Advances helping more survive prostate cancer

Norman Schwarzkopf’s prostate cancer almost wasn’t detected. “When you are a general, the doctors don’t tend to do a thorough digital rectal exam,” says the leader of the American-led forces in the Persian Gulf War.

Even though he had none of the symptoms, Schwarzkopf had been doing a lot of reading about prostate cancer. So, during a hospital visit for a different purpose, he asked a urologist to do a more thorough exam. The doctor felt a tiny lump.

In May, after a biopsy indicated cancer, Schwarzkopf had so-called nerve-sparing surgery that removed the tumor while avoiding the two problems that most torment men facing prostate cancer: incontinence and impotence. Today, says the 60-year-old retired army general, “I feel like a million dollars. … Everything is absolutely, totally back to normal.”

Schwarzkopf’s experiences are typical of both the problems that can hamper detection and the promise offered by quick diagnosis and new treatments in defeating a disease that, among cancers, is second in prevalence only to skin tumors.

A new blood test has the capability to detect prostate cancer before it has metastasized, and new surgical and radiation treatments can halt the tumor without debilitating side effects. “If it is detected early, you can be cured, and you can also have a normal life,” said Dr. Patrick Walsh of Johns Hopkins University in Baltimore.

Despite the advances, however, prostate cancer remains a devastating disease. Approximately one in every nine men will develop prostate cancer, about the same risk a woman has of developing breast cancer. This year, about 200,000 American men will develop it and 38,000 will die from it.

Part of the problem can be traced to the disease’s image. While it is more common than breast cancer, relatively few men are familiar with prostate cancer and fewer still are willing to undergo screening. Men simply do not want to think about it, experts say. And unlike with breast cancer and other diseases, only recently have celebrity spokesmen begun talking about prostate problems.

“There’s been no Betty Ford (breast cancer), no John Wayne (lung cancer),” Walsh said.

That situation is changing. In addition to Schwarzkopf, former pro quarterbacks Johnny Unitas and Len Dawson have spoken out about their experiences, as have Sen. Bob Dole, R-Kan., and retired Sen. Alan Cranston, D-Calif.