Hi All,
BREAKING NEWS out of Milan, Italy, this weekend, which might be a whisper now, but is a boon for men and men's health worldwide.
LINKS TO ARTICLES ON PROTECT REPORT RELEASED THIS WEEKEND AT EAU23:
CNN: https://www.cnn.com/.../prostate-cancer.../index.html
NBC: https://www.nbcnews.com/.../study-finds-active-monitoring...
STUDY: https://www.nejm.org/doi/full/10.1056/NEJMoa2214122
It's all about #prostatecancer (PCa), the second leading cause of cancer death in American men, behind lung cancer. About one man in 41 will die of PCa. That's to be taken seriously. But, as it happens, most men diagnosed with prostate cancer do not die from it.
As readers of my blog know, I've been on what's called #ActiveSurveillance (AS) (also referred to as "active monitoring" for my low-grade prostate cancer, diagnosed precisely five years ago.) It means I currently have tumors that will neither grow nor metastasize out of the prostate gland. Annual monitoring, which includes periodic PSA testing, imaging, and a biopsy if it's called for, is my protocol to determine if any more aggressive cancer is discovered down the pike.
Active Surveillance was unheard of until a group of doctors in the 1990s courageously came forward to challenge urologists who routinely surgically removed men's prostates no matter what diagnosis was determined. A renowned oncologist, Mark Scholz, wrote a book "Invasion of the Prostate Snatchers," which detailed this practice. Twenty-five years later, the percentage of newly diagnosed men with low-risk prostate cancer choosing Active Surveillance over treatments such as surgery or radiation has risen to 60% (as of a 2021 study). While encouraging, it still begs the question: what about the other 40%?
The American Urological Association (#aua ) has Guidelines (navigate to GUIDELINES tab in this blog) for urologists, which advise their membership to recommend as "preferred" AS for patients with low-risk or what's known as Gleason 6 tumors. For intermediate favorable risk- which involves slightly higher grading, their "preferred" extends to all three: Active Surveillance, Radiation, or Surgery.
I'm sure the Guidelines will be revised, but it is not a legal document, and urologists are free to tell patients whatever they want. As a patient and patient advocate with my blog, I aim to inform patients of facts based on data and science. I do not provide medical advice, only information so patients can make informed choices. Another issue is that of "shared decision-making" with doctors. Some men (and women) prefer to listen to their doctor, trusting 100% in their recommendations. However, more are researching (preferably being discerning with Dr. Google!) Therefore, I have selected the information outlets as my go-to for facts only. But back to my point - you, the patient, are the only one who makes a choice. And it should be based on discussions with doctors and getting second opinions after doing your research. That's the essence of shared decision-making, at least for me. I have been invited to make a presentation at the AUA conference in Chicago at the end of April. I'm looking forward to it!
Why am I so passionate about this?
Because many men in America are either not aware of prostate issues until they are older and are uninformed about data and science, or others talk to friends or colleagues or read stories in the media about persons "cured" of cancer. Some celebrities and sports figures often announce their PCa in the media just as they announce they have a great doctor, are undergoing treatment, and will be back on the job soon! Sadly, these men or their spokespeople don't give the public the whole story -- re their diagnosis, thus leaving the reader or viewer with the impression that "surgery" is the only "cure" for PCa. This is false and misleading. First, there is no cure for cancer; unfortunately, the word is bandied about with even supporting cancer-related organizations. The correct terminology is NED or "no evidence of disease." This can last for the rest of one's life or a short while until an unfortunate recurrence. But, again, there is no cure. However, I'll give a little rope to people who still want to use the word.
Men must become AWARE - even at young ages, of prostate issues and what prostate cancer entails. Right now, screening procedures vary - there is debate within the PCA community as to where the lines are drawn - some recommending as early as 40 yo, beginning with what I call the "check engine lights" of the PSA and accompanying 4-K blood test (screenings can be a chapter in a book!) However, I know of several cases where prostate cancer tragically hit much younger men, such as the son of a dear friend. It was also discovered in a 35-year-old man who had spent all his years previously eating junk food and suffering from mental distress while maintaining a high-profile job. He, fortunately, was diagnosed with low-grade cancer, so he, as well, is on AS with a healthy, nutritional, and exercise lifestyle. He's also become a big advocate in the PCa world. Anyone wanting the URL for his advocacy organization, let me know. And there are support groups; the only issue is a myriad of problematic conflicts of interest, which I won't get into here.
Suffice it to say; I am for the patient. Period. I am also for educating men who may know peripherally about prostate issues but need to pay attention. Some eat unhealthily; some are overweight; others don't seek to be informed. Unfortunately, I can't do anything about the latter - it takes someone who wants to be proactive with their health.
This study moves the needle and helps those of us who want to help men and newly diagnosed patients sort through the scientific terminology, ratios, and percentages to the bottom line. The good news is that the curve of reliable information is rising!
So, if you're a man out there (or know someone else) and a doctor gives you a #prostatecancer diagnosis, and you become anxious or depressed, know that it is not a death sentence by any stretch of the imagination. If you're tempted to tell your doctor to "get it out" (your prostate), fuggedaboutit (as it said in the Bronx in my current hometown of New York City) before you've done your research ), again, not medical advice, just a suggestion.
Please do your research, have someone do it for you, or contact me. If there's something I cannot help you with, I have a vast network. Hopefully, one day I can get on the airwaves and spread the message with a medical team supporting me with their MEDICAL advice.
Be well, and stay healthy and happy! And if you’re a first-timer, please scroll below and SUBSCRIBE!