By Peggy O'Farrell
The Cincinnati Enquirer

Jordan

The Rev. Donald Jordan knows how important prostate cancer screenings are.

Jordan, now 71, was diagnosed with the cancer in 1995 after a prostate-specific antigen (PSA) blood test.

Radiation therapy killed the cancer, and Jordan is cancer-free. To share his good fortune, Jordan and the University of Cincinnati's Barrett Cancer Center are teaming up to offer free PSA screenings at Jordan Crossing in Bond Hill, formerly Swifton Commons.

More than 200,000 American men will get prostate cancer this year, and an estimated 28,900 will die of the disease. Blacks are more likely to get prostate cancer and twice as likely to die from it as white men.

"It's a step in the right direction. A lot of men don't want to go sit in the doctor's office, especially African-American men," says Jordan, the pastor of Allen Temple AME Church, now based at Jordan Crossing. "This is in the neighborhood. They don't have to wait. They can be tested quickly and get the results. I think accessibility and availability have a lot to do with getting tested."

Dr. William Barrett, director of radiation oncology at the University of Cincinnati and the Barrett Center, says men will be able to get their PSA results instantly instead of waiting days to hear from the lab.

RISK FACTORS

Several factors increase a man's chances of developing prostate cancer: Age: 70 percent of prostate cancer cases are found in men over 65. Race: Blacks are more likely than whites to get prostate cancer and twice as likely to die of it. Prostate cancer is less common in Asia, Africa and Central and South America. Diet: Men who eat a lot of red meat or high-fat dairy products have a greater chance of getting prostate cancer. These men also tend to eat fewer fruits and vegetables. Doctors aren't sure which factor increases the risk. Exercise: Regular exercise and maintaining a healthy weight might decrease the risk of prostate cancer. Family history: Men with a close relative (father or brother) who had prostate cancer are more likely to get it, especially if the relative was young when he developed the disease. Sources: The American Cancer Society, Centers for Disease Control and Prevention.

"The plan is to make for earlier diagnosis, earlier treatment and better prognosis," Barrett says.

Barrett and Jordan hope the free screenings will be available beginning in early September. Screenings will be available from noon to 5 p.m. Saturdays. Information: 531-7539.

Steve Henry, Kentucky's lieutenant governor, sounded the call for Tristate men to get PSA screenings when he announced last week that he had prostate cancer. Henry underwent a prostatectomy at Johns Hopkins in Baltimore.

A study in the July 24 New England Journal of Medicine questions the accuracy of the PSA test, which measures a protein that indicates enlargement of the prostate gland. The study suggests lowering the threshold for potentially problematic results from 4 to 2.6 to catch cancers in younger men, but that could lead to more men getting unnecessary biopsies.

The test is not definitive: a higher reading could indicate a benign enlargement of the prostate rather than cancer. And as men age, it's not uncommon for their PSA levels to increase when no cancer is present, experts say.

Dr. Eric Kuhn, a urologist at Good Samaritan Hospital, agrees the PSA isn't perfect. But most doctors know they have to have some flexibility in interpreting results.

"If you're looking for a neat statement that says, your PSA is over 4, you have prostate cancer, you're not going to find it," Kuhn says. "There are age-specific ranges that many urologists rely on, and in black men, where prostate cancer is more common, we probably shift even those a little lower."

At University Hospital, a new surgical technique is available to speed recovery from prostatectomy, or surgical removal of the prostate gland.

Surgeons can remove the gland laparoscopically, rather than through an open incision across the lower abdomen, says Dr. Joseph Buell, a laparoscopic surgeon. Surgeons at Good Samaritan are training to perform laparoscopic prostatectomies with a robot.

For the procedure, five "poke hole" incisions are made in the patient's abdomen, each measuring less than half an inch in size.

A tiny camera is inserted through one of the "poke holes" to let surgeons see blood vessels, nerves and other structures during the surgery.

During a traditional surgery, the incision would be six to 10 inches long and would require four to six weeks' recovery time. After the laparoscopic procedure, most patients can return to work in two to three weeks, Buell says.

"Patients generally just do much better with it, and there's an increased potency rate," he says.

The laparoscopic procedure is generally limited to men with earlier-stage cancers and lower PSA scores.

The greatest risk factor is age; most cases occur in men over 60. Family history, obesity and high-fat diet also increase a man's risk for developing the disease.