Prostate Cancer and Agent Orange

Prostate Cancer

Who gets prostate cancer?

Prostate cancer is the most common cancer in men. About 1 out of 10 men will get prostate cancer. 41% of all cancer cases in men are prostate cancer and 14% of all cancer deaths are caused from prostate cancer. In 1966, 317,000 new cases of prostate cancer were found, with about 41,000 deaths from cancer of the prostate.

Men who are most at risk for prostate cancer are:

Black men
Men who are related to someone with prostate cancer.
Vietnam Veterans and those who came in contact wsith AGENT ORANGE.

What causes prostate cancer?

While there are many possible causes, prostate cancer has been found more often with:

a high fat diet
a family history of prostate cancer
race (black)
high levels of testosterone
some chemical exposures (such as Agent Orange)

How can prostate cancer be found?

Prostate cancer is most often found by Digital Rectal Exam (DRE) and by a blood test called PSA (Prostate Specific Antigen). If either test is abnormal, then a prostate biposy is done to get tissue from the prostate to look for cancer. It is recommended that men over the age of 50 get a PSA and DRE yearly. Black males and all men with a family history of prostate cancer should be checked yearly starting at age 40.

How can I tell if I have prostate cancer?

Most people with prostate cancer never feel anything. Some people will have urinary symptoms such as slow stream, and having to get up often at night to urinate. But other conditions can cause urinary symptoms and not be cancer. But again, not all pain is from cancer.

What if the biopsy shows cancer?

If the biopsy shows prostate cancer, then your doctor may wish to order additional tests, such as a bone scan, to see if the cancer has spread.

How is prostate cancer treated?

There are many factors to consider when deciding how to treat prostate cancer, such as your age, your state of health, the grade of the cancer, the bone scan results, and the results of the PSA.

There are four main ways to treat prostate cancer:

Radical Prostatectomy: This is a surgery where you are cut open and the prostate is removed entirely.
Radiation Therapy: You may receive External Beam Radiation Therapy, where you just lie on a table and get x-ray treatments each day for about 35 treatments. Or you may receive Brachytherapy, which is the implantation of radioactive seeds into the prostate.
Hormonal Therapy: Prostate cancer growth is stimulated by the male hormone testosterone, which is produced in the testicles and a small amount in the adrenal glands. You may have your testicles removed surgically, or receive pills and shots that stop the testosterone poroduction.
Do nothing: Some studies show that while many men will get prostate cancer, less than 25% of will actually die from it. Sometimes the best thing to do is nothing.

Each of these treatments has significant advantages and disadvantages. Your doctor will discuss the treatment options thoroughly with you.

After treatment: now what?

After you have received treatment for your prostate cancer, you will continue to be followed by your doctor with repeated PSA's and DRE's. Sometimes, even years after treatment, the cancer can reoccur. These recurrences can best be discovered by Digital Rectal Examination and a PSA blood test.

Other resources:

Prostate cancer, and it's treatment is a very complex topic. You will understand it better if you do some reading on your own.

Two very good books are:

The ABC's of Prostate Cancer by Joseph Osterling MD, published by Madison Books. ISBN 1 56833 097 9

Prostate and Cancer, A family Guide to Diagnosis, Treatment & Survival by Sheldon Marks, MD, published by Fisher Books. ISBN 1 55561 078 1

Many people benefit by joining the local Prostate Cancer Support Group.

The address is:

Prostate Cancer Support Association of New Mexico
133 Eubank NE, Suite #5
Albuquerque, NM 87123
phone: 1-800-2-SUPORT

Patient Health Education Program June 1998, Albuquerque, New Mexico, number 166.Written and developed by: D. McCulloch, PA, Urology Section, Approved by: Editorial Review Subcommittee for Patient Health Education Program, June 1998, RL 6.5

http://www.va.gov/station/501-Albuquerque/fountain/articles/pros.html

THE VA AND RESEARCH ON PROSTRATE CANCER:

About VA R&D: News Releases:
VA is a Vital Participant in the Largest Study Ever Conducted for the Primary Prevention of Prostate Cancer

News Release
Department of Veterans Affairs
Office of Research and Development
For immediate release, July 24, 2001

The Department of Veterans Affairs (VA), Cooperative Studies Program is participating in a National Cancer Institute (NCI) sponsored study that is the first clinical trial designed to determine if dietary supplements (Vitamin E and selenium) prevent prostate cancer. VA will provide nearly 40 sites and 6,000 patients for the 12-year Selenium Vitamin E Cancer Prevention Trial (SELECT) that will begin July 25. The study is intended to produce a new understanding of the disease that is a leading cause of cancer deaths among elderly men.

"VA is extremely pleased to collaborate with the NCI on this important clinical trial," said Thomas L. Garthwaite, M.D., VA Under Secretary for Health. "Through the combined resources and efforts of these two federal agencies, we hope to develop significant new insight into the prevention of prostate cancer."

The VA Cooperative Studies Program (CSP), directed by John R. Feussner, M.D., M.P.H., will supply essential study management services in support of SELECT. Its coordinating center in Perry Point, MD, will conduct data management, statistical analysis, and provide administrative support. The CSP Clinical Research Pharmacy Coordinating Center in Albuquerque, NM—the nation’s only such publicly funded and clinical research pharmacy approved by the Food and Drug Administration—will coordinate vitamin packaging and distribution for the study. The Massachusetts VA Epidemiology Research and Information Center (MAVERIC) will be the coordinating office for all VA SELECT sites.

"Prostate cancer is the most common cancer in the VA healthcare system and measures to prevent it would be of great impact to the VA and the nations’ veterans," said Michael Gaziano, M.D., director of MAVERIC.

Prostate cancer is the second most common cancer in the United States and is the leading cause of cancer death among elderly U.S. men. Approximately 209,900 men in the United States are diagnosed with prostate cancer every year. Nearly 42,000 deaths result from the disease annually. Prostate cancer rates nationally and in VA are also higher proportionally among African Americans. In 1998, there were more than 600,000 veterans hospitalized in VA medical centers, of which 19% were African Americans. In 1996, 28% of the 5,172 veterans hospitalized in VA medical centers with a principal diagnosis of prostate cancer were African Americans.

Within the main SELECT trial, the VA Cooperative Studies program will also be conducting an independent analysis of possible epidemiological and genetic risk factors for prostate cancer among veteran patients. This additional, veteran-only study will allow VA researchers to study potential important factors that may explain the development of prostate cancer. The main risk factors for prostate cancer include being over age 55, being of African-American heritage, or having a father or brother with prostate cancer. Further investigation of the link between dietary history and other potential factors and the risk of prostate cancer may yield important explanations for the reported racial differences in prostate cancer rates.