Prostate cancer is the silent, but deadly disease | TahoeDailyTribune.com

Prostate cancer is the silent, but deadly disease

"How do I know if I have prostate cancer?" As a urologist, I'm often asked that question. A male patient comes in with an unexplained pain or other symptoms and is worried that he might have prostate cancer. Consider two answers to how a man might know or suspect that he has prostate cancer. The first answer: pain. In some instances of severe or advanced prostate cancer, a man may experience blood in the urine, difficulty urinating, or unexplained severe bone pain. Usually these symptoms are not caused by cancer, but may be a sign of another urological condition. The better answer: no pain. Prostate cancer found early enough to be cured rarely causes any symptoms. As I tell patients, if you can feel prostate cancer, it is usually too late to cure it. While it can be controlled, it cannot be cured. Prostate cancer is a silent killer that usually gives a man no hint that it is present. Then how can you detect prostate cancer? Men in their 50s should have annual prostate screenings. In a screening, a health care provider conducts a PSA blood test and a digital rectal exam of the prostate. PSA, which stands for "prostate specific antigen," only screens for prostate cancer and no other cancers. Other cancer blood tests will not detect prostate cancer. Guidelines may vary, but I recommend annual prostate cancer screenings beginning between ages 50 and 55. If the man is in a higher risk group, such as he is African-American or has a family history of prostate cancer, he should start screenings earlier. Screening can slow down or stop around age 70 to 75. However, exact age depends on the individual and should be discussed with your primary care physician. Years ago, all men with prostate cancer received curative treatment such as surgery or radiation. Today, treatment protocols and in-depth conversations with your physician determine which patients need surgical or non-surgical treatments. Prostate cancer treatments depend on what is best for the individual patient and may include minimally invasive robotic surgery, radiation therapy, or other treatments. From extensive treatment experience, doctors have found a large percentage of patients can simply be observed and treatment isn't necessary. In summary, prostate cancer is a leading cause of cancer death in men and screening is an effective tool in detecting most prostate cancer. Men should see their doctor to determine what is best for them. Dr. Anderson is a board certified urologist with Barton Urology. He is trained in the da Vinci Surgical System and can perform minimally invasive surgical procedures. His office is currently located at the Community Health Center in South Lake Tahoe. To make an appointment with Dr. Anderson for any urologic needs, contact your primary care physician or call 530-543-5400.

Tahoans contribute: Safeway customers donate cash for prostate research

Safeway Inc. and the Prostate Cancer Foundation today announced they will collectively donate $6 million to fund the S.T.A.R. Program (for Special Team Amplification of Research), an innovative research initiative focused on exploring the role of targeted heat in cancer therapy to treat prostate cancer, as well as other research strategies. The S.T.A.R. Program is being launched for the first phase of research and development with a $3 million grant from the Safeway Foundation which raised the funds from its customers with donations made at checkout. Stores in Stateline, South Lake Tahoe and Tahoe City collected more than $177,000 toward the project, officials said. The Prostate Cancer Foundation (PCF) developed the collaborative research partnership and matched the initial funds dollar-for-dollar, for a total $6 million commitment. PCF is the world’s largest philanthropic source of support for prostate cancer research and has funded ten of the individual scientists making up the S.T.A.R. North American team. The program brings together an interdisciplinary team of investigators from multiple prominent cancer research centers. The team consists of investigators from the Johns Hopkins University School of Medicine (program lead and coordinator), the University of Michigan Cancer Center and the University of British Columbia. Additional expertise will be leveraged through the Prostate Cancer Foundation from the University of Washington, and from M.D. Anderson Cancer Center and Emory University. This unique program will bring expertise throughout the cancer research and treatment communities to focus on a new approach to prostate cancer treatment. “Similar to the program that Robert Goddard put in place to make space flight a reality, everyone that has input will be invited to the table to be part of the solution,” noted Jonathan Simons, M.D., CEO and President and David H. Koch Chair of the Prostate Cancer Foundation. “The S.T.A.R. Program is evidence of what can happen when you link the fundraising power of a major company like Safeway with the research vision of the Prostate Cancer Foundation,” emphasized Simons. “This program would not have happened without Safeway and its long-standing commitment to helping find a cure for prostate cancer. We are literally turning up the heat on metastatic prostate cancer research.” Prostate cancer strikes more than 218,000 men each year making it the most commonly diagnosed cancer in men. It also is one of the most deadly cancers, with more than 27,000 men dying each year from the disease, making it second only to lung cancer as a leading cause of cancer deaths in men. “Supporting this kind of innovative research has become a trademark of the Prostate Cancer Foundation, and the principle reason Safeway developed a relationship with the organization more than seven years ago,” said Safeway Chairman, President and Chief Executive Officer, Steve Burd. “We are pleased and honored to be associated with the S.T.A.R. Program initiative and what promises to be pioneering work by some of the world’s top cancer researchers,” Mr. Burd said. In another innovative effort, the S.T.A.R. Program will convene a “think tank” of some 70 experts in different areas of oncology from across the nation to explore the question of why current therapies cure some types of cancer but not others. The learnings from this effort will give direction to future research on prostate cancer and other types of common solid tumors that are currently the most difficult to treat. “We are grateful to the leadership of Safeway and their customers as well as the Prostate Cancer Foundation for this special effort,” said Robert Getzenberg, Ph.D., Director of Research, Brady Urological Institute, Johns Hopkins. “This unique approach and highly interactive team will develop these new concepts and extend them from the laboratory through testing in clinical trials to the patient setting,” Getzenberg said. The theory that heat can be used to help kill cancer cells comes from an observation and review of scientific evidence by cancer researchers at Johns Hopkins that testicular cancer patients, like seven-time Tour de France winner Lance Armstrong, have much higher rates of survival than others with different kinds of advanced cancer. Testicular cancer begins in the testes, which are a few degrees cooler than the rest of the body. The structural machinery of cancers cells spreading outside the testes may be altered by the higher body temperatures, making them more susceptible to standard chemotherapy treatments than other cancer types. While heat therapy is in limited experimental use, researchers believe the key to an effective treatment may be selectively heating cancer cells, which can also prevent damage in adjacent healthy tissues. The goal, note S.T.A.R. team members, is to find out the best way to deliver heat directly to cancer cells. To do so, some of the S.T.A.R. Program researchers will investigate the use of nanoparticles that are attracted to specific proteins carried by cancer cells. Once the nanoparticle locates this specific protein, it can enter the cancer cell, heating it from the inside out after exposure to a magnetic field. The S.T.A.R. Program team will look at this and other mechanisms for targeted heat delivery systems to cancer cells.

Prostate cancer: Sometimes it’s better not to know, survey says

Screening tests for cancer are often a good idea. Early detection of unapparent cancers of the breast, cervix or colon saves thousands of lives every year. Routine check-ups for these and certain other cancers at recommended intervals are part of a healthy adult lifestyle. But screening of men for cancer of the prostate gland, particularly among men over age 75, isn’t so clear-cut. So says a new report from the U.S. Preventive Services Task Force, an independent panel of experts in prevention and primary health care that judges the effectiveness of screening tests and other clinical preventive services. The task force conducted a rigorous and impartial review of all available evidence on the benefits and harms of the primary blood test used to detect prostate cancer in its silent, early stages: the prostate-specific antigen (PSA) test. The experts concluded that for men 75 and older, this test provides few health benefits, but can lead to substantial physical and psychological harm. For men younger than 75, the task force determined that there is insufficient evidence to recommend for or against screening for prostate cancer with the PSA test. Why are the experts so reluctant to advocate screening? Certainly prostate cancer is a serious public health problem. One in six men alive today will develop the disease during their lifetimes. More than 200,000 American men are diagnosed with it each year, and more than 27,000 of these will die from it. There is no question that increased awareness of prostate cancer and widespread use of PSA screening in recent years has enabled many men to beat the disease, when otherwise they would have died. Why not promote such screening for every man? The reason to withhold screening among those over 75 is the slow-moving nature of most prostate cancers. Cancers detected by screening with the PSA test generally take years to affect health. Those that grow serious enough to cause death typically take more than 10 years to do so. The life expectancy of 75-year-old men today is about 10 years. During that time they are more likely to die from heart disease, strokes and other causes than from slow-growing prostate cancers detected only through screening. In other words, older men who have the disease in its early stages are more likely to die with prostate cancer than from it. The same can be said for younger men with chronic medical problems that will shorten life expectancy to 10 years or less. They too are unlikely to live any longer because they undergo screening for prostate cancer. What they risk when they obtain screening for prostate cancer with the PSA test is physical harm and anxiety from the follow-up tests and treatments that may be necessary when the initial results point to a possible problem. Common complications from the treatment of prostate cancer include urinary incontinence and impotence. For many men in the last decade of life, untreated prostate cancers might never affect their health or well-being. For them, it may be better not to know. For men between the ages of 50 and 75, the best approach is an open discussion with health-care providers on the how the benefits and possible harms of screening balance out. Any decision about prostate cancer screening should be an informed decision. ” Jason Eberhart-Phillips, M.D., is the El Dorado County health officer. He can be reached at jeberhart-phillips@edcgov.us.

The Doctors: Four hopeful, helpful tips to fight against prostate cancer

About one man in six will develop prostate cancer during his lifetime. It’s the second leading cancer killer among men, and this year alone, more than 28,000 will die from it. Those aren’t the most comforting of numbers, but there’s reason to hope. Here are four out-of-the-lab findings: Reconsider supplements. Men who undergo hormone therapy for prostate cancer (to stop testosterone production, which prostate cancer cells need to grow) are at risk for osteoporosis, but taking calcium and vitamin D supplements may be making their condition worse. According to researchers at Wake Forest Baptist Medical Center, the supplements do not prevent bone loss and may boost odds for heart disease and aggressive prostate cancer. Previous research has shown vitamin E and folic acid supplements increase prostate cancer risk. Ask about aspirin. A daily dose may help men treated for prostate cancer live longer, suggests research. The protective effect was strongest among patients with a high-risk form of the disease. The results are preliminary, so talk to your doctor before adding aspirin to your regimen. Rethink red meat. A recent study found that pan-frying meat – red meat in particular – may raise prostate cancer risk by up to 40 percent. Scientists suspect the link is a result of cancer-causing chemicals that form when red meat is cooked at higher temperatures for longer periods of time. Braising produces fewer of those chemicals; so does steaming, poaching, stewing and microwaving. Consider ‘watchful-waiting.’ Also called active surveillance, it means to forgo medications, surgery or radiation and instead “watch” the cancer, and “wait” for changes. Because prostate cancer often grows very slowly, some men may never need treatment. In some cases, doctors will monitor it closely with tests and ultrasounds. In others, the approach relies more on changes in symptoms to decide whether treatment is needed. A new study published in the New England Journal of Medicine found men with early-stage disease who opt for watchful waiting are as likely to survive as men who undergo surgery. Experts agree active surveillance is not the best choice for everyone with low-risk cancer. – The Doctors is an Emmy-winning daytime TV show with pediatrician Jim Sears, OB-GYN Lisa Masterson, ER physician Travis Stork, and plastic surgeon Andrew Ordon. Check http://www.thedoctorstv.com for local listings.

Local Musician Wants to Share Valuable Lesson with Others

If he could, Angel South would give every American male a stern lecture. In fact, the South Tahoe-based musician says his frank talks with friends may have already saved the lives of four men. “Your body doesn’t lie. Small things can be a sign – I wish I’d known,” he said. Then he swallowed hard, looked straight ahead and said,”They’re telling me I might have a year and a half to live.” Unfortunately, South’s illness is not a rare one. It’s one that more than 165,000 American men each year discover they have – prostate cancer. “They don’t put this on the news for nothin’,” said the blues guitarist, singer and composer. “If I can save a few guys by talking about it, it’s worth it.” Because the prostate is a male sex gland, South, 54, says many men don’t get regular check-ups due to embarrassment, or they simply ignore what seem to be minor symptoms. “Just like women need to get regular mammograms and pap smears, men should be screened for prostate cancer,” said Valerie Rudd, health services manager for the El Dorado County Public Health Department. “The problem is, most men just don’t.” “It’s true,” said South. “Men aren’t educated about this at all. They’re used to toughing it out – those ugly cells couldn’t care less.” In the United States, prostate cancer is the most common type of cancer in men. Researchers are still learning more about the causes and early detection of this common disease. American studies show that prostate cancer is found mainly in men over the age of 55, however an increasing number of health workers – including Rudd – recommend screening while men are still in their 40s. Three years ago, South noticed he had to get up to go to the bathroom two or three times a night. He didn’t see a doctor. It went away. Last summer, the problem came back, only slightly more intense. He didn’t see a doctor. It went away. Finally, the same problem hit him harder in February. This time, South went in for a checkup. Tests revealed the cancer had already spread from his prostate to surrounding areas, including his pelvis and kidney. These days, South struggles with bouts of fatigue and pain, and often finds it hard to walk. He takes close to 50 pills a day – including a variety of herbs – and gets regular blood checks. Despite side effects of nausea and hot flashes, he is currently receiving hormonal treatment to “stop male hormones from feeding the cancer.” “But I still have to work, and I sweat bullets when I do,” he said. “No one’s paying my rent.” South continues to play one-man gigs around Northern California, including Sacramento, Auburn, Placerville, and the small town of Cool on Highway 49. After playing backup guitar for B.J. Thomas, South joined a band called “Chase,” which had two hit albums and won a Grammy. After most of the members of the band were killed in a plane crash, South moved to Tahoe and began again as a solo blues artist. His album “Swamp Doggy Dog” was ranked one of the Top 10 Blues Albums of 1994 by Blues Revue magazine. Two of his songs were featured on a CD album by blues legends John Lee Hooker and Charlie Musselwhite. His better-known hits include “Receipt for Playin’ the Blues” and “Heart Shaped Butt.” But playing gigs is still one of his greatest loves, and an impressive number of fans is testament to his talents. “I tell people about my condition at my shows – I want people to learn from my experiences,” said South. “I get a lot of standing ovations these days.”

Doctors urge baseline test for prostate cancer

An influential doctors group is backing off its call for annual tests after age 50 to screen for prostate cancer. “Many men do not need yearly screening,” but each man’s risk should be individually assessed, said Dr. Peter Carroll, who led the panel that wrote the American Urological Association’s new guidelines. They are being issued Monday at the group’s annual meeting in Chicago. The new stance brings the group more in line with advice from other experts, who say annual screening is leading to unnecessary biopsies and treatment with little proof that it saves lives. Screening involves a physical exam and a blood test for a substance called PSA. The urology group’s new advice says men should be offered a baseline PSA test at age 40, and follow-ups at intervals based on each man’s situation. A high PSA at age 40 greatly predicts a risk of prostate cancer, said Carroll, a urologist at the University of California at San Francisco. Doing a baseline test “makes a lot of sense to me,” said Dr. Eric Klein, prostate cancer chief at the Cleveland Clinic. Others disagreed. There is no proof that a baseline test will save lives, said Dr. Barnett Kramer, a National Institutes of Health scientist. “The same issue of harm comes up ” overdiagnosis. A baseline PSA, just like regular PSA screening, can lead to the diagnosis of cancers that would not have harmed a man had they not been detected,” Kramer said. Prostate cancer is the most common non-skin cancer in American men. An estimated 186,000 new cases and 28,660 deaths from it occurred last year. Cases rose in the late 1980s with the start of testing for prostate-specific antigen, or PSA, a substance the prostate produces when it is inflamed. Despite its name, PSA isn’t very specific. It can rise for many reasons besides cancer, such as normal prostate enlargement as men age, use of certain medicines ” even things like a hard bike ride or recent sex. Two big studies last month concluded that annual PSA tests do little to prevent deaths from prostate cancer. But many doctors believe the test may still have value ” if researchers can figure out better ways to use it. New studies at the urology meeting suggest ways. One found that a man’s PSA at age 60 can strongly predict whether he ultimately will die of the disease. Dr. Hans Lilja of Memorial Sloan-Kettering Cancer Center in New York tested stored blood samples from nearly 1,200 Swedish men from the early 1980s and checked cancer registries to see how many later developed or died of prostate cancer. If PSA was 1 or less at age 60, the risk of dying of prostate cancer by age 85 was very low ” less than 1 percent ” even if men had the disease for many years. About 90 percent of cancer deaths occurred in men whose PSAs at age 60 were in the top one-fourth of the group. In a different study, Dr. E. David Crawford of the University of Colorado Health Sciences Center studied 29,000 men from one of the large screening studies reported last month. Only about 1 percent of those whose initial PSA test was under 1 saw their scores rise above 4 in the next five years. Those with higher baseline scores had a much greater chance of that happening. “The bottom line is if you’ve got a PSA of less than one in your initial screen, you can wait to get another PSA for five years and not really be at increased risk of missing a cancer,” he said. “If your PSA is between 1 and 2, it’s also a small risk.” Crawford is the unpaid chairman of the Prostate Conditions Education Council, an industry-supported group that promotes screening. Dr. Robert Uzzo, a prostate surgeon at Fox Chase Cancer Center in Philadelphia, said many doctors are already advising longer testing intervals. “Everybody has to get screened at least at some baseline” to sort out future testing needs, he said. “If the baseline is quite low then I don’t insist on yearly screening.” Dr. Otis Brawley, the American Cancer Society’s chief medical officer, believes there is still some value to PSA testing, but added: “I am very concerned that the urology community and the American public may think there’s more value in PSA than there actually is.” Urology group: http://www.AUAnet.org/ Government advice: http://www.ahrq.gov/clinic/cps3dix.htm.cancer Risk calculator: http://tinyurl.com/cys84m

Governor has prostate surgery

Gov. Kenny Guinn is recovering at UCLA Medical Center after undergoing surgery Monday to remove his prostate gland. Guinn, 66, announced he had the disease in July after a regular test found elevated prostate- specific antigen levels in his blood. A biopsy confirmed he had the beginnings of cancer developing. He said at the time that early detection gave him several options including chemical and radiation treatment, but he and his wife decided to schedule surgery. “The patient is going very well,” said Dr. Ikram Kahn, his Las Vegas physician. “He’s wide awake, cracking his jokes.” Kahn said Guinn would remain at the medical center from three to five days, depending on how quickly he recovers. “It all depends on how he’s feeling,” he said. “We don’t want to rush him into doing things just because he’s governor. He should be just like any other patient.” Prostate cancer, with 200,000 new cases diagnosed per year, is second to lung cancer as a cancer killer of men. Kahn said the prostatectomy took about 90 minutes. Guinn said he chose Dr. Jean B. deKernion, chairman of the UCLA Department of Urology, to perform the procedure based on recommendations by his Las Vegas physicians. DeKernion is a pioneer in prostate cancer surgery and treatment who was appointed by President George W. Bush to the National Cancer Advisory Board in August. Kahn said the surgery removes the entire prostate gland: “There is no partial option. It’s a radical prostatectomy, that’s what he had.” Guinn, a Republican running for a second term against Democrat Joe Neal, will return to his home in Las Vegas once he has recovered to the satisfaction of doctors at UCLA. Guinn’s predecessor Bob Miller also was diagnosed with prostate cancer during his final term in office and underwent surgery. He has since said the surgery was completely successful in eradicating the disease.

Digger Phelps recovering from prostate surgery

SEATTLE – Digger Phelps had prostate cancer surgery and is recovering at the University of Washington Medical Center. His daughter said Wednesday that the former basketball coach and current ESPN analyst is resting comfortably. The 68-year-old Phelps, a regular at the American Century Championship at Edgewood Tahoe Golf Course, was diagnosed with prostate cancer on April 28. Daughter Karen Moyer said the cancer was detected during a routine physical. Moyer is a supporter of early cancer detection research through The Moyer Foundation, a nonprofit organization she established with her husband, Philadelphia Phillies pitcher Jamie Moyer. In 2003, the foundation created The Gregory Fund at the Fred Hutchinson Cancer Research Center. It is dedicated solely to early cancer detection research.

What’s Happening

Dr. Randall Nixon will present a free wellness lecture on the Prostate Specific Antigen lab test for prostate cancer from 5:30 to 6:30 p.m. Tuesday at the Tahoe Douglas Fire Protection District Station, 193 Elks Point Road in Zephyr Cove. PSA screening is recommended by the American Cancer Society for all men over 50 years of age, black men over 45 and men over 40 with a family history of prostate cancer. PSA is a simple blood test that detects substances that may be an early warning sign of prostate cancer. Any abnormal result should be followed up with an office visit and a digital exam, which is performed by your physician. Dr. Nixon attended medical school at Washington State University and completed his residency in urologic surgery at Vanderbilt. He has written more than 10 publications on the subject of PSA and prostate health. For more information call the Barton Health Resource Center at (530) 543-5537. Doctors’ day coming up soon National Doctor’s Day was established in 1990 with a resolution signed by then President George H. Bush to publicly show appreciation for our physicians. The enactment was to recognize the role of physicians in caring for the sick, advancing medical knowledge and promoting good health. Many of us don’t see behind the scenes, having to deal with life-threatening illnesses and injuries, spending endless hours at the hospital or emergency room or spending normal sleeping hours on call, and providing quality patient care throughout the night while the rest of the town sleeps. In honor of our local physicians, Barton Hospital Foundation invites you to honor your favorite physician by making a contribution as a tribute for his or her service, care, knowledge and compassion. With your tax deductible donation of $10 or more, a special “Doctor Appreciation” card of thanks will be sent to the local doctor of your choice with your name as the sender. Additionally, those physicians acknowledged will be highlighted at the presentation of the Physician of the Year award at Barton Hospital on March 30. To establish a tribute for your favorite local physician, send your check with the physician’s name to Barton Hospital Foundation, P.O. Box 7316, South Lake Tahoe, CA 96158. Donations must be received by March 29. Take a minute to thank someone who cares about you and your health. For comments or questions call (530) 543-5614. – Provided to the Tribune

Governor back on job after hip replacement surgery

CARSON CITY (AP) – Gov. Kenny Guinn is back on the job, 10 days after undergoing hip replacement surgery. Guinn, 69, said he was nearly pain free and walking smoothly when he returned to work Friday. The new, less invasive technique used by doctors to replace his hip joint April 4 at a Las Vegas hospital had him on his feet the next day, he said. “I’m doing really well,” he told the Nevada Appeal. Hospital officials said the procedure greatly reduces recovery time, which can be as long as three months using standard techniques. Guinn said he’ll eventually need to have the other hip replaced as well. He has said the damage to his hips probably dates to his days as a high school football player. Guinn also played football for the University of Southern California and for Fresno State University. The governor, who was briefed Friday by Chief of Staff Keith Munro, said he should be back to a fairly normal schedule this week. Guinn, who was elected Nevada governor in 1998, is in the final year of his second term. He is prevented by term limits from seeking a third term. He had successful prostate cancer surgery in 2002.