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Powell's Prostate Cancer Surgery Draws Attention to Disease - 2003-12-17

Prostate cancer is a leading cause of cancer death among men. Surgery earlier this week to remove U.S. Secretary of State's Colin Powell's cancerous prostate focuses new attention on the disease, which experts say need not be a death sentence.

Secretary Powell's surgery Monday to remove his cancerous prostate is said to be a success. State Department spokesman Richard Boucher made the announcement.

"Doctors say he had a localized prostate cancer," he said. "Surgery took approximately two hours. They say he did extremely well. There were no complications and a full recovery is expected."

The prostate is a walnut-sized gland that surrounds the neck of the bladder. It's involved in the secretion of sperm.

Secretary Powell had the operation several months after the cancer was detected.

The two main treatments for prostate cancer are surgery and radiation therapy, according to Jed Kominetsky a urologist at New York University Medical Center in New York. Dr. Kominetsky says the fact that Secretary Powell underwent surgery doesn't mean his cancer was life-threatening.

"I think that speaks more to the natural history of prostate cancer, which is, as we said, slow growing," he said. "And you really don't talk in terms of weeks or months, but in terms of years."

Dr. Kominetsky says surgery is usually the treatment option doctors recommend for younger men, such as Secretary Powell. The reason is men in their 50's and 60's are too young for "watchful waiting," a strategy to see whether a cancer becomes more aggressive. Given the potentially slow-growing nature of prostate cancer, Dr. Kominetsky says "watchful waiting" makes more sense in men in their seventies and eighties, even nineties, because they frequently die of other causes.

Prostate cancer is usually detected through a blood test, known as a PSA test, to check for a hormone that's frequently elevated when cancer is present. Screening also involves a so-called digital-rectal exam, in which a doctor feels for an enlarged prostate, which may indicate cancer.

He says the prospect of a digital-rectal exam, combined with an effect on their sexuality after surgery, scares off a lot of men.

If caught early through screening, New York University's Jed Kominetsky says prostate cancer can be controlled, as it was in Secretary of State Colin Powell's case. But he says once the disease has spread to the bones and surrounding organs, doctors can do little.

"It's amazing despite all the information and all the public awareness about prostate cancer, I still see patients who come in with advanced prostate cancer," said Dr. Kominetsky.

Experts say black men and those with a family history of prostate cancer are at greater risk of developing the disease. Dr. Kominetsky says people with a higher risk should be examined earlier than age 50, which is typically when doctors recommend men start being screened for prostate cancer.