Editor's note: This article is the first of a two-part first-person account by Rod King, who recently completed nine weeks of radiation therapy for prostate cancer.
Statistics show that one in every six men will develop prostate cancer in his lifetime. I was positive I was one of the five who wouldn't be affected by prostate cancer — until my Prostate Specific Antigens (PSA) test at my annual physical exam last December showed a huge spike. It had been running around six and almost tripled in just a year to 16. I knew immediately what that meant.
My doctor referred me to Dr. Thomas Nill, a urologist at Northeast Indiana Urology (NEIU). When I asked why this place, she explained they don't treat breast, lung, bone or any other kind of cancer. Just prostate cancer.
I didn't know prostate cancer is the most common cancer in American men. In fact, I didn't know anything about it and never even thought about it. Even though I regularly had a PSA test with my physical, I figured that maybe if I didn't think about it, it wouldn't happen to me. All I can say now is that I'm thankful for that test.
According to Dr. David Pollifrone, one of the urologists and driving forces behind the establishment of NEIU four years ago, “the PSA test at the moment is really the only reliable one available to identify cancer in the prostate. In spite of that, the government is attempting to disqualify it from Medicare coverage in order to keep costs down. That would be unfortunate as far as my compatriots and I are concerned because an estimated 240,890 men were diagnosed with prostate cancer in 2011 and the numbers are climbing every year. One of the main reasons they were diagnosed is because of the effectiveness of that test.
“We designed this facility for men with the express purpose of treating and managing prostate cancer whether by radiation, surgery, implants or radioactive drugs. And by treating just one disease, prostate cancer, and doing it over and over and over, we have gained valuable experience that helps us improve our outcomes and limit side effects.
“The disease itself is not changing, but newer technology like genetic testing and improved PSA tests are being developed that can do a better job of identifying the cancer more efficiently than the present PSA test. In addition, improved treatment methods are being tried. One is targeted cryoabluitation or freezing. A new form of radioactive seeds is in the experimental stage along with a special ultrasound treatment. What I've learned is that urology is an evolving specialty.”
Pollifrone said new technology provides information that gives doctors the ability to better follow, diagnose and understand the disease.
“A lot of men die with prostate cancer, but not because of it,” Dr. Pollifrone said.
My initial step in getting ready for radiation therapy or surgery was to have a biopsy that would tell for sure whether or not I had cancer. Dr. Nill performed the biopsy on Jan. 7, and as I suspected, the result was definitely cancer, a very aggressive one. My father had surgery for prostate cancer that ultimately returned, spread into his bones and caused his death.
On Jan. 18 I underwent a bone scan to determine if the cancer had spread outside the prostate. With great relief, I learned it had not. Dr. Nill suggested radiation therapy might be the best path for me because of my age, 75, instead of surgery. I wasn't very excited about going under the knife, anyway, so I agreed. Besides, if I had elected surgery, I'd be laid up for a few weeks and have to give up playing tennis.
So, after confirming that I had the “big C,” I was really anxious to get after it. Start killing those bad cells right away. Well, that's not exactly how it works. I first had to have a hormone shot that was the first step in the treatment process. It put the cancer in remission and shrank the prostate. Then I started taking testosterone control medicine – which, by the way, gives you hot flashes.
Two gold markers were inserted into my prostate by Dr. Pollifrone. That took place Feb. 12 and wasn't something I'd like to repeat in the near future. The markers are put in so the radiation treatment machine can zero in with just a millimeter to spare and not cause unnecessary damage to surrounding tissue. Gold is used instead of other materials because of its high density. X-rays would go right through other materials and not be seen. The markers are so small I won't have to worry about them increasing my net worth.
Next, a CT scan was done Feb. 21 so a detailed treatment plan could be set up specifically for my case. On March 1 I had another X-ray to make sure all was ready and received three dot-size tattoos that help in the alignment on the radiation machine. If I were into body art, I'd have requested three eagles. Radiation started March 4.
Even though a month passed before radiation was finally scheduled, I felt as if the NEIU and Northeast Indiana Prostate Cancer Center (NEIPCC) personnel knew exactly what they were doing, and that time period was necessary to make sure treatment would be absolutely perfect. Dr. Pollifrone explained that the month was not wasted, but was necessary to gather information on what they were dealing with. What's magic about nine weeks of treatment? Couldn't it be done in five or six weeks by increasing the radiation dosage? I learned increasing the dosage actually could shorten the treatment time, but greatly increase the possibility of damage to surrounding tissue and organs. So, nine weeks and 45 treatments it was.
I'm just one of between 35 to 40 guys who report to NEIPCC Monday through Friday for radiation therapy. They come from all over northeast Indiana. I live in New Haven and drove 30 miles every day, but I knew it would be worth it in the end.
The next piece in the series will cover the actual radiation therapy process.