The Dailey Oakland Press
March 20, 2005

Advances in technology give cancer patients more options

By ALLAN ADLER

Alexander Buhl of Rochester was first diagnosed with prostate cancer in May 2004.

Because of the 79-year-old's age, he said he was told surgery and chemotherapy were not good ideas to treat the illness.

Fortunately, technology has given Buhl, a retired General Motors Corp. worker, other options.

One development, explained Dr. Elayne Arterbery, clinical chief, department of radiation oncology at Crittenton Hospital in Rochester, is Intensity Modulated Radiation Therapy, known simply as IMRT.

She said it is a less invasive procedure for treatment, allowing a more precise delivery of radiation to the prostate and significantly minimizing doses to non-cancerous tissues.

IMRT has dramatically reduced side effects other prostate cancer treatments have on the rectum and bladder.

She said IMRT also is coupled with a new, image-guided X-ray technology that allows for daily scans to more accurately assess treatment progress.

Arterbery said surgery is still a very viable option and is preferred by many urologists. However, common side effects include urinary, bladder and sexual dysfunction.

She noted that while radiation is the least invasive procedure, cure rates are identical, whether the patient has surgery or radiation therapy.

Because of the "professional bias" often found in prostate cancer treatment, with different doctors favoring different treatments, Arterbery said it's "extremely important for patients to seek Second Opinions, both on radiation and on surgery.

"Patients have to make individual choices about their treatment based on lifestyle, etc., but they should always seek a Second Opinion and explore the other treatments - if nothing else, then for education."
According to the 2005 Cancer Facts and Figures booklet, released by the American Cancer Society, the highest incidence of cancer for men in Michigan is prostate, with a figure of 198.2 per 100,000 population. The number is higher than the national average of 166.7 and places Michigan as having the second highest incidence rate in the country.

However, because of technological advances, Michigan drops to 16th in the nation in prostate cancer deaths with a rate of 33 per 100,000.

PSA tests and rectal exams for men over age 45 (over 40 if there is a history of the disease in the family) are recommended as the best way to detect prostate cancer, which Arterbery stressed is a silent killer.
"(Prostate cancer) is usually asymptomatic," she said. "People don't know they have it. There are no symptoms in the early stages.

"Later symptoms include bleeding, frequent urination or difficulty urinating. But it's usually harder to cure at this stage because the cancer typically is more advanced."

Arterbery said a PSA of 4 or higher means there may be cancer present and the higher the number, the greater the likelihood of a tumor. Also a warning is if the PSA doubles in less than six months or a year.
For Buhl, an ultrasound exam detected the cancer and a biopsy confirmed it.

He's quite happy with his treatment.

"I feel kind of confident about it," he said. "With everything I'm taking, they shrunk the tumor and my PSA dropped to almost 0."

Buhl praised the support he is getting from his wife, Lorraine, 73, and their grown son and daughter.

He said there have been some side effects from his treatment, but he's not complaining.

"If I have to give up sex to prolong my life, it's worth it," Buhl said.