Singer Elton John has just revealed that he almost died from complications after surgery for prostate cancer. It’s an important reminder for cancer survivors to practice self-care during and after treatment. The 72-year-old John says his cancer was discovered through routine screening, which is also an important lesson for men.
“They discovered it during a check-up, John writes in a memoir which is being excerpted in The Daily Mail. My doctor noticed the level of prostate- specific antigens in my blood had gone up slightly and sent me to an oncologist for a biopsy. It came back positive.Read More
John says that he opted for surgery to treat his prostate cancer because he wasn’t at all keen on the other option which involved a rigorous course of radiation treatments.
“A lot of times, people are like, look, I just want the tumor out. Just cut it out, and I want to be done. I say, great, surgery’s a good choice for you,” according to Dr. Stephen Freedland of Cedars-Sinai Medical Center. Dr. Freedland was interviewed for SurvivorNet’s guide to decision making around prostate cancer.
“It’s a big operation, and just because you have it with a robot doesn’t make it any less of a big operation,” says Dr. Freedland.
According to Elton John’s new book, his prostate surgery was performed in Los Angeles. Just ten days after the operation he went to perform in Las Vegas and started to suffer enormous pain during the concert. Doctors subsequently discovered it was a fairly uncommon complication from the surgery which involved fluid leaking from his lymph nodes.
“Prostate cancer surgery is typically done through a robotic technique today, at least in the United States. But a lot of patients are still getting open surgery. Depending on the surgeon, it may be two, three, four, five hours– somewhere in that range, usually spend one night in the hospital. You wake up from the surgery with a catheter in your bladder. Once you’re home, it’s really just recovering, gaining your strength back.The catheter comes out about 10 days after surgery. Whether you have it open or robotic, I tell patients it’s probably a good month or so until you’re really getting back to yourself,” according to Dr. Freedland.
By undertaking a performance so soon, John was clearly pushing the limits.
The star was forced to go back to hospital to deal with the problem – before doctors cured it, seemingly by chance. ‘A routine colonoscopy shifted the fluid permanently, days before my 70th birthday.” However John subsequently had another devastating problem related to his lymph system which landed him back in the hospital and again in extremely serious condition. Thankfully, he was able to recover.
In the memoir, John writes:
“A couple of years ago David presented me with a sheet of paper. He’d written down a load of dates relating to our sons’ school life — when each term would start, how long the holidays were, the years they’d be moving from infants to juniors and then secondary school, when they’d be sitting exams. How much of this do you want to be around for?’ he asked. ‘You can work your tour schedules around it.’ I looked at the paper. It effectively mapped out Zachary and Elijah’s lives. By the time they reached the final dates on it, they’d be teenagers, young men. And I’d be in my 80s. ‘All of it,’ I said finally. ‘I want to be there for all of it.’ David raised his eyebrows. ‘In which case,’ he said, ‘you need to think about changing your life. You need to think about retiring from touring.’
“In a strange way, it felt like the time I spent recuperating was the answer to my prayers: if you want more time, you need to learn to live like this, you have to slow down.
Information about prostate cancer
Prostate cancer is more likely to develop in men who are 65 and older, and having one or more relative with prostate cancer increases the risk, according to the National Cancer Institute. It is the most common cancer other than skin cancer for men in America. Although most men who are diagnosed with prostate cancer do not die from it, it is the second highest cause of death behind lung cancer for men. It also occurs more frequently in African American men, and African American men are more likely to die from the disease.
Current recommendations suggest that men begin speaking with their doctors about screening for prostate cancer at age 50, but there aren’t any specific guidelines about when to get screened because research hasn’t yet proven the advantaged outweigh the risks of screening.
Information about prostate cancer surgery
The goal of the surgery is to completely remove the cancer, says Dr. Freedland at Cedars-Sinai.
Dr. Stephen Freedland of Cedars-Sinai Medical Center on surgery for prostate cancer
This can be done with traditional open surgery, laparoscopy or robotic-assisted surgery (which is becoming the norm). “It’s probably a good month or so until you’re getting back to yourself,” says Dr. Freedland.
The debate about when to get prostate cancer surgery
There are differences of opinion when you’re considering treatment for early stage, high-risk prostate cancer. Some facilities believe surgery is the way to go as long as the disease has not spread.
Others feel the change in the quality of life has to be balanced against the potential that you’ve improved the overall outcome. “That’s a very serious conversation (patients) should have,” says Dr. Patrick Swift, Clinical Professor of Radiation Oncology at Stanford University Medical Center, “and it involves choosing between surgery or just having radiation with hormone therapy.”
Information about screening for prostate cancer
Screening tests for prostate cancer include:
- Digital rectal exam, wherein a doctor or nurse inserts a gloved finger into the lower part of the rectum to feel for lumps on the prostate.
- Prostate specific antigen test (PSA), or a test that measures the level of PSA in the blood. PSA is a substance made mostly by the prostate that may be found in an increased amount in the blood of men who have prostate cancer.
- Gene 3 (PCA3) RNA, which measures the amount of PCA3 RNA in the urine after a DRE. If PSA has been determined high, and a biopsy has shown no cancer, high amounts of PCA3 RNA may lead to another biopsy and may help diagnose prostate cancer
- Transrectal ultrasound, a procedure in which a probe that is about the size of a finger is inserted into the rectum to check the prostate.
Information about signs of prostate cancer
Signs of prostate cancer are varied, and can include:
- Weak or interrupted (“stop-and-go”) flow of urine
- Sudden urge to urinate or frequent urination (especially at night)
- Trouble starting the flow of urine or emptying the bladder completely
- Pain or burning while urinating
- Blood in the urine or semen
- A pain in the back, hips, or pelvis that doesn’t go away
- Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia