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Lutz views this lack of una- nimity in treatment strategies as unfortunate because of the confusion and uncertainty it creates, but he is convinced that his colleagues act in the best interests of patients. "We simply do not have enough survival curve data," he says. He is encouraged by the 7 percent decline in the death rate and the survival rate improvement from 50 percent to 76 percent. But no one ascribes this to a single treatment strategy. For example, speakers at a recent prostate cancer sympo- Dr. Michael Lutz in one of his examining rooms. sium at the University of Michigan reported on seed -.=( argue that men must actively take implants (brachytherapy), cryothera- charge of their health. Grove coun- py, surgical options, external beam sels, "If you look after your invest- radiation, acupuncture, gene therapy, ments, you should look after your life diet, meditation and nutrition. as well." Dr. Robert Bloom, section chief Prostate cancer statistics are unset- for medical oncology at DMC Sinai, tling: 80,00 cases diagnosed in 1989; feels that divergent recommendations 300,000 in 1996. More sobering: in the treatment of early prostate can- 41,400 deaths. Informed women cer arise because "there are so many know that 1 out of 8 are at risk of very effective treatment options." 11t=( breast cancer; few men know that 1 notes that success rates appear to be out of 5 will develop prostate cancer. fairly equivalent. "Therefore," he Women pin pink ribbons and says, "decisions should be based on a emblems to their clothing and orga- patient's general health and personal nize marches to proclaim their deter- priorities." mination to combat breast cancer. No DMC Sinai radiation oncologist one has promoted lapel pins for men Dr. Nathan Kaufman also argues the to promote prostate cancer awareness, need for an individualized approach nor do they march for the cause; to treatment, based on factors such --‘,‹ Early diagnosis of prostate cancer, age, quality of life and the stage of simplified by the PSA (prostate spe- the disease. Often, he says, he spends cific antigen) test, is a mixed blessing. two or more hours explaining to An elevated PSA count poses treat- patients the pros and cons of surgery, ment dilemmas, in part because some hormonal therapy and radiation. He positive readings are false and pro- reviews several radiation regimens. voke needless fear. Because public figures such as For a number of older patients, General H. Norman Schwartkopf practitioners often suggest "watchful and former Senator Bob Dole have waiting." In these cases, the condition - also discussed prostate cancer experi is preferable to treatments, all of ences, public awareness has grown, which offer encouraging cure rates even if most men still remain silent but also potential side effects and no about their personal concerns. Lutz t uarantees. wryly notes that men view their sexu- adiation oncologists and urolo- ality as "the last bastion of maleness." gists are far from unanimous about He points to a quote on his office the most effective approach. After bulletin board: "Some men would surfing the Internet, a patient might rather be bitten by a cobra than have opt for prostatectomy in Baltimore, a digital rectal exam." Cifyotherapy in Pittsburgh, radioactive Lutz, as chairman of the Great iodine seed implants in Seattle. This Lakes Division of the American same battery of treatments exists Cancer Society's Prostate Cancer Task locally. :It would be a rare patient who Force, has agreed to address guests at would not seek consultations with at the Heritage Ball, much to least one other practitioner before Kleinfeldt's relief. He will thank them embarking on a course of treatment.