His Sex Prowess May Enter The Guinness Book of Records
31 Jul 2003
Every year thousands of men face a dilemma. Their blood test for prostate cancer (PSA) suspects a malignancy. Later biopsies prove that cancer is present. But today the wisdom of Solomon is required to know what to do about it. Particularly, when the first question they and their wives ask is, " Will the treatment result in impotence?"
Dr. Gary Onik is a radiologist and Director of the Centre for Surgical Advancement in Celebration, Florida. He recently reported to the Radiological Society of North America meeting in Chicago that freezing the prostate gland (cryosurgery) can save men from impotence, urinary incontinence and injury to bowel.
Cryosurgery kills the malignancy by freezing only part of the gland, but spares the nerves responsible for an erection.
The procedure involves inserting two to five probes about the diameter of a piece of spaghetti directly into the gland. Argon gas then cools the probes to a temperature of -40 degrees centigrade which freezes the cancer tissue for several minutes. The malignant area is then allowed to thaw, frozen again and allowed to thaw.
Dr. Onik reports that so far none have developed urinary incontinence, diarrhea or bowel complications. Nor has there been a recurrence of the cancer after three years. One man may be eligible for the Guinness Book of Records. The patient claims he had normal sex five days following the procedure!
Dr. Onik reports there’s another big plus for cryosurgery. It doesn’t launch a missile-like attack on the prostate gland that completely destroys it. Often, this treatment causes impotence and other complications. Moreover, since it’s not an all-or-nothing assault, it’s still possible to use cryosurgery again at a later date if a suspicion of recurrence occurs.
Patients treated with radical surgery don’t have the option of repeated therapy. Nor do patients who are given the full dose of X-rays. Tissue can only stand so much radiation.Currently men with prostate cancer have two basic choices. Some decide on "watchful waiting", hoping the repeat PSA test will show that the malignancy is not progressing. This approach appears to be totally contradictory to everything patients have been taught about cancer. That the sooner a cancer is treated the better the chance of survival.
But some cases of prostate cancer are akin to getting gray hair. Autopsy studies show that by age 70 about 50 percent of males have areas of microscopic cancer in the prostate gland! Since the malignancy grows slowly patients usually die of something else long before it causes trouble.
It’s for this reason that one of the world’s most famous urologists used to stress that "getting older is invariably fatal, cancer of the prostate only sometimes." Some patients, however, cannot sleep knowing cancer is present and want immediate treatment. Some elect to have surgery or radiation. One radiation technique, called brachytherapy, inserts radioactive needles into the gland to destroy cancerous tissue.
Unfortunately these procedures can cause complications. Some of the most tragic letters I receive come from men who have been treated by a radical prostatectomy for prostate cancer. They write that they would never have agreed to the treatment if they had been adequately advised of potential complications.
So what prompted these letters? It wasn’t what you might suspect, impotence. Rather, it was urinary incontinence. The fact that the quality of their lives had been totally destroyed by having to wear diapers. They complain that if this problem been thoroughly discussed with them prior to the surgery, they would have refused the operation.
How often urinary incontinence occurs is hard to determine. Some surgeons report low figures. But I suspect the statistics are higher because patients who wet their pants are much more aware of it than surgeons who carry out the treatment.
My advice is to always get a second opinion and think carefully about where and from whom you receive treatment. Remember the data published about urinary incontinence usually applies to the top urologists. For surgeons with less experience, there’s a greater chance of patients spending retirement years in diapers, not quite "the golden years" we all anticipate.
