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Colin Powell Undergoes Prostate Surgery

When Found Early, Prostate Cancer Is Usually Curable

From the WebMD Archives

Dec. 15, 2003 -- After being diagnosed in late summer, Secretary of State Colin Powell underwent prostate cancer surgery this morning, according to the State Department.

Treatment for prostate cancer can include everything from "watchful waiting" to removal of the entire prostate gland -- based on how large the tumor is, whether it has spread, and personal preferences, according to The Cleveland Clinic (CCF). The exact surgical procedure that Powell is undergoing is unknown at this time.

More than 180,000 men in the U.S. will be diagnosed with prostate cancer this year, and more than 30,000 will die of the disease. Eighty percent of men who reach age 80 develop prostate cancer.

Prostate cancer typically grows very slowly and when found early is almost always curable. Doctors have not yet announced the extent of Powell's prostate cancer.

Prostate Cancer Surgery

The most common surgical procedure for men under age 70 with prostate cancer is a radical prostatectomy, says the CCF -- Powell is 66. This usually involves complete removal of the prostate gland as well as surrounding normal tissues.

In recent years, a procedure known as "nerve-sparing" has become more common. During this procedure, the surgeon carefully locates the nerves on either side of the prostate gland. If the cancer has not spread to these nerves, the surgeon will not remove them. Because these are the nerves that are needed for erections and bladder control, leaving the nerves reduces (but does not eliminate) the risk of impotence and incontinence following surgery.

Depending on the man's age and the stage of tumor advancement, the CCF says that nerve-sparing techniques allow about 40%-65% of men who were sexually potent before surgery to remain potent after surgery.

On average, men stay in the hospital for three days and average time away from work is three to five weeks.

Other Treatment Options

Other common treatments for prostate cancer include radiation therapy, which can be done either through the use of radioactive seeds implanted in the prostate or through radiation beams directed at the prostate from outside the body.

Hormone treatment is primarily used if a man has cancer that has spread outside the prostate. It does not cure cancer. The purpose of hormone therapy is, first, to slow the progression of the cancer, and second, to increase survival while maximizing quality of life.

Get Screened

Since prostate cancer usually does not cause any symptoms until it is well-advanced, many organizations recommend that men regularly get checked for prostate cancer.

Screening tests include a digital rectal exam, in which the doctor inserts a gloved finger into the rectum to examine the prostate gland, and a PSA blood test. If the doctor suspects prostate cancer based on either of these tests, then further testing is usually done.

The American Cancer Society recommends that men get screened annually starting at age 50. However, recently updated guidelines suggest that high-risk groups, including men with a strong family history of prostate cancer as well as African Americans, should begin screening at a younger age -- around 45.

A new study shows these newer guidelines are appropriate for black men. Among 4,500 men with prostate cancer, researchers found that black men often had higher PSA blood levels from prostate cancer compared with white men. Black men with prostate cancer were, on average, two and half years younger than white men. The study shows screening at an earlier age is appropriate to diminish the differences in prostate cancer diagnosis among black and white men. The study was presented at the meeting of the American Society for Therapeutic Radiology and Oncology.

SOURCE: WebMD Medical Reference in collaboration with The Cleveland Clinic: Prostate Cancer Guide. American Cancer Society. News release, American Society for Therapeutic Radiology and Oncology.