The City of Davis has proclaimed September to be Prostate Cancer Awareness Month to increase awareness of this disease. Prostate Cancer affects one in six men in the U.S. and is more common in African-American men and those with a family history of the disease. It is the second leading cause of cancer-related death in men.

Most family doctors will tell a patient that “PC is a slow-growing cancer and most men die with the disease and not of it.” While true in general, some men develop aggressive disease and may die from it. Estimates are that about 33,720 American men will die of PC in 2011 (www.Cancer.org). One of the most pressing challenges in is determining who needs aggressive treatment and who can be left untreated.

Fortunately PC is one of the most curable forms of cancer if it is detected when still localized to the prostate gland. The longer a man has untreated PC, the greater the risk of cancer spread. This is called metastasis and is life-threatening. When treated before metastasis has occurred, the PC survival rate approaches 100 percent, but only 31 percent when treatment is started too late.

Early PC is usually symptom-free, so most cases of PC are detected by a routine blood PSA test (Prostate Specific Antigen) and/or an abnormal lump found by digital rectal exam. The digital rectal exam is important since 25 percent of men with a normal PSA are later found to have PC. A rapidly rising PSA over time does not necessarily indicate PC, since this can also be due to infection or benign hypertrophy (enlargement without cancer) of the prostate gland. In this situation, most doctors would want to biopsy to rule out PC. There is some controversy in the medical profession about the need for mass PSA screening, since less aggressive PC never needs treatment and some treatments can adversely affect quality of life. However, it is the view of our group that men have a right to PSA screening, along with in-depth consultation with a specialist. Some doctors often do not have specialist knowledge in PC. If you are a middle-aged man, are you willing to take the chance that “it won’t happen to me”?

If you have been diagnosed with PC, you will probably be under great stress and you will have a million questions. Where do you turn for help? Do you need treatment right away? What are my treatment options? What are the side effects? Where should I get treatment? This is where our support group comes in.

The Yolo County Prostate Cancer Support Group offer confidential support and advice to anyone who has been diagnosed with PC, and those who are in an at-risk group. The power of our support group is that we can speak from personal experiences with treatments, their side effects and treatment centers. Having PC is a journey with many forks in the road where life-defining decisions must be made. We can use our experience to help with those decisions. We also keep up to date with advances in the field to keep our members fully informed of the latest treatments. Most importantly, men in a support group can see that they are not alone and that many of us are still healthy many years after treatment.

Deciding between the many possible treatments can be overwhelming, especially for the newly diagnosed man who may be extremely fearful about his future. Many times a physician will recommend treatment only based on their particular expertise. Listening to the personal stories of other men helps sort through the choices and make an informed decision based on evidence. For example, some of our members have low-risk PC so have opted for “active surveillance”, where the PSA is monitored closely but no treatment is offered.

The diagnosis of PC is made by biopsy of the prostate gland which also gives an indication of the aggressiveness of the disease. The degree of aggressiveness is shown by the Gleason Score, which is used to weigh possible treatments and can be a source of much confusion in the newly diagnosed. Research has shown that pathologists often give very different interpretations of the biopsy slides, so a strong recommendation of our group is to get a second opinion on the pathology. Details of this free service can be obtained from our group.

The dreaded side effects of impotence and incontinence after some treatments are a source of great anxiety. These issues and coping strategies are discussed in confidence in our meetings, which can, on occasion, include spouses. Fortunately the latest treatments, especially robotic surgery and computer-controlled radiation therapy, produce fewer side-effects.

The future for PC treatment seems brighter each year as less invasive treatments are being developed. PC is being detected earlier and many men are starting to take charge of their health by joining support groups. If you are in an at risk group or have been diagnosed with PC come join the Yolo County Prostate Cancer Support Group from 7 to 8:30 p.m. on the second Monday of each month, in the conference room at 2030 Sutter Place, Davis. You will find hope and information.

For more, go online to www.Cancer.org, www.PCRI.org, www.pcref.org or www.ustoo.org/

— Phil Summers, Yolo County Prostate Cancer Support Group

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