Patrick C. Walsh - Dr. Patrick Walshs Guide to Surviving Prostate Cancer

This is our fourth edition of this book, and our sixth book about prostate disease. With every book Patrick Walsh and I have written since 1993, there has been exponentially more hope, and with this edition, there is so much more good newsespecially for those who need it most: men with advanced prostate cancer.

Were not out of the woods yet; men are still dying every day of this heartbreaking disease. In fact, this year, nearly 27,000 American men will die of prostate cancer. If you are an American man, your lifetime risk of getting prostate cancer is 1 in 8. But men who are diagnosed early have an excellent chance of being cured, with minimal side effectsparticularly incontinence and erectile dysfunction (see ); in fact, many men with minimal, very slow-growing cancer can be carefully followed without needing treatment for yearsor maybe ever. Moreover, men who have advanced prostate cancer are living much longersome for decadesand a small but growing number of men who in previous years would have succumbed to widely metastatic cancer are not only alive but feeling great, because of unprecedented advances in hormonal therapy, chemotherapy, immunotherapy and radiopharmaceuticals (radionuclides), and new use of surgery and radiation as treatment for men with limited metastases.

From 1993 to 2014, because of early diagnosisdue to the introduction of PSA testing and a growing awareness that this isnt just an old mans disease, but one that can strike in mid-life, and that prostate cancer screening saves livesand constantly improving treatment, we have seen a 51 percent decline in deaths from prostate cancer. Prostate cancer has dropped from the second to the third most common cause of cancer death, after lung and colorectal cancer, in American men.

Whos at higher risk? We know a lot more about that, too. In startling ) that work particularly well against these particular mutations in breast and ovarian cancer work well in prostate cancer, too.

We know that men of African descent are not only more likely to get prostate cancer, but to have a more aggressive form of the disease. Also sobering: In these men, cancer tends to develop in the part of the prostate that is the most difficult to reach with a needle biopsy. Fortunately, magnetic resonance imaging (MRI) is better than ever, and able to reveal cancer that previously couldnt be detected.

We know that obesity and smoking make it more likely for you to get prostate cancer, and that quitting smoking and losing weight can lower your odds of getting this diseaseor, if you already have it, make it less likely that you will die of it (see ).

We also know, unfortunately, that the U.S. Preventive Services Task Force (USPSTF) did a terrible disservice to all men in 2012 when it recommended against routine screening for prostate cancer for men with no risk factors. One major problem with this decisionmade without the advice of a single urologistis that a lot of men dont know they are at higher risk. They might have an African ancestor, or a family history of prostate or other cancer, and not know itbecause theyve lost touch with their family, or because many men still dont talk about this disease. It is not uncommon for a grown man to find out that his father or grandfather had prostate cancer, got treated for it, and never told the family. What about men who smoke or are overweight, and dont realize that their risk is higher?