Prostate cancer houston texas

Fear shot through my body like a jolt of electricity when my father told me the news: He had prostate cancer. It was spring of 1992, and his younger brother had died of lung cancer just a few months earlier. One of my best friends bad succumbed to breast cancer a few years before that. And now this. I didn't know what a prostate was, but I knew that any form of cancer was bad news. And so, as I talked with my father about the situation, I found it hard to ignore the little voice inside my head, the one that repeated over and over like a mantra: "He's going to die. He's going to die. Daddy's going to die. Soon."

Luckily, that little voice was wrong. Five years later, my father, Wesley Duckett, is still going strong at 71. Like Sidney Poitier, Marion Barry, Harry Belafonte, Archbishop Desmond Tutu and Kwame Toure (Stokely Carmichael), among others, Dad has battled prostate cancer and survived. An estimated one in four Black men will be diagnosed with prostate cancer in his lifetime and, surprisingly, that rate is much higher than sisters' one-in-ten risk of getting breast cancer. For Black men, the chances of developing prostate cancer are about 33 percent greater than for White men, and they are twice as likely to die of it. All told, African-American males have the highest rate of prostate cancer in the world.

"This disease has reached almost epidemic proportions, and people don't even know it," says Robert Samuels, chairman of the National Prostate Cancer Coalition (NPCQ, a Tampa organization dedicated to increasing public awareness of the disease and finding a cure. "If the death rate were two times higher in White men, you'd see a lot more action," he adds. But because the disease targets our community in high numbers, Black men-and women-must take action to learn about the condition, detect it early and get the best treatment.

A `Silent' Sickness

Cancer of the prostate begins as a silent, stealthy intruder that can fester and grow for years without yielding a telltale clue. The prostate is a walnut-size gland that lies just below the bladder and surrounds the urethra, the tube that carries urine. Cancer usually starts on the outer part of the prostate; a tumor has to grow fairly large before it begins to press on the urethra and cause urination problems. According to the American Cancer Society, signs may include weak or interrupted urine flow; inability to urinate or difficulty starting or stopping the urine flow; frequent urination, especially at night; blood in the urine; pain or burning while urinating; and persistent pain in the lower back, pelvis or upper thighs.

Experts don't know what causes prostate cancer, but in some cases the condition may be hereditary. A group of researchers who studied 66 families (including two African-American families) that had at least three first-degree relatives (father, son or brother) with prostate cancer have come close to identifying a gene known as HPCI. That, when mutated, raises the risk of the disease. Some studies have also pointed to dietary fat as a risk factor. A National Cancer Institute research project will soon look at additional factors in Black men, including environmental exposure among agricultural workers and hormone levels.

Sex, Stigma and Saving Lives

Whatever the cause of the disease, early diagnosis of a prostate malignancy saves lives. If the condition is caught before the cancer spreads, the five-year survival rate is 90 percent. Yet, too often our lovers, husbands, fathers and brothers wait too long before they agree to see a doctor--and even then they put up a fight. "There's a general myth that if you have a prostate problem, you may lose your sexual potency. Black men are very nervous about that," says David Burks, M.D., a Detroit urologist and surgeon.

That concern, coupled with a distrust of White physicians and a refusal to submit to the indignities of a prostate examination (a doctor must glide his or her finger into the man's rectum to feel the prostate), can set the stage for prostate cancer to flourish. But because Black men tend to develop the condition at a younger age, they should undergo annual prostate exams beginning at age 40.

The two standard tests for prostate cancer are the digital rectal exam, known as the DRE, and the prostate specific antigen, or PSA, test. During the DRE, a doctor examines the prostate for signs of enlargement or abnormality. The second, more accurate screening method is a blood test that checks the concentration of PSA, a protein that increases in the presence of prostate cancer. Recent research indicates that, for unknown reasons, Black men tend to have higher PSA concentrations than White men and require a different standard for diagnosis. If either the DRE or PSA results are suspicious, a biopsy should be performed.

Survival and Side Effects

Depending on the stage of disease, symptoms and a man's age upon diagnosis, immediate treatment may not be necessary. Prostate cancers tend to grow slowly, and "watchful waiting" is sometimes the best approach. However, when treatment is called for, options typically include surgery, radiation and hormone therapy.

Hormone therapy--which blocks the male hormone testosterone--is often used temporarily to shrink the tumor before radiation or surgery. Studies have shown that using hormones before radiation treatments prolongs the duration of remission. During radiation therapy, a high-powered beam is used to destroy prostate-cancer cells. This type of therapy is quite effective, and recent advances lessen the chance of such side effects as incontinence or impotence, says Richard Payne, M.D., a neuro-oncologist at the Anderson Cancer Center in Houston, Texas. Another form of radiation therapy, called brachytherapy--in which radioactive material is inserted directly into the prostate--may also lessen complications.

Surgery involves the removal of the entire prostate gland and its surrounding lymph nodes. Nearby nerves can be damaged during surgery, but a newer procedure known as anatomic radical prostatectomy minimizes that risk. Payne notes that problems with urine function and potency are usually temporary; fewer than 5 percent of cases are permanent.

After surgery, Bob Watson, general manager of the New York Yankees, suffered both incontinence and impotence. His wife, Carol, who occasionally speaks to church and women's groups about the need for prostate screening, says these problems were anticipated and, fortunately, transitional. "Any kind of surgery involves a recovery period," she says. "But do you worry about your sexuality when your life is at stake?" Watson, 51, gets his PSA monitored every six months. His cancer is now in remission.

My father opted for radiation therapy and, when his PSA levels rose again two years ago, hormones and chemotherapy. Over the years, three bone scans have been done to see if the cancer has spread; by God's grace, it hasn't. Today Dad's cancer is in remission, too.

Preserving Prostate Health

In addition to our learning about early detection and treatment, Samuels says, "We've got to educate African-American men about the value of preventive health maintenance." To lower your risk of prostate cancer:

Exercise routinely. Physical activity reduces testosterone, the male hormone that feeds prostate-cancer growth.

Cut the fat. "A high-fat diet is thought to increase the risk of prostate cancer," says Payne. "We need to have a daily diet with less than 30 percent fat."

Eat five servings of fruit and vegetables per day. These foods contain carotenes, which protect against cancer. A Harvard Medical School study found that men who eat ten or more weekly servings of tomato-based foods cut their prostate-cancer risk by a third, compared with men who eat fewer than two.

Consider supplements. Beta-carotene and selenium supplements have been shown to reduce prostate-cancer incidence. Vitamin C and zinc may also be beneficial.

To learn more, turn to these organizations: American Foundation for Urologic Disease, Inc. (AFUD), (800) 828-7866; Us Too! (800) 808-7866; and the American Cancer Society's Man-to-Man support group, (800) ACS-2345. Also check out Prostate Cancer: A Guide for Women and the Men They Love by Barbara Wainrib (Dell, $10.95) and Prostate Cancer: A Family Consultation by Philip Kantoff, M.D. (Houghton Mifflin, $10.95).

RELATED ARTICLE: Harry Belafonte Speaks Out

In 1996, after a simple blood test, I was told that I had activity in my prostate. Three biopsies later, I learned I had cancer.