Search Salon

- - - - - - - - - - - -

Recently in Salon Health & Body

Urge: Naked World
I'm too sexy for my hijab
Lingerie maker to sell underwear to Muslim women.
By Jack Boulware
[04/28/00]

Urge: Naked World
Girl rubbers
Japanese women now have their own condoms.
By Jack Boulware
[04/27/00]

Hell on earth
When a kidney stone taught me the meaning of agony, I also learned the limits of my own weak self.
By Albert DiBartolomeo
[04/27/00]

Urge: Naked World
Fishing for smut
The Canadian government is cracking down on sex-related Internet surfing.
By Jack Boulware
[04/26/00]

Immunized against addiction
Can a simple vaccine kill the appetite for cocaine? Researchers may soon find out.
By Dawn MacKeen
[04/26/00]

Complete archives for Health & Body

- - - - - - - - - - - -

- - - - - - - - - - - -

If the disease is truly at an early stage and is localized, the least serious of possible situations, Giuliani is likely to choose one of two very different types of treatment: radiation therapy or surgery.

"There's no right treatment in general," says Dr. Mack Roach, associate professor of urology and medical and radiation oncology at the University of California at San Francisco. "It's individualized; there's a lot of personal choice here. These different therapies have a different impact on one's lifestyle. In some patients their relationship to sexual dysfunction is a big deal. For others, they don't want to have the surgery. As best we can tell, the survival rates are about the same."

Erectile dysfunction, along with incontinence, is a common side effect of prostatectomy, the surgical removal of all or part of the prostate gland. New nerve-sparing procedures, however, can decrease the likelihood of E.D.

"There are lots of ways to treat both of those problems; people shouldn't have the impression that one or both of those side effects are inevitable or untreatable," says Dr. Ted Gansler, medical editor for patient information at the American Cancer Society. What's more, "Viagra has helped many men. And there are other treatments that have been useful, like prostaglandin, that can be injected into the penis to have an erection."

Bob Dole, a prostate cancer survivor, was diagnosed with the disease in 1991 and later underwent surgery to remove the afflicted gland. When he went public two years ago with his impotence problems, a result of the surgery, he became the poster boy for E.D. and Viagra. On Thursday, Dole offered his support to Giuliani and praised him for disclosing his illness.

Oncologists believe that patients are less likely to experience E.D. with radiation therapy, of which there are two types: external beam, which is done outside the body and is akin to getting a diagnostic X-ray, and brachytherapy, in which the doctor puts small pellets of radioactive material the size of plant seeds in the prostate. Both types of radiation kill the cancerous cells.

Giuliani's decision will also probably revolve around his schedule. He could be treated with radiation every day for a few hours or have the surgery and remain in recovery for three to five weeks. If the cancer is more serious and has spread, Giuliani is also likely to consider hormone therapy or, as a last line of defense, chemotherapy (which isn't as effective in treating cancer of the prostate as it is in treating other cancers).

Hormone therapy is really a modern day way of achieving what castration did -- stopping the production of testosterone without extreme and unpleasant surgery. Prostate cancer is a testosterone-dependent malignancy, and researchers discovered a way to turn off the production of testosterone without having to remove the testicles. The medication, given once every three months, stops the brain's hypothalamus -- where testosterone production originates -- from sending a signal to the pituitary gland, which, in turn, relays a signal to the testicles.

"Testosterone is like a fuel to prostate cancer," says Spark. "If you eliminate the testosterone, it's like shutting off the burner." While the treatment has proved effective, it, too, has side effects, which include hot flashes, fatigue and sexual dysfunction.

Giuliani says he will determine over the next few weeks which form of treatment to undergo. Spark applauds the mayor for coming forward, not only to increase awareness of the disease but also as a political strategy. "It's better that he announced it than someone from Hillary [Clinton's] camp saying he's going to be impaired because he's ill. It's better that he takes a proactive stance and says, 'This is what I have, this is what I'm doing about it and I'm going to be fine.'"
salon.com | April 28, 2000

- - - - - - - - - - - -

- - - - - - - - - - - -

  Get a printer-friendly version

  E-mail a friend about this article

  Backflip this article to find it again

- - - - - - - - - - - -

Search Salon