The news that financier Warren Buffett, in the public eye lately thanks to the politics of the so-called proposed “Buffett Rule” that would raise taxes on the very wealthy, has been diagnosed with Stage 1 prostate cancer may be noteworthy, but it’s not surprising.
Buffett will be 82 on August 30. It’s a truism among urologists that just about every man who lives long enough will get prostate cancer, but that most men will die with, not of, the disease. In 2011, 240,890 men were diagnosed with prostate cancer, according to the American Cancer Society, and 33,720 men died of it.
As those numbers suggest, most men survive prostate cancer. Stage 1, the phase of disease Buffet announced he has, is the earliest, and least deadly stage. At Stage 1, the cancer is limited to one-half or less of one lobe of the prostate. Buffett's cancer was discovered after routine blood tests showed his PSA level had jumped.
"I feel great — as if I were in my normal excellent health," Buffett said. "And my energy level is 100 percent. I discovered the cancer because my PSA level (an indicator my doctors had regularly checked for many years) recently jumped beyond its normal elevation and a biopsy seemed warranted."
Buffett said he was diagnosed April 11 and has received tests including a CAT scan, a bone scan and an MRI. He said the tests showed no indication of cancer elsewhere in his body.
Buffett has chosen radiation treatment — five days a week for six weeks. During radiation treatment, people feel tired and have some risk of urinary and bowel problems but usually can work and live normally, said Dr. Sean Collins, a radiation oncologist at Georgetown's Lombardi Comprehensive Cancer Center.
In general, treatments for Stage 1 prostate cancer can range from simple watchful waiting to treatments like surgically removing the prostate or implanting radioactive “seeds” to kill the tumor. Doctors in the UK recently announced in the journal Lancet Oncology that a new technique using ultrasound beams treated the cancer in test subjects without some of the serious side-effects like incontinence and impotence most men worry about.
Buffett's case is likely to renew controversy over PSA blood tests. A leading government task force warns against them for men older than 75 because prostate cancer usually grows so slowly in older men that it rarely proves fatal. That means many men are treated and suffer side effects unnecessarily. The American Cancer Society says only men in good health with a life expectancy of at least 10 years should consider a PSA test.
"Mr. Buffett made a decision to get it, but that may not be the right decision for every man in that age group," said Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer.
Likewise for treating the disease. Any man at that age should have "a careful conversation with his physician about the pros and cons of treatment," let alone which type is best, Lichtenfeld said. "We're becoming increasingly aware that not every man needs to be treated."
In a letter to shareholders, Buffett said, "The good news is that I've been told by my doctors that my condition is not remotely life-threatening or even debilitating in any meaningful way," he wrote in the letter.
Dr. Christopher Kane, chief of Urology at the University of California San Diego School of Medicine, told msnbc.com that for patients who are Buffett's age, if the cancer is determined to be slow growing (based on analysis of prostate specific antigen, or PSA), watchful waiting is a common tactic. If it’s more aggressive, then surgery or radiation using seeds or a focused beam may be considered.
Since the cancer is Stage 1, he said, “that implies the cancer is confined to the prostate, or that there is a low risk for metastases to other parts of the body.” Given that, Buffett’s prognosis would be good.
The Associated Press contributed to this report.