Kevin Whitehead: An Informed Decision
My name is Kevin Whitehead. I’m 58, and my wife Patricia and I have been married for 35 years. I run a wholesale distribution company, and Patricia and I lead very active lives.
When I went for my annual physical in June, 2011 my PSA had risen to 4.6. My doctor referred me to a local urologist, and in August I had a standard TRUS biopsy of 12 needles. Patricia joined me for the return consultation where we learned that two needles were positive. One was Gleason 3+3, the other was 3+4. The urologist showed me the ultrasound images, and we then discussed robotic surgery and radiation as available options, including the possible side effects. Neither treatment option sounded too appealing. He also referred me to a radiology group for more information. When I met with them, we talked about both external beam radiation and brachytherapy (seed implants).
My next door neighbor had been treated for prostate cancer a year earlier with brachytherapy. I talked with him about it. Patricia and I agreed we didn’t like the side effects of surgery, but I also didn’t like the idea of external beam with radiation scatter, or going in for 45 days of treatment.
I continued to gather all the information I could, and visited our local cancer center. There I learned about an “Us Too” support group in Morristown, NJ. I attended a meeting so I could talk with others who had treatment or were still deciding, and compared their experiences. Then my brother-in-law told me about focused laser ablation treatment or FLA, which he heard about through a friend of his. I liked the idea that it treats only the affected part of the prostate without affecting other organs. I especially liked that there is no surgery, and no treatment visits for 45 days. Best of all, it appeared to have little or no side effects.
I called Dr. Sperling’s office to talk with him about it, and did a thorough internet search including sites like Mayo Clinic, New York University, and his own site. I also learned about HIFU (High Intensity Focused Ultrasound) but I would have to go outside the US to have it done so I ruled it out.
I met with Dr. Sperling at his office, and was very impressed with the MRI images he showed me as he explained how the laser treatment worked, and how MRI could confirm the treatment. I had to make an informed decision since laser is not covered by my insurance and I’d be paying out of pocket. Patricia said, “If this eliminates the cancer and the issue of side effects, then it’s worth the money.”
I developed my own list of questions based on all my research. I again spoke with Dr. Sperling, who went over everything: the equipment, how urine flow is protected, and how sexual function is preserved. By now it was around Christmas. We hosted a holiday open house where I had a chance to talk with others who’d been through prostate cancer, and heard their stories, or stories of people they knew. I was able to share my knowledge about FLA and that it was a treatment option I was considering. Then, while vacationing in Manhattan over the holiday, I reviewed all the information I had collected and Dr. Sperling’s referral to a urologist at NYU, who was familiar with Dr. Sperling’s work. I decided to have focused laser ablation. When my local urologist found out, he recommended that a urologist familiar with FLA be in attendance, as Dr. Sperling is a radiologist. The urologist agreed to be there. My procedure was scheduled for January 10th at a New York City radiology facility.
Patricia and I drove into the city that day. The urologist went over what would be done, the medications, etc. When I was prepped, they gave me a small dose of a relaxant and a local anesthesia where the rectal MRI coil and laser applicator would be inserted. Before the ablation, the MRI was used to insure that everything was properly placed and targeted. I was awake during the procedure, which began around 10 am and took about an hour longer than the expected 1 ½ hours. When it was over, I was taken to a recovery area where I cleaned up, got dressed and ate lunch. I was surprised that I wasn’t sore.
At 1:30 the urologist came in and gave me a positive report. About 10 minutes later, Dr. Sperling came in and showed me MRI images of the lesion and showed me where they had destroyed the tissue. It was interesting to see that. By 2:30 PM, Patricia and I were ready to head home. She drove, since I had had the relaxant, and we were home by 4 PM. It was all so easy and unobtrusive. I would compare it to having a wisdom tooth pulled, or going in for some other minor outpatient procedure. There had been no cutting, no radiation. The laser uses heat to destroy the tissue and prevent the tumor from going anywhere else. I was relieved and elated. I went back to work the next day. With the surgery option I would have been out of commission and out of work with more recovery time; with radiation I would have been going for 45 days. Focused laser ablation was a whole lot easier than the other options and far fewer possible side effects.
For those diagnosed with prostate cancer, you discover you really don’t know what questions to ask at first. I didn’t know any of the doctors, or if I could trust what they were telling me. I recommend informing yourself as well as you can. Take time to do research, and go to support group meetings. As far as laser, it’s not well known yet, so I had to figure it out for myself. I talked to other people who worked with Dr. Sperling, including a patient whose TRUS biopsy had missed the cancer, but Dr. Sperling found it using MRI. It made me more comfortable that MRI is needed in this day and age for biopsy and treatment. I compare the difference between ultrasound and MRI to the difference between my grandmother’s 1950s black-and-white, grainy TV and today’s high definition wide screen TV. With MRI, you just get greater precision.
Would I do it again? Yes, definitely! Since I just had laser done in January, the jury is out on the long-term impact. But if I had to do it again, or cancer popped up somewhere else, I wouldn’t hesitate. I won’t have to figure out which is better. And I have no hesitation recommending it to others. It’s not for everyone, but if you do your annual physical, and monitor your PSA to provide early detection, you can have FLA as a treatment option and be done. I took the time to make an informed decision and am grateful that FLA was an available treatment option.