Treated 2002 • Posted 2002 

“By now, the quality of life issues were paramount in my thought process.”

The following is a description of my decision making process for prostate cancer treatment and how I chose LLUMC for proton/photon radiation treatments.

From January 2001 through October 2001, I met several times with my urologist in Upland, CA. In those appointments, he explained the five treatment options, discussed various side effects of each option. And I expressed my point of view that surgery was a last resort, not a first resort in any treatment process. During the course of this process, I changed my mind a half dozen times, at least.

10/25/2001 Diagnosed with prostate cancer. My PSA was 6.0 as of late September 2001, Gleason score of 3+3=6, from the biopsy a few days earlier. Five seconds after he told me, I did not hear anything else he said. My urologist provided me with a video, pamphlets, and books on prostate cancer to better educate myself. I finally heard him say, whatever you decide, be comfortable with your decision. You have to live with it.

During the next two weeks, I read those materials, plus hit the Internet. It didn’t take long to realize certain consistent points:

1) there are only five ways to treat prostate cancer;

2) too much material was designed to discredit other treatments or people-was not provided to benefit or assist the patient in making a choice; and

3) medical technology and biotechnology have made huge gains and progress in recent years, and that will continue.

Also spoke with seven men with prostate cancer. Most were comfortable with their choice… two had surgery, three had brachytherapy, two had hormones. Must say, those that had surgery were less than enthused. Those with hormones seemed vacant. Those with brachytherapy were the most pleased with their status and each stated limited side effects. Did not speak with anyone that went through LLUMC.

11/14/2001 Follow up visit with my urologist. I explained what I found in my research. I then told him what I wanted regarding my treatment and asked him to point me in the right direction. Here’s what I said I wanted:

1) wanted the least invasive treatment;

2) wanted the treatment with the least potential for side effects;

3) wanted the best chance to destroy, contain, or control the cancer; and

4) wanted the best option to take advantage of medical and biotechnology advances in the future.

My main concern and focus by this time was quality of life issues for determining what treatment to seek. At that time, my urologist recommended Dr. Rossi at LLUMC. Had his office make an appointment for me. In two days, it was scheduled for 2/19/2002. My urologist also suggested I get a second opinion.

11/29/2001 Met with Dr. Mark Sholtz at Healing Touch Oncology in Marina Del Rey. Their clinic was mentioned in several and various materials I had read, plus two of the men I had chatted with, recommended Dr. Sholtz to me. Basically Healing Touch Oncology seems to be a referral operation. They suggested for surgery, a urologist in St. Louis, MO; for radiation, the Cleveland Clinic in Cleveland, OH; and for brachytherapy, Dr. Blasko at the Seattle Institute in Seattle, WA. I informed Dr. Sholtz of my appointment at LLUMC. He responded that LLUMC has a good program with a very encouraging outlook, but he felt the rate of rectal bleeding for prostate treatment at LLUMC was too high at this point for him to recommend.

By now, I knew it was a matter of what do I want to deal with… prostate cancer or the side effects of treatment. The majority of my questions dealt with what is a side effect, the chances of getting a side effect, and the degree of severity of a side effect. By now, the quality of life issues were paramount in my thought process. I was inclined to pursue brachytherapy.

2/2/2002 Met with Dr. Blasko. At his request, I had my biopsy samples sent to him for their review. The pathologist determined my Gleason score to be 4+3=7, more aggressive than originally presented to me. As a result, he suggested 25 conventional radiation treatments; then 2-4 weeks later, have the brachytherapy implants, instead of the sole treatment of seed implants. This greatly disappointed me. I was leaning towards this treatment for the shear time and convenience of the treatment process, and the side effects were minimal.

2/19/2002 Met with Dr. Rossi. Reviewed my status. He explained the treatment procedure, which was a mix of 16 proton and 28 photon treatments. Most of my questions pertained to the degree of severity of any potential side effects. Specifically, I asked about what does he view as failure with the treatment, and what is done then. Dr. Rossi fully answered my questions and explained his answers to my satisfaction. Both Dr. Rossi and Dr. Blasko know each other; and both stated they would fully cooperate if I wanted to use both radiation and brachytherapy. I left LLUMC encouraged by the philosophy and confidence of the program that treats the patient as well as the prostate cancer.

2/26/2002 Met with my urologist to review my findings with LLUMC and the Seattle Prostate Institute. I discussed my thought process, wanting to know if my thinking was sound. I believed both treatments to be about the same, regarding success rates and the side effects. However, the need for additional radiation before the brachytherapy, caused me to lean tentatively toward the following conclusions:

1) Didn’t want two separate treatments;

2) Didn’t want treatment at two separate locations;

3) Didn’t want two treatments by two separate staffs.

My urologist told me my thought process was sound, that I took a hard and definitive look at all the options and he believed I would be comfortable with whatever choice I made. I was now leaning toward proton treatment.

2/27/2002 Went on a tour of the LLUMC prostate treatment facility in the morning with several others led by Gerry Troy. He strongly, yet politely urged me to attend the Prostate Cancer Support Group Meeting at LLUMC that evening. I did; and I was impressed by the openness of everyone. It actually seemed to relieve some of the stress I had been experiencing. Bob Marckini had returned to speak. I had the chance to visit with him about his concerns regarding brachytherapy and sing the praises of LLUMC. This was after I had spoken to the group as to my situation as an undecided. I left, still undecided, but leaning towards LLUMC.

2/28/2002 Met with my G.P. about my decision making process. He stated, it was well thought out, researched, and studied. My PSA was 7.3 as of 1/1/2002. It was time to get this handled. Later this day, I decided and I contacted LLUMC to sign up.

3/12/2002 First treatment.

5/10/2002 Last treatment.

9/11/2002 Follow-Up PSA results: 0.2

‘Nuff said.

Jim Henry - Upland, California