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Barry Bostwick advises on prostate cancer

March 9, 2002

By W. Reed Moran, Spotlight Health
With medical adviser Stephen A. Shoop, M.D
Published in USA Today


On the hit television series, Spin City, actor Barry Bostwick gets laughs playing an inept New York City mayor incapable of handling a crisis.


But off the set, Bostwick and actual former New York City mayor Rudolph W. Giuliani have both successfully handled a real crisis with character and courage - prostate cancer.

"When I was first diagnosed, the entire issue of cancer was new to me," says Bostwick, who also starred in the cult classic Rocky Horror Picture Show.

"I didn't have family members who'd dealt with this before me, and initially I was scared to death."

Bostwick reports that even the road to his diagnosis was filled with potholes.

"I'd gone to a clinic complaining of a fever, and was initially given antibiotics," says Bostwick. "It was only later I went to an urologist for some tests, but even these weren't conclusive.

"Finally, my doctor got back to me with the infamous 'good news/bad news' story - the bad news was that I had prostate cancer, and the good news was that something could be done about it," says Bostwick.

The medical team decided the best course of action in this case was to remove the prostate. The operation was performed in July, 1997.

"There's a lot of second guessing for patients when it comes to treatment options for this disease," says Bostwick. "Sometimes I still wonder if the surgical option was absolutely necessary in my case, but you never know. With a wife and children, I have no reason to want to gamble with my life."

Bostwick understands that many men avoid screening for prostate cancer because of real or imagined fears of the side effects of treatment.

"I've dealt with problems of incontinence, but that cleared up a few months after surgery," says Bostwick.

Bostwick also wants men to know the occasional sexual side effects of treatment aren't insurmountable.

"If I have to take something like Viagra, the worst problem I face is a lack of spontaneity. The worst problem men face by avoiding treatment is much graver."

The opponent

The prostate is a male sex gland located just below the bladder. It surrounds the urethra, producing the fluid component of semen and helping control the flow of urine.

According to the Association for the Cure of Cancer of the Prostate (CaP CURE), there were approximately 198,100 new prostate cancer cases last year in the USA. One in six men in this country will eventually develop this condition, which kills over 31,000 Americans every year.

The risk for prostate cancer increases with age, with men over age 65 at highest risk. Studies show that the risk doubles if a man has a close relative with prostate cancer. When three relatives have the condition, the risk of eventually developing prostate cancer is almost 100%.

African-Americans have the highest rates of prostate cancer, while Asians have the lowest.

While there is no known cause, age, race, and genetics may increase a man's chance of developing the disease. According to a recent study, at least 50-60% of all prostate cancers are the result of failure of just one gene.

And lifestyle behaviors may also have a substantial affect on developing prostate cancer.

Eat right

Scientists believe a crucial factor is diet.

Nutritionists supported by CaP CURE, the largest private funding source for prostate cancer research, are studying how a low-fat diet high in such nutrients as soy protein and fiber may slow the progression or prevent prostate cancer altogether.

And a lack of exercise may be as dangerous as poor diet. As sedentary men age, they often experience an increase in fat mass, a decrease in lean body mass, and a change in hormone levels. These factors have been shown to elevate the overall risk of prostate cancer.

Campaign strategies

The most common diagnostic technique is the digital rectal exam (DRE), in which a doctor inserts a gloved finger into the rectum to assess the texture and size of the rear portion of the gland adjacent to the rectum.

The more recent PSA test measures the level of a telltale enzyme produced by the prostate. Doctors also use ultrasound technology to visualize the organ, and biopsies allow studies of actual tissue samples.

Treatment for those diagnosed with prostate cancer is highly individualized. "Patients shouldn't be afraid of any course of action - even surgery," says Dr. Charles Sawyers, professor of medicine at UCLA. "Complication rates are actually very low when surgery is performed by experts."

Your course of action

Patients should discuss the following options with their medical team:

  • Surgery - Performed where tumors are still confined within the prostate. Surgery carries the risk of incontinence and impotence. But advances in nerve -sparing surgery have reduced these and other side effects.
  • Radiation therapy - Usually given to patients whose disease is confined or immediately outside the capsule of the prostate. It can be delivered by an external beam or by implanting radioactive seeds inside the gland.
  • Hormone therapy - Used to limit the supply of male sex hormones that typically promote the growth of cancerous cells. It is used in advanced cases where the cancer has spread.
  • Chemotherapy - Uses toxic drugs to slow or reverse the spread of the disease in advanced cases.
  • No treatment - "Watchful waiting" is based on the presumption that the disease only should be treated if it will reduce symptoms, prevent progression, or prolong the life of the patient.
  • Experimental therapies - Only available to patients enrolled in clinical trials. They include anti-angiogenesis compounds designed to target a tumor's blood supply, gene therapies that seek to normalize the function of cancerous cells, and immunotherapies that help activate the body's natural defenses.

Bright days ahead

The future may hold even greater promise in treating prostate cancer.

An investigational vaccine, BLP25, made by Biomira Inc, will soon be in a Phase II clinical trial as a potential treatment for prostate cancer that has recurred following removal of the prostate. The vaccine works by promoting an immune response to cancer cells producing a particular protein-carbohydrate compound.

Bostwick is pleased to serve as an example of success that comes with confronting adversity.

"Too many men have died because people are afraid to open up about this condition," says Bostwick. "You're not the only one getting cancer. It affects your entire family - and all the ones who love you. Taking care of your own health shows you care about others."


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