It had been several years since Mike Israel went for a routine physical. “I was relatively young at 58 and in seemingly good health, it seemed unnecessary,” he says. Mike felt good. He was active and often enjoyed hiking, biking, or using the treadmill or elliptical. It was Mike’s wife who nudged him to resume the annual physical he’d neglected for a few years.
As part of that physical, his doctor ordered a series of routine bloodwork which, for men over forty includes the PSA (prostate specific antigen). Mike’s PSA levels were at 8.2, a red flag since “normal” for men his age is considered anything less than 4. While an elevated PSA does not necessarily mean that cancer is present, it is an important indicator that warrants follow up. In Mike’s case, it was a lifesaver.
Further testing confirmed Mike had prostate cancer. The fact is one in eight men will be diagnosed with prostate cancer in their lifetime. And for most, it is a slow-growing cancer that causes few or no symptoms. Still, it is the second leading cause of cancer death. Catching it early with a screening can make all the difference. Our experts recommend that all men get a baseline PSA reading in their forties.
Mike’s next step was to research his options. “Deciding on how to treat the cancer was the most difficult part of this experience. I explored many different options and let the facts drive the result,” he says. Mike ultimately chose surgery—specifically, a newer variant of laparoscopic robotic radical prostatectomy called Retzius sparing. This method removes the prostate but spares nerves and ligaments that are beneficial for post-operative continence. It has been used with great success in Europe and by select surgeons in the U.S.
Mike was thrilled to learn that one of the leading centers of excellence to offer this approach was MedStar Georgetown University Hospital, part of the MedStar Georgetown Cancer Institute. The Institute combines medical expertise and the latest therapies available. Our research engine, Georgetown Lombardi Comprehensive Cancer Center, is the only National Cancer Institute (NCI)-designated comprehensive cancer center in Washington, D.C. providing access to clinical trials and the latest breakthroughs in cancer care.
Mike set up a meeting with Keith Kowalczyk, MD, interim chair of the Department of Urology at MedStar Georgetown. From the first meeting, Mike was impressed with Dr. Kowalczyk’s experience and knowledge. And as an IT professional, he was impressed by the advanced technology of diagnostic tools at MedStar Georgetown. Dr. Kowalcyzk explains, “Mike underwent a very specialized MRI that lets us precisely focus where to pinpoint biopsies. Very few centers offer this, but MedStar Georgetown has been doing it for over ten years.” He adds, “Two years ago, we also introduced a newer form of biopsy that we can do in the office called a transperineal prostate biopsy. This has reduced the risk of infections to almost zero percent, and it lets us sample a lot more of the prostate tissue, so the patient gets the most accurate diagnosis.”
Mike scheduled his surgery with Dr. Kowalczyk and it all went well. Since surgery, Mike has had normal PSAs and virtually no side effects. He says his surgery was “the right choice. I have no regrets.” Looking back, he believes that “Who you choose to treat you may be an even more important decision than the therapy you choose. Even if you ultimately remain with your initial physician, you should get opinions from a center of excellence with multiple specialists who deal with prostate cancer every day.”
Mike is grateful for the unwavering support of his wife and urges other prostate cancer patients to never underestimate the power of those human connections. He also recommends early screening. “Had my primary physician not ordered a PSA test, I might still be carrying a silent killer,” he says.
After his experience, Mike encouraged his younger brother to get screened. His tests came back positive, and he will be pursuing treatment in the coming months. Mike urges, “men, get screened and tell those you love to get screened. The sooner you catch prostate cancer, the more options you have, with a greater likelihood of favorable outcomes. The life you save may be your own.”