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CNN Saturday Morning News
The Novak Zone: Interview With Dr. Patrick Walsh
Aired January 04, 2003 - 09:29 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JOHN VAUSE, CNN ANCHOR: We're going to turn our attention now to health news. The prostate cancer this week on "The Novak Zone," the world's foremost authority on prostate cancer and the author of a guide to surviving prostate cancer, Dr. Patrick Walsh, who joins CNN's Robert Novak.
(BEGIN VIDEOTAPE)
ROBERT NOVAK, HOST, "THE NOVAK ZONE": Welcome to "The Novak Zone." I'm Robert Novak.
We're at the John Hopkins, the hospital in Baltimore. And our guest is Dr. Patrick Walsh, professor and director of the Brady Urological Institute at the hospital.
Thanks for coming in, doctor.
DR. PATRICK WALSH, DIRECTOR, BRADY UROLOGICAL INSTITUTE: It's wonderful to be here.
NOVAK: Doctor, just to have a full disclosure, you operated on me for prostate cancer 11 years ago, almost 11 years ago. I was 62 years old at the time. If a 62-year-old man in my physical condition were to walk in to you today with the same symptoms, would you also recommend or give him the foremost option of surgery, or have there been developments for other treatments since then?
WALSH: Well, there's been a lot that's happened since then, but the only time-tested, proven form of treatment to cure prostate cancer in someone who's going to live 20 years is surgery. There have been improvements in radiation therapy, but none of them has been tested to know whether or not they're going to work that well.
So if someone can have an operation and have it done in a way that they have very few side effects, it's -- there's no better way to cure the cancer. And certainly that is a very serious option that every young, healthy man should consider.
NOVAK: You are the -- known as the foremost surgeon in the world on prostate cancer, and you developed a different kind of technique, which is a radical change. Explain that.
WALSH: Well, in the 1970s, when I came to Hopkins as chairman, radical prostatectomies had fallen into disfavor. Although they were developed in the hospital in 1904, the operation wasn't done very frequently because every man that had the operation was impotent. Twenty-five percent of men had serious problems with urinary control, and excessive bleeding was common.
And so I decided that if this was the best way to cure the cancer, we had to reduce side effects. And so that's what I've worked on. And I've made discoveries using anatomy. I understood how bleeding occurred, and I was able to stop it. I discovered the nerves that no one knew were there that produced impotence and was able to preserve them. And in the process, have improved urinary control.
So today, in men under the age of 65, the chance of having recovery of potency is 86 percent, and the chance of having a serious problem with urinary control is around 1 percent.
NOVAK: Dr. Walsh, I have read several places that "only" 30,000 men in America die of prostate cancer. That is a horrible death, I believe, the death of -- from that type of cancer. And "only" 30,000, that's more than 10 times the people who died in 9/11. Isn't that a very high number?
WALSH: It is a very high number, but there's good news behind that the number. To pick up a couple points, it is a horrible way to die. Prostate cancer doesn't affect your heart, your lungs, or your kidneys. It goes to bone. And so patients die a painful death with bony metastases.
But, you know, over the last 10 years, there's a marked reduction in deaths from prostate cancer. Ten years ago, there were 40,000 deaths, about the same number as deaths from women from breast cancer. But it's fallen a third. We now have about 30,000 deaths.
And why is that? Well, I think one of the reasons is surgery. And that is that in the 1980s, men with prostate cancer really were not getting effective therapy. By 1992, 100,000 men in the United States underwent surgery that year.
NOVAK: What, doctor, are the chances for prevention? There's -- is diet going to be considered now a factor? Some people have talked about that. What has research indicated the chances of preventing prostate cancer?
WALSH: Well, as far as I'm concerned, that's the ultimate goal. Eventually what we want to do is to prevent prostate cancer. We want to turn it into the polio of this era. We have to understand what causes prostate cancer first.
There's a lot of interesting diet. Asian men that live in Asia have a 2 percent risk of developing prostate cancer. When they move here and live more than 25 years, their risk goes up to close to what a Caucasian man has. So is there something in the Asian die that they eat that we should? Or is there something in our diet that we shouldn't eat that they eat?
We don't know. But these are the elements that we understand today about what might cause prostate cancer.
NOVAK: I just read in the paper that Emperor Akahito has been -- a 69-year-old emperor of Japan, has been diagnosed with prostate cancer, is going to be operated on. So he's one of the 2 percent in Japan, I guess. There's no -- you're not completely safe from it because of diet, are you?
WALSH: You're not completely safe. And they believe the diet's changing there.
But there have been sort of three dramatic improvements in our understanding of what causes prostate cancer that have come from Hopkins. First of all, Dr. William Nelson has really shown us that oxidative damage is the cause. Dr. Angela DeMarzo (ph), a pathologist, has shown us that there's a lot of inflammation around these cancers that may be causing that oxidative damage.
And Dr. William Isaacs, a molecular geneticist in our department, has shown that there are some genes that cause prostate cancer to develop in families, and those genes normally protect you from getting an infection.
So someday we may feel that prostate cancer is caused by some infection of the prostate that leads to inflammation, that leads to oxidative damage. So there's a lot that has to be done before we can actually prevent the disease.
NOVAK: And now, the big question for Dr. Pat Walsh.
Dr. Walsh, how early in life should a man start getting screened for possible prostate cancer? And how often should he be screened?
WALSH: OK, there's a lot of recommendations out there. But the best one I have seen is -- came from one of my associates, Dr. Ballantine (ph) Carter, who carried out a study that suggested that men should have their first PSA when they're 40 years old, and a rectal examination, you need both. The second one when they're 45, and beginning at age 50, have one every other year.
And that scheme is the one that will diagnose the most cancers, save the most lives, and cost the least money.
NOVAK: Thank you very much, Dr. Pat Walsh.
And thank you for being in "The Novak Zone."
(END VIDEOTAPE)
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired January 4, 2003 - 09:29 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
JOHN VAUSE, CNN ANCHOR: We're going to turn our attention now to health news. The prostate cancer this week on "The Novak Zone," the world's foremost authority on prostate cancer and the author of a guide to surviving prostate cancer, Dr. Patrick Walsh, who joins CNN's Robert Novak.
(BEGIN VIDEOTAPE)
ROBERT NOVAK, HOST, "THE NOVAK ZONE": Welcome to "The Novak Zone." I'm Robert Novak.
We're at the John Hopkins, the hospital in Baltimore. And our guest is Dr. Patrick Walsh, professor and director of the Brady Urological Institute at the hospital.
Thanks for coming in, doctor.
DR. PATRICK WALSH, DIRECTOR, BRADY UROLOGICAL INSTITUTE: It's wonderful to be here.
NOVAK: Doctor, just to have a full disclosure, you operated on me for prostate cancer 11 years ago, almost 11 years ago. I was 62 years old at the time. If a 62-year-old man in my physical condition were to walk in to you today with the same symptoms, would you also recommend or give him the foremost option of surgery, or have there been developments for other treatments since then?
WALSH: Well, there's been a lot that's happened since then, but the only time-tested, proven form of treatment to cure prostate cancer in someone who's going to live 20 years is surgery. There have been improvements in radiation therapy, but none of them has been tested to know whether or not they're going to work that well.
So if someone can have an operation and have it done in a way that they have very few side effects, it's -- there's no better way to cure the cancer. And certainly that is a very serious option that every young, healthy man should consider.
NOVAK: You are the -- known as the foremost surgeon in the world on prostate cancer, and you developed a different kind of technique, which is a radical change. Explain that.
WALSH: Well, in the 1970s, when I came to Hopkins as chairman, radical prostatectomies had fallen into disfavor. Although they were developed in the hospital in 1904, the operation wasn't done very frequently because every man that had the operation was impotent. Twenty-five percent of men had serious problems with urinary control, and excessive bleeding was common.
And so I decided that if this was the best way to cure the cancer, we had to reduce side effects. And so that's what I've worked on. And I've made discoveries using anatomy. I understood how bleeding occurred, and I was able to stop it. I discovered the nerves that no one knew were there that produced impotence and was able to preserve them. And in the process, have improved urinary control.
So today, in men under the age of 65, the chance of having recovery of potency is 86 percent, and the chance of having a serious problem with urinary control is around 1 percent.
NOVAK: Dr. Walsh, I have read several places that "only" 30,000 men in America die of prostate cancer. That is a horrible death, I believe, the death of -- from that type of cancer. And "only" 30,000, that's more than 10 times the people who died in 9/11. Isn't that a very high number?
WALSH: It is a very high number, but there's good news behind that the number. To pick up a couple points, it is a horrible way to die. Prostate cancer doesn't affect your heart, your lungs, or your kidneys. It goes to bone. And so patients die a painful death with bony metastases.
But, you know, over the last 10 years, there's a marked reduction in deaths from prostate cancer. Ten years ago, there were 40,000 deaths, about the same number as deaths from women from breast cancer. But it's fallen a third. We now have about 30,000 deaths.
And why is that? Well, I think one of the reasons is surgery. And that is that in the 1980s, men with prostate cancer really were not getting effective therapy. By 1992, 100,000 men in the United States underwent surgery that year.
NOVAK: What, doctor, are the chances for prevention? There's -- is diet going to be considered now a factor? Some people have talked about that. What has research indicated the chances of preventing prostate cancer?
WALSH: Well, as far as I'm concerned, that's the ultimate goal. Eventually what we want to do is to prevent prostate cancer. We want to turn it into the polio of this era. We have to understand what causes prostate cancer first.
There's a lot of interesting diet. Asian men that live in Asia have a 2 percent risk of developing prostate cancer. When they move here and live more than 25 years, their risk goes up to close to what a Caucasian man has. So is there something in the Asian die that they eat that we should? Or is there something in our diet that we shouldn't eat that they eat?
We don't know. But these are the elements that we understand today about what might cause prostate cancer.
NOVAK: I just read in the paper that Emperor Akahito has been -- a 69-year-old emperor of Japan, has been diagnosed with prostate cancer, is going to be operated on. So he's one of the 2 percent in Japan, I guess. There's no -- you're not completely safe from it because of diet, are you?
WALSH: You're not completely safe. And they believe the diet's changing there.
But there have been sort of three dramatic improvements in our understanding of what causes prostate cancer that have come from Hopkins. First of all, Dr. William Nelson has really shown us that oxidative damage is the cause. Dr. Angela DeMarzo (ph), a pathologist, has shown us that there's a lot of inflammation around these cancers that may be causing that oxidative damage.
And Dr. William Isaacs, a molecular geneticist in our department, has shown that there are some genes that cause prostate cancer to develop in families, and those genes normally protect you from getting an infection.
So someday we may feel that prostate cancer is caused by some infection of the prostate that leads to inflammation, that leads to oxidative damage. So there's a lot that has to be done before we can actually prevent the disease.
NOVAK: And now, the big question for Dr. Pat Walsh.
Dr. Walsh, how early in life should a man start getting screened for possible prostate cancer? And how often should he be screened?
WALSH: OK, there's a lot of recommendations out there. But the best one I have seen is -- came from one of my associates, Dr. Ballantine (ph) Carter, who carried out a study that suggested that men should have their first PSA when they're 40 years old, and a rectal examination, you need both. The second one when they're 45, and beginning at age 50, have one every other year.
And that scheme is the one that will diagnose the most cancers, save the most lives, and cost the least money.
NOVAK: Thank you very much, Dr. Pat Walsh.
And thank you for being in "The Novak Zone."
(END VIDEOTAPE)
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
