Awareness key to early detection

It is a subject many men find embarrassing, and that is what is particularly alarming about prostate cancer -- through early detection, it is entirely curable. But early detection requires awareness, and awareness comes through taking a close look at the silent killer.

According to the American Cancer Society, prostate cancer is the most common type of cancer found in men, other than skin cancer.

In 2002, about 189,000 cases will be diagnosed, and approximately 30,200 men will die from the disease.

Prostate cancer is the second-leading cause of cancer death, exceeded only by lung cancer. In 1996, it eclipsed lung cancer for a short time.

And it's curable, if detected soon enough. That was the case for Fred Gilbert (a false named used at his request), who was diagnosed with prostate cancer four years ago. He was 46 at the time, and thanks to a persistent daughter, the cancer was caught on time.

"I was having what I thought was lower back problems, but there was nothing wrong according to my doctor," Gilbert said. "Then I started having blood in my urine, but I didn't think it was that big of a deal. My wife started harping on me, and then my daughter called the doctor and made an appointment for me and didn't tell me. Now, I'm glad she did it."

Gilbert was diagnosed with prostate cancer. Immediately, he thought his life was over.

"You hear 'cancer,' and immediately you ask how long you have," he said. "I didn't know anything about prostate cancer."

Gilbert had surgery to remove his prostate gland, and since that surgery four years ago, Gilbert is cancer free.

What is

prostate cancer?

The prostate gland is found only in men, right behind the bladder. It is about the size of a walnut, and the tube that carries urine runs through the prostate.

Most of the time, prostate cancer grows slowly. According to the American Cancer Society, autopsy studies show that many elderly men who died of other diseased had prostate cancer and didn't realize it.

Sometimes, however, prostate cancer can grow quickly, spreading to other parts of the body, such as the lymph nodes. That's why it is vitally important to detect it early.

What are

the symptoms?

There are a number of symptoms which indicate prostate cancer is possible, although just because someone has the symptoms, prostate cancer isn't always the culprit.

Among the symptoms are blood in the urine, pain while urinating, uncontrollable urination, pain in the hips and pelvis area, and impotence.

Beginning at age 50, the American Cancer Society recommends all men have a blood test and a digital rectal exam annually. African-Americans, who are twice as likely to get prostate cancer, should be tested starting at age 45.

Treatment options

There are a number of treatment options, and here in Alaska, one of the most cutting-edge treatment options is available at Alaska Regional Hospital.

There are surgeries available to treat prostate cancer, including removal of the entire prostate gland. There is also radiation therapy, hormone therapy and chemotherapy.

A relatively new option is cryosurgery, and two physicians in Alaska are performing it at Alaska Regional Hospital. Dr. Kevin Tomera and Dr. William Clark of Alaska Urological Associates are the only doctors performing the surgery in state.

Cryosurgery uses extreme cold to destroy cancer cells. It is a viable option for patients who have failed radiation.

During cryosurgery, a patient is treated with an epidural first. Although he is awake during the procedure, he can't feel the pain. A thin catheter that circulates warm water is placed in the urethra to protect it from the cold temperatures. Then, slender cryoprobes are inserted through a small incision into the prostate gland.

Liquefied argon gas, which is contained within the cryoprobe tips, freezes and destroys the cancer and tissue that reaches -40 degrees.

The entire procedure lasts about two hours, and can be done on an outpatient basis. Most patients can resume a normal lifestyle immediately following surgery.