The news is good about prostate cancer. Although it is the third most often diagnosed cancer in men in the United States, following skin and lung cancers, 98 percent of sufferers are still alive five years after diagnosis. This is a vast improvement over the 64 percent rate of the late 1980s. Although the rate drops to 91 percent ten years after diagnosis this is still an impressive survival rate considering that the group includes men who were first diagnosed with advanced cancer and many older men of whom an appreciable number have other health issues.
The news can be very good indeed; for example, 99 percent of men with Gleason 6 organ confined prostate cancer have not had any relapse (biochemical failure) a decade after surgical treatment. Further, it is very unlikely that these men will experience a recurrence after that time.

Keeping the aforementioned “good news” uppermost in mind. As it has been observed, a man is far more likely to die WITH prostate cancer than OF it. Prostate cancer tends to be an indolent disease and many men may live to a ripe old age to die of something else even if left untreated. Although treatment proffers survival advantages to many, such as men diagnosed at a younger age and those with aggressive disease, some men may do well with “watchful waiting”, frequently measuring their PSA readings to monitor whether their cancer remains at a stable level. The clearest case for watchful waiting seems to be for elderly men with low level disease with a less than 10 year life expectancy.

Concerns about masculinity – the prostate is an integral part of a man’s reproductive system; once removed or treated by radiation and most other therapies a man will not be able to father children. Many men, particularly those who have excellent sexual functioning may retain most of their sexual performance ability after treatment; others may not do as well. Problems may range from experiencing complete impotence to some impairment in the ability to have erections.

While cancer control is a crucial treatment concern other considerations include minimizing the side effects of surgical treatment. Of immediate concern are factors such as blood loss, infection control, pain management and length of hospital stay. Following discharge from the hospital and the successful management of the immediate post surgical process concerns usually shift to two primary areas; return of urinary continence and adequacy of sexual functioning.

Men may do well in one or both of these vital areas while some may have an impaired recovery. Factors that have an influence on the ultimate recovery of urinary and sexual functions include the extent of, and techniques used in the surgery, the particular physiological makeup of the patient and the skill and experience of the surgeon.

Take your time – In the majority of newly diagnosed prostate cancer cases there is no urgent need to decide on a particular course of treatment; consult with your physician to confirm that your situation is not pressing. In the course of your fact finding speak with at least one surgeon and a radiologist to better understand the advantages and drawbacks of these major treatment options. Not surprisingly, you may find that each type of physician may advocate the treatment he provides.
In general, the more experience a physician has the better his patients tend to do. Physicians in big city teaching hospitals tend to be continually reviewed to ensure they provide excellent care for their patients. And physicians who publish their work extensively in peer reviewed clinical publications are frequently at the top of their field, employing the latest advances. When you meet with the physicians you are considering for your treatment ask the important questions that may give you an indication about how you will do under their care.

Make a treatment decision that you are comfortable with – By the time most men finish doing their “homework” a treatment decision (or even the decision to defer treatment) will have assumed a certain shape in their mind. It will be the result of time spent speaking with their support crew of family and friends, hearing or reading about prostate cancer survivors’ experiences, reading the information available in print and on the internet, speaking to physicians about the best course of action to take and doing a fair amount of thinking. By the time most men move forward with their decision much of their initial fear and uncertainty has vanished and the road ahead assumed at least some sort of reassuring outline Over a longer span of time subsequent to treatment most men express a fairly high degree of satisfaction with the treatment decisions they made.

Learn more about prostate cancer. Contact Dr. Ash Tewari.