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Growing numbers of patients, clutching Internet printouts and timely new studies, are marching into their physicians' offices around the country, sometimes knowing more about their disease and ways to treat it than their doctors. In 1999, more than 25 million adults reported going online to find health-related information. This explosion of medical knowledge is changing how medicine is practiced. It enables patients to make more informed decisions and gain more control over procedures and treatment options.
One such example is men with prostate cancer. "We're seeing a unique phenomenon happening here where men have become the shoppers for treatment options while women with breast cancer waste no time getting aggressive procedures," explained Dr. Jerry D. Slater, vice chairman of radiation medicine at Loma Linda University Medical Center (LLUMC) in southern, California. " The men we see with prostate cancer are very motivated, they want to learn everything they can about their disease and possible treatment side effects. There's a ton of research information on the Internet and we're finding that men learn quickly that they face an array of treatment options. Sometimes it can be confusing. But a majority of those who do come here seeking proton therapy for their prostate cancer were detected early, have done their homework, sorted out the alternatives, and primarily are looking to avoid surgery. Having some peace of mind about their quality of life is a priority."
Why? Because if detected early, prostate cancer is curable. But it is also the most common male cancer, striking more than 180,000 American men each year. It's the second leading cause of cancer death in men and is expected to take the lives of some 32,000 Americans this year.
With early detection, the odds are very high the disease can be controlled or cured. Especially when the cancer is confined to the prostate gland. Yet, many men won't have the gland surgically removed. The fear is facing sexual impotency and urinary incontinence. Which is why many men are opting for non-invasive proton therapy.
Recently, one of the largest surveys of men who had their cancerous prostates removed found that nearly 60 percent were impotent and more than 8 percent lacked bladder control more than 18 months later. The study, reported in the January issue of the Journal of the American Medical Association, was done by the Fred Hutchinson Cancer Research Center in Seattle. The study noted that "it's important for men to know the full range of outcomes. Quite a substantial portion of the men studied are impotent. It clearly has a large effect on their quality of life. Its important that men know that before going into surgery."
The new study looked at a broad population of men treated at community medical centers across six states. Researchers also asked the volunteers -1,291 black, white and Hispanic men aged 39 to 79 years old - to assess their own function, rather than relying on the doctor's report. The new study seems to suggest that the results reflect the true incidence of side effects in the population as a whole.
The primary advantage of proton treatment is the precision of the proton beam and control of the dosage delivered to the tumor site. The proton beam can be delivered directly to the cancer site with significantly reduced or no damage to surrounding healthy cells, tissue or organs. When dealing with the prostate gland, that's a considerable advantage. A recent five-year study of men with early-to-late prostate cancer at LLUMC's Proton Treatment Center tracked nearly 600 men with localized prostate cancer and after five years researchers found that the overall disease-free survival rate was 89 percent with far fewer risks of life-style changes and activity-diminishing side effects commonly associated with x-ray radiation or surgery.
Since it opened its proton center in 1990, Loma Linda has treated nearly 6,000 patients with proton therapy. About half are prostate cancer patients. More information on proton therapy is available by calling 1-800-PROTONS (776-8667). Additional information can be obtained from the LLUMC Web site, www.llu.edu/proton .
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