Monika Graff  /  Getty Images file
Rudy Giuliani, former mayor of New York City, attends a book signing Jan. 12 in New York City. Five years after being diagnosed with prostate cancer, Giuliani is still cancer-free.
updated 6/18/2005 8:09:14 PM ET 2005-06-19T00:09:14

Rudy Giuliani was in the operating room, half-sedated for his prostate cancer procedure, when he saw a big piece of video equipment being wheeled into the room.

“Oh my goodness, they’re going to put this on television!” thought the mayor, who had been asked if his treatment could be filmed for the media. In fact, what rolled in was a medical monitor for doctors implanting radioactive “seeds” that would zap his cancerous cells.

Five years after his diagnosis, Giuliani is still cancer-free and he’s doing a lot of talking about his disease — one that remains tricky to treat.

He joins a list of prominent survivors that includes Lance Armstrong, Joe Torre, Norman Schwarzkopf, Bob Dole and Michael Milken. Prostate cancer took the lives of actor Jerry Orbach and musician Frank Zappa.

Tackling the enemy
These days, Giuliani gets calls from men around the world seeking support and advice on doctors. Since prostate cancer took his father’s life, New York’s one-time Mafia prosecutor has learned to tackle another kind of enemy: fear.

During an interview at his office, he described how he beat fear of cancer: “Talk about it. I always find that when there are things that I’m afraid of, if I talk about them, all of a sudden, I’m much less afraid of them. And it helps other people.”

Giuliani is honorary chairman of the National Prostate Cancer Coalition, a Washington-based organization that on Father’s Day plans to offer free cancer testing from a van that crisscrosses the country year-round. Any man who enters gets a PSA blood test, which measures a protein the prostate makes when it’s inflamed. An elevated number suggests the possible presence of cancer, which must then be confirmed through a biopsy.

The mobile unit arrived in New York from Chicago this week.

But cancer testing is a touchy issue. The federal government doesn’t recommend PSA testing because there’s no evidence it saves lives. Studies are under way to try to resolve questions.

However, the American Cancer Society does recommend testing for most men 50 and over — age 45 for men at higher risk.

Even so, Dr. Len Lichtenfeld, a cancer society oncologist, said, “If the test is abnormal, you start with a whole cascade of events and possible side effects,” including impotence and incontinence.

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Lichtenfeld and other experts say that in some cases, mainly older men, the cancer develops so slowly that a person is likely to die with it, not from it.

One in six American men has a lifetime risk of getting prostate cancer.

Nationwide, about 230,000 men are diagnosed each year, and of those, more than 30,000 are expected to die, according to the cancer society.

Lessons learned
Giuliani, 61, was in his mid-50s when his prostate cancer was discovered during a routine physical. Working with doctors at Manhattan’s Mount Sinai Hospital, he chose between surgery or radiation.

He opted for implantation of radioactive “seeds” in the prostate. Before the procedure, Giuliani was treated for four months with Lupron, a drug that blocks the production of testosterone, the male hormone that prostate cancer cells thrive on.

The “seed” treatment was followed by external radiation.

Giuliani said he chose double radiation over surgery because the expected side effects of impotence and incontinence “would be less, and more manageable. I had side effects for some time, but now my health is fine, and the side effects are gone.”

The encounter with cancer, he says, made him a better leader — especially when he faced the terrorist attacks on Sept. 11, 2001.

“I was facing so much death, that it helped me to have faced my own mortality,” he says. “It made me more peaceful.”

And, he added with a smile, “I understood how important it is to enjoy yourself.”

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