Several of the callers to Saturday's Deseret News/Intermountain Healthcare Hotline on prostate cancer wanted to be reassured they'd made the right choice between surgery and various forms of radiation.
It's not a question that the hotline experts, Dr. Jay Bishoff, director of the Intermountain Urological Institute at Intermountain Medical Center, and his colleague, Dr. Scott Chidester, could readily answer. Treatment selection has to consider the aggressiveness of the cancer, whether it has spread, the age and health of the patient and other factors, they said.
Patients with a diagnosis of prostate cancer need to do a lot of research into their options and it's very reasonable to get a second opinion, they said. But unlike most other cancers, prostate cancer is not a "must do it immediately" disease. It's typically a slow-growing cancer and that provides time to consider options.
"If someone says you need therapy and you have to have it tomorrow, that's a red flag," said Chidester.
That point was especially important in the case of a man in his 80s who is planning to go out of state for radiation therapy to treat his prostate cancer. Bishoff said flatly he wouldn't do it, were he an elderly patient. Most urologists believe that "watchful waiting" without treatment is appropriate for most elderly patients who have the slow-growing disease. They are still more likely to die with the disease than of it.
But as they fielded several dozen calls, the duo warned that sometimes a patient has a more aggressive form of the disease, requiring more prompt and aggressive counter measures.
The other thing to remember, said Chidester, is "there's hope." Prostate cancer is very treatable. And although it's the No. 1 cancer killer in Utah, that's a function more of male reluctance to get screened than it is of treatment failure.
"A lot of our calls were from daughters and wives who are concerned," said Chidester. "Even as liberal and informed as we are in 2008, there are still taboos among men about examinations 'down there,' rectal examinations, etc. But it's a very high cure rate if we detect it early. And the test takes 30 seconds."The Deseret News and Intermountain team up to tackle a different health topic the second Saturday of each month. And this month, the hotline is introducing an online component. Wednesday, answers to questions that were e-mailed in by Saturday afternoon will be posted online at deseretnews.com.
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