Jim Dennis Story
After beating prostate cancer, Jim Dennis, a well known 65-year-old photographer, became a "one man crusader" against the disease, which is the most common cancer and second leading cause of cancer deaths among American males, claiming the lives of more than 27,000 men each year.
Dennis 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 ñ a common symptom of prostate cancer ñ 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."
And although Dennis considered himself healthy, studies have found that African American men have a 34 percent greater chance of being diagnosed with prostate cancer and a 123 percent greater change of dying 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 ìprostate cancer is in epidemic proportions among black men in the Bay Area."
And after receiving his diagnosis, Dennis became his own advocate, reading all of the prostate cancer literature he could get his hand on and regularly attending 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.
After carefully examining Dennis, Roach determined that he was an ideal candidate for an advanced form of radiation therapy called 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."
Sandra DeQuant Story
Sandra DeQuant will never forget her 49th birthday: the following day, she was told she had anal cancer. "I was in a state of shock," remembers DeQuant. "I didn't know what to expect and had never heard of anal cancer before."
Although rare, anal cancer is becoming more prevalent in the United States and many other developing countries. The condition develops in the tissues of the anus, which is a short tube that connects the lower part of the large intestine, known as the rectum, to the outside of the body. The anus allows the controlled disposal of body waste during bowel movements. This type of cancer, like cancer of the cervix, is caused by exposure to human papillomavirus (HPV).
Although DeQuant was not considered at particular risk for anal cancer, she does have a family history of gastrointestinal cancer. Esophageal cancer claimed the life of her younger brother in 1992 and her other brother was later diagnosed with the disease.
DeQuant visited her doctor at Kaiser Permanente in South San Francisco to be tested for esophageal cancer. At the time, her only abnormal symptom was rectal bleeding, which she passed off as a hemorrhoid. However, after undergoing a sigmoidoscopy—an internal exam of the colon and rectum—DeQuant's doctor noticed an abnormality at the end of her anal canal. The next day, she received a diagnosis of anal cancer.
Because of the type of DeQuant's cancer—a three centimeter squamous cell carcinoma—her doctor advised that chemotherapy and radiation therapy, rather than surgery, were the recommended treatments, which would eliminate DeQuant's need for a colostomy bag, while still offering a possible cure. Invasive anal cancer is curable in many patients, particularly when it is diagnosed early and tumors are small. DeQuant's doctor referred her to UCSF Medical Center's Comprehensive Cancer Center, where she was treated by Dr. Richard Krieg, a radiation oncologist who specializes in the treatment of gastrointestinal cancers.
"When my doctor told me that I was going to UCSF for treatment, it was a great relief," says DeQuant. "I thought, Okay, I can do this. I felt very comfortable and secure going there. Everyone at UCSF was so wonderful that even if I hadn't had a positive outcome, I would still consider it a good experience."
Krieg recommended a combination of chemotherapy and radiation, the most common treatment for anal cancer, which causes tumors to completely regress in about 80 percent of cases. DeQuant underwent six weeks of daily radiation therapy and two weeks of chemotherapy.
"Ms. DeQuant had the expected side effects associated with chemotherapy and radiation therapy for this disease. She also had significant shrinkage of her cancer early in her treatment course,"" says Krieg.
DeQuant now boasts a clean bill of health and is four years cancer free. She is also involved in anal cancer patient advocacy groups and regularly gives advice to other women fighting the disease.
"My disease has made me more outspoken," says DeQuant, who believes in the value of sharing her story with others. "I learned that it doesn't matter what kind of cancer you have, you have to stay positive and believe you are going to get healthy and face it head-on."