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Surviving Prostate Cancer

Surviving Prostate Cancer: What You Need to Know to Make Informed Decisions

Illustrations by Carlton Stoiber
Copyright Date: 2006
Published by: Yale University Press
Pages: 304
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  • Book Info
    Surviving Prostate Cancer
    Book Description:

    When Dr. E. Fuller Torrey was diagnosed with prostate cancer, none of the books he could find was current enough or comprehensive enough to satisfy his need for information. This book is for the hundreds of thousands of other men who each year receive the same frightening diagnosis. It is the book Dr. Torrey wished he had when he was facing the countless questions that a man with prostate cancer, and his family and friends, all confront.Complete, up-to-date, and readable, the book explains how to come to terms with the diagnosis of prostate cancer, evaluate the severity of the disease, and assess the variety of treatment options and their complications. Many chapters provide information other books barely consider, such as a full discussion of the causes of prostate cancer and an evaluation of other books on the subject. Also included is a summary of the most useful Web sites.The author mixes his personal experience with factual material, and he maintains a reassuring sense of humor. His advice is practical, with dozens of tips and lists including "Ten Steps to Sanity for Men Recently Diagnosed with Prostate Cancer." With Dr. Torrey's book in hand, readers can now tackle all the important decisions about prostate cancer, confident in having the most accurate and complete information available.

    eISBN: 978-0-300-12801-7
    Subjects: Health Sciences, Public Health

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-x)
    (pp. xi-xii)
    (pp. xiii-xvi)
  5. CHAPTER 1 On Being Diagnosed
    (pp. 1-10)

    In the timeline of our memories, major tragedies stand out as spikes. Most people remember clearly what they were doing when they learned that hijacked airliners had crashed into the World Trade Center. Those of us who are old enough can pinpoint precisely where we were when we heard that President Kennedy had been shot. Being diagnosed with prostate cancer is comparable.

    I was sitting at my desk at the Stanley Medical Research Institute at 10 A.M. on May 4, 2004. The immediate problem was how to persuade research staff members who do not like one another to work together....

  6. CHAPTER 2 How Serious Is Your Cancer?
    (pp. 11-26)

    Several questions immediately came to mind on the day I was diagnosed with prostate cancer. How serious is it? Is it likely to kill me? If so, when? This chapter provides information you need to begin answering such questions. Those who wish to skip the more technical discussions will find a summary at the end of the chapter.

    Prostate canceriscancer. It affects the walnut-sized gland that sits beneath the bladder and contributes some of the fluid making up the semen; a detailed description of the prostate can be found in Appendix A. Prostate cancer should not be confused...

  7. CHAPTER 3 Surgical Treatment
    (pp. 27-45)

    The surgical removal of prostate cancer has for many years been the most common treatment of the disease. It has been controversial, with proponents arguing that surgery is the only real hope for permanently curing the cancer, and opponents claiming that the main effect of surgery is to produce incontinence and impotence without any clear evidence, compared to other forms of treatment, that it actually lengthens men’s lives.

    The surgical removal of enlarged prostates, both those caused by benign prostatic hypertrophy and those resulting from cancer, has a long history. Until the middle of the twentieth century, the operation was...

  8. CHAPTER 4 Radiation Treatment
    (pp. 46-66)

    After surgery, radiation is the most frequent treatment of prostate cancer in the United States. Its popularity increased after Andy Grove, chairman of Intel, published a 1996Fortunemagazine cover story account of why he had selected radiation treatment for his prostate cancer. An analysis of Medicare data found that radio-active seed therapy (brachytherapy) “is replacing radical prostatectomy as the treatment of choice for early-stage prostate cancer.”¹ Radiation is, of course, used to treat many forms of cancer. It works by disrupting the deoxyribonucleic acid (DNA) of cancer cells, which grow more rapidly than do normal cells; both types of...

  9. CHAPTER 5 Hormone Treatment
    (pp. 67-77)

    Testosterone, the male sex hormone produced by the testicles, stimulates the growth of prostate cancers. It was discovered more than a century ago that surgical removal of the testicles—castration—improves symptoms for men with advanced prostate cancer. Charles Huggins, a urologist at the University of Chicago, undertook experiments in 1941 to bring about the same effect by giving men with prostate cancer female sex hormones to block testosterone. This work, which in essence produces a chemical castration, was the first successful treatment of any form of cancer using medication. For his research, Huggins was awarded a Nobel Prize in...

  10. CHAPTER 6 Cryotherapy
    (pp. 78-80)

    The idea of killing cancer cells by freezing them has a long history. The technique is widely used for some forms of skin cancer. Cryotherapy, also called cryoablation, was first tried for prostate cancer in the 1960s, but the results were disappointing. This approach was revived in the early 1990s and, with improved technology, has gradually gained adherents.

    The best candidates are men who are relatively young and who do not have severe forms of prostate cancer. Cryotherapy is also commonly used for individuals who have been treated with radiation but whose cancer has recurred. Surgery cannot be performed on...

  11. CHAPTER 7 Alternative and Experimental Therapies
    (pp. 81-88)

    Alternative therapies for medical disorders have become increasingly popular in the United States, with 42 percent of adults reporting having used one or more.¹ The increasing popularity of alternative therapies has been fueled in part by rapid distribution of information on the Internet and in part by dissatisfaction with an increasingly dysfunctional traditional medical care system. Men with prostate cancer are especially susceptible to claims made for alternative therapies, since existing treatments produce a plethora of unfortunate complications.

    Alternative medicine covers a broad spectrum of therapies, ranging from special diets, vitamin and mineral supplements, and herbal therapies to hyperthermia, ultrasound,...

  12. CHAPTER 8 Treatment Decisions
    (pp. 89-117)

    Thomas Stamey, a prostate cancer researcher at Stanford University, wrote that when people are “faced with a serious illness beyond their comprehension, [each of us] becomes childlike, afraid, and looking for someone to tell us what to do.”¹ In the case of prostate cancer, men are frequently advised by different physicians to do entirely different things and then told: “But in the end, it is up to you to decide.” There is probably no other major disease in which the burden of treatment decisions is placed so fully on the shoulders of the patients.

    In addition to having to make...

  13. CHAPTER 9 Your Support System
    (pp. 118-131)

    It is said that being diagnosed with cancer changes a person forever. My internist, who is a personal friend and who discovered my cancer, said exactly that to me. I did not doubt him then, and I certainly do not doubt him now. A cancer diagnosis is one of life’s defining moments, a new tint to one’s glasses that puts the world in a different light.

    Cancer doesn’t just change the person, however. It also changes the person’s relationships with family members, friends, coworkers, and professional colleagues. It is not only thatyousee the world in a different light...

  14. CHAPTER 10 Major Complications and Their Treatment
    (pp. 132-151)

    Incontinence and impotence are the two most-feared complications of prostate cancer treatment. They are the Scylla and Charybdis of prostate voyagers, and rare is the man who successfully sails by both without being affected by one or the other. Even men who elect watchful waiting as their option may experience them as their cancer increases in size. Although incontinence and impotence have been briefly discussed in preceding chapters, their importance for men with prostate cancer merits a chapter of their own.

    It is vital, however, to place incontinence and impotence in proper perspective. For men whose cancer has grown beyond...

  15. CHAPTER 11 What Happens if the Cancer Spreads or Comes Back?
    (pp. 152-168)

    Living with prostate cancer, said one man, is “like being trapped inside a cage with a baby lion.” In the beginning, the lion is small and nonthreatening, but you know that the lion will grow and may eventually devour you. This man’s cancer did spread and in the end did “devour” him.¹

    Prior to the PSA era, by the time of diagnosis the prostate cancer would have already spread beyond the prostate in the majority of cases. By the 1990s, this number had been reduced to one third, and by now it is presumably significantly lower than that.

    Prostate cancers...

  16. CHAPTER 12 What Is Known About the Causes?
    (pp. 169-186)

    Once a man has been diagnosed with prostate cancer, he inevitably asks himself: What caused it? Personally, I very much wanted to know. Saying that I had a disease that strikes randomly, like a bolt of lightning, was not very satisfying. It would be better if I could understand its antecedents, even if my own behavior had somehow contributed to its cause.

    Yet when I began searching the medical literature for answers, I was disappointed. A 2003 review of the subject stated that “the etiology [cause] of prostate cancer remains virtually unknown.”¹ Given that a federal “war on cancer” had...

  17. CHAPTER 13 Factors That May Prevent Emergence or Recurrence
    (pp. 187-198)

    Given that one in every six American men is expected to be diagnosed with prostate cancer during his lifetime, we might anticipate that major research would have been undertaken to prevent its emergence or recurrence. The National Cancer Institute and other research groups neglected prevention research for so many years that today we know remarkably little. Most prostate cancer prevention trials were initiated only within the past five years and will therefore not yield useful data for many years to come. For example, trials of selenium and vitamin E (the SELECT trial); betacarotene and vitamins C and E (Physicians Health...

  18. CHAPTER 14 Science and Politics
    (pp. 199-207)

    Prostate cancer is a major threat to men’s health. Adult men in the United States have a 1 in 6 chance of being diagnosed with it in their lifetime. This compares with a 1 in 13 chance of being diagnosed with lung cancer, 1 in 17 with colon cancer, 1 in 68 with leukemia, and 1 in 81 with stomach cancer. Once diagnosed with prostate cancer, 1 of every 5 men will die from it. In 2005 this translated to an estimated 29,528 deaths, one every eighteen minutes.

    Since the American population is aging, the problem will almost certainly worsen....

  19. CHAPTER 15 Advice for Men Who Do Not Have Prostate Cancer
    (pp. 208-218)

    Chico, one of the comedian Marx Brothers, was once seen by his wife kissing a chorus girl. When pressed for an explanation, he quickly replied: “I wasn’t kissing her, I was whispering in her mouth.” We men have a remarkable ability to deny the obvious and create excuses—indeed, it may be one of our greatest strengths. Failing to get regular checkups to detect prostate cancer is simply another illustration of “denial vain, and coy excuse,” as Milton long ago called it.

    Many studies of men who have undergone regular exams for prostate cancer, including digital rectal exams and PSA...

  20. APPENDIX A The Anatomy and Function of the Prostate Gland
    (pp. 219-223)
  21. APPENDIX B Evaluation of Books About Prostate Cancer
    (pp. 224-234)
  22. APPENDIX C Useful Websites on Prostate Cancer
    (pp. 235-240)
  23. NOTES
    (pp. 241-266)
  24. INDEX
    (pp. 267-280)