Brachytherapy Keeps Patient Free of Prostate Cancer
By Abby Sinnott
Dennis, who is now 65 says, "I still go around and ask all of my friends, 'Do you know what your PSA level is?' 'When's the last time you had a PSA exam?' 'Do you know what PSA is?'"
In the spring of 1996, a prostate-specific antigen (PSA) test — which is used to help diagnosis prostate cancer — detected that Dennis had an elevated PSA level, which prompted his urologist to perform a digital rectal exam and prostate biopsy. PSA is a substance that is naturally produced in the prostate gland to help liquefy semen. Normally, a small amount circulates through the bloodstream, but if a higher than normal level of PSA is detected in the blood or rises over time, it may indicate prostate cancer.
"After the biopsy, when my doctor told me I had an early stage of prostate cancer, the diagnosis really floored me," remembers Dennis. "I thought, 'What in the heck am I doing with prostate cancer?' There's no history of prostate cancer in my family, so I was just baffled.
For months prior to his diagnosis, Dennis experienced frequent urination — a common symptom of prostate cancer — which he considered highly unusual. Though his doctors told him that everything was normal, and it wasn't until he got a third opinion that a diagnosis was finally made.
"After a while, I thought maybe the frequent urination was all in my head," says Dennis, who resides in Emeryville, Calif. "But it kept getting worse and worse. I'm very conscious of my body and I knew something was amiss, even if no one could figure out what the problem was. I was determined to get to the bottom of it."
Although Dennis considered himself healthy, studies have found that African American men have a much greater chance of being diagnosed with prostate cancer and are more than twice as likely to die from the disease compared to Caucasian men. Theories for why these discrepancies exist vary, including lifestyle, diet, late detection and lack of aggressive treatment. Dennis discovered that "prostate cancer is in epidemic proportions among black men in the Bay Area."
Dennis became his own advocate after receiving his diagnosis, and read all of the prostate cancer literature he could get his hands on and regularly attended different prostate cancer patient groups, where he met men who had all undergone surgery for the disease. At the time, surgery was the most common treatment for prostate cancer, though Dennis says he was discouraged by the severe side-effects and long recovery period described by the men.
"After hearing about the side effects the men were experiencing — incontinence and impotence — and the months of recovery time, I thought, 'I can't live like that,' and wanted to see what other treatments besides surgery were available," says Dennis, who visited UCSF Medical Center's Cancer Center, where he met Dr. Mack Roach, III, an internationally renowned radiation oncologist who specializes in the management and treatment of prostate cancer.
Roach carefully examined Dennis and determined that he was an ideal candidate for an advanced form of radiation therapy called LDR brachytherapy, which is recommended for men like Dennis whose prostate gland is not very enlarged. During this treatment, small radioactive pellets, often called "seeds," each about the size of a grain of rice, are implanted into the prostate and give out radiation for periods of weeks or months. This is done as a one-day outpatient procedure with virtually no recovery time.
And although brachytherapy can cause temporary side effects in some men, such as groin pain, urinary problems or erectile dysfunction, Dennis felt fine the day after his procedure and promptly returned to his regular work and exercise routine. After treatment, Roach regularly monitored Dennis's PSA level to determine the effectiveness of brachytherapy. Dennis's PSA steadily declined and he is now officially cancer-free.
"Our goal is to cure prostate cancer with minimal disruption to a man's quality of life," says Roach. "Fortunately, as with Mr. Dennis's case, we are usually very successful at achieving this goal with radiation therapy."
Ten years after his diagnosis, Dennis is still a busy photographer and although he has always been health conscious, prostate cancer inspired him to give up fast foods and a 25-year smoking habit. He's also still involved with prostate cancer patient groups and shares his experience with other men facing treatment decisions.
"I think it's important for men to know that they have options when making treatment decisions," says Dennis. "Attitude plays a big role in the process. When I found out I had cancer, I treated it like any other obstacle in my life. I got proactive and took charge."
Story written in July 2006
Abby Sinnott is a freelance writer based in San Francisco.