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Prostate Cancer Patient Gets to Work Quickly

Miami Today - Nov, 16 2006

When Charles Royce was diagnosed with prostate cancer at the age 39, the Michigan man knew he should only be concerned about his health. But he couldn't help thinking about his business as well.

"I own a small, third-generation-run manufacturing company, and the only sales force is my brother-in - law and me. We all balance ten plates in the air, so the thought of my being away from my work for weeks could have disrupted a lot of things", said Mr. Royce, whose company, Royce Rolls, manufactures hospital carts.

After doing some research, Mr. Royce came upon Arnon Krongrad, a pioneer in laparoscopic radical prostatectomy, in which the cancerous prostate is removed without major surgery.

"It went beautifully. I went from needing a recovery that could take months to only days," said Mr. Royce, who said he has been cancer free since 2001.

Prostate cancer is the second-most common cancer among men behind skin cancer. It is estimated that by Dec 31, nearly 235,500 men will have been diagnosed with it this year and an estimated 27,350 men will have died form it, making it second only to lung cancer as the leading cause of cancer death in men, according to the American Cancer society.

Dr. Krongrad, president and founder of the Krongrad Clinic in Aventura, heads the Prostate Cancer Project, a not-for-profit foundation and in 1999 was named a Health Care Hero by the Greater Miami Chamber of Commerce. He prefers to use more vivid terms to bring home the danger posted by prostate cancer. His patients have included televangelist Pat Robertson.

"It's as if you loaded a 707 jumbo jet with 200 men and crashed it into a mountain every single week. That's as many men as will die from prostate cancer" he said.

Because all men are at risk of prostate cancer, he said, screening is important. The risk increases with age and among those having a family history of the disease. Men sometimes avoid being screened because they are concerned that is they do have prostate cancer, they will be subjected to treatments that require lengthy recuperation, said Dr. Krongrad. "Most of my patients are very busy top-of-their-crier kinds of guys in the 50s and 60s. They look at conventional surgery, which takes four to six weeks of recuperation, and they say, ‘Who has time for that?'"

Laparoscopy is a minimally invasive procedure that has become popular, replacing general surgery for a variety of procedures including removal of the appendix and gall bladder, reparation of hernias and some cardiac and vascular work.

Carbon dioxide is pumped onto the abdomen to create more space in which the surgeon can work. Then, small incisions, or portholes, are maid in the abdomen. A special instrument called a laparoscope is inserted into one of the portholes so the surgeon can view the internal area on the monitor. The prostate and related lymph nodes are removed through one of the portholes, the laparoscope is removed and the portholes sutured.

As with any form of treatment, the use and success of prostate laparoscopy depends on the stage in which the disease is diagnosed." Early diagnosis is the key to effective management," Dr. Krongrad said. "It sounds like a mantra, and it should be. No mater what kind of cancer you have, if the disease is caught early, you have a number of treatment options."

Early detection is feasible in prostate cancer because of the development of the prostate-specific antigen screening test, a blood test that "can be combined with a cholesterol test," Dr. Krongrad said. It measures the blood level of a protein made by the prostate, which rises in the presence of the prostate cancer along with other conditions.

"If the disease is caught early, which happens in most cases because of prostate-specific antigen test and physical exams, you have a number of treatment options. If you are going the surgical route, which is extremely common and very fitting for many patients, you can diminish the pain and suffering which goes with radical surgery with laparoscopic radical prostatectomy . It is the same treatment, but there is much less pain, much less bleeding and patients end up much more functional. Most of my patients are out of bed within a few hours, out of the hospital in a day and driving a few days late," Dr. Krongrad said.

Mr. Royce was skeptical initially, he said. But after flying to Miami and meeting Dr. Krongrad, he was sold. He underwent the procedure, flew back to Michigan and quickly went back to work.

"I didn't make a point of telling my employees about it," said Mr. Royce. But he added, "When one of my employees was diagnosed with prostate cancer, I made sure he came down here to get the same treatment."