Yes, this warranty is legal and it applies to you, your friends, and relatives. The gift of life has no warranties or guarantees; however, if you read this article it could PROLONG YOUR LIFE OR THAT OF A FRIEND OR RELATIVE.

Prostate cancer is the leading type of cancer in men (behind skin cancer) and is the one whose prevalence increases most rapidly with age. It is the third leading cause of death in men (behind cardiovascular "heart" disease and lung cancer). In 1998 over 300,000 men were diagnosed with the disease and over 35,000 died from it.

While prostate cancer is terminal if men do not get an early diagnosis and appropriate treatment, prostate cancer is curable when detected early. The cure rate is directly related to the stage of the disease at detection because the various treatments used to treat the cancer decrease in efficiency as the cancer has spread. The key to beating prostate cancer is early detection.

Although this article contains other information about prostate cancer, the main purpose of this article is to: (1) make you aware that prostate cancer is deadly; (2) inform you of the Prostate-Specific Antigen (PSA) test; and (3) encourage all men to get a PSA. It could save your/his life.

Detection

The first steps to detection are having a PSA blood test and a digital rectal exam. A PSA test is used to measure the protein made by prostate cells. A PSA test result under four is considered normal as compared to results above four which are considered high. The higher the PSA number, the greater the likelihood of prostate cancer. If the PSA test result is above four, the doctor may recommend a transrectal ultrasound and a biopsy. This is especially true if: (1) the PSA number is above 10, (2) a sharp increase in your PSA occurred, (3) you are black, (4) you have a family history of prostate cancer, or (5) you have other symptoms of prostate cancer.

The risk factors of prostate cancer vary by race, age, heredity and other factors. In the absence of any high risk factor, prostate cancer will occur in thirteen percent of the male population, meaning that thirteen in every 100 males will have prostate cancer. The incidence of prostate cancer in blacks is two times that of whites. Men in their forties and fifties have a one in sixty-three chance of being diagnosed with prostate cancer. For men in their sixties and seventies, that chance increases to one in six.

Family history can result in a risk factor of two to three times the rate of most white males. A person whose father or brother had prostate cancer, has a risk two times greater than the norm. If both father and brother had prostate cancer, then the risk is five times greater and if a grandfather/uncle, then the increased risk is one and one-half times or more greater than normal. Remember, prostate cancer can be inherited from either the maternal or paternal side of the family therefore, your risk is substantially increased if prostate cancer has occurred on both sides of the family. In addition, diet, especially a high fat diet and hormonal factors, can play a part in increased risks.

The survival rate of prostate cancer, like most cancers, is directly related to the stage of the prostate cancer at time of detection. A recent study described a five year survival rate as follows:

100% when cancer is first detected at a local stage (i.e., confined to the prostate). 58%+ of prostate cancer are diagnosed at this stage.

94.1% when detected at a regional stage (i.e., prostate cancer has spread to surrounding tissue). 18%+ of prostate cancer are diagnosed at this stage.

30.9% when detected at a distant stage (i.e., it has metastasized). 11%+ are detected at this stage.

It is easy to see why taking the PSA test as early as practicable is important. Early testing is important for another reason: it establishes a base line reading from which future PSA test results can be compared. These comparison test results are very important to show "jumps" in the numbers. For example, in the author’s case, early PSA tests were below four, then, a subsequent test showed a large percentage jump to above four, but less than ten. A subsequent biopsy resulted in a positive finding of prostate cancer.

Although screening guidelines as to when to begin taking the PSA do vary somewhat, the following are used by some local urologists and recommended by various organizations:

Black males should begin regular (annual/bi-annual) testing at age 40.

Individuals with a family history of prostate cancer (father, grandfathers, uncles, brothers), age 45.

All others age 50.

If the author had waited until he were fifty for testing, he would not have the survival chances that now exist and in all likelihood, the cancer would not have been detected until it had metastasized and was thus incurable. A jump from a baseline PSA test occurred in the PSA test which led to early prostate cancer detection. Later, the author found out about his significantly greater risk of prostate cancer because of uncles and others in his family who had been diagnosed with prostate cancer. Thus, simple recommendations are: (1) find out your family history (pass on to other relatives, especially your sons, any knowledge of prostate cancer in the family), and (2) more importantly, take the PSA at age forty because it is an inexpensive and easy blood test that can save your life. The frequency of future tests will be based on race, family history, test results, doctor’s advice, and other factors.

Treatment

There are a number of prostate cancer treatment options available. The options selected will depend on the individual patient’s situation. These options include: (1) radical prostatectomy (RP) – this involves the removal of the prostate and some surrounding tissue. A procedure called nerve sparing surgery designed to minimize the post operative effects of prostate cancer surgery is a type of RP surgery; (2) radiation therapy – this is the use of high energy x-rays to target and kill prostate cancer cells and shrink the tumors. This may also be done as a follow-up to RP; (3) hormone therapy – this includes changing the hormone levels of the patient in order to inhibit prostate cancer cell growth; (4) transurethral resection - this involves the removal of the cancerous section of the prostate by a surgical procedure; (5) seed radiation – this is a procedure whereby radioactive "seeds" are inserted into the prostate with the design of killing the prostate cancer cells; (6) cryotherapy – this involves using cold liquid nitrogen to freeze the prostate causing cancer cells in the gland to rupture as they begin to thaw; and (7) watch and wait – this involves monitoring the cancerous tumor by subsequent PSA tests and other means. This is usually used in older men or men who have other life threatening health conditions.

A new vaccine provides some promise to prostate cancer victims. An October, 1999 article in the Journal of Cancer Research describes a new vaccine that may prove useful in attacking prostate cancer cells. Although it is not described as a cure, it is another breakthrough in fighting this deadly disease. There are numerous books, articles, and other information available about prostate cancer. Excellent sources of information may be found on the Internet, which has various web sites devoted to prostate cancer.

In summary, be aware of prostate cancer and if you or a family member/friend is over forty, promptly take the PSA test. If could save your/their life.

The author is a West Virginia lawyer. While his name is not important, his message is. The author is available to discuss prostate cancer with you or a friend and he can be contacted through the West Virginia State Bar Office c/o Tom Tinder.