Dr. Jonathan W. Simons on Prostate Cancer

Jonathan W. Simons, CEO and president of the Prostate Cancer Foundation, is a professor of hematology and oncology at the Emory University School of Medicine and professor of biomedical engineering and materials sciences at the Georgia Institute of Technology. He is the founding director of the Winship Cancer Institute at Emory University. Here, he shares some of the pros and cons of different types of prostate cancer treatment.

How would you characterize the current state of treatment for prostate cancer?

Prostate cancer is the second most-common cause of death from cancer for men, but fewer men are dying of prostate cancer than ever before. Still, 28,000 men a year are dying of prostate cancer.

Since prostate cancer can be lethal, shouldn’t a man seek immediate treatment?

Prostate cancer is maybe the most complex cancer to be diagnosed with. Some prostate cancers, if left untreated, are lethal, but many are indolent. If they hadn’t been found they probably wouldn’t have caused a problem.

How do you know if you have an aggressive cancer or an indolent cancer?

The Gleason grade is a way of scoring the cells taken at biopsy to determine how aggressive they look under the microscope. Working with your urologist, you want to get an understanding of what kind of prostate cancer you have and what the best options for treating it might be. Early prostate cancer is usually caught in a curable stage, and there are good options for treatment.

What are the pros and cons of surgery vs. radiation?

The side effects are different. With radiation, which takes six to eight weeks, there may be damage to the rectum; there may be colitis. But most patients do very well. With surgery, on one day your cancer’s removed, but then there’s a healing process afterwards.

How do you assess the physician who is going to treat you?

It’s important that the radiation oncologist or the surgeon has a track record. You want to know as a patient that they’ve done well in the past. The operation requires real skill so there’s no nerve damage. In radiation as well there’s a high level of expertise needed to deliver the right amount of radiation to kill cells without side effects.

Should patients surf the internet, read books about prostate cancer and be as informed as possible?

Patients who do the best are partners in their care. They don’t just sit back and let themselves be told “Here’s what you’ve got, good luck.” They’re partners in the conversation and they understand each step of the treatment process, including the various benefits and side-effects. To do that you want to have some questions and you want to get them answered. If you don’t understand what’s happening, keep asking questions until you do.

For more information on Dr. Jonathan W. Simons, visit www.prostatecancerfoundation.org.