An analytical approach to treating prostate cancer

Prostate cancer came out of the blue for John “Rick” Thornton of Dallas, Texas. At 47, “I couldn’t imagine having cancer,” says Rick, “I felt like I was healthy.”

But a PSA blood test to determine the likelihood of cancer was higher than expected. Rick had three more tests before his doctor recommended taking a biopsy of his prostate, the gland storing the liquid that carries sperm.

“I thought the whole exercise was needless,” says Rick, who was in denial and figured he was fine. Two weeks later, his physician told him, “I’ve got some bad news for you. You have cancer.” The news hit like a thunderbolt. After the shock, while considering his next steps, Rick tried to take emotion out of the equation.

“I’m very analytical,” says Rick, who has a degree in mechanical engineering and a master’s in business administration. He called the five smartest people he knew to advise him. “I told them I wasn’t thinking right,” he says. Rick began reading about prostate cancer and discovered how common it is among men. In fact, he found that Bob Dole, Sidney Poitier, Colin Powell, and many others have survived prostate cancer.

Rick was grateful that he was among the 90 percent of prostate cancer patients whose cancer had not spread beyond the prostate. Even so, he still had plenty to think about when it came to responding to news of the disease. He could just keep an eye on the slow-growing cancer. He could also choose among active strategies—surgery, radiation, or hormone replacement.

After confirming his diagnosis with other doctors, Rick explored his options thoroughly. Research isn’t clear about which approach is best for localized prostate cancer. Each man has to make a decision based on what he thinks about the benefits and risks. And all treatments can have long-lasting side effects.

“I was afraid of incontinence and erectile dysfunction,” says Rick. Prostate cancer treatments can cause long-lasting sexual, urinary, and bowel problems.

After discussing his circumstances with his second physician, Rick chose prostate surgery, “because it had the quickest recovery time, and the results posed a better outcome,” he says. For example, Rick liked the fact the cancer would be completely removed, and there is a high rate of recovery from erectile dysfunction. With the option, he would not have to deal with radiation or chemotherapy.

One important question remained: Who would do his surgery? Again, Rick investigated his choices. He ultimately found a urologist who had performed more than 2,000 radical prostatectomies—full removals of the prostate gland. Rick, who lived in Virginia at the time, traveled to Baltimore, Maryland, to visit with the surgeon. He was pleased that the surgeon was confident and had plenty of surgeries under his belt. “Repetition is what I want,” declares Rick. Hospitals and surgeons that do more prostate surgeries have better results.

Three years later, Rick says: “I never felt like I had cancer. I never had chemo or radiation. The surgery took care of it.”

Rick has some simple advice: Talk to more than one doctor. Find others who have faced similar circumstances. Explore all the treatment options.

“I was researching doctors and techniques and talking with my friends,” says Rick. “Once I did all my research, I was not afraid of the cancer.”

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