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News / Health / Clark County Health

Washougal mayor confronts prostate cancer

Guard to have prostate removed, but a variety of treatments exist

By Marissa Harshman, Columbian Health Reporter
Published: February 16, 2014, 4:00pm
2 Photos
Most men are in their 60s or older when they're diagnosed with prostate cancer; many could live out their lives without the cancer ever becoming problematic, said Dr.
Most men are in their 60s or older when they're diagnosed with prostate cancer; many could live out their lives without the cancer ever becoming problematic, said Dr. Adrienne Heckler, a Vancouver Clinic urologist. Photo Gallery

o The prostate is a gland of the male reproductive system. The main purpose of the prostate is to produce fluid for semen. The prostate is located in front of the rectum, just below the bladder and wraps around the urethra.

o A young man’s prostate is about the size of a walnut and grows slowly with age, sometimes constricting the flow of urine through the urethra.

233,000: The estimated number of new prostate cancer cases in the U.S. in 2014.

5,380: The estimated number of men in Washington who will be diagnosed with prostate cancer in 2014.

o The prostate is a gland of the male reproductive system. The main purpose of the prostate is to produce fluid for semen. The prostate is located in front of the rectum, just below the bladder and wraps around the urethra.

o A young man's prostate is about the size of a walnut and grows slowly with age, sometimes constricting the flow of urine through the urethra.

29,480: The estimated number of men who will die from prostate cancer in 2014 nationwide.

99: The percentage five-year survival rate for prostate cancer.

1: Prostate cancer is estimated to account for the most new cancer cases (27 percent) among men in 2014.

60: The percentage of all prostate cancer cases diagnosed in men 65 years and older.

146.6: The number of men per 100,000 who are diagnosed with prostate cancer.

2.6 million: The estimated number of men currently living with prostate cancer.

Source: American Cancer Society, National Cancer Institute

The possibility of prostate cancer has been in the back of Sean Guard’s mind for years.

Statistics show about 15 percent of American men will be diagnosed with prostate cancer at some point in their lives. In addition, Guard’s father was diagnosed with prostate cancer when he was in his 60s, increasing the odds that Guard would develop the disease.

In October, the possibility of developing prostate cancer became a reality for the 51-year-old mayor of Washougal. Today, Guard will undergo surgery to remove his prostate and, he hopes, the cancer.

“What he has is curable, and we’ll most likely cure it,” said Dr. Adrienne Heckler, the Vancouver Clinic urologist treating Guard.

Because of his family history, Guard’s primary care physician has been performing annual prostate-specific antigen blood tests for the past 10 years or so. PSA is a substance made by the prostate and typically exists at low levels in a man’s blood. Elevated PSA levels can indicate cancer but can also be attributed to other factors, such as having a large prostate, a long bicycle ride or recent intercourse, Heckler said.

Guard’s PSA levels, however, had nearly doubled in two years. Given the dramatic rise and his family history, Guard asked for a biopsy. He had no other symptoms.

A biopsy of the prostate can confirm cancer, but Heckler typically only recommends biopsies for those with a trend of increasing PSA levels over time or a rapid increase in levels.

Guard’s biopsy revealed he has low-risk prostate cancer.

While biopsies can confirm cancer, they can’t determine whether a person will ever be affected by the cancer, Heckler said. Low-risk prostate cancer, for example, might take 20 years or more before it affects someone. Intermediate- or high-risk cancer could impact a person within 10 years, she said.

Prostate cancer can metastasize, or spread; the biopsy can give urologists a good idea of the odds of that happening, Heckler said. Low-risk cancer has about a 5 percent chance of spreading, she said.

Most men are in their 60s or older when they’re diagnosed with prostate cancer; many could live out their lives without

the cancer ever becoming problematic, Heckler said. That’s what makes the decision of how, or whether, to treat the cancer tough, she said.

Men with prostate cancer have several options. One option is observation. Men with low-risk prostate cancer might choose to take no immediate action but have their PSA levels monitored and undergo annual biopsies to monitor the cancer’s progression, Heckler said. Older men or those with a life expectancy of 10 to 15 years (due to other health issues, for example), might opt to do nothing, she said.

Radiation and surgery to remove the prostate are two other options. Those options come with potential side effects, such as incontinence and erectile dysfunction, Heckler said.

233,000: The estimated number of new prostate cancer cases in the U.S. in 2014.

5,380: The estimated number of men in Washington who will be diagnosed with prostate cancer in 2014.

29,480: The estimated number of men who will die from prostate cancer in 2014 nationwide.

99: The percentage five-year survival rate for prostate cancer.

1: Prostate cancer is estimated to account for the most new cancer cases (27 percent) among men in 2014.

60: The percentage of all prostate cancer cases diagnosed in men 65 years and older.

146.6: The number of men per 100,000 who are diagnosed with prostate cancer.

2.6 million: The estimated number of men currently living with prostate cancer.

Source: American Cancer Society, National Cancer Institute

Despite the risks, Guard has opted for surgery. After two bouts with different skin cancers in the past decade, Guard said he doesn’t want to take any chances.

“This is the third time with a cancer,” Guard said. “And I don’t care to give it any edge.”

Before making his decision, though, Guard consulted with Heckler. If her father was in Guard’s position, Heckler said, she would encourage him to treat the cancer.

“He’s very young,” Heckler said of Guard. “The chance of it affecting him in his lifetime is higher.”

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Guard hasn’t told many people about his cancer diagnosis. But among those he did tell, Guard was surprised how little men know about prostate cancer and the screening process.

“Most people don’t realize how simple testing is, just a little more blood,” Guard said.

After his surgery and a few weeks of recovery, Guard should be able to resume his regular activities. And, if all goes as planned, he will be cancer-free.

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Columbian Health Reporter