Prostate cancer: then and now

That radiant smile belongs to Willie Stewart. There's more to his story than just a good round of golf...

KTAC 850 AM, Tacoma, carried a long-running program hosted week-to-week by Willie Stewart.

I was the sidekick to J.J. Reagan, the station's morning man, and Sean Carter, in afternoon drivetime.

Synchronicity: KTAC had both Reagan and Carter on the lineup.

I did traffic reporting and news and was the fill-in for News Director Chuck Bolland ("That's the Way the Ball Bounces").

Additionally, I was Public Affairs Director and Public Service Director. Each week I produced two talk shows: one was a live, call-in show with special guests such as Dr. Bob Ettlinger and Dr. George Krick; the other was a program I produced during the week featuring a variety of guests about topics of particular interest to women. "Women's World" dealt primarily with health-related issues.

Willie Stewart came to our studios each week in the Tacoma Mall Office Building to record his own public affairs program that would air the following weekend. I would help set up the equipment to facilitate the recording session. Willie was so organized and professional. He always had all of his program notes outlined on 3" x 5" file cards and was ready to get started.

I recently ran across an old tape with a recording on it of several commercials I had voiced, in 1987, at KOMO. One of the announcements was for a prostate cancer treatment center in the Seattle area. Part of the script proclaims, "Time counts with prostate cancer."

The peculiar irony that struck me is that indeed with the passage of time - more than 20 years since recording that commercial - prostate cancer has become the focal point of my professional life.

April 14, 2008 will mark the second anniversary of my work with William M. Dean, M.D., a board certified urologist with offices in Tacoma and Gig Harbor. http://roboticadvantage.com/
He has been in practice locally for more than 20 years.

Dr. Dean was the first surgeon in this area to undergo advanced training in robotic surgery that is used now for the treatment of prostate cancer and sometimes kidney cancer. Robotic surgery has applications in other medical specialties, as well. It was Dr. Dean who spearheaded the drive to bring the da Vinci Surgical System to MultiCare at Tacoma General Hospital. Even now there are fewer than a handful of doctors locally who are skilled in the robotic technique.

Recently, the Franciscan Health System also acquired the da Vinci Surgical System and it is in place now at St. Joseph Hospital.

When creating content for the Web site, I came up with the name "RoboticAdvantage" quite simply because there are so many advantages for the patient who opts for the robotic surgery:

• improved cancer control


• shorter hospital stay


• smaller incisions


• less blood loss


• decreased risk of infection


• quicker return to work and normal activities

But best of all, most men who undergo the robotic surgery will be able to return to their preoperative level of sexual potency and urinary continence. In other words, a return to their normal sex life (whatever it was prior to the operation), and they won't need to be wearing pads or Depends for the rest of their lives. Those are especially significant issues for younger men.

Prostate cancer is better understood now than in the past. It is now known that prostate cancer begins in the late 20s and early 30s. All men should begin being tested annually for prostate cancer by age 40. If there is a family history of prostate cancer - especially if the family member who has had prostate cancer is the father or brother - then other male relatives (other sons or brothers) should begin testing even earlier than age 40. If prostate cancer has been identified in a close family member, then others in the same family should begin testing in their late 20s.

In the news yesterday, it was announced that former Yankees third baseman Graig Nettles has prostate cancer. http://www.newsday.com/sports/baseball/yankees/ny-spynotes235623516mar23,0,4053041.story Graig was only recently diagnosed with the disease, because his younger brother Jim had just been diagnosed with it and his doctor told him that his brother should also be checked. Sure enough, he was also found to have the disease.

Willie Stewart, well-known locally through his 30+ years of service to Tacoma in the areas of public education and service organizations such as the Boys & Girls Club is a remarkable man with a stunning testimonial about the importance of testing for prostate cancer. Willie is an African-American prostate cancer survivor. African-Americans are at significantly increased risk for developing the disease.

After having not seen Willie since 1981 at KTAC, it was serendipitous that I next came in contact with Willie when he presented his testimonial at a prostate cancer screening event held at the Tacoma Nature Center http://www.metroparkstacoma.org/page.php?id=20 at Snake Lake.

Willie's story is a powerful object lesson: one of his brothers had died. The brother lived in Texas and they were not close, but on learning of his brother's death, he traveled down to attend the funeral.

Upon returning to his office at the Tacoma Public School District headquarters, a coworker who knew that he had been away for a family funeral asked him about how his brother had died. Willie explained that the death certificate said "prostate cancer" but that was as much as he knew about it.

Next the curious coworker wanted to know if Willie had been tested for prostate cancer and explained that if one family member has or has had prostate cancer, there is an even greater risk that other family members will also develop the disease. More concerning though was the high incidence of prostate cancer in African-Americans.

Willie felt fine, but at his coworker's urging decided that it was prudent to get tested. He was shocked when he received the diagnosis of prostate cancer.

Willie comes from a large family. I believe he said there were five brothers. After Willie's diagnosis, he contacted his other brothers and encouraged them to all be checked for the disease as well. It turned out that all of his brothers - except one - were also found to have prostate cancer.

Willie is passionate about educating people about prostate cancer and especially about the family connection and need for testing. He is also involved with the Tacoma Prostate Cancer Support Group http://http://www.tpcsg.info/ for men, their wives, and other family members. Contact information for Willie Stewart and Jack Hudspeth (another leader of the organization) is given on the Web site including date and times for the twice monthly meetings. Dr. Dean is a frequent guest speaker at the support group meetings, which are held at the University Place Presbyterian Church. http://uppc.org/

In the '80s, my knowledge of prostate cancer was simply this: a) men have a prostate gland and, b) men can develop prostate cancer. However, over the past couple of years working with Dr. Dean, I have gained a much broader comprehension of the disease and today's treatment options for prostate cancer. More and better treatment options than ever before.

PROSTATE CANCER'S EARLY SIGNS

Do you know the early warning signs of prostate cancer?

That's a trick question.

There are NO early warning signs of prostate cancer.

By the time symptoms develop, prostate cancer can be quite advanced.

When symptoms do occur, they may include:

• Frequent urination, especially at night
• Inability to urinate
• Trouble starting or holding back urination
• A weak or interrupted flow of urine
• Painful or burning urination
• Blood in the urine or semen
• Painful ejaculation
• Frequent pain in the lower back, hips or upper thighs

Last September, we hosted an exhibit in the Expo Hall during the 17-day run of the Puyallup Fair http://thefair.com/ to take the information directly to the public about not only the availability now of the nerve-sparing robotic surgical approach, but also to emphasize that waiting to be evaluated until symptoms motivate an evaluation can be a mistake with serious potential implications.

It was fascinating and alarming how many men who stopped by our booth would remark that they "would just rather die than know" that they have prostate cancer. They didn't want information about the topic. Women would wonder why that is. Men probably know why that is.

Fear.

Men know that often after having the prostate gland removed, impotence and urinary incontinence will be their lot for the rest of their lives.

• They don't want to hear about it.
• Don't want to know about it.
• Can't bear to think about it.
• Would rather just not know.
• Would rather roll the dice...
• Hope they will never get it...
• ... and, if they do...
• ...accept their fate.

We would also ask men at The Fair:

"Do you know your PSA level? When was the last time you had your PSA checked?"

• Most men we talked with had never heard of a "PSA level."
• They did not know what a "PSA test" was.
• They did not know if they had ever had a PSA test.
• Men know about the infamous, often dreaded digital rectal exam (DRE), but few know about the PSA test.

PSA or prostate specific antigen test is a blood test that is the new gold standard for assessing for the possible presence of prostate cancer. A simple blood test. Yet so many men were/are completely unaware that such a test even exists.

The primary focus of my work today is to increase a consious awareness of not only the risks and assessment of prostate cancer, but also to extend hope by opening the eyes and the minds of those who are so fearful of the diagnosis and historic consequences of prostate surgery that they are shutting themselves off from what is no longer futuristic technology from a sci-fi movie, but is technology that exists today and is available today right here, right now.

Getting the word out to the community, to the public is why we participate in prostate cancer screening events and health fairs; recently at St. Mary's Episcopal Church, in Lakewood, next month at Foundation Health, in Federal Way. Dr. Dean welcomes the opportunity to speak to men's groups, congregations, or other civic organizations. If your group has an upcoming event and you would like to share this information with your members, contact me by e-mail to jaynie.jones@gmail.com to schedule Dr. Dean's appearance.

Presently, the outreach is local with our participation in community events, regional with transit advertising. Perhaps you've noticed the "fullback" ads on the back of Pierce Transit buses with the slogan "Maximize your Advantage over Prostate Cancer...RoboticAdvantage.com" The images used include an African-American couple and a local couple, Roger and Paula Miller. Roger was retired from a 30-year career as football coach for Fife High School, so is a well-known, high-profile individual locally. He underwent the robotic surgery in 2007. He is enthusiastic about getting the word out to men that they must not wait for symptoms to appear before going in for testing. He had been so absolutely confident that he had no symptoms whatsoever, he couldn't possibly have the disease. But he did. He wants everyone to know they must not wait for symptoms to show up.

Locally and globally our outreach extends with flash banner advertising here on The News Tribune http://www.thenewstribune.com/news/local/ and our primary Web presence http://roboticadvantage.com/ where comprehensive information is available including video of the robotic prostatectomy. Site visitors can also request a free CD of the surgery to be mailed to them.

Men need to be aware of their PSA level and follow it from year to year to become more aware of whether or not the number is staying about the same or trending upward.

I created the PSA Tracker. It's a simple card, the size of a business card, that men can carry in their wallets and jot down their PSA level from year to year in the spaces that are provided. By carrying it in their wallets and seeing it from time to time, hopefully it will create a greater awareness and serve as a reminder that it's time to get that PSA test done. The PSA Tracker is available free for the asking: http://roboticadvantage.com/psa.html

It is vitally important for men to take an active rather than passive role in the maintenance of their health. Begin annual testing by age 40. Carry the PSA Tracker.

Inertia can be deadly. Move forward with courage, without fear. Let Willie Stewart, Jack Hudspeth, and Roger Miller be your inspiration. Never before have there been so many treatment options for men with prostate cancer. It's a great time to be alive. Just ask Willie, Jack, or Roger...