Prostate cancer surgery

Q I have prostate cancer, but I have refused to get an operation because my friends say it will end my sex life. What should I do?

M.C., Chicago

A You should run, not walk to the nearest hospital or specialist. Recent medical advances can help to eliminate many of the fears associated with prostate surgery, and urologists and other health care professionals can recommend new medication and other procecures that can extend your sex life.

It may not even be necessary for you to have surgery. New procedures in the treatment of prostate cancer include implanting radioactive seeds--called brachytherapy--into cancerous prostate glands. In some cases, about 100 radioactive seeds, each smaller than a grain of rice, are placed into tumors inside the prostate gland to destroy the cancer cells.

Other treatment options include "watchful waiting," an approach that consists of regular exams to monitor the cancer's progress without any actual treatment, and hormone therapy to stop the cancer cell from growing, using hormones and bioligical therapy.

Doctors say 1 in 6 men will get prostate cancer, occurring almost 70 percent more often in African-American men than it does in White men, and African-American men are twice as likely to die.