Men Don't Get Prostate Cancer
by Dr. John E.
Bonfadini, Ed.D., Professor Emeritus, George Mason University
I wanted the title of this column to
convey what I believe is the general publics attitude toward prostate
cancer. Unlike breast cancer, which has been brought to the forefront of
public awareness, prostate cancer remains largely in the closet.
Can you visualize thousands of male
senior citizens in a 5-K run wearing brown T-shirts with a symbol that looks
like an apple? It just isn't going to happen. We can appreciate the
devastation that breast cancer can bring to a woman for obvious reasons. The
prostate is a hidden, walnut-sized gland that few ever discuss except in old
age. One common idea is that both types of cancer can be cured with early
detection, but can lead to death if not treated in their early stages. I
cant talk about breast cancer, so Ill leave that important topic to
someone else. But as of this year, I have more than enough experience to
talk about prostate cancer, the No. 2 killer of men.
Last year 28,000 men died from the
disease. About one in six men will get prostate cancer, but only one in 35
will succumb to the disease. These statistics might create the illusion of,
Why worry about it?
I frequently tell the story about my
suffering from severe stomach problems. One day, on my way to the emergency
room, I spotted one of my family doctors so I stopped and expressed my
concern about having stomach cancer. He said the statistics were in my
favor, about 100 to 1. Then he added, What do you care about the
statistics if you're the one?
Over the past eight years I have been
dealing with prostate problems and in November I found out I was the one.
I'm going to share my story in hopes that it may help someone now or in
the future who is concerned about prostate cancer.
According to the American Cancer
Society, the relative five-year survival rate is 100 percent and the
relative 10-year survival rate is 91 percent for all men with prostate
cancer. The relative 15-year survival rate is 76 percent. Keep in mind that
five-year survival rates are based on patients diagnosed and first treated
more than five years ago, and 10-year survival rates are based on patients
diagnosed more than 10 years ago. Modern methods of detection and treatment
mean that many prostate cancers are now found earlier and can be treated
This analysis makes me feel a little
better, but I still realize that 28,000 will die of the disease and I may be
one. My story began eight years ago when I had a yearly physical exam. My
wife called me to say the doctor called he'd told her that everything
was fine, except my prostate-specific antigen (PSA) level was a little high
4.6 and I should see my urologist. She wasn't concerned; however,
the fact that the 4.6 reading was higher than the 4.0 possible-biopsy level
got my attention. Id been having urination problems and felt something
was wrong. After a digital-rectal examination (DRE), my urologist
recommended antibiotics, and that I have a follow-up PSA in two weeks. I did
this and got good news my PSA had fallen to 3.9. The doctor told me to
go home and come back in a year. As long as the number was less than 4, I
had a false sense of security.
Over the next few years, I had several
examinations. The PSAs fluctuated in the 3-to-4 range until one test showed
up at 4.2. At this point my doctor recommended a free-PSA test, which would
provide another measurement. My free-PSA test results were in the range
where a biopsy is recommended. Oh! The dreaded biopsy! After having 12 holes
punched in the walnut gland, I anxiously waited for the results. My
doctor called and said the results were negative. I thought about the
Seinfeld episode in which George gets a call from the doctor and
misinterprets the meaning of negative. My spirits were lifted, but I
continued having problems related to the prostate. I thought, Who cares?
I don't have cancer.
Over the next few years I had PSA
readings of 3.2, 2.9, 2.8, and 2.6. My PSA level was falling, so I felt
there was no need to worry. Then one day after an examination, my urologist
said my prostrate didn't feel just right. But since my PSA level was going
down, wed just follow it for a few months. During the next DRE, my doctor
found a small nodule on the right side of my prostate so it was time for
a second biopsy. I asked my doctor what were the chances of this being
cancer. He answered, about 14 percent. I taught statistics at George Mason
University, so to me, numbers have always been important.
After a few days, my doctor called and
said he'd wanted to wait until after Thanksgiving to discuss this, but my results
showed that two of the 12 biopsy cores contained cancer cells. The nodule
tested negative. My staging was T2b (in both sides of prostate) with a
mildly aggressive Gleason score of 6. The computer graph showed there was an
80-percent chance that the cancer was confined to the prostate.
My urologist told me all treatment
options were open. I could choose surgery, radiation, seed implants, or
cryotheraphy. Id already read everything on the subject I could find on
the Internet and could probably qualify for another Ph.D. on prostate cancer
to match my educational doctorate. I knew I wanted to go the Brachytherapy
route (seed implants). At this point, I got a stroke of luck. My urologist
recommended consulting with Dr. Koutrouvelis, who did seed implants using a
special 3-D Stereotaxis method at Uro-Radiology Prostate Institute in
During my initial meeting with Dr. K, he
said that if my test results were correct Id probably live 10 years if I
did nothing. He added that his research has found in a significant
number of cases, patients are under-staged and therefore he recommended
another biopsy using his procedure, which included biopsy of the seminal
vesicles. His process uses a CT scan rather than the traditional ultrasound
in placing the needles. It produces a 3-D image, allowing increased accuracy
and seminal-vesicle biopsy. My result showed that not only was the nodule
cancerous, but I also had cancer in my left seminal vesicle. I was upstaged
to T3b cancer outside the prostate. Dr. K said he could successfully treat
the cancer using his method because it allowed him to seed the seminal
vesicles and was extremely accurate in placing the seeds in the prostate.
I completed the treatment on Jan. 27,
2009, receiving 200 seeds in the prostate and seminal vesicles, delivered by
57 needles. Can you say OUCH? I was given a spinal injection anesthetic and
I personally chose not to have any further sedation, so it really wasn't
that bad. I was able to get up and go home in three hours.
Since then, I've battled some side
effects that follow almost any treatment for prostate cancer. They are
improving, and I hope my next PSA-test results will show I'm headed in the
right direction. Dr. Ks book, A Breakthrough in Prostate Cancer
Treatment, will give you more details and statistics on prostate cancer and
its treatment. His book is available from Amazon.com. I highly recommend it.
Living with the side effects of the treatment can sometimes be worse than
My goal in writing this column is to
show that numbers do lie, and to encourage a discussion on prostate and
other cancers. Most all families have or at some point will have loved ones
who suffer from cancer. With hope, more knowledge will lead to more cures
and extended lives.
If you need more information, e-mail me