Cancer Insights: My father's prostate cancer changed how I practice
August 26, 2014 | by Jennifer Linehan M.D.
Jennifer Linehan, M.D., an assistant clinical professor in City of Hope’s Division of Urology and Urologic Oncology in Antelope Valley, thought she knew all there was to know about treating prostate cancer. Then her father was diagnosed with the disease. This is her story.
My father is 69 years old, has no health problems, is very active and still works diligently every day, from 5 a.m. till the evening. He is always smiling, laughing and enjoying life no matter what comes his way. He is an inspiration to me.
About 12 months ago, I was waiting for him to send me his prostate specific antigen (PSA) results from his recent physical. I just wanted to take a look. He was busy at work and told me that his PSA number was fine. I asked my mom to email it to me anyway. His PSA score was 28. I was stunned. I re-read the number at least twice to make sure it didn’t read 2.8 instead of 28.
How could this be? I am a urologist. How did I miss this? My head spun as every worst-case scenario started to fill my mind. As I was trying to calm down, I realized he needed a prostate biopsy. I started to think about who would do his surgery. He needed to come to City of Hope. My thoughts were racing. I began to wonder how far the disease had spread.
Finally, I got the nerve to call my parents; they could hear that my voice was panicked. I was panicked. I knew the realities that came with a high PSA and being diagnosed with prostate cancer. I was trying to keep calm, but instead blurted out: “How did this happen? Hasn’t your primary care physician been checking?”
Apparently, my father had been given the option of having his PSA checked for the last five years, but he refused every time. He told me that it was easier not knowing and not getting checked, because he was feeling fine. I tried to explain to him that prostate cancer is a silent killer. Often, a man won’t have any symptoms until the disease has progressed into the spine. I took a deep breath, apologized for my overreaction, and walked my parents through the next steps.
I was supposed to be the calm one, in control, but it's all so different when someone so close to you is diagnosed.
Without a doubt, this experience has changed how I practice as a physician. It affects how I care for my patients, approach them and speak with them. I constantly want to learn more about prostate cancer – anything new that is published or reported. I also want to know every detail and every prostate cancer discovery. With my dad’s permission, I start every cancer consultation with this exact story.
It helps the patients understand that I know what they are going through. I discuss their specific cancer with staging and explicitly explain the treatment options, the same way I did with my dad. I review every statistic, nomogram and all the variables. I spend time emphasizing quality of life and really try to understand what is important to my patients as individuals, not just as “prostate cancer stage T1c.”
My dad underwent a robotic prostatectomy. He left the hospital in less than 24 hours and is doing well. His lymph nodes were positive for prostate cancer. I wanted him to get radiation, but he refused. It is his choice and his body. He is on a medication that helps block testosterone; he takes it every three months to control the cancer. He seems to be doing well, with no complaints and back to life as normal.
We will never be out of the woods completely. To say the least, his diagnosis haunts me. But prostate cancer when compared to other cancers tends to advance at slower rates, so at least we can try to get ahead of the enemy.
*** Learn more about prostate health and prevention tips at City of Hope. Become a patient or get a second opinion at City of Hope by visiting us online or by calling 800-826-HOPE (4673). Our staff will explain what previous medical records we'll need for your first appointment and help you determine, before you come in, whether or not your insurance will pay for the appointment.
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