Rare isotope to treat cancer being produced at LANL
After I was diagnosed with prostate cancer this spring, my wife and I met with radiation oncologists and urologists to discuss my treatment options.
We were both anxious. I really didn’t want treatment and intended to monitor the disease with regular testing. My wife wanted to make sure I was listening to the doctors.
Although surgery and radiation are effective in treating prostate cancer, the side effects can have a major impact on your quality of life.
Most prostate cancers are discovered during screening — a prostate-specific antigen blood test or a digital rectal exam.
According to the American Cancer Society, an MRI and a bone scan can be used to determine if the cancer has spread beyond the prostate, and genomic tests can help determine which cancers are aggressive and identify genetic mutations that contribute to cancer.
After the prostate is biopsied, the samples are studied by a pathologist, who gives the cancer a Gleason Score, based on a decades-old grading system, to determine a prognosis.
Jonathan Epstein, director of pathology at John Hopkins Hospital, said in a statement that a “second review of pathology frequently brings changes to the cancer grade or stage, which can affect prognosis as well as therapy.”
After all the results were in, my cancer was determined to be an intermediate grade with one caveat.
I was taking finasteride, a drug prescribed to decrease the risk of low-grade prostate cancer.
According to Patrick Walsh, professor of urology at Johns Hopkins School of Medicine, finasteride also can prevent patients from knowing they have prostate cancer because it lowers the PSA, which may mask the signs of aggressive but curable prostate cancer.
My PSA levels were already high, doubling my score and placing me in an aggressive stage.
I started six months of Lupron, a hormone treatment also called androgen deprivation therapy. Alone, it does not cure prostate cancer, but studies have shown that men with intermediate prostate cancer who are treated with both radiation and ADT have better outcomes than with radiation alone.
ADT blocks production of testosterone, which cancer cells depend on for their survival.
Because of this, I have had hot flashes, a few headaches and a noticeably lower libido — similar side effects to what women experience in menopause.
But my PSA has dropped to safe levels, and I will start radiation treatment in September.
My oncologist recommended that I increase resistance training, keep running and stay sexually active, which has helped to reduce the side effects.
In his 2018 book The Key to Prostate Cancer, Mark Scholz argued that hormone treatment be considered as a stand-alone treatment in men who have intermediate prostate cancer and who have a good initial decline in PSA levels after starting treatment.
Similarly, a recently published study in the New England Journal of Medicine found that almost 70 percent of women who are diagnosed with the most common form of breast cancer could benefit from hormone therapy rather than going through chemotherapy. More than 10,000 women in the study, who were screened with genetic tests and randomly assigned to receive a combination of chemotherapy and hormonal therapy or hormone therapy alone, all had similar results.
The study is the largest ever done of breast cancer treatment and may spare up to 70,000 patients a year the ordeal and expense of chemotherapy.
Cancer treatment and recovery often mean time away from work.
The Americans with Disabilities Act and the Family and Medical Leave Act provide job-protected leave from work for health conditions and disabilities under certain circumstances.
According to the U.S. Equal Opportunity Employment Commission, the FMLA covers private employers with 50 or more employees and the ADA covers private employers with 15 or more employees.
Andy Winnegar has spent his career in rehabilitation and is based in Santa Fe as a training associate for the Southwest ADA Center. He can be reached at a@winnegar.com.