YOUR HEALTH
Choosing best treatment for prostate cancer
DR. DONOHUE

DEAR DR. DONOHUE: You missed the boat in your prostate treatment article. Four old goats in our euchre club have all had prostate cancer. We all had the radioactive seeds and had wonderful results. I have no problem having an erection. It is the only way to go in our neighborhood. -- P.H.

ANSWER: I have to correct a matter for the club. That article was on treatment of prostate enlargement, not prostate cancer. Each has different treatments.

I'm glad to hear all of you have had such successful results with the radioactive seeds -- brachytherapy, as it is called. Small radioactive pellets are implanted into the gland. It's one of the accepted treatments for prostate cancer, but it's not the best treatment for all patients.

The choice of treatment depends on the man's age, his general health, the grade of the tumor and whether the cancer has spread out of the gland to lymph nodes or a distant site. Tumor grade is evaluated by the Gleason score. A score of two indicates the least-aggressive cancer, and a score of 10, the most aggressive.

Furthermore, treatment choice lies not just in the hands of the doctor. An informed patient has his say, and his say often depends on the potential complications from each treatment. He can judge if potential complications would be too great for him to have a meaningful life.

Complete removal of the gland (a radical prostatectomy), radiation from a machine, the implantation of radioactive pellets and the eradication of all sources of male hormone production are acceptable treatments. Each has its good and bad points. Every man deserves to know how each of these treatments applies to his cancer and what he can or might expect from each treatment. For any given individual, the circumstances of his cancer might permit only one treatment choice.

The booklet on prostate enlargement and prostate cancer provides information on both subjects. Readers can order a copy by writing: Dr. Donohue -- No. 1001, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853- 6475. Readers may also order health newsletters from www.rbmamall.com. 2006 North America Syndicate Inc. All Rights Reserved