After years of inconclusive tests, 65-year-old Mike was diagnosed with prostate cancer. Concerned about treatment side effects such as incontinence and the inability to have an erection, Mike discussed his options with a surgical team at Memorial Sloan Kettering. He opted to have minimally invasive, nerve-sparing surgery to remove the tumor, preserve his sexual function, and maintain his ability to urinate normally.
Unlike a lot of men my age, I make it a point to go in for annual check-ups with my doctor. I had been retired from teaching in the Lakeland school district in the town of Cortlandt Manor, New York, for several years, and my days were taken up with babysitting my two grandchildren, but I still made it a point to go in for my exam.
“Mike, Call Me”
It was December 2003, right around Christmas, when I had the physical. At the time, I felt perfectly fine, with no signs or symptoms of any problem. As part of the check-up, my doctor did a PSA (prostate specific antigen) test. I didn’t give it a second thought until I came home a few days later to a message on my answering machine from my doctor that said, “Mike, call me.” At that point, I knew something was wrong.
My doctor informed me that my PSA level was 5.8 ng/ml, which is high. He said there could be a number of other explanations for the rise besides prostate cancer, so he scheduled me for another test in three weeks. By the second test, my PSA level had dropped to 4.8, and by the third test, taken another three weeks after the second, it had dropped again to 3.8. No longer as concerned, my doctor told me to get it checked again in six months, “just in case.”
At the six-month mark, in June 2003, I went back for another test, which found that my level had increased again, this time to 4.2. To be safe, my doctor sent me to a urologist for a digital rectal exam, which found nothing unusual. At that point, no one thought it was anything more than a normal fluctuating PSA. But a friend of mine told me that a PSA level of 4 was the warning-sign threshold for men my age, so I was still worried.
A Diagnosis, at Last
At my next urologist appointment, in June 2004, I received an ultrasound imaging test, which turned up nothing. I saw the urologist again six months later, in December 2004, at which time my PSA was still in the 4s, though when he did another digital rectal exam he felt nothing unusual. It wasn’t until June 2005, when my PSA shot up to 6, that my urologist performed another digital rectal exam and felt what he described as an unusual ridge. That was enough to necessitate a biopsy, during which two tumors were found in one lobe of my prostate.
It was certainly a shock to get the diagnosis of cancer, but all along I had this strange feeling that I did have cancer, so I was, in some ways, prepared. It helped that they had caught mine early, while it was still in its early stages — stage I, to be exact. My wife and children were more shocked than I was. It’s not that I wasn’t scared; I was. I wondered what would happen to my wife if I didn’t make it and who would take care of my grandkids during the day. I tried to stay focused on my immediate needs, which were simple: I wanted to get the thing out. The urologist explained there were a number of options other than surgery, but I wanted to have it surgically removed.
Finding an Expert
With that thought in mind, I decided to find the best prostate surgeon in New York. After an exhaustive online search, I located, with my daughter’s help, two top contenders: Karim Touijer, a surgeon at Memorial Sloan Kettering Cancer Center specializing in nerve-sparing laparoscopic prostatectomy [surgical removal of the prostate], and a surgeon at another prestigious New York City medical center.
When I first met with Dr. Touijer, I was struck by his youthful appearance. So much so that with some embarrassment I asked him, “How many of these laparoscopic prostate removals have you done?” His answer, calm and confident, was that, at the time, he had done approximately 300, which was all I needed to hear. I told him about my fears, which included incontinence [the inability to control the flow of urine and or feces] and erectile dysfunction, and he assured me that none of that was a foregone conclusion. In my own mind, I told myself that I needed to be around for my son’s wedding the following summer.
I liked Dr. Touijer’s experience, his confident but thoughtful manner, and his expertise with laparoscopy. Performing the surgery in this minimally invasive way, through small incisions, produces the least possible damage to surrounding tissues, which translates into less blood loss and a quicker recovery. I felt quite confident choosing him. Still, to prepare myself for all possible outcomes, I went out and bought a large stock of urinary incontinence pads.
Regaining Quality of Life
My surgery took place on Tuesday, August 16, 2005. Dr. Touijer was able to perform the procedure laparoscopically and, most important to me, was able to spare the surrounding nerves. After the surgery, when I regained consciousness, the first thing I said was, “Thank God I’m alive!” The post-op nurse asked me to rate my pain on a level of one to ten, ten being the worst pain in my experience. I told her that except for some discomfort caused by two drainage tubes purposefully left in me, I had no pain. And the day after the surgery, I was able to get up and take a shower. Most remarkably to me, I went home on Thursday afternoon, only two days after the procedure. When my neighbors, who knew of my surgery, saw me, they said, “What are you doing home so soon!”
At my six-week post-surgery check-up, when I had already returned to my normal routine, Dr. Touijer told me that while the pathology report found that the cancer had extended into the seminal vesicle, qualifying it as an advanced stage cancer, he had been able to remove it all with clean surgical margins, which meant I would need no further treatment. And at my three-month check-up, I surprised Dr. Touijer with the news that I no longer needed to wear incontinence pads.
A year after the surgery, I was going in for check-ups just once every six months. I am a cancer survivor, though, to be honest, the week before my six-month check-up, I usually start to worry that the cancer has come back. But I think that is to be expected. Most importantly I am cancer-free and have fully recovered my quality of life.
Trust Only the Best
I have two pieces of advice for anyone who is either worried about prostate cancer or who has been recently diagnosed, and both are pretty simple. First, get checked on a regular basis. Second, make sure you put your life in the hands of a doctor and a hospital with a lot of experience treating your specific cancer. My family and I knew that Memorial Sloan Kettering is the place to go for cancer treatment. When you go there, you know you’ve gone to the best. And, for me, Dr. Touijer is literally a lifesaver. I thank God he was there to do the procedure.