Batman, the dog, the who had surgery and received an expermental treatment for a brain tumor, was up and groggy late yesterday, but he’s fine. The ten-year-old mutt has a row of surgical staples down his nose. “He looks like Frankendog,” said his owner, Anna Brailovsky. Now, the waiting begins to see if the treatment works. To read the story about Batman and the research to find a brain cancer treatment for dogs and people go here.

(Editor’s note: A new feature, Second Opinion, will occasionally ask Twin Cities doctors to elaborate on health news.) 

The case: Let’s say a 76-year-old man is worried about prostate cancer and goes to his doctor for a routine screening test. If you were his doctor, what would you tell him, in light of Monday’s recommendation from the U.S. Preventive Services Task Force that doctors should stop doing those tests on men 75 or older?

Today’s doctor: Dr. Daniel Zapzalka, a urologist at Park Nicollet Clinic in St. Louis Park.

“I think it’s actually not too far from what people, urologists, have been recommending for a long time,” Zapzalka said. “For years I’ve been recommending after around 80ish to stop checking PSAs (prostate-specific antigens, the test for prostate cancer).”
Why? By the time a man reaches his late 70s or early 80s, there’s little chance, statistically speaking, that prostate cancer will cut his life short. Meanwhile, the treatment — from biopsies to surgery — can cause infections, impotence and incontinence.
“This is one area where you can easily get caught in where the treatment is worse than the disease…. What I tell these guys…when they’re around 80, don’t let anybody check your PSA anymore unless you develop any new urinary symptoms, such as difficulty urinating or blood in your urine.”

 Usually, they’re happy to hear it. “Most men are pretty realistic. Most of them say, sounds good to me,” Zapzalka said.
Of course, if they have symptoms, they should “absolutely” check them out, he added. The debate is about routine screening for cancer, not about treatment.

Exception to the rule: If someone is unusually active and healthy, Zapzalka might give the test past age 75. Also, if someone insists, “I say, well this is America, you have that right.”

Who should get routine tests for prostate cancer?  Men 50 and older, or 40 and older if they have a family history of prostate cancer.

For more information:
• U.S. Preventive Services Task Force report on prostate cancer screening
• The National Cancer Institute

Dr. Chris Moertel, a brain tumor expert at the University of Minnesota, has eased my mind about this firestorm over the alleged connected between cell phones and brain tumors. (For those of you who saw yesterday’s post on this, sorry, I accidentally deleted it.) Moertel did the smart thing – he honed in right away on the memo posted by the University of Pittsburgh cancer expert that started the whole thing earlier this week.

“It’s almost like a Saturday Night Live skit,” said Moertel, who is clinical director of the brain tumor program at the university’s Masonic Cancer Center.

Among other things the memo, written by Dr. Ronald Herberman to staff and faculty at the University of Pittsburgh, says:

Do not allow children to use a cell phone except for emergency. When communicating try to keep the cell phone away from the body. Avoid carrying cell phone at all times. Do not keep it near you at night – particularly if you are pregnant. Carry it key pad in to avoid the most dense radiation. Only use cell phones to establish contact: The biological effects are directly related to length of the conversation.

And this is Moertel’s favorite part: Before putting the cell phone to the ear, wait for your correspondent to pick up. “Well, how can you tell if you are not listening? Hello? Hello? Shout if there’s anyone there,” he said.

Seriously folks.

There have been some studies that show a remote association between cell phone use and various rare forms of brain cancer. Herberman’s point was that especially for children, who theoretically could be at greater risk, it’s better to be safe than sorry. The evidence of a link could take years to develop, and by then it might be too late.

Moertel describes the logic in that thinking this way: People are listening to cell phones, which emit low levels of non-ionizing radiation. There are brain tumors out there. Therefore cell phones cause brain tumors.

“There has got to be a higher standard,” he said. “Worldwide, cell phone use has boomed. Why haven’t brain cancers boomed?” There was a slight increase in the number of detected brain tumors when imaging technology like MRI’s got better because suddenly small tumors could be seen. But that’s leveled off.

It’s absurd to treat cell phones the same way we treat second hand smoke or sun exposure, he said. There is incontrovertible evidence that both cause cancer. There is no such evidence on energy waves from cell phones. Moreover, our houses are filled with devices that emit similar waves: lights, ovens, and let’s not forget microwaves and MRI’s, which are based on electromagnetic waves, he said.

“We incorporate risk into everything we do,” he said. The risk of driving a car is far greater than the chances of getting brain cancer by talking on a cell phone in a car.

It doesn’t hurt to learn more, he said. But in the end, what people need is good evidence on which to make sound and prudent judgments. With brain cancer and cell phones “we’re just not there,” he said.

Apparently when it comes to broccoli not all men are created equal.

About half the population carries a gene called GMST1. Those people get more benefit from eating broccoli and other cruciferous vegetables than the other half. Now, researchers know why — at least when it comes to broccoli and prostate cancer.

In a study published this week in the on line journal PLoS ONE, men at risk for prostate cancer ate either 400 grams of broccoli or 400 grams of peas every week for 12 months. Researchers measured the activation of every gene in their cells. They found the broccoli eaters had more gene activation than the pea eaters. In fact, broccoli had a “profound effect on the gene expression” in the men with the GMST1 gene, the scientists wrote. Eating just a few portions of broccoli per week, they think, can amplify the signal to the cell nucleus, where genes are expressed, and that reduces the risk for cancer.

Of course, most of us have no idea whether or not we carry the GMST1 gene, so what to do? Eat MORE vegetables.

“Eating two or three portions of cruciferous vegetables per week, and maybe a few more if you lack the GSTM1 gene, should be encouraged,” the researchers concluded.

Here’s a list of the cruciferous club: broccoli, Brussels sprouts, cauliflower, cabbage, rocket, watercress, garden cress, kale, bok choy, radish, horseradish and wasabi.

And don’t forget the red wine.

For the past year I have watched as my friend Kevyn Burger faced down a terrible beast — breast cancer. Many of you know her, too. She was for many years a reporter for WCCO-TV, and now hosts The Kevyn Burger show on weekday mornings on FM 107.1. I asked her to review a new DVD for cancer patients called Visions for Cancer Recovery. In the process she reveals some of the weapons she used to force the beast back into its cave.

The DVD was produced by Mary Hallman, a Minneapolis nurse who is also a cancer survivor. (You can find out more about it here.)

Kevyn Burger: Her blog is at http://gabster.fm1071.com/fm107_kevyn/blog/

When I was a little girl, I relished visiting my grandmother–right until bedtime. My beloved Oma understood that I felt lonely and frightened in that unfamiliar bed. She used to tuck me in and pat me on the back while I slipped into slumber, murmuring all the while to “just let go…to let my body feel like … it’s just an old washrag.”
That was my first encounter with creative visualization.

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