Navy veteran Joe Nemec is going for a second round in his bout with potentially deadly prostate cancer.
“They go at it from four directions — one from either side and two at 45 degrees from the front,” Nemec said, describing the targeted radiation therapy he endures five days a week. “It only takes a few seconds.”
But there are side effects, including “a lot of exhaustion and fatigue. My arms and legs feel like lead weights.”
Had Nemec, 66, heard of a controversial procedure combining surgery and intensive radiation, he might have tried that one year ago, rather than surgery alone.
The procedure has not been shown to improve survival. Up to half of men who have radical surgery to remove cancerous prostate glands may still have cancerous cells in their body, according to Dr. Gregory Swanson of the University of Texas Health Science Center in San Antonio. Swanson published his findings in the Journal of the American Medical Association Tuesday.
Removal of the prostate gland is recommended for approximately one-third of the 230,000 men diagnosed with prostate cancer each year in the United States, according to the article.
But cancer outside of the prostate is detected in 38 percent to 52 percent of these patients, and this is associated with recurrence and death.
Adding radiation therapy to treatment has been used for more than four decades to reduce the risk of disease recurrence, but it is unknown if this reduces the risk of the cancer spreading or improves survival, Swanson writes. However, “arguments in favor of radiation include the approximately 50 percent reduction in risk of … relapse or disease recurrence.”
Currently, most men have the option of surgery or radiation for treatment of prostate cancer.
Radiation techniques like inserting radioactive “seeds” or targeted blasts of radiation have cut back significantly on side effects, including urinary dysfunction.
Surgery alone is not always 100 percent effective.
The procedure is somewhat controversial said Dr. Robert Brookland, chairman of Radiation Oncology at Greater Baltimore Medical Center. “Will this actually mean that more men are living longer at this point? Or with aggressive treatment following recurrence, will they still have the same chance of survival?” Brookland said.
However, it likely will become a standard method of treatment, since doctors can tell with precision who would benefit by analyzing the prostate gland for signs that cancerous cells might have escaped into the blood or surrounding tissue.
Nemec, a former steel worker, said he would have chosen radiation first, to see if any part of his prostate gland could be saved.
