Learning About Prostate Cancer
- Actor Robert De Niro is a prostate cancer survivor who’s known for keeping things on the down low.
- De Niro’s first experience with prostate cancer came long before his own when his father died of the disease at age 71.
- De Niro’s prostate cancer was successfully treated and “detected at an early stage because of regular checkups.”
- Treatment for prostate cancer can vary greatly from person to person.
- Early-stage prostate cancers can be treated with many options including active surveillance, surgery, radiation and focal therapies, among other things.
“Blonde” and “Knives Out” actress Ana de Armas, 34, recently made her “Saturday Night Live” debut and her monologue was a touching reflection on the start of her career after coming to the United States from Cuba in her 20s. One person who made her feel welcome in the industry was none other than the Hollywood legend himself.
Read MoreThe sweet action was not for show, and De Niro likely thought no one would ever really hear about it. But this is not the only time he’s kept things on the down low.
Robert De Niro’s Cancer Battle
Robert De Niro’s first experience with prostate cancer came long before his own. His father passed away from the disease at 71.
More on Prostate Cancer
- 1 Important Question Every Prostate Cancer Patient Getting Radiation Should Ask Their Doctor
- A Devastating Prognosis and a Revolutionary Treatment for Prostate Cancer with Zytiga
- People With Low-Risk Prostate Cancer Can Rely on Monitoring the Disease Without Increasing Risk of Death in 15 Years — How to Make the Important Decision for Treatment
“The doctor was not a sensitive person and said [things] in a mean way, a crude way, that only helped to exacerbate the fear that my father had of having a prostatectomy,” De Niro said in 2015. “I wish I’d been on him more to deal with it.
“Because he could have been alive today.”
When Should I Get Tested for Prostate Cancer?
After a statement was released by his publicist in 2003, the world found out De Niro was diagnosed with the same disease at 60.
“Doctors say the condition was detected at an early stage because of regular checkups, a result of his proactive personal healthcare program,” publicist Stan Rosenfeld said. “Because of early detection and his excellent physical condition, doctors project a full recovery.”
Thankfully, De Niro did make a full recovery following prostate surgery the same year of his diagnosis. It’s unclear if he underwent any other treatments because little was shared about his cancer journey.
Treating Early-Stage Prostate Cancer
Treatment for early-stage prostate cancer varies from person to person depending on multiple factors, like the stage of the cancer and how aggressive your particular cancer is in nature.
Treatments also differ because it’s not uncommon for prostate cancer doctors to have differing opinions on what the best options are. That’s why you should never hesitate to get multiple opinions.
One option for people with early-stage, low-risk prostate cancer is to undergo active surveillance. In fact, a recent study suggests people with low-risk prostate cancer can manage the disease through monitoring without increasing their risk of death from it in 15 years.
“The concept of active surveillance [monitoring] 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
A benefit to this option is that you can maintain your normal functioning. It’s important to remember, however, that you might still need treatment later on.
Dr. Brooks says about 50% of men who opt for active surveillance will have changes within five years that require active treatment.
“You don’t have to suffer some of those potential side effects of sexual dysfunction or urinary dysfunction,” Dr. Brooks explained.
Watchful waiting, a less aggressive form of monitoring, is another option for older adults and those with other serious or life-threatening illnesses who are expected to live less than five years.
If watchful waiting is chosen, routine PSA tests, digital rectal examinations and biopsies are not usually performed, but treatment may be recommended if the prostate cancer causes symptoms, such as pain or blockage of the urinary tract.
Early-stage patients who choose to undergo active treatment may be able to eradicate their cancer with local treatments like surgery and radiation. The main type of surgery for prostate cancer is a radical prostatectomy – the removal of the entire prostate gland plus some of the tissue around it, including the seminal vesicles.
But patients can have this surgery performed in two different ways:
- Traditional open surgery: This approach is less common nowadays and involves a surgeon making a large incision.
- Laparoscopy: This approach requires a smaller incision and a shorter recovery time. A newer type of laparoscopy, known as a robotic-assisted laparoscopic prostatectomy (RALP), or robotic surgery, allows surgeons to make these small incisions with more precision.
Laparoscopic Surgery vs. Traditional Open Surgery: What’s the Best Choice for Prostate Cancer?
Radiation options for prostate cancer patients include:
- External beam radiation: 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 with the temporary option meaning you can have it done as an outpatient procedure that only takes one to two hours. The permanent therapy requires doctors to place radioactive seeds directly into the prostate and leave them there to slowly release radiation over several weeks or months.
- Brachytherapy (internal radiation): The delivery of 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, told SurvivorNet.
Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation
Focal therapies – prostate cancer treatments for small tumors that are in only one area of the prostate – are another option. These less-invasive treatments can include:
- Cryosurgery (also called cryotherapy or cryoablation): The freezing of 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. Note this is NOT an established therapy or standard of care to treat newly diagnosed prostate cancer.
- High-intensity focused ultrasound (HIFU): A relatively new treatment that uses high-frequency ultrasound energy to heat and kill cancer cells in the prostate. It is usually only offered to men with early stage, localized cancer that is in one area of the prostate, though it is rare to see a prostate cancer confined just to one area of the prostate. If patients do have such a diagnosis, however, HIFU can “reset the time clock on the cancer so they can avoid the full treatments until a later date,” according to Dr. Swift. Note 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.
Overall, make sure you feel confident about your treatment plan. Don’t be afraid to get multiple opinions and consider all your options.
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