On February 1, WWE Hall of Fame wrestler Bret “Hitman” Hart shared with the public that he has been diagnosed with prostate cancer, and is undergoing a radical prostatectomy in the next several days to treat his prostate cancer. The Hitman had a long career as a professional wrestler winning the world heavyweight championship seven times, and the US heavyweight championship five times.
Check out our infographic on the Stages of Prostate Cancer.
Hart, although the latest celebrity to share with the public his plight against the disease, is not the first to do so. There is a long list of celebrities who have prematurely succumbed to this disease, including the actors Bill Bixby, and Telly Savalas, the musicians Frank Zappa and Joey Ramone, and businessman Steve Ross—the former chair of Time Warner. Numerous other public figures have shared their disease and treatment with the public. Some of these celebrities chose surgery including James Bond 007 Roger Moore, actor Mandy Patinkin, Baseball Hall of Famer, Joe Torre, Secretary of State John Kerry and golfer Arnold Palmer. Radiation therapy was chosen ex-NYC mayor Rudy Giuliani, ex-California governor Jerry Brown, and Warren Buffet (who at age 84, many would consider controversial but more about that later). Cryotherapy was chosen by actor Ryan O’Neal. Surveillance therapy was chosen by Sir Ian McKellan.
So how do we decide the correct therapy when presented with the diagnosis?
Professional wrestlers including Bret Hart have admitted to steroid usage. The thought that may come to the mind of many is whether this steroid use is a causative factor for the development of prostate cancer. There are many known complications attributable to steroid abuse, however there is no known association with the use of steroids and the development of prostate cancer.
Steroids have been used in several different treatment protocols as a second-line therapy for metastatic hormone-refractory prostate cancer in conjunction with mitoxantrone as well as docetaxel. This group of patients has disease that does not respond to the standard hormonal deprivation therapy that can usually control the metastatic prostate cancer for a period of time. More recently they are being used with newer oral agents, and even in some first line therapies. These patients can now receive abiraterone and prednisone (a steroid) and demonstrate improvements in overall survival and radiographic progression-free survival.
When diagnosed with prostate cancer many different options exist for therapy. Active surveillance is one option that may be suitable for some patients. The standard surveillance protocol involves repeating the prostate biopsy to be certain that the disease is not progressing. Radical surgery is an option that is very popular with patients. This technique is usually performed today robotically, although some centers still advocate open surgery. Radiation therapy is another treatment available to patients and can be performed with either external beam or seed therapies. Prostate cryotherapy is another excellent option for patients and recent efforts have been directed at focal therapy, which only treats the tumor and not the surrounding healthy tissue (www.endocareprostate.com/Cryotherapy).
When patients are diagnosed with cancer, many immediately begin to panic. They are very fearful of their diagnosis and have heard horror stories of others who have succumbed to malignancy. Prostate cancer is usually not that type of cancer. It is a very slow growing tumor and in some patients treatment may not be needed. Today’s treatment options are very effective in eradicating the disease and maximizing life expectancy. If you are skeptical after hearing the recommendations from your Urologist, a second opinion would go a long-way to provide the reassurance that you need.
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