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Larry King Live

What's the Best Way to Treat Prostate Cancer?

Aired April 27, 2000 - 9:00 p.m. ET


LARRY KING, HOST: Tonight, New York Mayor Rudy Giuliani has prostate cancer. Joining us to discuss how this could affect his health and his political hopes in New York, Joan Rivers, good friend of Mayor Giuliani; actor Barry Bostwick, a prostate cancer survivor, who by the way, plays the mayor of New York on ABC's "Spin City"; in Washington, Sam Donaldson, co-host of ABC's "This Week," and Dr. Patrick Walsh, chairman of the Brady Urological Institute at Johns Hopkins Hospital; and in Los Angeles, Dr. Stewart Holden, urologist at Cedars Sinai and medical director of CaPCURE. They are all next on LARRY KING LIVE.

We begin with here's a little bit of what Mayor Giuliani had to say at a press conference in New York City this morning.


MAYOR RUDY GIULIANI (R), NEW YORK CITY: I was diagnosed yesterday with a -- with prostate cancer. It's a treatable form of prostate cancer. It was diagnosed at an early stage. It came about as a result of taking a PSA test.


KING: Our two doctors with us, Dr. Walsh in Washington, Dr. Holden here in Los Angeles, two of the most famous urologist in the United States, they deal with this every day. Barry Bostwick had his surgery at Cedars Hospital here in Los Angeles.

So let's begin with Dr. Walsh.

What does Mayor Giuliani have, Patrick?

DR. PATRICK WALSH, BRADY UROLOGICAL INSTITUTE, JOHNS HOPKINS HOSPITAL: He has a curable form of cancer, a problem that can be cured and can result relatively quickly, and a good recovery and good outlook.

KING: And the curable aspect is what, Dr. Holden? There are various ways it can be cured, correct?

DR. STUART HOLDEN, UROLOGIST, CEDARS SINAI MEDICAL CENTER: Various ways to cure the cancer. I think -- I don't know the details of the mayor's case, but I know that he's 55 years old, and presumably, this is an early diagnosis, and I think that would make him an optimal candidate for surgery.

KING: When you see say "presumably"...

HOLDEN: I'm sorry.

KING: Presumably meaning? Meaning you guess that it's an early diagnosis? He could have had it for 10 years.

HOLDEN: I don't know the details of this case. But from what I've heard in the media, this is a curable case, which means that it's in early stage.

KING: There are many forms of curing.

Barry, how did you know you had it?

BARRY BOSTWICK, CANCER SURVIVOR: Well, I probably, just like the mayor did, I had a PSA test because I had a bladder infection, and it found out that I had an acute prostatitis, and I had a simple PSA test, and they found out that it was elevated to 15, and I went through some...

KING: Biopsy?

BOSTWICK: ... some courses of antibiotics to try to bring it down, and it still stayed up. So I got on the sort of circuit of tests for prostate cancer, actually, with Dudley Danoff, Dr. Holden's organization there, and I finally ended up in the surgical room 10 days later.

KING: You had choices, did you not, Barry?

BOSTWICK: Well, you know, I had a lot of choices, but I was in a position where I totally trusted Dr. Danoff and his point of view on this, because I was uneducated at the time, and I didn't feel I had the time to really go out there and do a lot of education. I had to get back to work quite swiftly. It was on a hiatus from "Spin City." And being an actor, I have a very fertile imagination, and it's a help and a hindrance. It's helps me in my work and it hinders me whenever I have an illness, and so I didn't want to blow this thing up into something that, you know, carries on in years and years and years. I wanted to deal with it swiftly and...

KING: Right there.

BOSTWICK: ... yes, right there -- and basically cut it out of my life.

KING: Dr. Walsh, this is a slow-growing cancer, right? It grows inside the prostate gland. It can grow for years.

WALSH: That's right. It's estimated that at the time the diagnosis is made, it's probably been there 12 years.

KING: In other words, Mayor Giuliani has probably had this for a while. WALSH: That's exactly right. And his father, as we learned from the press, his father died at age 73 of prostate cancer, and it's very likely that his father had it at a curable stage at around the same age, but unfortunately, back then, there was no way to diagnose it at this early curable stage. So it has a long antecedent history before it becomes clinically evident. There is a nice window of curability, and then ultimately, if you miss that window of curability, that's when you're in trouble.

And as Dr. Holden said, we assume from everything he said that like many other patients, he's been picked up within this window of curability.

KING: In the next two weeks, what's going to happen? Will they do tests to see -- to make a determination what decision he should make, Stuart?

HOLDEN: I think the critical issue, when I said "presumably" and what Dr. Walsh is also referring to, is that we want to know what what's the probability that his cancer is localized to the prostate. And I think it's not very controversial that if the prostate cancer is localized to the place where it originates, just the same as it would be in breast cancer or any other cancer, if we remove that place, you're going to have a very high, if not 100 percent, cure rate. The only reason that surgery doesn't cure 100 percent of the patients is sometimes it's spread outside.

KING: Will they know within two weeks whether it's spread or not?

HOLDEN: They'll know to a very high degree of probability. There is an algorithm for evaluating whether or not the cancer is localized. It has to do with the grade of his cancer, the number of positive biopsies, what his PSA level was. And most people do some additional testing to try to get as much evidence as you can to prove that it's localized to the prostate. And if it is, he stands an excellent chance of being cured.

KING: Now there are various decisions he has. He can have radiation, seed implants, cryogenics, hormones, surgery or watchful waiting. Chickens choose watchful waiting, I guess, right?

HOLDEN: I would say gamblers may choose watchful waiting, not chickens.

KING: In other words, gambling with...

HOLDEN: They're rolling the dice with their life.

KING: Barry, did you consider radiation? Did you consider any other thing but surgery?

BOSTWICK: Well, I had two choices really the doctor gave me, was radiation and surgery, and I didn't want the radiation to go out over a long period of time, and he said that the surgery would -- basically, there was a very high percentage of curing it. And so I went with the surgery, even knowing the side-effect issues.

KING: And we'll discuss that and other things that the mayor will have to deal with in this decision making. Later Joan Rivers, a close friend for the mayor, will join us for a brief time, and then Sam Donaldson, a cancer survivor, will be with us. He'll also get into the political aspect of this as well.

We'll be right back. Don't go away.


GIULIANI: The bad news is that there's cancer, and the good news is that there are lots of possible options, and it's going to take a while to determine which option is the best one to bring about a complete cure.




GIULIANI: Over the next week, maybe two weeks, maybe 2 1/2 or three weeks, I'll figure out with my doctor and other doctors what the best and optimum form of treatment will be. Obviously, the bad news is that there's cancers, and the good news is that there are lots of possible options, and it's going to take a while to determine which option is the best one to bring about a complete cure.


KING: Dr. Walsh, what do you say to patients about the options? How do they make that decision?

WALSH: I tell people there are three options, but there's a best option for everyone. Watchful waiting is the best form of treatment for someone who has less than 10 years to live. Surgery is the best form of treatment for the patient who is curable and who's going to live long enough to need to be cured, and the mayor falls into that category. Radiation therapy is an excellent option for many patients, patients who are older, have some illnesses or have diseases too far advanced to cure with surgery. And then there are patients in the middle, and for them, they have the option to choose.

KING: And do you ever, Dr. Holden, say, if it were me, I would do this?

HOLDEN: Patients rarely ask that anymore. It's interesting, they used to ask that...

KING: Really? If it were you, what would you do? That would be my first question.

HOLDEN: Well, it's a fair question. But I think today, patients are so much better informed. Patients come to me, they've got a whole dossier from the Internet, from various sources. They have so much information. They've given a great deal of thought to this. And in many cases, the patients don't really care what the doctor might do, although I think it's a pretty telling thing. I think were I in the mayor's situation, knowing what I know of it, which is not 100 percent...

KING: Assuming from what we know from what we know, you would do surgery?

HOLDEN: Well, I think that if I were 55 -- and I was 55 at one time -- I think I would have the surgery, because I think it gives him the best probability of being alive 15 and more years from now.

KING: How long does it lay up, Barry?

BOSTWICK: I was only down for about four or five weeks. I unfortunately, had a little problem with my sutures, and so I was catheterized for six week, which was a problem for me and a problem when we had to take it out. But you know what? If the mayor chooses to do this, he'll be up and running really soon. It won't get in the way of his political campaign, believe me.

KING: Is your sex life over, Dr. Walsh?

WALSH: Not by a long shot. As a matter of fact, today men that undergo surgery in his age group should have a 90 percent chance of having recovery of sexual function. There are lots of reasons why it's better, the operation is better. The cancers are detected earlier, so we can preserve the nerves, and Viagra has helped a great deal in these patients. It doesn't work if the nerves aren't spared, but if the nerves are spared, it aides many patients who previously might not have been able to perform without it.

KING: Dr. Holden, if you do the surgery, do you know you've got it all?

HOLDEN: Well, you do.

KING: You remove the prostate, but it could still have spread, right?

HOLDEN: Well, we have a tremendous asset in prostrate cancer, which is a biomarker, a blood test. So the blood test is useful in diagnosing the cancer, but in many ways, it can be equally useful at following patients after surgery. If Dr. Walsh, or I or any urologist does the surgery, we expect the PSA to be zero post-operatively, and if it's not or if it starts to rise, that means there is residual cancer, and that helps not only to get an earlier diagnosis and earlier treatment, but it helps us to plan a treatment course subsequent to the initial treatment.

KING: So Barry doesn't have to wait five years.

HOLDEN: No, if his PSA is zero, he's had an excellent result. Obviously, it could come back a later time. But after a certain period of time, if it remains that way, he has an excellent outlook.

KING: It's not our business, Barry, but is yours zero?

BOSTWICK: 0.12, and it's sort of been staying at that. After post-op, it's been recommended you have PSA test taken every three months, and I've been religious about that, and once you find a sort of benchmark and you send your results to the same laboratory, you -- if it hangs in at one particular number, like my number I think is pretty safe. Wouldn't you agree, doctors?

HOLDEN: I completely agree.

KING: Do you, Dr. Walsh -- both tests are important, right, the PSA and the old-fashioned digital, the finger in the rectum?

WALSH: You certainly have to do both to have the disease diagnosed early. The PSA test is good, but 25 percent of men with cancer will have a low PSA. For example, General Schwarzkopf has told us that he would not have been diagnosed were it not for having a physical exam. So having both of them -- and of course, the mayor also was tipped off to the fact he was at increased risk because his father had the disease, and that doubles a man's risk for developing prostate cancer.

KING: So in other words, if your father had it, get your PSA pretty early?

WALSH: That's right. We recommend that people with a strong family history should have it taken beginning maybe in their 40s. Now one family member with it probably beginning at 50s is all right. The other curious thing about a family history is you can inherit the tendency from either your father or your mother. So you need to not know not only about father's history, and his brothers and your brothers, but mother's father and her brothers.

KING: But your mother can't get prostate cancer.

WALSH: No, but she can transmit the gene to you, just like you can transmit -- a man can transmit the gene for breast cancer to his daughter. A mother can transmit the gene for prostate cancer to her son.

KING: We're going to take a break. When we come back, I want to get your opinion, doctors, as to why the rate of death is falling in this country. The good news is the death rate is declining: 31,000 will die of it this year; 180, 000 men will be diagnosed with it. Then Joan Rivers, then Sam Donaldson.

Right back, don't go away.


GIULIANI: In fairness to me, to the Senate race, to the Republican Party, to all the parties and everybody else, you need some time to think about it, and I really need to know what the course of treatment is going to be before I can evaluate it. The answer is, I guess the same answer about the Senate race I have about the course of treatment -- I don't know the answer to that yet. I hope that I'd be able to run, but the choice that I'm going to make about treatment is going to be contingent upon the treatment that gives me the best opportunity to have a full and complete cure, and then after I determine that, then I will figure out, does it make sense to run this year, or doesn't it or whatever?



KING: Dr. Holden, I know you head the CaPCURE medical division. That's Michael Milken's thing. Do you think that had something to do with the death rate down?

HOLDEN: I think it's had an enormous effect. We're the largest private supporter of prostate cancer research. We've put over $100 million into this field over the last seven years. But even more importantly than that, I think the reason that the death rate is down is that people like Mike Milken, Senator Dole, Senator Stevens, General Schwarzkopf, and an almost endless list.

KING: Stan Musial.

HOLDEN: Stan Musial, Joe Torre, just an almost endless list of people that have come forward and have spoken publicly about their disease, and that has raised awareness of the PSA test and its benefits. There's been a lot of controversy about this test. But to me, when you see the striking diminishing, death rate, it can only be owed to one explanation in my opinion, and that's early diagnosis. It's got to be better to diagnose a cancer when it's the size of a pea than when it's the size of a grapefruit. It's hard to prove that scientifically, but it's so obvious that I don't think it requires proof.

KING: Do you think through CaPCURE and others, we're going to cure it?

HOLDEN: I believe we definitely are.

KING: Do you think, Dr. Walsh, we're going to cure it?

WALSH: I do.

KING: Cure it?

WALSH: I think we're going to cure it. Well, we are curing it today. I believe one of the reasons death rates are going down is that up to 1980, we really weren't treating the disease. Only 7 percent of men with localized cancer were undergoing surgery, and the radiotherapists will tell you radiotherapy was not working. They radiotherapy today is certainly better. But the death rate from prostate cancer was going up 1-2 percent a year until 1991, and at that point, it's come down.

In countries like Sweden, where they don't treat prostate cancer, the death rate is still going up 1-2 percent per year. So in this country, the death rate fallen from -- number of deaths from prostate cancer has fallen from 40,000 in 1991-1992 to 30,000 today. So it has been a dramatic decrease, and I think it's related to better treatment, earlier diagnosis.

KING: And you want to add something, Stuart?

HOLDEN: I'd like to just add that I think this is great news, it's very exciting, and it validates what people like Dr. Walsh, and myself and others have been saying about this test.

However, during the course of this program, four men are going to die of prostate cancer. And it's a very serious disease, the second leading cause of cancer death in men. There's a lot of work to be done. CaPCURE is focused on patients who fail surgery and radiation and who have advanced disease, and for that group of people, we still don't have effective treatment.

KING: Four men are going to die in this hour.

HOLDEN: One man every 15 minutes in the United States.

KING: There is controversy over PSA. I wonder why, Barry? There is. I mean, I had an elevated one once, and Dr. Holden did a biopsy, and it turned out to be negative, so I was happy to learn that.

BOSTWICK: Well, yes, and not too many men want to go into the biopsy situation, though, because it's an unknown, and you know, the fear is that it's going to hurt, or they're going to have to talk about it to their buddies or to their family members, and you know, it really is a silent epidemic. There aren't a lot of -- ways that you detect it, you know, in terms of your general health, and silent because men don't talk about it.

KING: That's ending, isn't it, Dr. Walsh? We talk about it now?

WALSH: You've helped an awful lot, you have. You've had people on here. I think what Mike Milken has done -- I'd like to second what Stuart has said -- it's been tremendous. He has made a lot of awareness of this disease, and I believe that once we find the cure to this disease, Michael's efforts and Stuart's in helping raise awareness and raise funding for it will be instrumental in that success.

KING: And with what you know, Stuart, you'd bet on a Giuliani recovery?

HOLDEN: From everything I can see, he's in a favorable situation. The test was good to him, and he should have a good result.

KING: Thank you all very much. Two of the major urologists in America, Dr. Patrick Walsh of Johns Hopkins, Dr. Stuart Holden of Cedars Sinai. And Barry Bostwick, who uniquely enough, plays the mayor of New York on "Spin City" and has defeated prostate cancer through surgery.

Joan Rivers, a close friend of Mayor Giuliani, is next, and then Sam Donaldson, a cancer survivor.

Don't go away.


GIULIANI: I don't think it's fair to answer questions about the Senate race right now. I think that my focus right now has to be on how to figure out the best form of treatment. And then after I decide that and get a while to absorb this, to figure out, you know, should I do it? Would I be able to do it the right way? I hope that's the case. It may not. It may be. I think it would be unfair to give an answer right now.



KING: Joan Rivers has been with us on a lot of fun occasions. She has assisted us at special drawings, at concepts-like awards and also when they auctioned off Lady Di's suits and dresses, but this is a serious occasion.


KING: She is a close friend of Mayor Giuliani.

Were you shocked this morning, Joan?

RIVERS: Oh, so upset. I mean, you talk about coming out of the blue, something from nowhere knocking you out, yes, very upset.

KING: Did you call him?

RIVERS: I called. I didn't get through to him. I got through to Elliot Cuco (ph), who's his best, best, best friend, and we had a long talk about it.

And what are you going to do? The mayor is very smart, he's very courageous, he's very positive, and he's going to handle it, as he handles everything.

KING: What did Elliott say?

RIVERS: Elliott said the same thing, that they think they caught it very early, that they have a very positive, you know, outlook on it ,and they think that indeed, he's one of the lucky ones, that he's going to absolutely get away from it and continue on.

KING: As you know him and from what we heard in these first 20 minutes, do you think, on all things considered, he would choose surgery?

RIVERS: I think he'll choose -- he's a very smart man, you know, and I think he'll choose exactly probably what the doctors tell him to choose. I was listening -- now we're all so involved. I think the whole seeding thing is brilliant. I had people calling me up on my radio show talking about they put the 69 seeds inside the gland and all that, and I think perhaps he'll go that way rather than the radical surgery.

KING: Have you had anyone in your life, any man in your life, relative or otherwise, who had this disease or has it?

RIVERS: Not has it. My husband had prostate trouble, you know, and I had an uncle who died of it, but of course that goes back to different times when it was a long time ago, and that was what you died of.

KING: Because to the caregiver, to the spouse, or the daughter or the relatives, this is a tough thing?

RIVERS: Oh, it's -- and again, as we were saying, what Barry was saying before, it's a silent thing, no one ever talked about it. You never mentioned the word "prostate." You didn't talk about it, that's not something to discuss.

KING: And now that they are, certainly we're all the better for it?

RIVERS: Don't you think? I mean, also what kind of an idiot doesn't go and get checked? Over 50, every intelligent person, you go and you get checked once a year or once every two years for all these things that they can find early and take care of.

KING: There is a fear, Joan, I don't know what it is, maybe it's male. I had a slightly elevated PSA, they did a biopsy, you've got to wait for three days, and I turned out, thank God, to be negative. But during those three days, you know, there is a hesitancy, sometimes you don't want to know. I mean, it's kind of weird but it's true. I was glad I did it, glad I don't have it, but there is a part of you that doesn't want to know?

RIVERS: Well, of course you don't want to know. That's facing reality and that's facing my manhood, the same as a lot of women don't want to know about breast cancer, because that's taking away from your femininity, but I think it's better -- you just have to face it. At one point, we have to grow up and face it.

KING: Do you then, always take every test that women are supposed to take every time they take it?

RIVERS: Larry, as we're talking now I'm having a mammogram. It's just that my breasts have fallen so far down, you can't see it. Yes, I'm very good with that. But I'm a single parent, and until Melissa got married, I really did it because I said there's only one of us left, and I damn well better be here for her. I'm very good with that.

KING: We'll take a break, come back. We're going to spend a few more minutes with Joan Rivers and then talk with a cancer survivor himself, Sam Donaldson, suffered from melanoma, had a lymphnode removed five years ago. He's at that critical point now, about a five-year wait. We'll also ask Sam his thoughts on the political involvement of all of this.

Right back with some more moments with Joan Rivers, then Sam Donaldson, right after this.


GIULIANI: Good morning. I was diagnosed yesterday with prostate cancer. It's a treatable form of prostate cancer. It was diagnosed at an early stage. It came about as a result of taking a PSA test about two, 2 1/2 weeks ago. The PSA was elevated, and so I took antibiotics for a while, took the PSA test again. It remained elevated, so I went in for a biopsy yesterday, and the biopsy revealed that several of the samples, thank goodness not all, and not most, had indications of cancer. And therefore, it's at a very, very early stage of the disease. It's also at a very early stage of determining what to do about it.



KING: We're back with Joan Rivers. In a couple of minutes Sam Donaldson.

All right, Joan, you know him. You know he's going to deal with options. You know he's very intelligent.

RIVERS: Also, I hope he did what every smart man does, which is take that blood test once a year. Over 50, all they have to do is take a blood test once a year.

KING: It's simple. Funny how many people don't.

RIVERS: Well, you know, every wife out there, if you like your husband, make him. It's that simple. Hold back sex, or offer it, depending on the marriage.

KING: Do you think he'll run?

RIVERS: Do you think he'll what? Run?

KING: Run?

RIVERS: I think he'll absolutely run, I think he'll be fine, I think he will run, I think this won't stop him, unless God forbid, it turned out to be something that he hasn't heard from his doctors that will be very extreme, which I doubt. I think he'll run, absolutely.

KING: Because he does have, as he said this morning, has two weeks, 2 1/2 weeks, clearly, to make this decision on how it will be treated. and whether he will run based on that. Republicans choose the candidate at the end of May, so we do have a time factor here.

But you're pretty sure all things as they are now, he would run?

RIVERS: Absolutely. I think he's very gung ho. He's very positive. He's doing well. People are behind him. God knows the city is a better place because of him, and I hope he runs and I hope it will be a strong, terrific campaign.

KING: You know him as well. Do you think he's frightened?

RIVERS: I think everybody is frightened. I think, you know, you walk into a doctor's office, and the minute they say "sit down," it changes your life forever. Suddenly your mortality hits you, and he's a young man. To hear this in your 50s -- you don't think about that in your 50s. You think about that these days in your 70s, and even your 70s, you say, what am I 70? I'm a young person. I have a friend who is ill now who said to me "I'm 91! I can't believe this," you know it's like.

KING: Have you ever had a test where you had to wait for a result that you were nervous about?

RIVERS: Yes, yes, and it's a nightmare. You know, your whole life passes -- nothing bothers you anymore. Nothing bothers you anymore. You say, why was I upset that the dog tinkled on the floor? When you're waiting for the big things, the little things suddenly are silly.

KING: Thanks for spending some time with us, Joanie.

RIVERS: My pleasure, and thank you very much. And I hope that he and Hillary can go at it again, and both of them are well when they do it.

KING: Joan Rivers.

And by the way, the president and Hillary did express their wishes for a full and speedy recovery to the mayor.

We'll come back with Sam Donaldson, himself a cancer survivor. And we'll approach it two ways, living with this disease, fighting it, dealing with it. It's not prostate, but it is cancer, and then his thoughts on the political aspect of all of this.

Tomorrow night, Bill Maher.

We'll be right back with Sam Donaldson. Don't go away.


HILLARY CLINTON (D), NEW YORK SENATE CANDIDATE: Well, like all New Yorkers, my best wishes and prayers are with the mayor for a full and speedy recovery, and I know that all of us wish him very well.

QUESTION: Does this affect your schedule at all or how you campaign?

CLINTON: I will continue to travel around the state and I'll be meeting with people. I'll be keeping my schedule.

QUESTION: Do you have plans to give the mayor a call or his campaign staff?

CLINTON: I have put in a call to the mayor. I wasn't able to make connection with him yet. But I hope to be able to speak to him personally.

Thank you all.



KING: My fellow 65-year-old November-born now 66-year-old November-born Sam Donaldson joins us from Washington, the co-host of ABC News "This Week," a cancer survivor himself.

We'll talk about that and his thoughts on the mayor as well, take some phone calls as well.

Sam, what was it like when you were told you had cancer? And how were you told?

SAM DONALDSON, CANCER SURVIVOR: Well, I had a biopsy, because I had a lump in my groin, and you know, that's not good, you hope maybe it's something else, and they said no, it's melanoma. I was shocked. I was upset. It's like that first Indiana Jones movie, remember the boulders coming down faster and faster, you know you're not going to be able to jump out of the way, and you think I'm going to die. I went home and I said to my wife, I don't know much about cancer, but melanoma sounds really terrible from what I've read. I think we're going to have to prepare for maybe two or three months. I thought that.

KING: How much time did you have between the biopsy and being told?

DONALDSON: Well, right away.

KING: It was immediate?

DONALDSON: Had a biopsy one day, and the next day after they'd done all the tests and all of that, the doctor told me on the telephone, because I said call me on the phone, and he said, well, it is what I suspected, it's melanoma. And most doctors are good about this and know how to talk to patients. And as Dr. Steven Rosenberg of the National Cancer Institute says in practices, you know, patients want optimistic doctors, so he didn't say, you are going to die, Donaldson. But at the same time, he said we've got to do something about this.

KING: Did you have, as Mayor Giuliani will have, options?

DONALDSON: No, not really in my case, you needed to remove it. The first thing you needed to do was remove the lymphnodes and see how many were involved. And in my case, fortunately, only one lymphnode was involved, and you look at statistics of the graphs, and that gives you the best chance of never seeing it again. If three or more lymphnodes in melanoma are involved, you only have about a 20 percent chance of not seeing it again and those aren't very good odds.

KING: What do you think of this decision-making that he will face? You have gone through all this. You didn't have a decision to make, you had to operate.

DONALDSON: That's true.

KING: That's a lot to ask of a man, you might not be able to have sex again. There is no guarantee that that operation, while it may get rid of the cancer, it may also take that away as well. I mean, how do you deal with that, do you think?

DONALDSON: Well, I mean, Mayor Giuliani is going to have to think about two or three things. He's going to think about what Patrick Walsh -- who I'm a Patrick Walsh man.

KING: Me, too.

DONALDSON: If they ever tell me the PSA is up, I'm going to see Pat Walsh. Said, I mean, the most effective way to cure this, if you want to live 10 or 15 more years, is to remove the prostate. Now there are other options, and he can take them.

But he's involved in a political campaign, Larry, and although many people interpreted what he said this morning as maybe being a little wishy-washy this afternoon about whether he really is going to run, his people are calling out this afternoon saying no, he's going to run.

KING: He's definitely keeping his schedule. But is that keeping up a front, do you think? Because he said it's based on his decision in the next two weeks. Do you buy what they're saying? Or do you think...

DONALDSON: It's keeping up a front, sure. You don't want to immediately say to people, oh gosh, I'm going to lie down and think about this for a while.

But you yourself pointed out something that I think is very difficult for him in the decision making process. By the end of May, the Republicans are going to have to make a decision. Now if he uses, as I understand it, the implanted radiation seeds, which is up -- the hospital where he's going to, it's one of the therapies that they really like and think is effective, he'd only be out of commission a few days. His energy wouldn't be sapped for very long, and he could come back right away and say, you see, here I am, and let's go at it, Hillary. If he goes the Patrick Walsh route, it's going to take a little while: You are in the hospital, you come out, it takes a while to get back, your energy level is lower, the end of May is coming like another big boulder.

And I hope -- I'm not a doctor -- but I hope the mayor, for the sake of his long-term survival, does not let that weigh too heavily on how quickly he needs to get back and say fight and stance.

KING: Joe Torre told me that he was knocked out after the surgery. I mean, he fell asleep at 2:00 every day. He was laid up. It was very uncomfortable. You have a lot of after-pain. You know, your penis has a tube in it, and as Barry Bostwick said, he has that for six weeks. This is no simple jump-out-of-bed thing.

DONALDSON: Obviously not. Roone Arledge, ABC's great president -- now he's our chairman -- went to Pat Walsh, and I visited him up at Johns Hopkins in the hospital bed, and it was several weeks before Roone -- he's a very dynamic guy, if you know him, Larry...

KING: Sure.

DONALDSON: ... was really back to the point where he could come out and do all of these things, but Roone is cured as far as we know. Roone is walking around today, and this was what, eight or nine years ago.

KING: As you know the mayor, would you bet he does run? If he has the surgery, let's say, he is laid up, he'd be laid up the end of May? I mean, he wouldn't be walking on the streets the end of May.

DONALDSON: He might be. I'm not a doctor. I think he wants to run, and I bet he will run from the standpoint of assuming what we've heard is correct and his doctors -- we have no way to doubt them. We shouldn't doubt them -- that it is curable, that they caught it early, I think he can run, and I think he will run.

And you know, today, Larry, 10, 15 years ago, anyone who had cancer, we all thought, we can't vote for them, I mean, well. But today, thanks to the work of all of the doctors, Holden and Walsh and all the rest, I think the public knows that this particular cancer if caught early is curable, and there's no reason not to vote for someone because they've had it.

KING: So with your political acumen, is it a wash? Does it benefit him with the sympathy vote, or does it hurt him?

DONALDSON: I think it's a wash. I mean, in the short-term now, the campaign come to a halt, as far as people calling each other.

KING: He's making an appearance tomorrow night. He's still going to Saratoga Springs, and he's going to make a speech.

DONALDSON: Yes, he makes an appearance, Mrs. Clinton makes her appearances, but they don't slam each other. Mrs. Clinton, quite properly, you know, wishes him -- and I believe she's sincere -- a speedy recovery. She's not going to talk about all of the things she's been talking about this man. But that's a short-term thing, because once it's apparent that he is going to be fine, that it's going to work, that he's going to be back on the campaign trail full time, then it's wham bam, just like it was going to be, and the election will be determined as it might have been on all the other issues, and not whether Giuliani has cancer or not.

KING: So it will never be discussed. Hillary won't bring it up. He won't bring it up, unless asked at a press conference. But what does it do, do you think, to the voter's mind, say, in November? You can't not think about it?

DONALDSON: I can't get into a voter's mind. But as I said, I think the voters will think about this particular cancer as opposed to other diseases or other problems that people have. As the doctors say, well hey, they took out the prostate or they implanted a seed and it's cured. And so they're not going to say, well, I can't vote for him, because God knows in three years, maybe he is no longer able to serve the people of New York.

KING: We're much more aware of the disease, and we know that -- of course, remember Paul Tsongas. Of course, he didn't have prostate cancer.

DONALDSON: He didn't have prostrate cancer.

KING: But he said he was fine, and then he passed away.

DONALDSON: You mentioned Ted Stevens, senator from Alaska. Many, many years ago, he sat in the Senate today, and as far as I know, he'll be reelected forever. Norman Schwarzkopf, Arnie Palmer, all these people, they're alive and kicking.

Let me just say to the mayor, if he's watching tonight, welcome to the cancer club. I know you didn't want to join. I don't blame you for not wanting to join. But there are 10 million of us out there with various forms of cancer that are alive, kicking, and I'm just as mean as I always have been, and you can be just as lovable as you always have been. Let's get out there and do it.


KING: Sam, we keep hearing about this five-year thing. Yours is five years now, isn't it?

DONALDSON: Yes, but five years doesn't mean anything anymore. In the old days, many people thought, if you can survive five years, you're clean. Tell it to the woman who's had breast cancer, and after eight, 10, 12 years, it's back. I mean, If you have cancer -- excuse me, and prostate is a little different, because if it's confined to the prostate and you remove the prostate and it hasn't spread, you're home-free, I mean, from the standpoint of starting even. But if you have other forms of cancer, you can go a long time, never see it hope to be hit by a truck at age 95, but it's still could come back. Melanoma cases are cases on record, not just one or two, like in "Ripley's Believe It or Not," where after 15 years, 20 years, here it comes, it's back.

KING: Do you have any repercussion at all from it?

DONALDSON: Yes, but there's so minor it's hardly worth talking about. I wear a very heavy stocking on my right leg. Lymphodema is a swelling of the limb when you cut the nerves and the lymph canals to the extent that the leg doesn't drain as well. But I put on that stocking every morning, and I run around and do everything at age 66 you could do with your right leg, and so that's a very minor inconvenience. The nerves get cut -- I'm sorry. KING: We'll take a break and come back. I want to ask about that. We'll take a break and come back, and we'll take your phone calls, want to take to cancer survivor and one of the 10 million -- he just welcomed Mr. Giuliani, not happily, but welcomed him to the club of cancer survivors, people who've lived with it and who've beaten it.

Back with more after this.


GOV. GEORGE W. BUSH (R-TX), PRESIDENTIAL CANDIDATE: I've just got off the phone with Mayor Rudolph Giuliani. I called him to wish him all the best, and tell him my family's prayers are with him. I'm pleased to report he's as feisty as ever. His spirits are high. On the plane coming down, I was asked the question, do you think he'll stay in the race? And his answer is absolutely, and he looks forward to becoming a United States senator from the state of New York.



KING: The reason we're urging everyone to take the PSA test and take the digital as well is there are no symptoms of prostate cancer.

Were there symptoms in your case, Sam?

DONALDSON: Well, no, I mean, I felt one night as I was soaping myself in the shower this big bump in my groin.

KING: But you had no pain or anything?

DONALDSON: No, no pain or anything.

KING: Let's take a call for Sam Donaldson.

Perrysburg, Ohio, hello.

CALLER: Hi, Larry.


CALLER: I'm 73. In 1981, I had a bypass. Three week ago and two days ago, I had prostate surgery, and I had the tube removed after two weeks, I'm doing fantastic, and I urge every man out there to get a PSA test because prostate surgery is curable. And I said, I'm 73, and it's curable.

KING: Sam, what you're pointing out here tonight is that cancer used to be the dreaded big c. When you heard cancer, you thought death?

DONALDSON: That's right. That's it, and that's gone, and you locked yourself away, or you were locked away. Today, it's very survivable in many, many cases. In the case of melanoma, I don't have stage-four metastasis melanoma. That is all through the organs of the body. But until 1984, when Dr. Rosenberg saved his first patient, it was absolutely incurable. You die. Now many hundreds of people live who've had metastasis melanoma.

Larry, we are making progress.

That gentleman is living proof, though, of someone who keeps trucking. And Dr. Walsh, during one of the breaks said to you earlier that one of the recommendations is that if you have 10 years to live, you might just use watchful waiting. So I said to him, doctor, who decides when the 10-year mark is up, you know? My mother lived to be 93. He laughed. He said, well, you're quite right. I mean, we're talking about people who may have other infirmities or diseases and what have you, but there is never any time to say, well, let's see, 10 years, OK.

KING: So you're saying at 66, if you, god forbid, were diagnosed with this, your inclination would be surgery.

DONALDSON: It would be surgery, because I think I would have lived, you know, to 93. My mother did. Why not?

KING: Aurora, Illinois for Sam Donaldson. Hello.

CALLER: Hi. I'm wondering if Sam actually feels like he's in the safe zone since he's at the five-year point right now. Actually, I'm going through that right now with my husband. Five years ago, he had melanoma. He had tumors behind the left side of the ear. He had a radical neck done (UNINTELLIGIBLE) took out 42 lymph nodes. They were all fine. We're at a five-year point now. Three weeks ago, he had a new lump behind that left side, just had surgery on Tuesday, waiting for the biopsy to come back tomorrow.

So I don't feel like we're in a safe zone at all. My -- his oncologist told him several times this is the kind of cancer, it's very tricky.

KING: Well, Sam, said...

CALLER: Here today, gone tomorrow.

KING: I think Sam you said there is no safe zone, right?

DONALDSON: Yes, that's right. If your husband, if the biopsy does come back negative, of course, the likelihood is that that can be removed just as the original one was removed and he's going to go on and be fine. But there is no point when you can say, OK, now I'm, you know, 100 percent sure of not getting it back.

But I have never, from the first moment really I decided I might live, never lived my life thinking, well, I shouldn't do this, I shouldn't build a new house, I mean, I can't make a plan here. Just go ahead and do it because you want to be optimistic about it.

KING: We'll be back with our remaining moments with my friend, my fellow 66-year-old November-born Sam Donaldson, right after this.


KING: Sam Donaldson, when you get this kind of news, did you ever think of alternative methods? You know, these people who fly off to other countries or look for a magical cure somewhere in the Bahamas.

DONALDSON: No, because fortunately, again, after removing the tumor, so far, so good. I understand why people in extremis say, well, wait a second, why not flap a bed sheet at the aurora borealis or go...

KING: Who's life is it anyway, right?

DONALDSON: Yes, that's right. And I can understand that. But I think our best for being cured from disease is to follow medical science, or if your faith is such that you to place your hands in God, I have no objection. I would not in any way disparage that.

But I would simply say that medical science is making such strides, and by doing double-blind field tests, we know what works and what doesn't work. To go to somebody who says, hey, give me a little money and I can cure you, you know, take this potion or what have you, I think, as Holden said earlier, that's gambling. That's gambling.

KING: What about -- we discussed this some time back with you and Mr. Milken -- we had a march -- about this, if cancer were an enemy, if cancer were another country, we would be going nuts.

DONALDSON: Well, no kidding.

KING: If this is an enemy that kills us, why don't we spend more? Remember Nixon was going to wipe out cancer...

DONALDSON: Well, in those days...

KING: ... and he meant it when he said it.

DONALDSON: Oh, yes. President Nixon declared war on cancer. We didn't know the mechanisms. We thought we could learn them quickly, and it took a long time.

General Schwarzkopf says, you know, I commanded -- we lose 465,000 people in the United States alone every year to cancer. They die. And that was about the number of troops he had under his command in the Gulf War, with all the allied troop. He said, "What if I called up the White House at the end and said, `President Bush, I've got a little bad news here: I've lost every one of my personnel'?" He said: "I would have been strung up. Before I'd hung down the phone, I would have been" -- no trial. And he's right.

So we lose those Americans, and we sit around saying: Gee, that is too bad. And someone says: Well, we spend $2 billion on each B-2 bomber that we build in order to bomb, well, we're not quite sure who. But hey, it's jobs. But we don't have the money to fund more research for all these dreaded diseases: cancer, Alzheimer's, Parkinson's, muscular dystrophy. As a country we can't afford that. Oh, give me a break.

KING: Sam, I'm going to return -- I'll be with you on Monday.

DONALDSON: On Monday, you're coming on my Web cast.

KING: I'm going on the Donaldson Web cast.

DONALDSON: The World Wide Web, we're seeing -- or where the Web is all around the world. And I'm not going to spare you, I'm going to pummel you within an inch of your life.

KING: Go at it. Go for it.

DONALDSON: You've been nice to me.

KING: We're on at what?


KING: We're on at what?

DONALDSON: We're on at 12:30 Eastern Time.

KING: Eastern Time on Monday.

DONALDSON: Log on, Hit my face, which you'll see there with your cursor, up comes the king!

KING: I will be the Donaldson guest. And what, Sam -- you can help a lot of people tonight. Certainly, we've helped a lot of people by telling them to get the PSA, get the digital if you're a man over 50.

DONALDSON: Check your skin.

KING: Check your skin.

DONALDSON: If you see a mole that looks a little different, it's changed a little bit, run to your nearest oncologist and say, look at this mole, because if it's melanoma and you get it at that point, you're going to be fine.

KING: Get your colonoscopy every year.

DONALDSON: All of that.

KING: You take your full tests, right, Sam?

DONALDSON: You mean the Roto-Rooter?

KING: Yes, do you do that, Sam? You have to do it.

DONALDSON: No, I don't. And I should. I should. I mean, I'm at the age where...

KING: You don't do it! You don't do it! DONALDSON: I'm of the age, because just the fact that you have one cancer, you're a little bit more susceptible to other cancers, according to the statistics. And I should do it, I should let them go all the way up like President Reagan did.

KING: Let me tell you, Sam, it's nothing, it's nothing. It's bark is bigger than its bite. And every woman watching, every man watching, it's nothing. They give you a little Valium. It's kind of like nice. Really. You lie there and you talk to the doctors. Do it!

DONALDSON: You've convinced me and you may just have saved my life. Thanks.

KING: I convinced Imus to do it. He did it. It's nothing, colonoscopy. Do it. PSA is a joke. It's a blood test.

DONALDSON: Yes, yes.

KING: I'll see you Monday, Sam.

DONALDSON: Checking the skin is OK, too. That's easy.

KING: Yes, checking the skin ain't going to kill you, but it could kill you not to.

DONALDSON: See you Monday, Larry, on...

KING: Thanks, Sam.

DONALDSON: See you Monday, Larry.

KING: OK. On the Web site with Donaldson. We thank Sam Donaldson for joining us and Joan Rivers, two of the famed doctors that deal with this ever day, Patrick Walsh and Stuart Holden, and Barry Bostwick, who had the surgery and defeated it.

CNN "NEWSSTAND" is next. Bill Maher will be with us tomorrow night. He's never dull. It's going to be a lot of fun.

And Saturday night on LARRY KING LIVE WEEKEND, we're going to play an encore recording of our interview with Gerald Ford.

Thanks for joining us. Get well, Mr. Mayor. Good night.



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