Prostate Cancer Patients Find Seeds of Hope
When Wallace Black found out he had prostate cancer, he thought it was the end of a normal life.
Doctors told the 55-year-old Federal Express worker that they would remove his prostate, and that he’d probably end up impotent and with little or no control of his bladder.
Instead, he chose to have the cancer treated by injecting it with radioactive pellets, a procedure that has slowly gained favor since the first such operation in the 1970s.
Skeptics say there’s not enough evidence to prove that the procedure, called seed implantation, is as effective as surgery for prostate cancer.
“I was so excited that there might be another route, another way,” said Black, of Powder Springs, Ga. “When some guy tells you he’s going to make you impotent, and you’ll lose your life . . . you look at every avenue there is.”
Cancer of the prostate, the walnut-sized gland at the bottom of the bladder, is the second leading cancer killer among men, after lung cancer. About 317,000 men in the United States will be diagnosed with it this year; about 41,000 will die of it in 1996.
Surgery, the most common treatment, removes the gland. In seed implantation, 60 to 100 rice-sized pellets packed with radiation are injected into the prostate. Both options are possible only if the cancer is caught early and has not spread.
The seeds later become dormant. The injections take about an hour, and most patients can return home a few hours later.
Frustrated that his own doctor wouldn’t tell him about it, Ed Lerner researched seed implantation himself.
“My doctor wanted to hurry me into the hospital to get the cancer out,” the semiretired computer consultant said. “I wasn’t sure I wanted to be in so much of a hurry. The whole idea was devastating.”
He and Black both turned to Atlanta urologist Dr. Steven Morganstern, who has performed 500 seed implantations over the past six years.
He has also patented a needle that strategically places the seeds to best attack the cancer.
Morganstern tells patients that fewer than 5% of men who get seed implants lose bladder control, and only about 15% of men under age 70 become impotent after the procedure.
Those odds, he says, are better than the odds from prostate surgery.
In 1995, a study released by Seattle’s Northwest Hospital showed that 95% of 451 patients who underwent seed implantation had remained free of cancer six years later.
The American Urological Assn. accepts seed implantation as a prostate treatment at the same time it acknowledges the lack of long-term results. Some prostate experts say there’s little long-term proof that the cancer won’t return after the radioactive seed implantation.
Dr. William J. Catalona, chief of urologic surgery at Washington University School of Medicine in St. Louis, said one drawback is that some patients are resistant to radioactivity.
“The treatment shouldn’t be advertised as the magic bullet,” Catalona said. “The longest results they have are six years. This is something very sensitive, and we don’t want to jump on the bandwagon.”
