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Although it occasionally jumps into the news — as it did with the recent death of bestselling author Vince Flynn — it also tends to disappear from the public consciousness just as suddenly.

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Prostate cancer survivor: We need to speak up about a silent disease

  • Article by: Jeff Strickler
  • Star Tribune
  • June 28, 2013 - 2:35 PM

Virgil Brown has won his battle with prostate cancer and is doing everything he can to heighten awareness of the disease, but he realizes that there’s only so much that a regular Joe like himself can do.

“There are no Angelina Jolies out there,” he said of the movie star whose recent decision to go public with the news of her double mastectomy generated international attention for breast cancer. “There have got to be some very powerful people dealing with this, and I’m sure they might be doing things to help behind the scenes, but we need more” of a public effort.

Prostate cancer is the second-leading cause of cancer death for American men, behind lung cancer, according to the American Cancer Society. Although it occasionally jumps into the news — as it did with the recent death of bestselling author Vince Flynn — it also tends to disappear from the public consciousness just as suddenly.

Brown, a Minneapolis resident who works with special-needs students in the Fridley school district, realizes that it’s a topic that makes men uncomfortable.

“Here’s a disease that accentuates that you’re not the man you used to be, and that can be devastating for a lot of men,” he said. The prostate helps make semen, “and that’s a pretty powerful thing in our minds.”

Brown, 63, who had his prostate removed in the fall of 2009, said that medical advances, including implants and hormonal treatments, have led to vast improvements in recovery.

“Once you get past the denial stage, you come to realize that you still have the same quality of life as you had before,” he said. “Plus, you still have life itself.”

Having a strong support network also helps. “I was fortunate that I had a friend, Kevin Johnson, who drove me down to the Mayo Clinic every time I needed treatment,” he said. “It’s very important to have someone you can reach out to to talk to about this. Women are willing and able to talk about this [medical] stuff. Men aren’t.”

Dr. Natarajan Raman, director of radiology oncology at Hennepin County Medical Center, said that ignoring things only worsens the odds down the line.

“This is an eminently curable disease if we pick it up early enough,” he said. “But it’s a silent disease. There’s no pain, there’s no blood [indicating a problem]. A lot of times, you don’t realize it’s an issue until it’s too late.”

Dispute over testing

There are two methods of screening for prostate cancer: a rectal exam in which a doctor feels for an enlarged prostate, and a blood test often referred to as a PSA test (it measures prostate-specific antigen).

Raman is a big supporter of the PSA test. “It’s cheap, it’s easy and it saves lives,” he said.

But the screenings have become controversial because they’re both prone to false readings that can lead to other issues. A false positive can result in someone undergoing unnecessary treatment, while a false negative can mask a potentially serious problem.

In 2010, the American Cancer Society softened its guidelines pertaining to the tests. Its current stance is that “men thinking about prostate cancer screening should make informed decisions based on available information, discussion with their doctor and their own views on the benefits and side effects of screening and treatment addressing the test.”

The wide array of prostate cancer further muddies the situation, said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society. There are fast-growing cancers, like the one that resulted in Flynn’s death, and there are slow-moving cancers that men live with for decades and sometimes aren’t even discovered until after they die of other causes.

“One problem we have is that it’s very difficult to sort that out,” he said. “We need to sort it out so we know whether to give it aggressive treatment or not. Some of these cancers we just want to keep an eye on because the side effects from the treatment can be worse than the cancer.”

Age plays a role

A certain amount of prostate cancer is an inevitable part of aging, Lichtenfeld said.

“Most men who live into their 90s have it,” he said. “I also think that if you did an autopsy of a man in his 40s and did a very, very careful dissection of the prostate, you could find cancer cells.”

Raman believes that diet also is a factor. He said that men who eat a lot of red meat, especially if it’s from hormone-enhanced cattle, are at a higher risk.

“We were traditionally taught that this is a disease of older men, but the rate of prostate cancer among younger men is going up,” he said. “You can see the rate go up over the years from when cattle were grass-fed to now, when cattle are fed hormones.”

Prostate cancer screening used to be recommended for men starting at age 50, especially if there was a family history of cancer. African-Americans also are at a higher risk.

Raman doesn’t agree with the decision to downplay screening. In fact, he would like the testing age moved to 40, with high-risk men starting at 35. “We have to do this when it still can make a meaningful difference” to the patient, he said.

Brown is worried about that very thing with his son. Cancer has been a frequent enemy in his family: His grandfather and father both had prostate cancer, his wife died from brain cancer and one of his daughters was born with cancer. (She had surgery when she was 9 months old. She’s 33 now and cancer-free.)

He doesn’t want to go through another cancer scare, but he isn’t sure if his son is emotionally prepared to buy into the program.

“He’s 38, and he needs to start to look at being checked,” he said. “But, like with most guys, I don’t think it’s happening. All I can do is keep educating people in hopes of making them aware of what we’re dealing with.”

 

Jeff Strickler • 612-673-7392

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