removed. The Gleason count was 7 and moderate.

Wow! What did this really mean? If the cancer advances beyond the prostate, you are in deep trouble and generally incurable (Walsh’s book, page 101). As you can see from the biopsy (only one needle was cancerous), the ultrasound data, the finger exam, and a low PSA count, the cancer was supposed to be confined to the prostate. Dr. Mangelson would not know the true condition until he personally examined the organs in the operation which he did and took the proper corrective action by removing the cancerous glands. His expertise has saved my life, and this knowledge is why you need the best doctor. The cancerous organs must be removed and cancer cells killed to stop the generator of cancer.

11. April 30, 2001 – Review of the Operation

The oncologist who looked at the biopsy and recommended the seed treatment was wrong. Only the prostate would have been affected, and the seminal vesicle along with the lymph gland would not have been treated. The biopsy did not tell the whole story. The needles missed some cancer in the prostate misleading to a low content in that tissue. The PSA count dropped from 38 to 0.6 (before the operation) indicating cancer activity was likely at a low level and contained – which was not the case.

In the Spring of 2001, the hospital used a new pain intervention method, and there was no pain during or after the operation. Amazing! I used a catheter to drain the urine, which was not a problem, lasting for about 10 days. When the catheter was removed, I had no problem controlling the urine, and at my age, sex was also no problem. But a person undergoing treatment should discuss these matters with his doctor.

Post operation tests reveal my cancer is under control. There is no tiredness and my appetite is satisfactory. On September 2001, my PSA count was below 0.1; December 2001, below 0.1. With my false sense of security in mind and a review of my case, I highly recommend you do your homework well to collaborate medical advice.

Prostate Cancer Facts

This section is separated into examination for prostate cancer and treatment of the disease. Additional information on the main points of my discussion is treated in detail in Dr. Walsh’s book, The Prostate, and are given a page number from that book which appears in my margin. This information will permit a man with the prostate cancer problem to discuss the approaches (solutions) with his doctor.

Examination

It is common knowledge among doctors that in testing for prostate cancer, the elevated count of PSA in a blood test points to a cancerous condition. When your PSA count is over 4.0 nanograms per milliliter, it means you have some prostate "trouble." PSA levels are about 10 times higher in cancerous tissue. It is believed younger men should have blood tests with their physical, and those over 50 should have tests each year – or twice a year, especially if the condition is in the family.

Biopsy

This test is done in the doctor’s office and is directed through the rectum to the prostate. The biopsy instrument contains six needles which are positioned by ultrasound and a scope. They are used to take samples of the prostate which are sent to the laboratory to determine the extent of the cancer as shown by the amount of cancer in the needles, and the degree of cancer activity which limits the life span.

Treatment

Positive cancer tests of the prostate have four main treatments: Watch & Wait; Surgery, Radiation, and Freezing the Prostate. Hormone medicine is used to control the products of the prostate gland and lower cancer activity.

Radiation

This treatment is the freezing of the prostate gland by liquid nitrogen causing cancer cells to rupture and die as they thaw.

These are chemicals (medicine) used to control testosterone and other products of the glands serving the prostate.

Summary

I trust this work will offer technical guidance to the men climbing out of the dark hole of prostate cancer. Further, it is estimated that 90 percent of the cancers are due in part to poor eating habits, smoking, and exposure to hazardous chemicals. A health program of a low-fat, high fiber diet with plenty of fish and fowl (not red meat) along with beta carotene (Vitamin A) from different vegetables is helpful in lowering the cancer risk. The National Cancer Institute said that tomato based foods will help with the containment of prostate cancer, and I eat a tomato a day. Linus Pauling said somewhere that Vitamin C aids in holding the cells together; thus, I reason that it will aid in resisting cellular enlargement of the tumor. So I take a significant share. In closing I wish the best of luck to those interested in successfully battling this deadly cancer. I believe prayer can provides scientific guidance in this deadly medical dilema.

References

P.C. Walsh, M.D. and J.F. Worthington, The Prostate, Johns Hopkins University Press, 2715 North Charles Street, Baltimore, Maryland 21218-4319, University of Utah Bookstore (801) 581-3536.

Prostate Cancer Education Program Feedback Kit (includes prostate glossary).

NIH National Cancer Institute, 31 center Drive, RM 10A03 MSC 2580, Bethesda , MD 20814-9692, toll free 1-800-4-cancer or 1-800-422 6237, http://www.nci.nih.gov