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Warren Buffett's Prostate Cancer Treatment

By Daniel J. DeNoon

Warren Buffett, CEO of Berkshire Hathaway, will undergo radiation treatment for early-stage prostate cancer.

Buffett yesterday revealed his diagnosis of stage I prostate cancer in an open letter to shareholders posted on the company web site. He said he learned of the diagnosis last Wednesday, with follow-up scans on Thursday.

“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,” Buffett wrote. “[T]ests showed no incidence of cancer elsewhere in my body.”

Buffett, 81, said he underwent a prostate biopsy after blood tests showed suspiciously high levels of prostate-specific antigen or PSA.

The U.S. Preventive Services Task Force (USPSTF) does not recommend PSA screening for men over age 75. New USPSTF draft guidelines advise against routine PSA tests for men of any age with no sign of prostate cancer. These recommendations are controversial and opposed by the American Urological Association. The American Cancer Society recommends PSA screening only when men are fully informed of both the risks and benefits of screening.

Buffett’s doctor clearly performed the test, which led to a biopsy and a diagnosis of prostate cancer. Not all prostate cancers are life threatening.

The usual course of treatment for stage I prostate cancer in an 81-year-old man is “active surveillance,” says Louis Potters, MD, chair of the department of radiation medicine at North Shore University Hospital in Manhasset and Long Island Jewish Medical Center in New Hyde Park, N.Y.

This would mean a digital rectal exam (DRE) and PSA test every three to six months with an annual prostate biopsy. Treatment would begin only when the cancer showed signs of getting worse.

But Buffett has chosen to undergo radiation therapy. In his letter, he says he’ll get radiation every day for eight weeks beginning in July. Potters says the usual course of radiation therapy is nine weeks with a type of treatment called intensity-modulated radiation therapy.

The fact that Buffett and his doctors opted for immediate treatment suggests that he has what doctors call “clinically meaningful” cancer, Potters says.

“In the context of having successfully treatable disease, to select definitive therapy he probably has more intermediate-risk disease rather than low-risk disease,” Potters suggests. Potters is quick to note that his opinion is speculation based on the incomplete information Buffett has made public.

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