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>> You're watching Prostate Cancer, A Matter of Fact, on ABC 27 brought to you by Penn
State Milton S. Hershey Medical Center.
>> Welcome back. A Hummelstown man dealt with an elevated PSA for nine years, then he got
the news. He had prostate cancer. Here's his story.
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>> Pieces of glass turned into a work of art, Don Garland's specialty.
>> I'm just starting to dabble around that with a new pattern that I just copied and
I just traced out a couple of pieces.
>> Don cuts the glass into special shapes, smooths out the edges then pieces them together.
So many details and details is what Don wanted when he found out the news.
>> I was very shocked when I did receive the phone call that it was initially that I have
an elevated PSA and quite frankly I was--I didn't. That began the education process of
what did all of these mean and what was the next step and what was gonna happen.
>> These questions begin back in 1999 when Don retired from the military. Over the years,
doctors watched Don's PSA level which included four biopsies.
>> It was up and down for every 6 months from 2002 to 2006 and then for some reason it just
started elevating again.
>> Well, you try not to overreact and you try to be a supportive spouse. So we just
said, well, we'll go with what the doctor said and we'll plan accordingly.
>> Some time in the early 2008, March, April, I was starting to have some other side effects
and symptoms that I knew would possibly be--cause me some problems.
>> Urologist Dr. Carl Reese suggested another round of biopsies.
>> That biopsy demonstrated we found a very small focus of prostate cancer in his prostate
gland.
>> In the back of my mind, I always kind of suspected that it was there, the cancer was
there and my wife and I, we came to the conclusion and obviously we prayed about this and said,
"Okay, Lord, what are you gonna do? What do you want me to do? I'm depending on you to
give us a guidance here."
>> We knew at some point you do not play with these numbers without, you know, ultimately
becoming malignant.
>> The bad news is he's got prostate cancer. The good news is it's very treatable and there's
a bunch of good treatments out there for him.
>> We pretty much had made up our mind from the years that I've been having the problems
with this elevated PSA and all these biopsies and we always played the what if scenario
that it was cancer, what would we do. And we finally had come to conclusion that the
best thing we should do is just get it removed.
>> A day after their 41st wedding anniversary, Bev remembers the morning of the surgery.
>> I did well until he left me and had to go in that intermediate room then I sort of
fell apart. Any surgery is major surgery. And yes you anticipate them coming through
surgery but you really don't know. Once you say your goodbyes, you don't know.
>> Dr. Reese explained the surgery.
>> A radical retropubic prostatectomy which is an open, it's a small incision below the
umbilicus, below the belly button, usually about the width of my hand and I have a small
hand where we go in and we remove the prostate and sew things back together.
>> Don spent less than 4 hours in the OR. A day later, he went home then he got the
good news.
>> His report was very favorable. He did have a small tumor in his prostate, about the same
area that we biopsy it. The margins were all negative, that means there was no cancer near
the margins. He had a clean healthy tissue around that so we didn't leave any cancer
behind with it.
>> Dr. Reese says Don is cured.
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>> It was a big relief. Yeah, definitely. And we knew at that point that once we heal
up and we get back to some normalcy in our life and we'd be--and that was great.
>> I was thankful. I was thankful the Lord saw us through that time and was gracious
enough to allow us to have more years together, so we're just grateful.
>> Don tells me by four weeks he was able to cut the grass, six weeks he went back to
work. It's been two years now and he says everything has been fine. We'll send it back
to you in the studio, Chuck.
>> Thank you, Debra, and Dr. Reese joins us in the studio now and we were looking at Mr.
Garland's story there. His PSA numbers kept rising but there was no sign of cancer. Is
that rare?
>> That's not all that uncommon, Chuck. We see that quite frequently. There're a lot
of things that cause an elevated PSA, only about 20 percent of the time that they have
cancer. The other 80 percent of the time, they have something else such as infection,
inflammation. A recent *** can also cause that and what we--I'm sorry.
>> We talked more before the show. A lot of men talk about, "Oh, my PSA is going up,"
but they don't know what PSA is. What is that?
>> PSA is a substance that is produced by the normal prostate. It is used in normal
*** function and it's elevated we feel in prostate cancer because the cells of the
prostate cancer are leaky to the blood vessels. So the PSA that they make actually leaks into
the blood vessels and we're able to detect it at a higher level.
>> You're telling people to be screened, telling men to be screened. Why is that important?
>> It's important because if we catch a prostate cancer when it's early, we can cure--potentially
cure it and we can save lives later on down the line.
>> And there more and more people respond, and what's an age? What age should I be concerned?
I'm 64, I've been getting screened pretty regularly. Is there a start age?
>> What we recommend for starting for screening of PSA, we recommend--the American Urological
Association recommends doing a baseline PSA between 40 and 45 and then starting an annual
digital *** exam and a PSA at age 50. In African-American men or men who have a family
history of prostate cancer, we recommend starting that screening at age 40 and then doing it
annually thereafter.
>> We've been talking about this cancer now for 25 minutes or so and there might be people
out there saying, I wonder if I have a sign or a symptom. Is there something they should
watch for? Can they watch for that?
>> In early and prostate cancer, there are usually no signs and symptoms. They're totally
asymptomatic. Late signs of disease, they can develop pain in their bones. They can
have difficulty voiding. They can feel poorly because the prostate cancer is much more advanced.
>> Alright, we'll break for right now but Debra Pinkerton is in the ABC 27 call center.
What questions are we getting in there, Debra?
>> As I'm 78 years old and was diagnosed with prostate cancer over a year ago with stage
T2 and a Gleason of 6 with a PSA of 2.0, is it safe to just get checked every three months?
>> That's a very good question. Short answer is yes for this gentleman. Again, it points
out that prostate cancer is very individualized and we use these parameters. Gleason score
is just a measure of how ugly the tumor looks like. PSA, the patient age, co-morbidities,
et cetera, to come up with the idea of how much the patient is at risk to die at prostate
cancer versus other things and for this patient just observation would be very reasonable
with those parameters that were described.
>> Okay, thanks so much. And we'll send it back to you in the studio, Chuck.
>> Thank you Debra. Doctor, the last question referred to T2 and Gleason of 6. Tell me what
that is.
>> First we'll talk about the T stage and when we--when we stage prostate cancers, we
use the TNM or tumors, nodes, and metastases. When we're talking about the T stage, the
tumor stage, a T1c is a patient is with an elevated PSA and a normally palpable gland.
And that's the majority of the prostate cancers we're diagnosing because of the elevated PSA.
A 2T--a T2 cancer is a prostate cancer we can actually feel. A T2a is a small little
nodule that you'll feel. T3 cancers are cancers that are extending into contiguous structures
such as the bladder or the seminal vesicles. And T4 disease is tumor that is spread outside
the prostate gland into other structures in the pelvis such as the pelvic side wall or
the ***. And when we're looking at the Gleason score, the Gleason score is an architectural
grade. Its how the pathologist looks at it under the microscope and it goes from the--the
grade goes from 1 to 5. Once--grade 1 being the most normally looking cells and grade
5 being the most abnormally looking cells. The pathologist looks at the specimen underneath
the microscope and he assigns a score which is the most predominant pattern that he sees
and in the second number the second most predominant pattern and that's we will come up with the
score or the Gleason score. In this particular instance, he had a Gleason 6. Usually most
commonly it's a 3 plus 3.
>> That's a lot to cover in a few short minute but when in doubt, come in and talk to a doctor
about it.
>> Yes.
>> And see how that works. Thank you, Doctor, for joining us here tonight.
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