By Donald F. Cohen, DDS
Prostate cancer affects one in seven men today, making it the most common cancer in America outside of skin cancer. This year alone, nearly 233,000 men will be diagnosed with prostate cancer, and more than 29,000 will die from the disease. The reality is that no man is immune to this deadly disease—not even a doctor like myself.
Having lived with high blood pressure for quite some time, I visit with my cardiologist every year for an evaluation. Among all the blood tests he runs, one is the Prostate-Specific Antigen (PSA), which measures the activity of the prostate gland. Over the years, my PSA level had remained fairly constant within the normal range of 0.0–4.0 ng/ml, so when we discovered that the value had suddenly risen, the reality set in that something could be wrong.
It wasn’t before long that I was back in my doctor’s office facing some alarming news: my PSA level was elevated to 4.2 ng/ml. I can still remember that very moment I saw the test result and felt my heart sink into my stomach. It is normal for men’s PSA levels to go up as they age, so I wasn’t exactly sure what this meant for me. The initial shock overtook me, and I hoped for the best but certainly wanted to prepare myself and my family for the worst.
It was at that time that I had a biopsy done, indicating I had adenocarcinoma—a type of cancer that forms in mucus-secreting glands and accounts for 95 percent of all prostate cancers. Adenocarcinoma starts in the prostate gland and, if not treated successfully at an early stage, can spread to other parts of the body. According to the American Cancer Society, 217,730 cases of adenocarcinoma are diagnosed every year.
It was at this point in time that I was left with one of two options: have my prostate surgically removed or undergo radiation therapy. Fortunately, there are various types of surgery options today that provide patients with a quick and easy recovery period. One option involves the surgeon making an incision in the area to remove the entire gland that contains the cancer.
A newer approach performed by many surgeons today uses a robotic interface (also known as the da Vinci system). The surgeon sits at a panel near the operating table and controls robotic arms to perform the operation through small incisions made in the patient’s abdomen.
While the alternative option to surgery was to undergo radiation and hormone therapy, I opted for the surgical removal of my prostate using the open system. As a surgeon who often sees patients with cancers in their mouths, I feel that it is best to just remove a cancer surgically, rather than treat it over time with radiation.
My surgery was scheduled for September 22, 2014. After three weeks of rest and recovery, I was back at work and treating patients. Five weeks following surgery, I went in for my follow-up appointment with my surgeon, and my PSA level was as low as the machine could measure. Now, I am proud to be living cancer-free.
This experience helped me further realize the importance of the cancer screening I have been doing for my patients throughout my entire career. Every patient I see gets a complete cancer screening examination, followed by treatment for the problem they came in for. I check their mouth, gums, and tonsils, palpate their facial structures, feel their jaws, and palpate under their tongue to ensure there are no masses in their neck. From there, I move on to treat the patient for their problem. We are taught in dental school to perform these thorough examinations, and this proves to be an absolute necessity as the national figures for cancer diagnoses continue to rise.
What this experience also taught me and the message I hope to deliver to other men is that getting tested for prostate cancer early and often is absolutely critical. I had no family history of prostate cancer and never thought it would be something I would have to deal with, but the reality is that no one is immune. The American Cancer Society recommends that men at an average risk of prostate cancer should discuss testing with their physician starting at age 50. Men who are at a higher than average risk due to family history, age or race should have the discussion as early as age 40.
I’m fortunate to have discovered the problem as early as I did, but if I had let too many years pass without getting tested, I could have missed the opportunity to save my life. Work, family, and life obligations often get in the way of keeping regular appointments, but the next one you make could be the one that determines your future.