PR December 15, 2003 - Prostate Cancer Foundation

SANTA MONICA, Calif., Dec. 15, 2003 -- Today, Colin Powell underwent surgery for prostate cancer. He joins John Kerry, Norman Schwarzkopf, Rudy Guiliani, other political leaders, and over 220,000 men in the United States who will be diagnosed with prostate cancer this year, making it the most common non-skin cancer in America. One in six men will get prostate cancer during their lifetimes. A man is one-third more likely to get prostate cancer than a woman is to get breast cancer. We estimate that over two million American men are now battling prostate cancer and that over the next decade, about three million more men will be compelled to join the battle.

Men are typically diagnosed with prostate cancer after a blood test measuring the presence of prostate specific antigen, called PSA, registers a high reading. Prostate cancer can also be detected with a digital rectal exam. A positive finding on either test typically triggers a biopsy of the prostate during which tissue samples are removed and examined for cancerous cells. Medical authorities typically recommend that all men receive annual PSA tests beginning at age 50 and those at increased risk of prostate cancer, as a result of a first-degree relative having had it or being African-American, beginning at age 40.

In prostate cancer, there is no one-size fits-all treatment. To the contrary, selecting a treatment for prostate cancer is a highly individualized decision, balancing the nature of the patient's disease, health status and lifestyle along with the likelihood of success of the various options as well as the expected side effects. Fortunately, prostate cancer typically grows very slowly. Thus, we recommend that a patient take his time to evaluate the full array of choices, and, in consultation with his family and physician make the decision that is most appropriate for him. Clearly, Secretary Powell has followed this advice since he was diagnosed in September and is beginning his treatment in December.

Men diagnosed with prostate cancer typically must decide among three treatment options. Approximately 40% of men select surgery to remove the cancerous prostate. An equal number select radiation treatment -- using external beam radiation, internally planted radioactive seeds or a combination -- to kill the prostate cancer cells in and around the prostate. And, about 15% to 20% of men elect watchful waiting, in which they monitor the progression of the disease prior to intervening. In addition, since prostate cancer cells initially require male hormones in order to grow, many men get drug treatments to block the production of these hormones.
Fortunately, over 90% of all men diagnosed with prostate cancer survive at least five years. The treatments, however, can result in impotence, incontinence, osteoporosis, bowel disorders and other unpleasant side effects. Each year, 30,000 men succumb to the disease.

In general, most physicians recommend surgical removal of the prostate for relatively younger, healthy men diagnosed with early-stage, organ-confined disease. These men are strong enough to recover quickly from the surgery and have a life expectancy long enough to gain the long-term benefits of the surgery. The data shows that 15 years after surgery, 82% of men do not have their disease return. Years ago, this surgery almost always resulted in impotence, and frequently caused incontinence. Over the past decade, advances in surgical techniques and deeper understanding of the anatomy have enabled surgeons to develop a "nerve-sparing" surgery that dramatically reduces the incidence of impotence and incontinence.