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Rudy Giuliani, Dick Riordan, Joe Torre. What is it that links these three men? Giuliani and Riordan are both recent mayors of the largest cities in the USA. However, Joe Torre is a baseball manager. Torre and Giuliani are both from New York, but Dick Riordan is from Los Angeles. No, the thing that links these three men together is the fact that they have all been successfully treated for one of the commonest forms of cancer to affect men over the age of fifty - Prostate Cancer.
It is a proven fact that around 40,000 men die of this disease each year in the United States. However, this doesn't have to be the case as long as its existence is detected early enough for treatment to be applied. Most men just don't want to think about the possibility of having Prostate Cancer because of the false impression that its presence and treatment may rob them of their masculinity. It's a macho thing and the main reason many men won't request a simple blood test to check the possibility whether or not additional testing might be indicated. This test is known as a PSA test, with PSA standing for Prostate Specific Antigen, and should be conducted at least once a year for all men over the age of fifty (and even younger in the black community). Generally, a small amount of PSA present will not raise a warning flag but when a value in excess of 2.5 is found it will cause the doctor to start monitoring it more carefully. If he notes that it has risen above this value at the next test he may well suggest a more thorough examination. It is at this point that some men will go into a state of denial and not proceed further. Many of those 40,000 who die of Prostate Cancer have either waited too long for the PSA test or have neglected to act on its warning signs. The medical community has a saying; "All men will die WITH Prostate Cancer if they live long enough, but very few men have to die OF Prostate Cancer".
Less than twenty years ago the normal treatment for this disease was via an operation, called a Prostatectomy, to physically remove the prostate gland along with any other affected tissue. Electron Beam Radiation Therapy (EBRT) was also used but, because the beam can't be focused on the gland itself, this also tends to affect the surrounding tissue and organs to some degree. Although Prostatectomy is still the standard treatment method, there are now several less invasive methods available for treatment of early stage prostate cancer. The key word here is "early stage" and the simple PSA test is the primary way of obtaining an early warning if a problem exists.
I feel very fortunate that my doctor insisted on checking my PSA last April. Noting that it was slightly above 5.0 he made an appointment for me to get a biopsy at a local urologist. When cancer was found in two of the samples I then had to make a decision with regards to my next step. Prostate Cancer is not a fast moving species as long as it is in the early stage. So I was able to use the next few weeks to read all the literature that I could, and discuss options with my urologist as well as a renowned radiologist. After assessing all my options and considering the possible impact on my Quality of Life I opted for the process known as 3D-CRT, or "Three Dimensional Conformal Radiation Treatment". This was to be performed at the Torrance Little Company of Mary Oncology Center, although there are many facilities in the Los Angeles area that have similar equipment.
Being an engineer, I found the whole procedure to be extremely interesting. The first thing that happened was that a lab tech drew a series of location marks with a felt pen at various places around my lower torso. Computer assisted tomography (CAT scanning) was used to provide a three dimensional view of the infected area . The position of the tumor was located with respect to the prostate and the ink marks and the data entered into a computer file. I was told not to remove the ink graffiti until the next day when the tech would use the previous day's data to tattoo a series of permanent "freckle" like marks on my hips and lower stomach. These were to be used to align my body exactly the same during each radiation session via laser beams similar to those used by tool rooms in major manufacturing facilities. The other thing that was obtained from the tomography exercise was to obtain data so that a series of "lead blockers" could be manufactured. These each consisted of a three inch cube of lead with a specifically shaped "pass through" hole machined into it. Each lead mass was then attached to a thick clear plastic sheet that would be inserted across the radiation beam (one for each of six positions in my case) in order to align and concentrate the beam at the prostate.
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As can be seen from the accompanying photographs, the radiation "gun" can be rotated to various positions around the body located on the table below it. (Yes, that is ME in the last photograph).
With six independent locations for the beam to pass through on the way to the prostate, this meant that the prostate would end up getting the full dose while surrounding tissue would only get a sixth of it. I was told that the therapy would take place over about eight weeks with three "zaps" being given five days a week. Although this sounds like a long haul, each session only required a visit of about five minutes with a weekly check by the oncologist to see how I was getting along. I was told that possible side effects might consist of urinary frequency, loose bowel movements and tiredness. However, I have not personally experienced too many of these so I assume everyone is different and the frequency of the mentioned side effects are not a given.
The point of this news item is to impress on those men who read it that, although prostate cancer is a potentially serious problem, it is not necessarily a terminal one as long as it is detected early enough. This in turn requires a pro-active response from the male community to take matters into their own hands and "Go get checked"!
