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Prostate Cancer and Choices

Dave Cook

I want to start my personal story about prostate cancer by making it clear that I am not a trained medical professional. My professional background is in economics, the study of evaluating choices and the costs associated with them. My professional skills were about to be applied to a very special task.

Also, my story has a happy ending. I’m very lucky because my cancer was detected early. This story is about the choices I made; choices based upon the medical advice my doctors gave me. I hope my story helps others to understand that prostate cancer can be successfully treated, particularly when it’s discovered early.

I’m 53 years old and my family physician, Dr. Michael Jones, has been monitoring my health for many years. I took a blood test called the PSA almost two years ago that can indicate the possible presence of cancer activity in the prostate gland (located just below the bladder). The PSA test results were borderline. Dr. Jones referred me to a local urologist, Dr. James Cunningham, for further evaluation. The results of a more sophisticated “free PSA” blood test did not indicate the likely presence of cancer at that time. However, Dr. Cunningham recommended that I continue annual testing to watch for any changes.

Now remember that this is a story about choices. I could have easily decided to dismiss the early borderline blood test and not pursue further testing with Dr. Cunningham. Instead, I chose to actively monitor my condition. Ultimately, those choices would lead to an early-stage cancer discovery later.

My annual repeat of the “free PSA” blood test was scheduled for March of this year. Fortunately, I didn’t procrastinate and I kept the scheduled exam. The test results were still mostly borderline. However, a subtle change in one factor looked suspicious to Dr. Cunningham. He recommended a needle-biopsy procedure to obtain better information. The following week, a needle-biopsy was performed. A week later the pathology report was ready. The report confirmed that cancer was present in my prostate gland.

Again, my choice when faced with a biopsy was uncertain. I could have refused the biopsy at that time since the blood test results were not totally compelling. However, I trusted my doctor, his experience, and his reputation when he recommended the biopsy. My choice to perform the biopsy provided me important information for the more difficult decisions yet to come.

The treatment of prostate cancer involves a number of options including: 1) surgery, 2) radiation therapies, 3) hormonal therapies, 4) watchful waiting. The selection of any particular treatment approach is different for each individual. The choice is influenced by the technical and medical factors affecting the cancer patient. Ultimately, each individual prostate cancer patient, in consultation with his doctor, decides upon the treatment most suitable for himself. In my own situation, I chose a surgical procedure called “radical prostatectomy.” I decided to have my cancerous prostate gland entirely removed through surgery.

The decision to perform the biopsy led to the early detection of my prostate cancer. Early detection gave me more treatment choices with better possible outcomes.

My surgery was scheduled for mid-June after WNCC’s spring semester ended, which will allow me to recover during the summer break. The surgery appears to be a complete success. Yes, I’m thrilled with the outcome and very grateful to both Dr. Cunningham and Dr. Chen, my urologists. My recovery is progressing right on schedule. I spent six days in Carson-Tahoe Hospital. I have nothing but praise for the nursing care I received there. The entire Carson-Tahoe Hospital staff was wonderful.

The exceptional quality of the medical professionals who reside in Carson City provided a foundation to support me in making good health decisions. I’m fortunate that we have exceptionally high quality medical professionals in our community such as the Carson Medical Group, Carson Urologists, and Carson-Tahoe Hospital. I’m a cancer survivor because of them.

Of course I’m thankful for the support that my family, friends, and colleagues gave me. My personal network was very important in helping me formulate my decisions. I really appreciate all their help.

Prostate cancer has a high survivor rate. However, the important choices I made in the beginning led to the early detection of the presence of my prostate cancer. It was that early detection that provided me the most options for the best possible outcome.

And finally, I’m learning that there is life after prostate cancer, and that it can be a very good one.

Dave Cook, a professor business and economics at Western Nevada Community College, is a former member of the Nevada State Board of Education and Carson City School Board.