Parallels Between Prostate And Breast Cancer
Most men don’t talk about it. Not in mixed company, anyway, and usually not even when it’s just “us guys.” But prostate cancer is so common, striking one man in five, that if it doesn’t touch you directly, it will touch someone you know or work with.
Nationally, prostate cancer is the second-leading cause of cancer deaths among men — behind lung cancer — and it accounts for $5 billion of the $35 billion we as a nation spend annually on cancer treatments.
That doesn’t count the cost of lost productivity: the time patients are away from work for treatment and recovery. The cost to corporate health plans is significant and growing annually.
Historically, prostate cancer primarily has hit older men, but that’s changing. As male life expectancy increases, men are working longer and retiring later. Today new diagnostic techniques can detect prostate cancer years earlier.
These two trends have converged to magnify the economic impact of the disease as it strikes men in their highest-paid and most productive years.
Fortunately, new therapies have been developed that can reduce time lost from work from many weeks to a matter of days. And the likelihood of damaging side effects, which can cause men to avoid seeking treatment until it’s too late, has been greatly reduced. Together, these improvements can alleviate the toll prostate cancer takes every year – but only if men and their employers are aware and pro-active in speaking up when it comes to a disease that often shows no symptoms until it is too late.
Until recently, prostate cancer was detectable only after the tumor had grown large enough for a physician to feel during a physical exam. By then the cancer may have been growing for years.
There is a parallel between prostate cancer and breast cancer – The sooner it’s detected, the better the treatment results will be.
Since 1985, a test has been available that detects levels of prostate-specific antigen (PSA) circulating in the bloodstream. Elevated levels of PSA may indicate prostate cancer, as well as noncancerous conditions such as prostatitis or benign prostatic hypertrophy (BPH).
Because a high PSA level does not necessarily mean that there is a tumor, the test often is followed up with a biopsy for a definitive diagnosis. This has created a controversy over whether the PSA test is a cost-effective way to save lives, or just leads to unnecessary biopsies. As a result, some health-maintenance organizations will not pay for the test.
The cost-benefit analysis of early detection depends on what courses of action are available after diagnosis. The gold-standard treatment for prostate cancer has been radical prostatectomy (surgical removal of the prostate). Because it’s an invasive procedure, the recovery time is lengthy — up to six weeks.
Radical prostate surgery can have other side effects, including incontinence and impotence. Patients require hospital stays, sometimes as long as five days or more following surgery, and are often unable to return to work for as long as six weeks. While the recent use of robotic surgery has dramatically reduced recovery times, men still need to be careful for up to 8 weeks following surgery.
The advantage of this procedure is that if the tumor has not spread beyond the prostate, removing the gland cn get rid of the cancer entirely. Yet, for many men, the physical and psychological costs of radical prostatectomy are enough to keep them from getting treatment, or even from getting screened in the first place.
Just as most women are in the habit of regular cancer screening — annual Pap smears and perhaps mammograms — a man needs to discuss prostate screening with his physician and determine an appropriate protocol.
Whatever you do, don’t ignore the thought of prostate disease in the hope it will go away. Silence is not a cure. Recent advances mean that the cure is no longer necessarily worse than the disease.
The technology available today represents a significant advancement over earlier therapies, allowing men to live longer and preserve quality of life.
Today real men speak up…real men get tested.