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Men,Women, and Prostate Cancer
Page 16

Over the past few years, these prominent spokespeople have contributed to a groundswell of interest in prostate cancer, while at the same time revolutionary breakthroughs in detection and treatment have occurred. Successive-refinements in measuring the level of prostate specific antigen (PSA) in a man's bloodstream have led to a relatively simple, inexpensive, and comfortable means of testing for the possible presence of prostate cancer (as discussed in chapter 3 of this book). And a sophisticated ''nerve-sparing'' surgical technique can now sharply reduce the risk of impotence associated with cancerous prostate gland removal (as discussed in chapters 4, 6, and 8).

Unfortunately, each of these highly significant medical advances has generated its own maelstrom of controversy, which only further perplexes today's patients and their caregivers. Because prostate cancer is typically very slow to grow, a man who has a small tumor may live a long, healthy life and die of some other natural cause (including advanced age) long before the cancer can become a problem. Thus, early detection — now made more possible by PSA testing — often raises agonizing questions: Should an early-Stage C/T3 or T4 cancer be treated aggressively, in which case the patient may run an unnecessary risk of impotence and incontinence, or should the patient simply put off treatment, waiting to see what develops over time, in which case he may wind up risking his life?

As for the nerve-sparing surgical technique, many conservative medical experts warn that its actual success rate has not been accurately determined. In the meantime, they say, exaggerated claims about its effectiveness are influencing many patients and their caregivers to look, more favorably than they should, upon surgery as a treatment option.

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