Support & Love Matters For Cancer Patients
- Al Roker has been absent from TODAY because he's been in the hospital for “a number of issues” including blood clots. But his colleagues recently gave him a much needed pick-me-up when they arrived at his house to sing him a Christmas carol.
- Roker is also a cancer survivor. He announced he was diagnosed with prostate cancer in November 2020. Since undergoing treatment, he's been given consistent 'all-clears,' but he'll be doing lifelong testing to make sure the cancer does not return.
- In addition, Roker had gastric bypass surgery in 2002. Since that surgery and his continued efforts to live a healthy life, he's lost over 100 pounds.
- Prostate cancer is the most common cancer in American men. Symptoms of prostate cancer are inconsistent and hard to pinpoint but may include changes in urinary function like urinating more or less often or waking up at night to go more than usual.
- Treatment for prostate cancer can vary greatly from person to person. Early-stage prostate cancers can be treated with many options including: active surveillance, watchful waiting, surgery, radiation and focal therapies, among other things.
Roker was shocked when dozens of his colleagues showed up at his doorstep to surprise him with a cheery rendition of the song, “Jingle Bells.”
Read MoreBut Roker quickly became overwhelmed with emotion as he expressed his gratitude for their show of support.View this post on Instagram
“You guys mean more to me than anything in the world,” he said. “I just want to thank you all.
“It’s been a long, hard slog and I’ve missed you all so, so very much. All these faces, it just means the world to me and to our family.”
Al Roker’s Latest Health Battle
In a post from November 18, Al Roker shared a short message relating to the cause of his absence.
View this post on Instagram
"So many of you have been thoughtfully asking where I've been," he wrote in his caption. "Last week I was admitted to the hospital with a blood clot in my leg which sent some clots into my lungs.
"After some medical whack-a-mole, I am so fortunate to be getting terrific medical care and on the way to recovery. Thanks for all the well wishes and prayers and hope to see you soon. Have a great weekend, everyone."
According to the Mayo Clinic, blood clots are "gel-like clumps of blood" that are beneficial when they form in response to an injury or a cut by plugging the injured blood vessel to stop bleeding. But when blood clots form inside your veins without dissolving naturally, they may pose a problem like in the case of Roker.
"These may require medical attention, especially if they are in your legs or are in more critical locations, such as your lungs and brain," the Mayo Clinic states.
Then, in a more recent update from December 12, Roker said he’d been struggling. We don’t know too many details about how his recovery is going, but we do know that he had to take another trip to the hospital for “unspecified reasons” and that he’s “got a number of issues” going on.
"It's been a tough slog," he admitted. "I'm not gonna deny this. It's been the hardest one yet. And you know, I've had my share of surgeries. But it gives you a profound sense of gratitude for this outpouring of prayers and thanks. I'm a very fortunate person."
Al Roker's Prostate Cancer Journey
As mentioned before, the blood clots are not the first time Al Roker has been faced with a harrowing medical issue. After almost delaying a doctor's appointment because of the COVID-19 pandemic, Roker was diagnosed with prostate cancer.
“It’s a good news-bad news kind of thing,” Roker told TODAY . “Good news is we caught it early. Not great news is that it’s a little aggressive, so I’m going to be taking some time off to take care of this.”
He shared the news of his diagnosis on the TODAY show in November 2020 and explained that he would be having surgery.
"My first reaction was, 'I just want this out. I don't want to do radiation,'" Roker previously told SurvivorNet of the prostate cancer that was growing inside his body. "At the end of the day, I thought, 'surgery first,' then I thought, 'no, maybe radiation,' then I went back and (said), 'no, surgery.' That was that. Once I make a decision, I don't really second guess it."
His procedure took place in November 2020 and resulted in the removal of his prostate and some surrounding tissue and lymph nodes. This type of surgery a radical prostatectomy is known to effect a man's sexual function since it requires removing the seminal vesicles.
"There really was no pain," Roker said on how he felt post-operation. "The biggest issue, obviously, is sexual function, and there's treatment for that. I'm happy to say everything's working fine."
The biggest issue for Roker actually came during surgical recovery.
"To be honest, the hardest part really there's a little incontinence (loss of bladder control) to begin with that eventually goes away to me," he said. "The hardest part was that initial week after surgery where you're wearing a catheter (a soft tube that drains urine from the bladder). But even that was not onerous, it's just a little inconvenient, but you know that it's temporary."
Since then, Roker has been given consistent 'all-clears,' though he'll be doing lifelong testing to make sure the cancer does not return.
And even Roker's cancer surgery was not the first time he had a major operation for the sake of his health. In 2002, Roker, who had long struggled with his weight, opted to have gastric bypass surgery to drastically limit his food consumption. Since that surgery and his continued efforts to live a healthy life, he's lost over 100 pounds.
Understanding Prostate Cancer
Prostate cancer is the most common cancer in American men except for skin cancers. About one in eight men will be diagnosed with prostate cancer during his lifetime. The disease begins in the walnut-shaped prostate gland located between the rectum and bladder. This gland produces the fluid that nourishes sperm.
RELATED: Prostate Cancer: Overview
Symptoms of the disease are inconsistent and hard to pinpoint.
"Prostate cancer is a very odd disease in that it doesn't have a particular symptom," Dr. Edwin Posadas, director of translational oncology and the medical director of the Urologic Oncology Program at Cedars-Sinai, explained.
But changes in urinary function like urinating more or less often or waking up at night to go more than usual could be a sign of the disease. However, it's important to note that these potential symptoms could also could be caused by a urinary tract infection or even an enlargement of the prostate gland (which is not cancer).
There's No One Definitive Symptom for Prostate Cancer, But There Are Clues
Doctors that have spoken with SurvivorNet shared a hopeful outlook when considering a prostate cancer diagnosis because there are many treatment options, and there's been significant treatment progress over the past decade.
Surgical and radiation options, for example, have made improvements in reducing side effects of treatment while still providing excellent cure rates. Even for men with an advanced-stage diagnosis, many new options exist to treat prostate cancer and help them maintain an excellent quality of life.
Prostate Cancer Screening
In the United States, many prostate cancer cases are caught with screening examinations. Screening guidelines depend on your risk for the disease. Age, race/ethnicity, geography, family history and gene changes are the main risk factors for prostate cancer. You should talk with your doctor regardless, but here are some things to consider when gauging your risk for the disease:
- Men younger than 40 are less likely to get prostate cancer, but age-related risk quickly rises after age 50. Approximately six of ten cases of prostate cancer are found in men older than 65.
- Prostate cancer develops more often in African-American men and in Caribbean men of African ancestry than in men of other races, and these men tend to develop the disease at a younger age.
- Prostate cancer is most common in North America, northwestern Europe, Australia and on Caribbean islands. It is less common in Asia, Africa, Central America and South America. The reasons for this risk factor are unclear, but more intensive screening and lifestyle differences like diet might be contributing factors.
- Most prostate cancers occur in men without a family history of the disease, but it's still important to look at your family history because prostate cancer does seem to run in some families. Having a father or brother with prostate cancer, for instance, more than doubles a man's risk of developing the disease with a higher risk for men with a brother with prostate cancer than those with a father who have it. The risk is also especially high if a man has several affected relatives that developed the cancer at a younger age.
- Inherited gene changes, or mutations, like that of the BRCA1 or BRCA2 genes can also elevate risk, but this probably accounts for a small percentage of overall cases.
It's not clear if the benefits of prostate cancer screening outweigh the risks for most men. Nevertheless, screening can be life-saving, and it's important to at least discuss the pros and cons of screening and your risk factors for the disease with your doctor.
When Should I Get Tested for Prostate Cancer?
Prostate cancer screening methods look for possible signs of the disease, but they can't determine for sure if you have cancer. The only way to know for sure if the patient has prostate cancer is with a prostate biopsy a procedure in which small samples of the prostate are removed and examined under a microscope. But generally speaking, screening for prostate cancer involves a PSA (prostate-specific antigen) test and a digital rectal exam to feel the prostate gland.
"It's slightly uncomfortable but painless, and takes less than 30 seconds," Dr. Posadas said of these methods. "The amount of information that is gained from that is tremendous, and it can be a life-and-death type decision that is made."
But it's important to note that the PSA test is not perfect. The prostate-specific antigen is a protein secreted by the prostate gland. Men have a small amount of PSA in their blood all the time, but large amounts can be a sign of cancer because when cancer cells grow, PSA spills into the blood.
An elevated PSA test, however, does not always mean you have prostate cancer. It can simply reflect that your prostate is enlarged which is common or it could signal an infection or inflammation. Because of this, the PSA test is controversial since high levels may lead to over-treatment in men who are more likely to die from something else. Regardless, our experts maintain that the PSA tests are helpful, and you should talk with your doctor about your own risks for the cancer and screening options.
Treating Early-Stage Prostate Cancer
Treatment for early-stage prostate cancer can vary greatly from person to person. Doctors' treatment recommendations will depend on multiple factors, including the stage of the cancer, but they will also look at things like how aggressive your particular cancer is in nature. Additionally, prostate cancer is a disease where many doctors have differing opinions on what is the best treatment path to take. So, it can be a good idea to get multiple opinions.
One option for people with early-stage, low-risk prostate cancer is to undergo active surveillance.
"The concept of active surveillance is you're watching a man, and if something changes while the cancer is still in the prostate, you treat it then," Dr. James Brooks, the chief of urologic oncology at Stanford Medicine and director of the U54 Stanford O'Brien Urology Research Center, told SurvivorNet. "An ideal man for active surveillance might be a man, for instance, in his late 60s who has a barely elevated PSA, let's say just above 4, who undergoes a biopsy and is found to have one of the 12 biopsy cores with a small percent of low grade, what we call, Gleason grade 3 plus 3 prostate cancer.
"That man has a very low probability, it's certainly less than 1% chance, of dying of prostate cancer in 10 years."
The Benefits of Active Surveillance
Perhaps the biggest consideration for active surveillance is the fact that it allows you to preserve your normal functioning.
"You don't have to suffer some of those potential side effects of sexual dysfunction or urinary dysfunction," Dr. Brooks explained.
But even if you opt for active surveillance, there is still the chance you'll require treatment later down the line. About 50% of men who opt for active surveillance will have changes within five years that require active treatment, says Dr. Brooks.
In addition to active surveillance, watchful waiting may also be an option for older adults and those with other serious or life-threatening illnesses who are expected to live less than 5 years. Routine PSA tests, digital rectal examinations and biopsies are not usually performed if you've decided on watchful waiting, but treatment may be recommended if the prostate cancer causes symptoms, such as pain or blockage of the urinary tract,
For early-stage patients who do undergo active treatment, local treatments like surgery and radiation may get rid of the prostate cancer completely.
Laparoscopic Surgery vs. Traditional Open Surgery: What's the Best Choice for Prostate Cancer?
When surgery is performed, you can either have traditional open surgery or laparoscopy. The latter is more commonly used nowadays since traditional surgery requires a surgeon to make a large incision and laparoscopic surgery offers a smaller incision and a shorter recovery time. And a newer approach, known as a robotic-assisted laparoscopic prostatectomy (RALP), or robotic surgery, allows surgeons to make these small incisions with more precision.
RELATED: How to Choose a Surgeon Does Volume Matter?
Radiation for prostate cancer, on the other hand, can either be done via external beam radiation and brachytherapy (internal radiation).
Brachytherapy is an internal form of radiation where small radioactive seeds are placed inside the prostate. The two forms of this therapy are permanent low-dose brachytherapy and temporary high-dose brachytherapy. The temporary option means you can have it done as an outpatient procedure that only takes one to two hours. If you choose the permanent therapy, doctors will place radioactive seeds directly into the prostate and leave them there to slowly release radiation over several weeks or months.
RELATED: The Benefits Of High-Dose Brachytherapy: Temporary and Fast
External beam radiation, on the other hand, delivers high doses of radiation to the tumor in the prostate in a non-invasive way. Experts say developing technology has allowed for more precision in the aim and amount of radiation administered.
"Over the last ten to fifteen years, we have done remarkable things with our technology that allows us to aim much more carefully, reduce the amount of radiation that nearby critical structures get, and thereby get a higher dose in a quicker period of time," Dr. Patrick Swift, a radiation oncologist and a Clinical Professor of Radiation Oncology at Stanford, previously told SurvivorNet.
Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
Focal therapies are another option for small prostate tumors. These less-invasive treatments can include cryosurgery (also called cryotherapy or cryoablation) and high-intensity focused ultrasound (HIFU).
Cryosurgery involves freezing cancer cells with a metal probe inserted through a small incision in the area between the rectum and the scrotum, the skin sac that holds the testicles. But it's crucial to note that this is NOT an established therapy or standard of care to treat newly diagnosed prostate cancer.
High-intensity focused ultrasound uses high-frequency ultrasound energy to heat and kill cancer cells in the prostate. This relatively new treatment is usually only offered to men with early stage, localized cancer that is in one area of the prostate, though it is admittedly rare to see a prostate cancer confined just to one area of the prostate.
But if patients do have such a diagnosis, HIFU can "reset the time clock on the cancer so they can avoid the full treatments until a later date," according to Dr. Swift. Still, you should be aware that the long-term effectiveness of HIFU is still being determined.
Depending on the stage and aggressiveness of your cancer, other treatments like hormone therapies and anti-androgen drugs may be recommended (which will be discussed more below). No matter what, you should feel confident in your treatment plan. Don't be afraid to get multiple opinions and really consider all your options.
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