>>> AND WELCOME BACK.
ONE OF MY MAIN DRIVING FORCES TO
GO PUBLIC WITH MY PROSTATE
DIAGNOSIS IS TO HOPEFULLY
EDUCATE AND HOPEFULLY SAVE
LIVES, ESPECIALLY FOR
AFRICAN-AMERICAN MEN, WHO ARE
TWICE AS LIKELY TO DIE FROM THIS
DISEASE.
THIS MORNING I’VE ASKED MY
SURGEON, DR. VINCENT LADONE OF
MEMORIAL SLOAN KETTERING CANCER
CENTER TO JOIN US AND HIS
COLLEAGUE, DR. CAROL BROWN.
SHE’S ALSO A CANCER SURGEON AND
CHIEF HEALTH EQUITY OFFICER AT
MSK AS WELL, MAKING IT HER LIFE
WORK TO STUDY DISPARITIES
BETWEEN PROSTATE CANCER BETWEEN
AFRICAN-AMERICANS AND THEIR
WHITE COUNTERPARTS.
DR. LADONE, THIS IS ACTUALLY THE
FIRST TIME I’VE ACTUALLY SEEN
YOUR WHOLE FACE.
>> I HOPE I DIDN’T DISAPPOINT
YOU.
>> NO, YOU’RE A HANDSOME MAN!
EVERY TIME I SEE YOU, YOU HAVE
THE MASK ON.
THIS IS GREAT.
WE TALKED ABOUT THE DIFFERENT
MODALITIES, ABOUT WHETHER IT
WOULD BE RADIATION OR SURGERY.
WE KNOW THE ONE THING, I WASN’T
A CANDIDATE FOR ACTIVE
MONITORING.
CAN YOU EXPLAIN WHAT THAT IS AND
WHY IT WAS NOT RIGHT FOR ME.
>> RIGHT.
NOT ALL PROSTATE CANCERS ARE THE
SAME.
THEY DIFFER IN TERMS OF
AGGRESSIVENESS, IN TERMS OF THE
EXTENT.
AND SO FOR EACH MAN WHO HAS
PROSTATE CANCER, WE HAVE TO
DETERMINE EXACTLY HOW AGGRESSIVE
HIS CANCER IS AND WHAT THE
EXTENT OF IT IS.
AND ON THAT BASIS WE CAN CHOOSE
THE APPROPRIATE TREATMENT.
AND FOR MANY MEN WITH WHAT WE
CALL LOW RISK OR NONAGGRESSIVE
PROSTATE CANCER, ACTIVE
MONITORING OR WHAT WE CALL
ACTIVE SURVEILLANCE MAY BE THE
BEST CHOICE.
UNFORTUNATELY, IN YOUR CASE YOUR
CANCER WAS A LITTLE BIT MORE
AGGRESSIVE AND SO WE RECOMMENDED
TREATMENT.
AND YOU WOULD HAVE BEEN A
CANDIDATE FOR SURGERY, FOR
RADIATION OR FOR SOME OF THE
OTHER MANY TREATMENT MODALITIES
WE HAVE FOR PROSTATE CANCER, BUT
AFTER A LONG DISCUSSION WITH YOU
AND WITH YOUR PARTNER, WE ENDED
UP CHOOSING SURGERY AS THE RIGHT
WAY TO GO.
>> DOCTOR, CRAIG MELVIN HERE.
HOW RIGOROUS -- HOW RIGOROUS IS
THIS KIND OF SURGERY?
AND WHAT WILL AL’S RECOVERY --
WHAT WILL IT LOOK LIKE, HOW LONG
WILL IT LAST?
>> SO AL WILL COME IN ON THE DAY
OF HIS SURGERY, THE SURGERY
ITSELF WILL TAKE ABOUT THREE
HOURS.
WE DO IT WITH A ROBOT SO IT’S
CALLED MINIMAL INVASIVE SURGERY,
IT’S ESSENTIALLY LAPAROSCOPIC
SURGERY WITH THE ADDITION OF THE
ROBOT.
MOST FOLKS SPEND ONE NIGHT IN
THE HOSPITAL AND THEN GO HOME
THE NEXT MORNING.
RECOVERY FOR THIS WILL TAKE
ABOUT FOUR TO SIX WEEKS TO GET
HIM BACK TO DOING MOST OF THE
THINGS THAT HE NORMALLY DOES.
OF COURSE ALONG THE WAY WE’LL BE
MONITORING HIM CAREFULLY AND
HELPING HIM WITH THAT RECOVERY.
AS YOU MAY HAVE HEARD, HE’S DONE
A LOT OF THE THINGS THAT NEEDS
TO DO ALREADY.
AL’S GOT HIMSELF IN GOOD SHAPE,
HE’S WELL PREPARED BOTH MENTALLY
AND PHYSICALLY FOR THIS AND THAT
MAKES A HUGE DIFFERENCE.
AS DYLAN SAID EARLIER, A
POSITIVE ATTITUDE REALLY IS ONE
OF THE KEYS TO SUCCESS WITH ANY
TREATMENT.
>> THAT’S IMPORTANT.
DR. BROWN, LET ME BRING YOU IN
HERE.
AL WAS TALKING ABOUT THE FACT
THAT HE KNOWS HE’S LUCKY AND
FORTUNATE AND BLESSED TO HAVE
ACCESS TO HEALTH CARE TO HELP
HIM FIND THIS CANCER.
WHY ARE SO MANY MEN,
PARTICULARLY AFRICAN-AMERICAN
MEN, NOT GETTING SCREENED FOR
PROSTATE CANCER?
>> THANK YOU SO MUCH, SHEINELLE.
I THINK IT’S REALLY IMPORTANT TO
TAKE THIS OPPORTUNITY, AS AL
MENTIONED, TO EDUCATE THE PUBLIC
ABOUT PROSTATE CANCER WE WANT TO
SEND A SPECIAL MESSAGE OUT THERE
TO AFRICAN-AMERICAN MEN AND THE
PEOPLE WHO LOVE THEM.
AND THAT IS THAT THERE IS
SCREENING FOR PROSTATE CANCER
AND SCREENS SAVES LIVES.
UNFORTUNATELY, ABOUT NINE YEARS
AGO, ONE OF THE GOVERNMENT
BODIES THAT TALKS ABOUT CANCER
SCREENING TESTS MADE A
RECOMMENDATION THAT THE PSA, THE
BLOOD TEST THAT AL GOT THAT LED
TO HIS DIAGNOSIS, DID NOT NEED
TO BE ROUTINELY DONE FOR ANY
MEN.
AND I THINK ONE OF THE REASONS
THAT AFRICAN-AMERICAN MEN STILL
HAVE A LOWER RATE OF SCREENING
THAN CAUCASIAN MEN IS THAT THAT
MISINFORMATION THAT SCREENING IS
NOT VALUABLE OR HELPFUL IN
PROSTATE CANCER IS STILL OUT
THERE AMONG MANY OF THE DOCTORS
AND PROVIDERS, WHO SHOULD BE
DOING THIS SCREENING.
>> DOCTOR, CAN I JUMP IN THERE A
SECOND?
GENERALLY IT’S CONSIDERED 50s
WHEN YOU SHOULD START, BUT YOU
THINK IT REALLY SHOULD BE 40,
ESPECIALLY FOR AFRICAN-AMERICAN
MEN, RIGHT?
>> ABSOLUTELY.
SO AS YOU MENTIONED,
AFRICAN-AMERICAN MEN ARE TWICE
AS LIKELY TO DIE AND THEY’RE 50%
MORE LIKELY TO GET PROSTATE
CANCER.
AND THEY SHOULD START SCREENING,
AT SLOAN KETTERING WE RECOMMEND
THIS AND THE AMERICAN CANCER
SOCIETY AND MANY OTHER GROUPS,
AFRICAN-AMERICAN GROUPS SHOULD
START SCREENING AT AGE 40 AND
ALL MEN BETWEEN AEJGE 40 AND 45.
>> AND TO BE CLEAR, DR. BROWN,
THAT’S REGARDLESS OF FAMILY
HISTORY, RIGHT?
>> ABSOLUTELY.
SO FOR AFRICAN-AMERICAN MEN,
BECAUSE THEY’RE AT HIGHER RISK
AND THEY’RE AT HIGHER RISK OF
HAVING A MORE AGGRESSIVE TYPE OF
CANCER, NO MATTER WHAT THEIR
FAMILY HISTORY, THEY SHOULD
REALLY TALK TO THEIR PHYSICIANS
ABOUT STARTING SCREENING AT AGE
40 AND FOR ALL MEN IT SHOULD BE
BETWEEN THE AGE OF 40 AND 45.
IF YOU DO HAVE A FAMILY HISTORY,
THEN YOU SHOULD ALSO START
SCREENING AT AGE 40.
>> WHY ARE AFRICAN-AMERICAN FOR
SOME REASON MORE LIKELY TO GET
THIS AND MORE LIKELY TO DIE FROM
IT?
>> SO WE’RE LEARNING THAT WITH
PROSTATE CANCER AND MANY OTHER
CANCERS, IT ACTUALLY PROBABLY
ISN’T ALL ABOUT ACCESS, AND
THERE PROBABLY ARE SOME
DIFFERENCES IN THE BIOLOGY OF
THE TYPE OF CANCER THAT
AFRICAN-AMERICAN MEN GET.
AND THERE’S ACTUALLY A LOT OF
GREAT RESEARCH GOING ON.
IN FACT, THERE ARE TWO VERY
LARGE STUDIES GOING ON TO GET
AFRICAN-AMERICAN MEN ENROLLED SO
THAT WE CAN STUDY THEIR PROSTATE
CANCERS ON THE MOLECULAR LEVEL
AND UNDERSTAND WHAT ARE THE
GENES DRIVING THEIR CANCERS TO
BE MORE AGGRESSIVE.
WE THINK THAT THE ANSWER
PARTIALLY LIES IN THE BIOLOGY OF
THE TUMOR AND IT CAN BE THE
EFFECTS OF STRESS AND THE
ENVIRONMENT ON THE CANCER GENE
THAT IS CAUSING THIS WORST
OUTCOME IN AFRICAN-AMERICAN MEN.
>> DR. LAUDONE, I WANT TO ASK
SPECIFICALLY ABOUT THAT PSA
TEST.
YOU WERE TALKING ABOUT YOU NEED
TO SCHEDULE YOUR MAMMOGRAM TEST.
IS THE PSA TEST UNCOMFORTABLE OR
IS IT AN EASY TEST.
>> THE PSA TEST IS NOTHING MORE
THAT BE A STANDARD BLOOD TEST.
FOR ANYBODY THAT’S HAD A BLOOD
TEST OF ANY SORT, IT’S NO
DIFFERENT THAN THAT.
SO IT RAEEALLY IS A VERY SIMPLE
TEST TO OBTAIN.
>> DR. LAUDONE, WE APPRECIATE
IT.
I’LL SEE YOU NEXT WEEK.