MAURER: A prostate cancer treatment worth considering

At Mickey’s Camp in August 2009, law school classmate Millard Lesch and I paused to enjoy the setting sun. Millard surprised me with the revelation that he had recently been treated for prostate cancer. He outlined a protocol I had not heard of, the implantation of radioactive seeds. He underwent that procedure at a center of excellence led by Dr. Peter Grimm in Seattle. This information would become very important to me.

Here are the basics of prostate cancer: (1) most males get it sooner or later; (2) the three things to be concerned about after a positive diagnosis are (a) cure, (b) incontinence and (c) impotence.

Millard said he was OK on all counts. I congratulated him and thought little about it until later that week when camper John Thompson confided in me (it’s no longer a secret) that he had been diagnosed with prostate cancer. I said, “John come with me, I want you to meet Millard.” Within weeks, John flew to Seattle for a consultation with Dr. Grimm. Months later in response to my inquiry, Thompson said, “All systems go.”

Last summer it was my turn for the prostate cancer diagnosis, and I took off for Seattle posthaste.

Periodic blood tests for PSA (prostate-specific antigen) are meant to provide an indication of the disease, but the test is unreliable—fraught with false positives and false negatives. A March 27 article in The New York Times heralded the arrival soon of sophisticated tests that might supplement the PSA check. Some physicians, including oncologists, counsel to avoid the test altogether. That’s bad advice. A high PSA score or one trending upward should lead you to a biopsy and could save your life.

Prostate cancer can kill you, and it’s a bad way to go. A biopsy is the only sure way to determine if you have prostate cancer. It is an uncomfortable procedure and may cause infection, but if the PSA is suspicious do it anyway.

Some say even with a prostate cancer diagnosis, the best course of action is to watch and wait rather than to undergo what might be an unnecessary procedure with the adverse consequences described above. There are nuances and subtleties to help guess whether “watch and wait” is appropriate, but if you guess wrong it might be time to buy a Bible and start studying for finals. Good friend Charles Williams, the first paid president of Indiana Black Expo, waited too long and died a painful death. I had seen my grandfather succumb to this disease, so I did not wish to play that game.

In the course of my investigation, I talked to a couple dozen members of the prostate club who had about as many stories. None but Millard and John had chosen seed implantation. Many had opted for surgery, some of those robotic. Others were treated with general radiation and some with less-proven therapies.

I have heard that under the knife of a brilliant surgeon performing nerve sparing surgery, a patient could lose his prostate and keep his manhood. Forgive me, but I found no hard evidence. Welcome to the world of implantable pumps, uncomfortable shots, and flat out just giving up.

Why hadn’t the cancer patients I talked to thoroughly researched seeds? Some had never heard of this option, and some cited the advice of their urologists, which included “we have the finest surgeons here at IU, you’ll be OK” and “you don’t qualify for seeds.” A second opinion may have been warranted.

Our health scares behind us, Millard, John and I invited Peter Grimm to be one of the presenters at this year’s Mickey’s Camp for men, Aug. 14-16. He has performed many thousand seed implant procedures over the course of a long career and has accepted our invitation to present his data.

In the midst of trapeze, poker, billiards and all the rest, I’m sure a number of campers will pause and learn about a disease that inevitably will affect them and their families.•

__________

Maurer is a shareholder in IBJ Media Corp., which owns Indianapolis Business Journal. To comment on this column, send e-mail to mmaurer@ibj.com.