September is Prostate Cancer Awareness Month. Contrary to popular belief, Prostate Cancer is not just an old man’s disease, and the lack of a standard screening program in the United States is taking an avoidable and regrettable toll on men’s lives, including young men.
Murray Keith Wadsworth continues to fight this Systemic failure.
5 Things I Learned During my Fight with Prostate Cancer By Murray Keith Wadsworth
I was not categorized as ‘high risk’ for Prostate Cancer. But, as a single, sole-providing parent of two, I began annual screenings before I was forty. At forty-seven, a ‘screening alarm’ rushed me into a Biopsy.
Shaken and confused by all the misinformation surrounding this disease, I became dangerously complacent about my ongoing screening results and excused the early warning signs that showed in the following years.
At fifty-eight, while working in London, a better screening procedure than I had ever received back home in Texas identified a Prostate Tumor. After additional diagnosis and risk stratification, I returned to Texas for a Prostatectomy.
The procedure failed to clear all my Cancer. Next, I tried Salvage Radiotherapy – standard American protocol. But that procedure failed to clear all my remaining Cancer.
The best U.S. standard practice offered was Non-curative cChemotherapy and Hormone-suppressing drugs.
Discouraged, I returned to Europe for imaging not available in the U.S., which identified Cancer in my upper Pelvic Lymph Nodes. After consultations with American doctors, I opted for a unique approach, Salvage Lymph Node surgery in Belgium, another procedure not available to me in the U.S.
Today, over three years later, my outcome is as favorable as possible. Although I am grateful, I am still diligent with continued post-treatment PSA testing.
I know there is no absolute proof of a cure.
My younger brother’s general practitioner is generally unsupportive of Prostate Cancer Screening. Here is what I have told my brother and any man or their partner that will listen:
1. Today we know three out of four elevated PSA Blood Test results are not from Cancer – the key is to identify the one that is. And we know most physical screening exams miss early stage Cancer, so we must be cautious with the ‘all clear’ finding. To save lives, men must dispel the misinformation that Prostate Cancer is an old man’s disease, that screening has unmanageable risks and that men should fear overtreatment and unwarranted side effects.
2. Before a Prostate Biopsy is performed, imaging should be done, just as it is routinely done for Breast Cancer. Although the U.S. lags behind Europe in Prostate Cancer Screening, the Multiparametric MRI is becoming increasingly available.
3. If a Biopsy is recommended, additional imaging should be done during this procedure to target the Biopsy needle to the more concerning areas of the tumor.
As critical treatment decisions are based on the Biopsy grading, men should obtain a second reading of the Pathology and Genomic Testing (or similar).
If the Pathology findings do not align with the imaging, further investigations should be done. I came to learn this is standard practice in much of Europe.
4. Men have many treatment modalities available with Prostate Cancer. I investigated the majority of them, including several that were not available in the U.S., five years ago. If I could do it over, I would seek out Ga68 PSMA PET CT before my treatment decision to aid in determining if the Cancer is likely within the treatment field of reach. This is a critical decision.
5. It is imperative for men to understand that the very common medical terminologies including “undetectable,” “relapse,” “recurrence,” “Cancer free,” and “NED” (no evidence of disease) give a false sense of security and are often applied when men still have remaining Cancer, active or not.
Men face significant disparities regarding the laboratory number that defines these terms. Our own American Urological Association still clings to PSA 0.2 as the threshold to identify Cancer recurrence.
Many patients and doctors say 0.1 is undetectable, NED, etc., yet imaging and the Salvage Lymph Node Surgery I had in Europe at PSA 0.1 confirmed Cancer at my Para-aortic Nodes – the precipice of Incurable Disease.
Each man should seek as many opinions as possible to determine the best treatment plan for their specific risks. Imaging is key. Men must take the time to understand the options available to them as well as the nature and extent of their Tumor. And men should remember that it’s never too early to begin screening.
Murray Keith Wadsworth, the author of Prostate Cancer: Sheep of Wolf?, is passionate about spreading the dark truth about Prostate Cancer.
His sudden diagnosis and shocking process to treatment continues to drive him to untangle and share the Systemic misinformation around the disease.
Thank you,
Glenda, Charlie and David Cates
