Prostate cancer: deadly but defeatable
McHenry County State’s Attorney Lou Bianchi vividly remembers the day he was diagnosed with prostate cancer.
It was eight years ago – and just four days after he had announced his candidacy to be the county’s top prosecutor. He withdrew from the race, not knowing whether he would survive.
“Your first thought is that you aren’t going to live as long,” Bianchi, 69, said. “Most people fear that ‘c’ word. As the shock wears off a little bit, you have to understand that you have to look at the alternatives and see what options are out there.”
Because the cancer was detected early, Bianchi learned, his survival rate was high if his prostate was removed. He had the surgery and was declared cancer-free months later.
“It’s all about early detection,” Bianchi said. “I will never forget what the doctor said to me after the surgery, ‘Your report is to get back in the race.’ I went back to work and resumed my campaign.”
Bianchi is one of tens of thousands of men each year diagnosed with prostate cancer, the most common cancer in American men other than skin cancer, according to the American Cancer Society. But emphasis placed on early detection and swift treatments have many experts confident they can keep the disease in check.
BY THE NUMBERS
More than 240,000 new cases of prostate cancer were diagnosed in 2012, according to the cancer society, and more than 28,000 died last year. It is the second-leading cause of cancer deaths in American men, behind lung cancer.
One in six men will be diagnosed with the disease in his lifetime; two-thirds of those diagnosed are 65 or older. The average age of diagnosis is 67 years old. Prostate cancer is rare in men younger than 40.
Survival rates vary based on how far the cancer has progressed when diagnosed.
In the local stage or regional stage, when the cancer has not spread beyond the prostate or has spread only to nearby areas, the five-year survival rate is nearly 100 percent, according to the National Cancer Institute.
Prostate cancer diagnosed in the distant stage – having spread to lymph nodes, bones or others organs – has a five-year survival rate of 29 percent.
A LOSING BATTLE
Christopher Ducey lost a more than five-year battle with prostate cancer in October.
The McHenry resident had three key loves in his life – a wife, a daughter and a 1954 Ford Crestline convertible. When it came to visiting the doctor, it was something the 68-year-old avoided unless necessary.
His daughter, Jacki Ducey, said she believes doctors may have been able to stop her father’s cancer from spreading to his bones if he had not waited to be tested until symptoms became visible.
Early prostate cancer usually causes no symptoms. Advanced prostate cancer symptoms include trouble urinating, more frequent urination, blood in the urine, weakening of legs or feet, or loss of bladder control.
“He just thought age was creeping up on him, and then it got to be too much,” Jacki Ducey said. “It was hard because as a family, we could support him, but couldn’t help him in any other way. I wish I could have fixed it, but you just feel powerless.”
The once-strong man slowly began to deteriorate after years of chemotherapy and participation in clinical trials.
“It was very hard,” said Verlene Ducey, his wife. “I would try to keep his spirits up, always hoping that something would come along to help.”
The average man should start discussing screenings about age 50, and men with family members who have had prostate cancer and African-American men should start between the ages of 40 to 45, the cancer society advises.
Screening typically consists of a prostate-specific antigen test, which measures the blood level of PSA, a protein produced in the prostate gland. There also are rectal exams and biopsies, depending on test results.
Data released last year by the U.S. Preventative Services Task Force suggest that potential harm of PSA screening of healthy men outweighs the potential to save lives, and recommends eliminating the test in healthy men.
Some physicians vehemently disagree.
“The worst thing we could do as a health care system for these men is to ignore it, and wait until a guy comes in with symptoms,” said Dr. Brian Keuer, a urologist at Comprehensive Urologic Care, which has offices in Lake Barrington and Crystal Lake. “That will take us back 20 or 30 years, and we won’t have a lot of successful treatment options to offer these men.”
Early testing can detect lower-level prostate cancer that may not affect the patient and allow professionals to monitor the disease over time.
“Everyone thinks prostate cancer is slow-growing, but that isn’t always the case,” said Dr. David Goldrath, a urologist at Comprehensive Urologic Care. “Once you know you have cancer, you need to get it taken care of relatively quickly so it doesn’t progress.”
FIGHTING THE GOOD FIGHT
Carl Smith began being regularly tested for prostate cancer more than 10 years ago.
The 60-year-old’s PSA levels consistently tested low until December 2011, when they skyrocketed. He had prostate cancer, and his prostate was surgically removed a month later. The McHenry resident has been cancer-free since.
“When you are told you have cancer, your initial response is shock,” Smith said. “But I knew this was something I could handle. I accepted it.”
Treatment ranges from removal of the prostate, to radiation or other therapies, with each with the potential to cause problems such as erectile dysfunction, impotence, urinary incontinence or bowel damage.
Left untreated, the disease can progress rapidly.
“We tailor treatment based on pathology reports and the patients’ age and health conditions,” Goldrath said. “Each person is different. Recovery is remarkably faster now.”
“The advancements are so great that the side effects are minimized,” Keuer said. “In general, the treatments have never been better than they are now.”