Women whose husbands receive a diagnosis of prostate cancer are often the ones who swing into action, research treatment options, advise their husbands, and offer emotional support before, during and after treatment.
And unlike wives of husbands who may be fighting heart disease or diabetes, couples confronting prostate cancer face a delicate dilemma since the man’s ability to be sexually intimate with his partner may be compromised. Some treatments may also render the man incontinent, forcing him to wear an adult diaper for an extended period or even for the rest of his life.
Three women, Sharie, Gail and Nancy live in different cities and have diverse careers, but they each became instant caregivers and experts in prostate cancer therapies when their husbands received the troubling diagnosis. And each couple chose a different procedure.
Sharie, who works at a Colorado bank, dug up so much information about the disease she ended up creating a spreadsheet to keep track of all the pros and cons for the treatments available to her husband of 27 years who was diagnosed with localized prostate cancer at the age of 56 in 2016.
Besides learning about levels of PSA (prostate-specific antigen) as well as Gleason scores which are both used to assess the severity or risks of prostate cancer, Sharie and her husband Les were concerned about the side effects of several treatments.
For more than a generation, the notion of lumpectomy instead of radical mastectomy for breast cancer was met with scorn and treated as heresy. Now, it is the standard of care and has saved the physical QoL for many women. Prostate cancer (PCa), which is similar to breast cancer in many ways, has also been considered not amenable to focal therapy as a form of lumpectomy. This is because of the size of the prostate, its relative inaccessibility, the fact that PCa is often multifocal, and concerns that focal therapy may rule out some treatment options if the cancer recurs. However, with the recent FDA clearance of high-intensity focused ultrasound (HIFU) in prostate disease, this therapeutic option has become viable. HIFU has been used for decades in Europe with excellent oncologic control and acceptable AEs.
The potential for prostate lumpectomies expanded notably in June 2018, which is when the FDA cleared the Focal One HIFU device as the first medical apparatus designed specifically for focal treatment of the prostate, although earlier devices made this procedure possible. As with all technological advances, long-term studies and clinical data will ultimately determine whether Focal One distinguishes itself as a uniquely useful instrument. Nevertheless, its arrival is significant due to the degree of precision with which diseased prostate tissue can be ablated while sparing healthy tissue and thus reducing AEs.
Read the full December 2018 issue
Extract from Cure (Cancer Updates, Research & Education)
After taking a deep breath I finally heard the doctor’s diagnosis of my condition: early-stage prostate cancer.
Fortunately for me, I was sitting in the office of Dr. Clifford Gluck, my urologist in Hingham. I say I was fortunate because Dr. Gluck took his time to carefully explain the pros and cons of my medical options, making sure I understood them and what to expect during recovery from each procedure. He went over a range of treatments, from active surveillance all the way to radical surgery, or chemotherapy and radiation.
Then Dr. Gluck told me about one procedure that is widely used overseas but not that common in the U.S. It’s called HIFU – which stands for High Intensity Focused Ultrasound. This procedure was less invasive, and my recovery time would be quicker. Even though Dr. Gluck was the first in the Boston area to use it and has been providing the procedure to patients since 2016, he didn’t try to sell me on it – like a car salesman who only pushes the car he wants you to buy. He gave equal time to each option.
I decided to seriously consider HIFU when I heard that within a month of having the procedure I’d likely be able to get back to refereeing, working with the school kids, teaching them basketball and helping them stay out of trouble. I checked with my primary physician, and after researching it, he told me that if he had to make the choice, he’d go with HIFU too.
During recovery, I got stronger and stronger. I was able to jog and lift weights within 6 to 8 weeks and I could run up and down the court. I did have a catheter initially, and after it was removed I wore protective undergarments because there was some leakage in the early stages. After about 6 months, leakage dramatically declined. Now, leakage is rarely an issue for me. Regarding the two major side effects (incontinence and impotence), neither was a major issue.
In this segment of The Dan Show, Dan Lynch interviews Dr. Jordan Luskin, a board-certified urologist from San Juan Urology in Montrose, CO. In the interview, Dr. Luskin discusses the new High Intensity Focused Ultrasound (HIFU) procedure for prostate ablation, speaks about his most recent treatment, and answers questions from listeners.
When Gunnison resident Les Lisowski learned he had prostate cancer, his doctor gave him five options for treatment. He and his wife, Sharie, started making a pros and cons list.
Lisowski, 56 at the time of diagnosis, was pretty lucky. His cancer had been discovered early thanks to a blood draw that showed high Prostate-Specific Antigen numbers (PSA), often an early indicator of prostate cancer.
While his first tests showed no cancer, his PSA numbers continued to rise and, eventually, the prostate cancer surfaced after a biopsy.
Lisowski’s cancer was highly survivable, but many of the treatments had long recoveries with a risk of impotence.
His urologist, Dr. Craig Peterson, presented him with choices: observe the cancer until it worsens, radiation treatment, surgery to remove the prostate, cryotherapy or something new.
Peterson and his partner at San Juan Urology in Montrose, Dr. Jordan Luskin, were the first urologists in Colorado to try High-Intensity Focused Ultrasound (HIFU) treatment, which localized the treatment to the area of the prostate affected by the cancer. Les’ cancer was on the front of his prostate.
The procedure was much quicker than any of the others and had a quick recovery time, which appealed to Les.
For Movember, ProstateCancer.net is highlighting community perspectives on men’s health awareness. Community member Victor’s experience in public health, and his discovery that African American men are at higher risk, inform his approach. Here, Victor reflects on prostate cancer awareness, education, and his own journey.
To educte is to advocate
Getting a diagnosis of prostate cancer is a scary thing and most men don’t want to deal with it. We focus on our manhood and if we think we might lose it then it’s not worth living. But we’re centered on the wrong thing. It’s like playing cards. You play with the hand you’re dealt. Things happen and prostate cancer happens to a certain group of people. But it’s not the end of the world. There are resources out there and groups of people who’ve had a similar experience and lived through it. And having worked in healthcare for a number of years, I know that the medical community is always trying to improve on medical issues.
As we approach the season for expressing gratitude and good wishes to friends and family, I have one important thing among many to be thankful for: Colorado’s Early Blood Draw program.
Why would I focus my gratitude on that?
Because it may have saved my husband’s life!
Let me explain…
My husband, Les, was able to get a basic blood panel workup in Gunnison, CO through the Early Blood Draw program, which was covered by our health insurance. One of the things they checked was his PSA level. Doctors use the level of a man’s PSA — which stands for prostate-specific antigen — as one of the screening tools for diagnosing prostate cancer. When he was first checked in 2016, his PSA was at 3, which is towards the normal end of the scale. But then, with later blood tests, it started going up and up and up. By March of 2017 it hit 9.77!
African American men who delay testing or treatment for prostate cancer run greater risks with their health than other males — because they are roughly 1.6 times more likely to develop the disease than white men, and also more than twice as likely to die from it as white men.
In those explorations, I ultimately discovered a medical procedure called HIFU, which is shorthand for High Intensity Focused Ultrasound. Essentially, with HIFU, the doctor directs high-frequency sound waves to heat up and burn off diseased tissue in the prostate using an ultrasound probe. As I found in my research, this approach has been shown to result in reduced side effects like impotence and incontinence, according to some studies in Europe and elsewhere in the world.
In light of those statistics, a recent study in Cancer, a peer-reviewed journal of the American Cancer Society (ACS) recommends that black men be screened for prostate cancer more often and at a younger age. The study is significant because it challenges the conventional wisdom that early screening of typically slow-growing prostate cancer can lead to over-treatment.
The recommendations of the ACS study may get a needed boost from a relatively new ultrasound procedure known as HIFU.