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Preventive Health Prostate cancer

An Unexpected Delay

by Andrea Breeding / November 3, 2020
Conceptual image for viral ethiology of prostate cancer. 3D illustration showing Human Papilloma Viruses HPV infecting prostate gland which develops cancerous tumor

Image from Hackensack Meridian Health

Bill Harris knew something wasn’t exactly right when his first PSAs were 3.8.  “That’s your normal.”  said his doctor.  Still, it was a little unsettling to know that his PSAs were increased from the start.  Not the usual 2.5 as it is in most men.  Luckily, he had an annual physical done which included a PSA.  This allowed him to keep up with any changes.  But, by the time he was 61, Bill’s PSA was 5.3.  A definite change and not for the better.

Bill received most of his health care from the VA in Johnson City, Tennessee.  In 2014 a prostate biopsy revealed three of twelve positive samples with a Gleason of six.  The cancer was low grade and not aggressive.  This was a good sign and meant that Bill could take his time deciding how he wanted to proceed.  The various prostate cancer treatment choices were explained to Bill.  He chose active surveillance with plans for a repeat biopsy in 12 – 14 months.  His PSAs remained stable.

In 2017 Bill decided to follow up the prostate cancer with a local urologist to avoid the long drive to the VA.  His next biopsy, also done in 2017, showed four out of twelve positive samples.  This made him think more about his options since it appeared the cancer had spread.

After visiting the Provision Cares Proton Therapy Center in Knoxville, Tennessee, Bill decided that proton therapy was the way to go.  But then he faced an unexpected event. Bill developed shortness of breath and chest tightness.  It was December 2017.  A stress test was done to determine if his symptoms were heart related.  Sure enough, the test showed abnormalities which were so severe that he was taken by ambulance to the local hospital.

At the hospital, the cardiologist performed a heart catheterization which showed blockages in his vessels.  Bill would need by-pass surgery to correct the problem.  Just before the procedure Bill said, “I’ve got to get out of here.  I was supposed to start proton therapy for my prostate cancer.” The cardiologist was blunt with Bill.  “If you don’t stay here you can forget about prostate cancer.  You won’t live to get any kind of treatment.”  Of course, Bill followed through with the heart cath and ultimately, with the by-pass surgery.

In February 2018 Bill had the by-pass operation.  He did well with no complications.  But he was stressed about the prostate cancer and how he had to wait for therapy.  He was told he should wait a year to start any form of treatment, whether that was surgery or radiation.  To say that was a worrisome time is an understatement.

Bill had his third biopsy in June 2019.  Whenever there is a delay of a few months in treatment, the biopsy must be repeated.  A man’s treatment decision may change based on the latest biopsy, which could show worsening of the cancer.  In Bill’s case,  the cancer had spread to another location, making the total positive specimens five out of twelve.  The Gleason increased to seven.  These are not drastic changes but they are enough to cause concern.  Even though his urologist believed it was ok to continue active surveillance, Bill wanted to follow through with proton therapy.

Bill completed the proton therapy in July 2019.  He decided that proton had the fewest side effects and he liked the data that he read about the outcomes.  As it turns out, he did well after 38 treatments with only minor burning on urination, which was temporary.

By December 2019, Bill’s PSA dropped to 1.9.  His most recent PSA, done in September 2020, was 0.9.

An ordeal that started years ago is finally over.  Bill believes he made it through those trying times with the love and support of his girlfriend, Betty, and his daughter, Julie.  He read books and articles, which helped, including Bob Marcini’s book You Can Beat Prostate Cancer.  And, of course, information he gained at the local prostate cancer support group was invaluable.  He owes a debt of gratitude to Pat Smith and Rudy Vranes, members of the support group who provided Bill with information on proton therapy.  Bill says he will never forget what Pat Smith said to him during one of the meetings.  “Don’t wait too long to decide on a treatment.”  That one statement helped Bill make his final decision; one he has not regretted.

Prostate cancerProstate cancer treatment
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