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(POC: Dick Healy –
dhealy60@comcast.net)
As some of you know, we have been running a class prostate cancer
support group since 2002. The aim of our support group is to
provide information, based on our experiences, to newly diagnosed
classmates. That information is intended to better arm the newly
diagnosed for their subsequent conversations with urologists and
treatment specialists. We are also linked with several other class
support groups (55-59, 62, 64 and 71), which widens our experience
base considerably. Our groups share information from a number of
open sources which provides us all with some degree of knowledge
about what is currently happening in the PC world. Perhaps 30-40
messages, usually based on new study results, float between the
groups yearly. I maintain an extensive library of those sources of
information, including case studies of most of our classmates who
have been treated. Not all the reporting on study results is high
quality. In fact, some is downright poor. We try to point out
shortcomings.
In my ’60 database, I list 72 classmates who have been diagnosed
with PC. About 32 more have been treated for BPH, other prostate
maladies or high PSA readings. I expect there are 5-10 more
classmates who have been diagnosed that I know nothing of. We have
had about eleven classmates, to my knowledge, die from or with
PC. Two died without treatment, the cancer having spread before it
could be effectively treated. Another died of a recurrence of PC
after participating in an experimental study with the drug
finesteride. Nine more, who had been treated for PC, have died of
other causes. The first treatment took place in 1993, and the most
recent is on-going (Dec 2017). All this puts us on the national
average, and we have the expectation that others of us will be
diagnosed as time marches on.
All of the remaining 51 of us have had our cancer treated in some
respect, treatments ranging from surgery to several types of
radiation (including one watchful waiting case which was later
treated with radiation once pre-established markers were reached) to
alternative options. At least six members notified us that they
have been diagnosed with a recurrence of the cancer and are
currently considering or undergoing follow-on treatments.
But the others seem to be doing well, at least thus far, at least
to my knowledge. So, let me offer some generalizations based on
what I think I know from our database and the information passing
through our support forums.
First, the risk of PC (and other cancers) can be reduced through
low-fat, well balanced diets, regular exercise, adequate sleep and
low stress life styles. A paper on Preventative Measures follows.
Routine screening is a must so that the cancer can be detected
early and treated before it spreads from the prostate. I believe
our class figures are reasonably good because of aggressive
treatment selection after the diagnosis.
The problem with routine screening is that it is largely based on
PSA test scores, and those scores are not a totally reliable
predictor of cancer (and, oh, yes, the digital exam, too). Research
is being done on better tests. However, a high PSA reading doesn’t
necessarily mean there is cancer, and a low reading doesn’t
necessarily indicate the absence of cancer. The possibility of
cancer being present may, however, be respectively higher or lower
based on the PSA figure. A jump in PSA results (velocity) from one
test to the next is a stronger indicator of the possibility of PC,
and a biopsy can follow. Actually, the biopsy can be used in any
situation of doubt, and some of our guys have had several. They
used to be painful; now they are just a little uncomfortable. If
the biopsy finds cancer, we know it is there, but even the biopsy
can miss finding it. The biopsy is currently the only way to
determine whether the cancer is aggressive, although the PHI test (a
simple blood test) aims to assist in that determination. Included
below is a list of books and websites for additional information on
the subject.
Recent study results seem to argue that we are being over-screened
for PC and if a cancer is found, over treated. These conclusions,
of course, are based on percentages and the knowledge that most
prostate cancers are slow growing (you’ll probably die from
something else), just a few types being aggressive (you’ll probably
die from the PC, if left untreated). The down sides of unnecessary
treatment are the possibilities of incontinence and impotence
following treatment. But the risk of either incontinence or
impotence is much less now than it was even 10-15 years ago in that
the surgical and radiation techniques have improved greatly.
Another factor is our age; as we age, treatment options become more
limited and the likelihood of PC being diagnosed increases. But, we
are for the most part still a young 79-84, meaning most options
remain available to most of us. As we get to about 80 there is a
reduced inclination of doctors to recommend aggressive treatment
options (e.g., surgery).
So, what’s a guy to do? Stan Bacon (’58 Support Group), the man
who was behind the formation of all our support groups, has a one
liner I heartedly subscribe to: we are each a statistic of one. If
a person wants to play percentages, be my guest. Our two early PC
deaths probably resulted because those men chose not to be screened
or were unaware that screening was available or needed. The
relative well-being of most of the rest of us is probably because we
opted for screening and aggressive treatment following
identification of the cancer.
I highly recommend the Prostate Cancer Foundation’s 2017
Guide which is at a. below.
It is a comprehensive and up to date guide, the best out
there.
If you’d like to join the PC forum, let me know. If you are
diagnosed with PC at some point, you can correspond on the forum (or
directly) with people who have already received one or more of the
various treatments available. We really do try hard to be
responsive and helpful. Dick |