Local Doctors Fight Prostate Cancer

Although prostate cancer is a worldwide health issue for men, several local doctors are highly involved in efforts to deal with the disease.

William C. Baker, M.D., is the Sacramento Veterans' Hospital's Chief of Urology and an Assistant Professor of Urology at the UC Davis Medical Center. "The most important thing that I can tell people is to seek early detection through the PSA and a rectal examination," Baker said.

Baker explains some of the feelings patients have when faced with an array of treatment decisions after a prostate cancer diagnosis: "I don't sense that patients are frustrated with the treatments. If they are frustrated, it's because there is nothing standard about the treatments." Baker explains that doctors "won't tell you what to do" when presenting up to six different treatment options to prostate cancer patients.

Those treatment options include surgery (removal of the prostate gland), radiation, radiation seed therapy, observation, hormones and chemotherapy. The choice of treatment depends on the stage and location of the cancer. "If the cancer is inside the prostate, statistically, removal is the best option," he said. But prostate removal has "more potential complications, including incontinence and impotence." Another option, radiation, "statistically cures less people" and, if it fails to eliminate the cancer, Baker observes that it may "not be reasonable to go in and remove the prostate after radiation." In some cases, Baker believes that observation is the best option.

Ralph deVere White, M.D., the director of the UC Davis Medical Center's Cancer Center, is confident of what the future holds for the potential to slow the spread of prostate cancer and for curing the disease. Even if a cure is not readily available, deVere White believes there is more certainty in finding ways to control prostate cancer and make an impact on quality of life for those who have received the diagnosis.

"There is a great deal of hope in finding a cure for prostate cancer. One reason is that people are now aware of it. This awareness brings in funding." By way of illustration, deVere White explains that in 1987, the National Cancer Institute received $11 million in funding for prostate cancer. In 2003, the funding is expected to approach $300 million. deVere White describes a snowball effect created by the funding for prostate cancer research, which "brings in and returns bright researchers who will spend the time to find a cure." This has an "enriching" effect on the pool of researchers. As an example of what funding can bring to research efforts, world-renowned cancer researcher Moon Chen, M.D., recently joined the Cancer Center.

Another reason for deVere White's high confidence level is the statistical evidence of decreases in stage migration of prostate cancer. "About 12 years ago, 30% of those diagnosed with prostate cancer found that it had already spread to areas outside the prostate; that is now down to 5%." Male patients today are screening for prostate cancer earlier than men did before.

The slowing in the stage migration of prostate cancer poses a question of profound importance to deVere White. "If this cancer grows very slowly, can we come up with ways to prevent it?" One of the areas of research that deVere White describes is nutrition. "Nutrition was found to increase longevity and to slow [the cancer]." deVere White is also convinced that physicians have made great strides in avoiding adverse side effects of removing the prostate. "Everything has been done to improve the surgeries and radiation treatments." The result is better quality of life for those who have been diagnosed.

One of the treatments for prostate cancer, hormone therapy, has revealed to researchers that some cancer cells appear to be hormone independent. The discovery of those cells may create an opportunity for finding a cure. deVere White said that is the key question for future research: "Can we knock out those cells before they start?"