By Dick Hodgetts

In 1993 the American Cancer Society had guidelines that recommended men should have a series of procedures to determine if they had prostate cancer.  The PSA test was then and even today is not a perfect test but combined with a physical exam by a physician, one could usually determine if prostate cancer was present. Men were encouraged to take the PSA test at age 50.  If the signs were positive, they take a biopsy of the prostate and advise the patient if prostate cancer was present.  In 1993 several options existed: the first and most common was surgery.  The surgeon would tell you with confidence that the disease should be physically cut out. Another option was the use of external beam radiation.  The third option, which the Europeans seemed to endorse, was careful observation sometimes using sawmill palmetto-a supplement available in drug stores.

All this sounds fairly benign but you should know a few additional factors: First, the surgery option could make you incontinent, or impotent, or both; and the surgery was not an easy process-it’s an ordeal.  Most American men choose surgery as it is most likely they asked a surgeon for advice.  Another unpleasant aspect of all this is that African-American males had, and continue to have, a much higher incidence of this disease.  In the black community this is compounded by less access and perhaps willingness to have check-ups.  Ignoring this disease is a very risky option. Black men are advised to have the first PSA checks at age forty. Don’t take that advice lightly.

My first PSA test indicated that I had prostate cancer, the physical exam and biopsy confirmed the test results. I took the external beam radiation treatment.  I was fifty, in really good physical shape, and a friend with the American Cancer Society pointed out that people taking the external beam option lived almost exactly the same number of years as those who had surgery.  At the time that was 15 years of continued life.

Therapy such as radiated seeds and cyro were very new and no reliable data existed in 1993.  Those approaches are much more sophisticated and successful today.  External beam radiation was to my mind-set, much ado over nothing.  You went for thirty days, lay on a table and they “zapped” you.  The Doctors and nurses assured me: “we are hunting rabbits with a bazooka. This will kill this disease.”   That was just what I wanted to hear, and there were no after-effects with my treatment.  For several years I sat with men who cried about how surgery had ruined the quality of their life as they were incontinent and impotent and still in their fifties.  Should you read this and assume that all surgery patients had these effects, absolutely not.  Every person varies just as their disease varies.  But I considered myself very lucky to have made the choices that I did. Then in 2001, my PSA jumped up and my doctors tell me the disease had returned.  At that point, I went to world famous MD Anderson Cancer Center in Houston Texas to go on a drug for advanced prostate cancer called Lupron.  Once it wears off, we don’t have many options available.  The side effects of Lurpon are not nice.  You gain weight, you are lethargic, and it diminishes your sex drive.  The option is to do nothing and die.  And, oh yes, Prostate Cancer is not a fun way to die. That is the understatement of the decade!!

Six months ago in 2009, my PSA jumped up again-the disease has returned.  I am newly and happily married, I am doing interesting things here in Madison, I have grand-children who are a delight.  And this news could not be more deflating.

My wife suggests the Cowles Clinic for a second opinion.  Some of you know that I have a high regard for Dr. Robert Cowles and Dr. David Lowther who have developed a new approach for treating returned Prostate Cancer as well as those newly diagnosed with the disease.  The treatment plan in lay terms is to do a MRI of the pelvic region and determine just where the cancer is located.  Then you go through a series of High Density radiation rods that go to the exact spots and the radiation hits very specific diseased locations.  You are under during this process and don’t know what they are doing to you.  Three months after my treatment, my PSA drops from 4.58 down to 0.58-which in today’s language means: we can’t find any prostate cancer.  I feel I have a new lease on life and do not know how to express my thanks.

Here are some things you should know:  1. If you go to a BMW dealer he is going to tell you to buy a BMW.  Doctors are the same.  They believe in their treatment.  You better learn about this disease and manage it.  2. Have an advocate who is not the least bit awed by white coats.  My wife serves in this capacity.  This person has to be able to say: “I am from Missouri-show me”.  3. If you are Black, coach blacks, know blacks, have family and friends who are black, or profess to be a Christian, tell black men: “please get tested for Prostate Cancer at age forty-you can beat it if caught early.”  Do not let them avoid the message.  If they work for you, make it a condition of employment.  Black men are dying far too often from this disease and it’s not necessary.  If you own a black barber shop, put up a big bold sign: “Get tested for Prostate Cancer”.

Normally this column is written by a health care professional.  I am not one.   I have through some inspired medicine with Dr. Cowles and Dr. Lowther survived a dreadful disease.  You can have the same experience if you are a guy who is willing to be checked.  If you love a guy, make him be tested.

Next week this column will be written by a professional with a more science based message.  Sorry to be so wordy, but don't die of this disease.