I saw the Larry King Show on prostate cancer last Friday evening (August 21). Despite individual celebrity appearances and promoting the Prostate Cancer Foundation, it did provide some substantive information we survivors or new patients might want. Most noticeably missing, though, was any clear reference to difficulties and coping mechanisms while recovering from treatment after-effects of the kind I’ve mentioned in both my book and blog, Conquer Prostate Cancer.
Larry King did openly ask Joe Torre, former Yankees manager, how prostate cancer and its treatment affected his sex life, and Torre totally downplayed any problem, giving some sort of pollyanna answer like “it’s all good”. Heck, the guy’s glad to be alive and wanted to keep that part of his life private. I can’t blame him, but nobody, even the oncologist, Dr. Rose of Beverly Hills, also on the panel, expressed a need to discuss such issues as ED and incontinence.
General Collin Powell came the closest to saying it like it is, but he felt he need not get too graphic about how he functioned in the months right after his surgery.
Also when mentioning the massive cancer research he’s underwriting or hooked into in 20 countries, Mr. Milken made no reference to competing, wasteful research in the multiple billions of dollars. I wonder how Mr. Milken would have responded had Mr. King asked whether he could try to use his wealth and influence to centralize cancer research projects.
I plan to write to Larry King Live’s producers to see if I can address these and related issues with a couple of leading doctors, if they want to arrange a follow-up show with us.
The good news is that everyone on the show weighed in on the side of getting a routine annual PSA test starting at age 40 or at least 50. But the oncologist on the show didn’t quite commit to that, though he made a necessarily hasty attempt to explain why some leading medical folks oppose routine screening.
Physically, each prostate case is different, and how the individual is affected long-term entirely depends on what is removed by whichever procedure. Given that there are two main “tubes” on either side of the prostate that supply the penis with the “wherewithal” to function properly, in most surgeries one or even both tubes may have to be removed depending on the spread of a man's cancer. Nowadays surgeons are very careful to try to save as much as possible- but it’s not always possible. If a man’s cancer is on one side of the prostate, as it usually is, it’s almost a certainty that he will lose one of the two tubes. In such a case, his capability may be affected (although not necessarily), even if prior to the procedure he had no difficulties in achieving full, firm erections etc. If on the other hand he was experiencing difficulties before one tube was removed, it is highly likely that his capabilities will be even further reduced.
----J.S.
I agree that every patient is different, in terms of how prostate cancer can affect them physically as well as emotionally and spiritually. However, there are plenty of common denominators such as the presence of tumors, whether early-stage or more aggressive.
When you refer to "tubes" you mean the two sets of neurovascular (or "nerve") bundles on either side of the prostate. Dr. Patrick Walsh was the first urologist to conduct nerve-sparing surgery in the early 1980's, a couple of years after a German pathologist told him the nerves were not within the prostate itself. You are right that most doctors aim to spare the prostate nerve bundles from being excised unless there's evidence that they too are impacted by a man's prostate cancer. Nerve-sparing makes it possible for most men to continue having erections after surgery, radiation or other prostate cancer treatments, often in conjunction with other erectile medicines or devices.
----Rabbi Ed
Posted by: Prostate Problems | August 30, 2009 at 06:34 AM