SAN ANTONIO – President Joe Biden’s diagnosis of aggressive prostate cancer has brought the disease into the national spotlight.
The National Institutes of Health report rates of prostate cancer, the No. 1 diagnosed cancer in men, are lower in South Central Texas than in other parts of the state and the country.
The rate among South Central Texas men is 121.2 cases per 100,000 men. The rest of Texas is at 146.4 per 100,000 men, and the nation at 156.0, according to the NIH.
Michael Hatzenbuehler is one San Antonio man who falls under the survivor category.
In 2018, Hatzenbuehler got a check-up for other health issues, but tests revealed his prostate cancer diagnosis
“I was floored. I didn’t even know what a prostate was,” Hatzenbuehler said. “They caught it somewhat early. I got very lucky.”
Here’s how prostate cancer diagnoses typically go:
- Men are screened by taking blood tests called a Prostate-Specific Antigen, or PSA, test. A high PSA can mean a few things, but one of them is prostate cancer.
- If levels are high enough and lesions are found, doctors suggest a biopsy.
- The biopsy is tested for severity and is graded as a number called the Gleason score. The scale ranges from 6 to 10. The higher the number, the more aggressive. The highest numbers likely mean the cancer has spread to other places in the body.
“They said, ‘This is pretty serious,’” Hatzenbuehler remembered.
Hatzenbuehler received a Gleason score of 7. The cancer hadn’t spread, so he was able to get surgery to successfully remove his prostate.
Hatzenbuehler acknowledged that a lot of men do not go to the doctor as often as they should. He previously considered himself to be one of those men.
“You don’t think you need it. I’ve learned since then,” Hatzenbuehler said. “I hadn’t been to a doctor for years. And after that, I go regularly. You need to know what’s going on. It’s real important to have knowledge and don’t be afraid of knowledge.”
“There are usually no symptoms, and by the time there are symptoms, it’s aggressive,” said Dr. Ahmed Mansour, a urologist and prostate cancer surgeon at University Health and UT Health San Antonio.
Mansour said prostate cancer has a wide spectrum of severity and is treatable if caught early.
“I tell my patients, ‘It’s a disease that you would likely live with for a long time,’” Mansour said.
Most men should be screened annually, starting at 50 years old, unless they’re in a higher-risk group.
“Like African Americans, patients with (a) family history of prostate cancer, should start earlier in their 40s,” Mansour said.
There is some back and forth about whether screening should stop at 70. Experts are weighing the side effects and procedures for a slow-moving cancer.
“This decision should be highly individualized according to the age of the patient, according to their health status of the patient, and according to life expectancy,” Mansour said. “Patients should talk to their doctor.”
Patients with tumors that have not spread past the prostate have the option to get radiation or surgery.
Mansour said seven to 10 percent of prostate cancer patients have had it spread, or metastasize, which is not considered as aggressive as other cancers.
“Another good piece of news is treatment for metastatic prostate cancer. It is generally well-tolerated,” Mansour said. “So it’s not like toxic chemotherapy, although it has significant side effects, but these side effects are generally well-tolerated with certain measures that we discuss with the patients.”
The treatments center around testosterone which Mansour said fuels prostate cancer.
“Most of the treatment depends on blocking testosterone’s effect on the tumor. And this can be done by medications, which decrease the production of testosterone,” Mansour said. “And medications which work on the cells themselves to decrease the effect of testosterone on the cell.”
However manageable prostate cancer can be for some, there is a large number of people who die from prostate cancer.
Approximately 35,770 men are expected to die from prostate cancer this year, according to the National Cancer Institute.
In South Central Texas, the good news is that the prostate cancer mortality rate was lower than the state and national rates. Locally, it is 18.8 per 100,000 people, according to the NIH.
KSAT anchor and reporter Courtney Friedman spoke with her uncle, Ron Darnell, who survived an aggressive prostate cancer diagnosis. His prostate was successfully removed six months ago.
Catch Darnell’s interview special here.
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