Eye of the beholder 6/8

Sunday, June 8, 2003

"They looked like works of art. The doctors showed me the pictures. You could see two glowing areas where the prostate cancer was." reports V5, a two-tour Vietnam Dust Off pilot. "Back in the 1980s, I'd signed up on the Agent Orange Registry. I knew Vietnam vets were developing prostate cancer in their 30s, 40s, and 50s. I'd have the routine exams. That last time, my PSA blood level had gone up. Nothing could be felt. I didn't feel bad. Then two of the six needle biopsies came back positive. So I had to decide what to do. I had internal radiation. It's now been almost three years since treatment. I'm okay." According to the American Cancer Society, prostate cancer is the most common form of cancer other than skin cancer among American men. While some men may have a very slow growing seemingly noninvasive form, that is not always the case. Prostate cancer is the number two cause of cancer death among men. It is estimated that one in six men will develop prostate cancer. This year, some 220,900 men will be diagnosed. According to the American Cancer Society, about 28,900 men will die from the disease. What causes it is unknown. Sometimes there is a family history. Lifestyles, diet, hormones and chemical exposures may be factors. With Agent Orange exposure, the Veterans Administration considers it a service connected disorder. What is known is that it can be deadly. Even among current references, it is sometimes considered an old man's cancer. One source states that the median age is 72. That is no longer accurate. Younger men are developing prostate cancer and dying. The prostate gland is a walnut-sized gland just below the bladder. The urethra, or the tube that carries urine, runs through it. The gland lies in front of the rectum. It produces an alkaline secretion that aids in fertility. As a man ages, it may increase in size and cause difficulty with urination. Early prostate cancer may have no symptoms. Later as the cancer grows, there may be difficulty with urination, frequency, urgency, urinary retention, urinary tract infections or blood in the urine or semen. Then, as it spreads to other organs or locations, other symptoms such as pain occurs. Examinations and tests are very important. Digital Rectal Exams are used to feel for bumps, lumps, size, and hardness. A blood test called the Prostate Specific Antigen. An elevated PSA level can indicate inflammation, infection, or cancer. Using ultrasound technology, needle biopsies can be taken. The cells are then examined for cancer. If the biopsies are positive, the next step is to determine the extent of involvement. This is called staging. Imaging tests provide pictures of where the cancer may be. Prostate cancer can spread to the lymph nodes, rectum, bones, or other locations. Some of the tests might be CT scan, MRI, and bone scans. One type of scan uses radioactive material to show the prostate cancer as well as lymph nodes and other organs. Once the data is collected, states 0-4 are assigned. According to the American Cancer Society, the lower the number, the less the cancer has spread. A higher number means more involvement. Working with the doctors, treatment team, family, the man has to decide what to do next. Being informed about his health, treatment options and outcomes is very important. One option is to wait and monitor. Another option is radiation either external or internal. There are surgical procedures such as the removal of the prostate gland. Drugs may be used. Follow-up care is important. Going through this experience is traumatic to both the man and his family. The American Cancer Society, at (800) 227-2345 or cancer.org has a program called Man to Man. Besides providing health information, Man to Man provides one to one visits with a prostate cancer survivor and self-help and/or support groups. Side by Side groups are for the spouse or partner. Information about local groups or how to set up a group can be obtained from the American Cancer Society or health care facilities. With detection and treatment, the prognosis is good. According to information provided by the Harvard Medical School's Consumer Health Information, if the cancer has spread the cure rate is decreased. So get tested. Your life depends upon it!

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