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>> Tonight.
>> I think it's unnecessary for a man to die from prostate cancer.
>> An abc27 special presentation.
>> It's a very treatable disease. When treated early we can cure it.
>> Penn State Hershey Cancer Institute presents Prostate Cancer: A Matter of Facts. Brought
to you by Penn State Milton S. Hershey Medical Center.
>> Good evening, I'm Chuck Rhodes. Excluding skin cancer, prostate cancer is the most diagnosed
cancer in the United States for American men and second only to lung cancer as the leading
cause of death from cancer. In 2010, approximately 218,000 new cases of prostate cancer will
be diagnosed and more than 32,000 men will die from the disease. One in 6 American men
will likely develop prostate cancer in their lifetime.
>> Thanks Chuck. A Dauphin County man and his wife had to make a very difficult decision,
that's when he was diagnosed with prostate cancer. Just to let you know, there is a graphic
shot of the surgery. Here's the story.
>> They've got trout and they've got small mouth bass and rock bass.
>> Sixty seven-year-old Fred Maddox knows all about fish, a rod and reel had been by
his side since he was 7 years old. On this day, he casts his line in the Wiconisco Creek.
>> Got one. I don't keep the fish. I catch and release. I think that just the thrill
of catching a fish and pulling 'em in and releasing back so somebody else could catch
'em is a good thing.
>> But Fred's favorite pastime hit a snag. In January, doctors diagnosed him with prostate
cancer.
>> I was actually devastated because you always have the feeling that it will never happen
to me. And when it does, it's quite shocking and I was quite upset about it.
>> I just bursted out crying. I was--I didn't know. That was very devastating to both of
us to find that out 'cause you know, it's gonna be changing your life.
>> Fred and Nancy didn't want change. They had enough twists and turns in their lives
going back 45 years ago when they first meet.
>> She was 16 and I was 21. I was in the military.
>> After a year of dating, Fred went to Vietnam. They lost track of each other until 15 years
ago when Fred made a telephone call.
>> Nancy got on the phone. She said, "Hello," and I said, "Nancy, this is Fred Maddox. You
may not remember me but I used to date you when you're in high school." She went crazy.
>> I was shocked when he called me and he said, you know who this is, and he said, Fred.
I thought--I remember you and I was real thrilled. I was like on the top of the world that day.
>> Come to find out that she wanted to be with me as much as I want to be with her.
>> Eight years ago, Fred and Nancy exchanged wedding vows.
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>> A promise to be devoted to each other in sick and in health. So, they face the prostate
cancer diagnosis together.
>> This is a picture of the prostate right here and we have nice clear boundaries all
around it and the area inside the circle right in the middle here is the area of cancer.
And what we can see is that it's confined to the prostate without any evidence of spread
outside the prostate.
>> Dr. Jay Raman talked to the couple about a few options to treat the cancer including
robotic surgery.
>> Robotic surgery is essentially just one type of minimally invasive surgery. Basically
making 3 or 4 small incisions and doing the entire surgery through there. One of the advantages
of using the robotic technology is that the last 2 centimeters or so basically can mimic
your wrist. I can essentially take this wrested instrument and move it 360 degrees forward,
backwards, open and close, and really move it all around in very narrow spaces. It really
just a fraction of the size of space needed for my own hand.
>> I was apprehensive. The old cliche, fear the unknown. I didn't know what to expect,
how much pain would be involved, the recovery time but I'd like to have it removed 'cause
that way, there's no doubt in your mind that it's gone and that's what I wanted.
>> I see him right before he went in the operated room. I just can't help, just can't--just
crying 'cause you don't know, anything can happen, you know, when you go in.
>> He did wonderfully. He did fine. The operative procedure was uncomplicated.
>> I was up and walking around about 14 hours after surgery, walking up down the hallways.
I had operation on Friday morning and Sunday afternoon, I went home.
>> Dr. Raman delivered the good news a few days later.
>> His margin status was negative which means all the cancer was out. Once all the cancer's
out, you're already looking at an excellent cure rate.
>> A sigh of relief from Fred and Nancy. Now, they can focus not only on the present but
their future.
>> His whole attitude is so much better than it was before and mine, too. We were both
thrilled. We could tell we're relaxed, very happy.
>> He saved my life. It's the way I looked at it, you know, he'd done the operation,
got rid of my cancer and if he hadn't done that, I don't know what could happen. I'd
probably end up dying from prostrate cancer, although some prostrate cancers are slow growing,
you'll never know.
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>> And the song, 'After All These Years', that's Fred and Nancy's wedding song. Fred
had the surgery this past May. He told me he never took pain medication. In fact, he
was on his riding lawn mower a week after the surgery. We'll send it back to you, Chuck.
>> Thank you, and the man who saved Fred's life, Dr. Jay Raman is right here with us
now and first of all, it's gotta to make you feel great when you hear some a patient say
that.
>> It really does, makes you feel wonderful.
>> Well he chose to have the robotic surgery, how common is this procedure?
>> Well, the robotic approach was first developed in actually 2000 and since then, its use has
really skyrocketed overtime and that's largely because of its ability to revolutionize practice.
They estimate in 2010 over 80 percent of prostate cancer surgeries are done by a robotic approach.
>> Why do you think this should become so popular, this robotic surgery?
>> I think it's because of benefits for both patients as well as for surgeons. For patients,
certainly there's less scarring, shorter hospitalization, less blood loss. And all of that translated
to a faster recovery and back to daily living. For surgeons, we see, we visualize a lot better
and that allows us to remove the prostate with the cancer while preserving vital structures
within the pelvis.
>> Can this type of surgery be used for any prostate cancer patient, when they commend,
you say as a go?
>> Yeah, the answer for that is increasingly yes. We used to think that larger men or obese
man or those with large prostate glands or patients with advanced cancer, were not candidates
for minimally invasive surgery. But multiple studies have shown overtime that robotic surgery
can safely and efficaciously treat all of these patients.
>> Now for not a candidate for that type surgery, what are some of the other treatment options
available?
>> Well certainly if you look beyond surgery whether it be minimally invasive or open,
radiation therapy, active surveillance which is also called watchful waiting, as well as
hormonal or chemotherapy for advanced cancers. And certainly the selection of one those depends
both on disease characteristics but also patient preference.
>> Make a lot of progress and seems like a short time as a lot of progress are coming
up. And right Alice go back to the abc27 call center, check on Debra and see what we're
getting for calls in there, Debra?
>> Help us answers some of the questions here on the call center, Dr. Joseph Drabick. Thanks
for being with us.
>> Oh my pleasure.
>> This is the first question we have. My husband had radiation treatments last fall
for prostate cancer. His PSA test following his treatments was below 1. Then at his 6-month
check up, it was 3 and the doctor said it might be a false positive. Two months later,
he's up to 4 and shortly after was up to 15. He's scheduled a biopsy for 2 months from
now. Should he wait? My husband is having anxiety over this.
>> Well, it's understandable that he has anxiety and it's important to realize that the PSA
is very useful test and we do use it for following a patient who's had potentially cured to therapy
like radiation therapy in this case. But it does have some limitations and for example,
when you've had radiation therapy to the prostate, the prostate is still there and there's still
a lit bit of prostate PSA that's elaborated, that's called the nadir PSA. So you had a
very nice nadir but you can have bumps on that. Sometimes for example if the prostate
get infected with prostatitis, that can actually falsely elevate the PSA. So doctors usually
like to see what the PSA does overtime to see if there's a trend in the increase as
was done here. But I'm concerned that his PSA is climbing up and I suspect he may have
recurrent disease so he'll need further therapy. The 2 months is not anything to get worried
over. It's kinda typical but I'm glad that he's being followed up on that.
>> Okay, now the second question, a good friend of mine was diagnosed with prostate cancer
over a year ago. However he's received no treatment and says it's because it's a slow
growing cancer, should he get some type of treatment?
>> Well, it's another very good question 'cause prostate cancer has the--a wide spectrum of
bad, so to speak. There are patients who have very aggressive disease and there's a large
amount of patients men who are very indolent disease, that is very slow growing and festering
so that die with their prostate cancer than die of the prostate cancer. So in appropriate
situations, observation is a reasonable thing. The important thing is that for each man,
their disease is different and each man is different so you have to kinda tell or the
therapy to the man at his specific cancer and watchful waiting or observation is reasonable
for some.
>> Okay great, and we will check that with you in just a little bit but now we'll send
it back to you in the studio, Chuck.
>> Doctor, who heard him say about the slow growing, maybe the watch and wait procedure,
is this a type of cancer were we can do that? You can back off, see what happen.
>> Sure. A fraction of them you can. So some prostate cancers are slow growing. What we
have to keep in mind though is that there are some prostate cancers that are more aggressive,
that are fast growing. And so it's important for patients when they're thinking about a
watchful waiting strategy to have regular interval visits with the urologist to check
PSA's, to do repeat biopsies as necessary, to make sure that we're not missing a more
aggressive cancer that may be spread.
>> Do they worry if you say let's watch a little bit? Do they think you wanna--they
should do something?
>> Not so much. I think that they trust it as long as there's a systematic plan for the
watchful waiting that they're not gonna get lost in followup.
>> Okay, thank you. Thank you for joining us here tonight, doctor, I appreciate that.
>> Thanks very much.
>> The Penn State Hershey [background music] Cancer Institute is looking for healthy male
volunteers between the ages 20 and 79 for a prostate research study. Participants will
be required to visit the medical centers 6 times over 18 months. Now, if you're interested,
call Wanda at 717-531-11--I'm sorry 531-1002.