A production of South Carolina ETV.

♪ ♪ ♪ ♪ Patricia Bennett> Good evening and welcome to this special edition of Job Man Caravan.

I'm your hostess, Patricia Bennett.

Prostate cancer kills more men than any other major kind of cancer.

And African American men get prostate cancer more often and earlier than Caucasian men.

We don't know why.

What we do know, we'll share with you this evening about detection, treatment and overall health of the prostate.

Joining in this discussion are Mr.

Jim Solomon, a prostate cancer survivor.

Dr Mark Adams, urologist.

And Ifeanyi Eminike, a PhD, health educator.

Also, we want you to get involved with questions or comments.

You can call us toll free at 1-800-768-3886 or here in Columbia.

Call us at 252-1137.

First of all, I'm going to go to Dr.

Adams and get a feel for exactly what we're talking about when we're talking about the prostate.

Where is it located and what is it?

What does it do?

>> Well, Patricia, the prostate gland, as you might be able to see, on this diagram is a walnut shaped, reproductive organ, which is located at the base of the bladder.

Indeed, the urinary channel runs, through the prostate.

But the purpose of the prostate is to make some of the secretions which are mixed with the sperm during climax or ejaculation.

So it's a reproductive organ in the male.

Bennett> A lot of people are confused about the actual symptoms, when we're talking about prostate cancer, do we...are there always symptoms?

Dr.

Adams> Absolutely not.

If prostate cancer is detected in its early stage, it's typically asymptomatic.

It's almost exclusively asymptomatic.

It's only when the prostate cancer has grown for, certainly a matter of years, that it starts causing symptoms.

Generally, these symptoms would be, really the same as what symptoms, of benign, non-cancerous growth of the prostate would cause.

That is, obstructive symptoms of, of urination with, several different, symptoms, such as getting up at night to urinate, having a weak stream when you urinate, intermittency, where the stream stops and starts and stops and starts.

Typical symptoms like these.

Bennett> Now, that's something that we do want to talk about later on, is the fact that a lot of men, they may have these kinds of symptoms and automatically assume they have prostate cancer.

We want to talk about prostate health a little later in the show, but we want to go to Mr.

Solomon.

Now you've dealt with this problem.

Mr.

Solomon> Yes.

>> Tell me what happened with you, Mr.

Solomon?

Mr.

Solomon> Well, I had no symptoms.

I did have a temperature that was caused by a kidney infection, and I actually went to the doctor, to, to have that addressed.

And my doctor, apparently gave me a PSA and discovered that, that I had prostate cancer.

I had no idea.

Bennett> So you're one you're one of the people who had no symptoms.

No symptoms whatsoever.

So how advanced, was your cancer?

Mr.

Solomon> It was not advanced at all.

It was in the very early stages.

And, I, had my prostate removed and, had no further cancer.

Bennett> So how long ago was this?

>> This was, in 1989.

Bennett> Okay.

So you've dealt with it.

Mr.

Solomon> I've been cancer free for several years now.

Bennett> You know, that's one of the things I think people assume is that they hear the word cancer and they assume it's all over.

So we have to talk about the importance of early detection, especially in African-American men, and talk about two the ages or the age that maybe African-American men should start thinking about being checked.

Dr Adams, what age do you suggest?

Dr.

Adams> Generally 35.

It's particularly, important for men who have a first degree relative or family history, of a family member with prostate cancer.

That would be the father, the grandfather or, brother, or an uncle.

Those would be significant.

First or second degree relatives with prostate cancer.

Bennett> But 35 seems awfully young.

We've heard other people say 50 years old is a good time, and then maybe 40.

Why 35?

>> Well, this is controversial in the, urological circles, throughout the United States, but, generally, prostate cancer has been found, and we know that it is particularly more aggressive and, if you will, faster growing in African American men than in Caucasian men.

We have seen, many, many there have been many, many men throughout the United States, in their late 30s, who have been detected with early, generally early stage prostate cancer and only in its early stage, is it curable?

Bennett> But one thing that we don't want to do on this show is to make everybody so fearful that they won't go and get checked.

We want men to be aware that there are other situations that may cause similar symptoms.

Dr Eminike, tell me about those other situations and generally about prostate health.

Dr.

Ifeanyi Eminike> Well, in general, when people have any symptoms, if they have any, people assume that it must be prostate cancer.

And in many cases, and in many circles, people talk only about prostate cancer.

But we do have other problems with the prostate, like the inflammation of the prostate, which I... I'm sure a urologist call them prostatitis.

That is inflammation of the, the prostate.

That is a problem.

And it can occur in some young men.

It doesn't have to be old people.

People assume when you talk about prostate problems, it's got to be, older men, and, but young people 25, 30, 35 can have, prostatitis.

That's inflammation of the, of the prostate.

Also, we, we also know that the prostate can unlodge.

As soon as you get, African Americans, when you get to the age of 40, I'll say 40, even though I will agree with, Dr.

Adams that people need to be concerned at 35 and start checking.

But I suspect that at 40 the prostate will begin to enlarge.

And that is what we call benign prostatic hyperplasia or hypertrophy.

I think they have two names for that.

And, that enlightenment does not necessarily mean it is cancerous.

Bennett> But it may have some of the same symptoms that you talked about earlier.

Is that right, Dr.

Adams?

Dr.

Adams> Well that's correct.

Indeed, it's impossible to decipher when somebody comes in with these types of symptoms, whether it's, whether they're caused by benign, non-cancerous growth or by cancerous growth.

Bennett> So the only thing you can do then.

You talked, Mr.

Solomon talked about the test, the PSA.

What exactly is that?

Dr.

Adams> Well, PSA is an enzyme substance that's actually made by the prostate.

And it it's, present in, to a certain degree in the seminal fluid that comes out in the ejaculate, but more importantly, it also is, secreted into the bloodstream.

And so levels of this enzyme can be measured by a relatively inexpensive, laboratory test.

Bennett> One of the things, Mr.

Solomon, that people, that men are very fearful of, and it's something that we do need to discuss, when you talk about prostate cancer.

Men are really concerned about impotency, and they're also concerned about incontinence.

I mean, those are, those are issues.

Those are concerns.

How did you deal with those?

Mr.

Solomon> Those audiences... prior to my surgery, my wife and I, consulted with our urologist and, talked about all of the possibilities and what might be best for us.

I decided to have my prostate removed.

I knew that once I did that, that impotency would be a problem.

But there are ways to deal with that.

And, I'm not a doctor, so I can't, talk in medical terms about it, but what I can say is that the method suggested to me by my doctor has been very effective.

And, we continue to enjoy, a normal sex life.

Bennett> That's really important to hear, I think, for everybody out there.

But there are also new methods now dealing with prostate cancer.

He talked about having his prostate removed, but there are other methods that may not necessitate having a prostate removed.

Is that right, Dr.

Adams?

Dr.

Adams> Well, that's correct.

There are indeed several different treatment, treatment options available for prostate cancer.

They're generally based on several different factors: the man's overall health, aside from just his prostate health, you take into consideration the entire man, his overall health.

But indeed, there are a lot of different options available for early stage prostate cancer.

My personal feeling is that the only way to effectively, completely rid the body of the cancer is to go in and take it out with an operation.

Indeed, there are other ways of treating it.

Radiation therapy can be used, in a couple of different ways.

There are radioactive seeds which can be deposited into the prostate through small needles, a minor, relatively minor operation.

Bennett> Now is that brachytherapy that I Dr.

Adams> That...is brachytherapy.

That's correct.

They are radioactive seeds that are inserted, in several, many, many seeds, based on the size and the shape of the prostate.

Bennett> But...there's also, where you actually wait to see what, what happens.

There's a term that's actually used for that.

And I think that a lot of times in older men, they suggest that they just wait to see and not do anything.

Is that right?

Dr.

Adams> That's correct.

I should elaborate that really and truly prostate cancer, even though, it looks the same under the microscope for older men, well over 70 and into their 80s and men who have prostate cancer who are in their 30s, 40s, 50s, the prostate cancer looks the same under the microscope.

However, we have found that generally it acts differently.

For some reason, it may, it seems to be relatively slower growing and less aggressive in older men, particularly men, older than their mid 70s.

And so quite often we would, we would encourage or counsel the patient that perhaps based on, this behavior of prostate cancer, that watchful waiting, perhaps would be a best option or maybe better option.

Bennett> Let's get folk involved again here.

I'm sure there are people out there who have questions.

Women, too, wives out there.

You may have questions, too, because like you said, Mr.

Solomon, this, of course, involves the wives in this situation.

So if you have questions, please give us a call throughout the state.

Call 1-800-768-3886 or locally here in Columbia, call 252-1137.

We have a doctor here.

We have a health educator here.

We have a person who has dealt with this issue here who could answer your questions.

So take advantage of their knowledge and do give us a call.

Getting to dealing with this, did you find it easier, Mr.

Solomon, to talk about it and kind of get it out, or were you reserved?

And because I've found that a lot of men just don't want to talk about this.

Mr.

Solomon> Well, it isn't something that's easy to talk about.

And any cancer causes fear.

Certainly I, I was concerned when I found out that I had it, but the more I learned about it, and the more I talked with my doctor about it, and the more my wife and I read about it, the better I began to feel.

And I was.

I was especially grateful that, we discovered it early.

Bennett> Yeah.

Mr.

Solomon> And, that...would be, I think the one thing that I would encourage every, male to do, and that is to, to begin having tests early.

Bennett> And we want to emphasize that, but we are going to take a caller.

Greenville, go ahead, please.

Caller #1> Yes.

Bennett> Is Greenville there?

Caller #1> Yes.

I'm here.

I happen to be.

Bennett> We seemed to have lost Greenville, but we want to continue to.

Okay, let's try again.

Greenville, are you there now?

Caller #1> Yes, I am.

Bennett> Okay.

Go ahead, Sir.

Caller #1> Yes, I am a patient that has been treated for, benign prostatic hyperplasia now for the last seven years.

I'm on a treatment, where I take, Hytrin for control of, urine control.

But, I was treated to the point where my PSA had developed into a history, to where it was almost conclusive that I could be approaching a cancerous condition.

However, I had a second opinion, and I wanted to encourage those who are under treatment to consider also, second opinions when it comes to the conclusions that someone might be able to, bring by just one physician on just PSA.

Because I understand that the PSA is not all altogether totally conclusive when it comes to this treatment.

I think that might be something that the, listeners might be interested in.

Bennett> Thank you very much, sir.

We appreciate your comment.

Mr.

Solomon> I might add that although the PSA, gave the first indication, just as the gentleman said, there were several other tests, including biopsies that were taken, where I was concerned before it was concluded.

Definitely that I had prostate cancer.

So he's entirely correct.

That should be, the PSA would give the first indication, but there should be follow up examinations.

Bennett> Yeah, absolutely.

I think that second opinion, Dr.

Eminike> of course, the PSA goes with a digital rectal exam where the doctor has to examine the patient, manually and, with gloves, the doctor should be able to check and see whether there is there are certain nodules.

Dr.

Adams should be able to explain that more, but that, an indication first that something is wrong.

Then you go to say if the PSA is high, it's above four.

Generally, beginning to be suspicious, you know, from one to four it's considered to be normal.

Bennett> Yeah.

Dr.

Eminike> Anything above four is considered abnormal.

Bennett> Of course.

We want to talk more about the other test.

And also that second opinion, which I think is valuable.

We have a caller now from Ridgeland.

Go ahead please.

Caller #2> Okay.

There are so many cases of prostate cancer.

And I was wondering what is the cause of prostate cancer.

Bennett> That's a very good question and something that we are going to discuss a little bit.

I don't know if we have a totally clear answer as to why we have why prostate cancer, like any other cancer, we're not sure, but there are some suppositions or some research being done on that.

Dr.

Adams> Well, Patricia, several different studies are ongoing.

Some factors that we have found that have come into... play are genetics, diet.

These are probably the two, key roles right now that are being investigated.

It's...being investigated that a high fat diet certainly can make us prone over the years or more at risk for developing prostate cancer.

Genetics is certainly important.

Underlining or emphasizing the fact that, if it runs in the family, then indeed, you should be screened with, a PSA blood test and with the digital rectal exam even earlier, perhaps, than most other men.

But I think 35 is, is a relatively conservative, recommendation.

Bennett> That high fat diet situation is really interesting.

We have another caller from Ridgeway.

Go ahead please.

Caller #3> Yes.

Recently, I'm 29 years old and I have prostate infection.

And a doctor gave several, reasons It could be nicotine, caffeine.

I was wondering how many other different reasons could you possibly give that, someone my age would start being prone to prostate infection?

Bennett> Interesting question.

Dr.

Eminike, do you have a response to that?

Dr.

Eminike> I don't think there is any particular age, as I indicated earlier.

Even if you are 25, you are still prone to prostate infection.

It's, it's not a question of age.

The important thing is for you to make sure that you get treated.

If you don't get treated, you don't see a urologist, chances are that you might, get some complications.

So you... as soon as you get inflammation of your prostate or infection, see a doctor.

Bennett> He mentioned, though, caffeine and nicotine.

How, how, how do they play in this?

Dr.

Adams> Nobody really knows, Patricia.

How caffeine, even some people feel that tea and coffee and chocolate and these substances somehow in our diet, can make us a little more prone to prostatitis.

If I could, show this, this model in a theory, perhaps, of what causes prostatitis.

It's been found that, in about, 80% of cases.

Indeed, there's no documented infection, or you can't grow the germs out in the laboratory.

But the theory is that perhaps urine as it's, passes through the prostate, back washes up into the prostatic ducts.

And since urine is usually acidic or acid, with a pH of five, generally, it will pool into the prostate and cause it chronic inflammation or swelling, which leads to symptoms which can be very irritating.

So the treatment, for prostatitis, should include, frequent emptying of the prostate, with ejaculation and that indeed can help alleviate some of the prostatitis symptoms.

There are a lot of other treatments such as antibiotics and anti-inflammatories, etc.. Bennett> Interesting.

Okay.

We have a caller now from Allendale.

Go ahead please.

Caller #4> Yes.

I would like the doctor to address, the condition of prostate cancer that is advanced.

That is out of the capsule.

You know, I feel a little depressed when doctors mentioned that only those with not advanced cancer may, has the only one has a chance to survive.

However, what about those who have some advanced cancer are able to take a treatment of radiation when I am still surviving after four years and five years.

Bennett> Thank you sir.

Dr.

Adams> Well, one of the important, pieces of information to know once the prostate cancer has spread beyond the capsule of the prostate, as shown here, this, this cancer here has significantly grown.

It's important to know, whether the prostate cancer has spread to the lymph nodes of the pelvis.

And really, the only way, to adequately sample those lymph nodes, is with a relatively noninvasive, operation to sample those lymph nodes.

Bennett> He... he sounds fearful though.

He's talking about advanced cancer.

And what are his chances of survival?

What are we talking about?

Whether he has to chance of survival after we've, if it's passed out of the prostate?

Dr.

Adams> Every scenario, every man is different.

It truly depends on this man's PSA.

It depends on what the PSA has done over the last few years, if that data is available.

It depends on his digital rectal exam.

It depends upon what the cancer looks like under the microscope.

There is a bit a wide spectrum of how this cancer appears underneath the microscope.

There are relatively well differentiated cancers that, it can be extrapolated that perhaps these cancers are more slow growing than other more aggressive cancers, as it appears underneath the microscope.

Bennett> Let's...let's take another caller.

We have so many people waiting, we don't want to, not get to them.

In Conway, go ahead please.

Caller #5> Yes.

My question is more aligned to alcohol and how that affects different types of symptoms.

As far as pain after, as you say, ejaculation or whatever you want to call it.

And it seems to be enlarged afterwards, and does alcohol having an effect on that?

Dr.

Eminike> That's, that's another problem.

The, the person who mentioned caffeine or any stimulant, will aggravate if you have prostatitis, it will aggravate it.

If you drink alcohol for some reason that we can't explain, it will also aggravate, the prostatitis.

That's inflammation of the cancer.

I mean of the prostate.

Plus the people who have the benign enlargement of the, of the prostate also should avoid alcohol.

Stimulants like coffee, tea, or any stimulant at all that will aggravate, the the inflammation or the benign prostatic hyperplasia.

That's the normal enlargement that people have had from 40 for African-Americans or for Caucasians around age of 50.

You should avoid alcohol.

Bennett> Let's get back to the importance of getting screened early, especially for African-American men.

You mentioned the age is 35, and I'm sure most African-American men out there are not even thinking about being checked for prostate cancer at that early age.

Why is it so critical?

Dr.

Adams> Well, Patricia, it's important because men, particularly, in their early ages, relatively early ages of 35 to 50 or so will have absolutely no symptoms.

And it's very difficult to get these men, to come in to the doctor for wellness checks rather than for illness checks.

And it's important to, to each year, be screened, not only for the prostate issues, but there are other, health issues at hand as well.

So it's important to have that physical each and every year.

And certainly a prostate exam with the prostate blood test, should be included in that.

Bennett> Okay, doctor, thank you so much.

We have a caller from Edgefield.

Go ahead please.

Caller #6> Yes.

I, just recently turned 45 years of age, and I've had no cancer of any type in my family.

Good health.

But I noticed in my ejaculate, had a bloody clear, bloody fluid and no pain.

No problem.

And I said, well, I better go to the doctor and give it a check.

But at the same time, I wanted to give it a week or so and it cleared up.

Should I pursue this or should I possibly, did I possibly bruise something or injure myself in some way?

And, I'm...I see a doctor quite frequently anyway, for a weight loss program...problems.

So, I could, you know, ask him on a monthly basis as I see him, but, I've not had any PSA.

I have had the DREs on a yearly, to two yearly basis for the last ten years, and no problem.

Bennett> Thank you, sir.

We're going to have to answer your question, because we only have about a minute left in the show.

Doctor, with that kind of symptom, what should he do?

Dr.

Adams> Generally, blood in the ejaculate is, relatively, it's very scary to see it, of course, but generally it's a, it's, as long as it's not causing other symptoms, it's not a big concern.

Infection can cause it to... particularly seminal vasculitis, but if you're not hurting, certainly you should go to the doctor and be checked, but nonetheless, usually, it's of no, long term consequence.

Bennett> Should he have a PSA, though?

He said he hadn't had one, I don't think.

>> Indeed he should.

Dr.

Eminike> He should.

Bennett> He should have a PSA.

Dr.

Eminike> He should have a PSA.

Bennett> Sir, thank you so much for calling.

We appreciate all of your calls this evening.

We also appreciate the panel.

This 30 minutes has really gone by quickly.

That means that there are a lot of folks out there who have questions.

We appreciate your joining us with Job Man Caravan.

And do join us again next week when Job Man Caravan will continue with some very interesting comments.

See you next time.

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