Task force preparing prostate cancer study

Tuesday, Sept. 24, 2002 | 9:31 a.m.

Unrelated to Gov. Kenny Guinn's case of cancer, a governor's task force is preparing a report on prostate cancer, the first statewide report for any disease, officials said Monday.

The effort to document the disease arose from a 2001 legislative bill that created the Governor's Task Force on Prostate Cancer. The Nevada Health Division is preparing the report with the task force and other organizations as a basis for recommendations and outreach on the disease.

"This was done before the governor was diagnosed with the disease, and showed a great vision of public health," said Dr. Ihsan Azzam, a state health division employee who serves as an expert on the task force.

"It was a very intelligent decision, since one out of three men will develop this disease in their lifetimes."

This includes 30 percent of men ages 50 and older nationwide. In Nevada, an estimated 1,400 cases will be diagnosed in 2002 and 274 men will die from the disease, according to the American Cancer Society, Nevada chapter.

Despite the frequency of the disease, Azzam said the chances are low of most men going as far as Guinn did -- going in for testing and choosing a course of treatment.

"About 10 million men nationwide are perceived to be healthy, but have prostate cancer and don't know about it," he said.

This is because its symptoms -- more frequent and interrupted urination, occasional pain in the lower abdomen -- are not seen by many men as very serious.

"These symptoms are insidious and associated with aging more than anything else," Azzam said.

When added to the disease's low mortality rate -- less than 3 percent -- men have historically chosen to avoid testing for the disease.

Karen Power, program manager for the state cancer registry, said one thing that has helped draw more men into testing in recent years has been well-known men such as golfer Arnold Palmer going public with the disease.

Two tests are used -- the prostate-specific antigen, or PSA, blood test and the digital rectal examination. If the blood test is negative, the second is not necessary, Azzam said. If it is positive, the second test can help confirm if the increased enzyme being detected is due to cancer, or some other cause.

At-risk groups -- other than men above 40 -- are black males and males with close relatives who have had the disease. Blacks contract the disease at a rate of 191 per 100,000, compared to whites, who show a rate of 123 per 100,000.

Nutrition plays a role in reducing the risk of getting prostate cancer, with vitamins D and E, a chemical called lycopene found in tomatoes and a mineral called selenium playing a role not fully understood by doctors.

Once the disease is detected, doctors are still divided about what course of action to take.

"The options include surgery, radiology, chemotherapy and what the Centers for Disease Control calls 'watchful waiting,' " Azzam said.

If the cancer is not aggressive and the symptoms do not become uncomfortable, it may not be necessary to operate. On the other hand, recent research shows that life expectancy may be increased by surgery.

The relative benefits of timely, annual testing and treatment are controversial, Azzam said. "This is what we are trying to solve."

The task force's next meeting will be Oct. 19, when it may decide to adopt the American Cancer Society's position and recommend annual testing after 50, and earlier for at-risk groups.