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I listened to medical scientists ten years ago; consequently, I am cancer-free



… went to good doctors, followed their advice


Ten years ago, I was told after having a PSA [Prostate-Specific Antigen] that it was very elevated, and that I should have a biopsy to see if I had prostate cancer.


Immediately, I started my own research. I knew from previous research since I had a family-link to that cancer that the high Gleason score was likely an indication that I had prostate cancer.


I was right, but in the interim, I did extensive research into the disease and the potential treatments. This score came back in late 2011, and I had a limited window in which to make a decision what route to take.


Essentially, for prostate cancer, two alternatives were available: Surgery and radiation. I was approaching just months short of my 65th birthday, and recovering from surgery would be a challenge. In addition, since I had experienced four surgeries over 15 years from the time I was 14 until I was 29, I wanted to avoid surgery at all costs.

The experts said that surgery has the highest rate of recovery from it since it removes the cancer completely. However, the side effects and pain could be worse than the cure.


That led me to radiation.


HDR — and some great physicians


First, I went to see a top surgeon at UPMC in Pittsburgh. I made a decision to go to Pittsburgh and UPMC because of some terrible experiences that members of my family had in being treated for cancer in Johnstown.


I knew that Dr. Joel B. Nelson would be the surgeon who should do the work if I chose to do so. He was very professional and genial, and he is one of the top prostate surgeons in the U.S. We had a nice talk, and he said that he sometimes regretted that he had not become a writer, which I thought was ironical.


Nevertheless, I was determined to look at the alternatives to surgery.


Radiation


Two forms of radiation were available. I went first to Dr. David Stefanik of UPMC, who fortunately, was located in Johnstown. He was absolutely great in presenting what he could do with external beam therapy.


However, I was also fascinated by the prospect of something called High Dose Rate, and Dr. Stefanik referred me to Dr. Sanjeev Bahri, also of UPMC, for another consult. In all, I had four consults before making a decision. Dr. Bahri’s office was in Greensburg, which is a much shorter trip for me than Pittsburgh, so both of these were convenient.


According the urologist who works with Dr. Bahri, the HDR expert attracts people from across the country to take his form of Brachytherapy.


What is Brachytherapy — HDR?


The form of brachytherapy that I chose to use was called High Dose Rate. In this, seeds are implanted in the prostate that kill the tumors that are present.


Low Dose Rate keeps the seeds implanted, while HDR does not,


Brachytherapy


Brachytherapy is a form of radiation therapy where a sealed radioactive source is placed, inside, on or near the tumour. Brachy comes from the Greek word for short. It is often thought of as ‘internal radiation therapy’. These sources produce gamma-rays, which have the same effect on cancer cells as X-rays. This treatment reduces damage to surrounding healthy tissue, thereby limiting side effects.


There are two main types of brachytherapy: low dose rate (LDR) and high dose rate (HDR).


LDR brachytherapy


Low dose rate brachytherapy can be thought of as ‘take-away’ radiation. Small radioactive ‘seeds’ are permanently implanted near or in the tumour. These stay permanently in place, releasing small amounts of radiation over several weeks or months.


HDR brachytherapy


High dose rate brachytherapy is based on similar principles to that of low dose rate brachytherapy, but the delivery is a bit different. Firstly, the radioactive sources are removed from the patient at the end of each treatment session. Secondly, the radiation sources deliver a more intense but short-lived dose of radiation during each of several (usually 1–3) sessions. HDR brachytherapy is used for more high-risk but localised prostate cancers and gynaecological cancers, amongst others. HDR brachytherapy is often given in conjunction with External Beam Radiation Therapy (EBRT).

“Brachytherapy,” Targeting Cancer


Dr. Bahri suggested that because of the high Gleason score along with the aggressive nature of the cancer in my tumors, I should have 25 external beam radiation treatments first — which I could do over five weeks in Johnstown — and then have the HDR done at Latrobe Hospital.

I followed the advice of both physicians, and as a result, in about four weeks, I will celebrate ten years of being cancer-free.


I took the advice of experts like those who told me to take the Covid vaccine, to wear a mask, and to engage in social distancing, The advice said that it was the best way to avoid the devastation from these diseases.


And they were right — and I was right — and in about six weeks, I will celebrate my 75th birthday. Had I used my supposed constitutional right [I am being facetious] to decline to take my prostate treatment ten years ago, I would likely not be alive today.


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