Prostate cancer is the second most common form of cancer among men in the United States, according to the CDC. Fortunately, when caught in its early stages, prostate cancer is often easily treated. The chance of developing prostate cancer increases with age, and some men are more likely to develop the condition based on different risk factors.
Thankfully, Washington University urologists at Siteman Cancer Center diagnose and treat prostate cancer with the most sophisticated imaging techniques, diagnostics, and therapies available. Physicians use their experience across thousands of cases to formulate the best individualized treatment plan for each patient.
Mark Autry was confronted with a prostate cancer diagnosis after a hospital stay for colitis treatment. “I was in the hospital for four days and when I got out and my bloodwork came back, we saw that my PSA (Prostate-Specific Antigen) was 11,” he says. “I knew that wasn’t good.”
Urologists are able to detect prostate cancer by the level of PSA—a protein produced by the prostate—present in bloodwork. Healthy prostates produce PSA, but a higher-than-normal level of the protein can be a sign of prostate cancer.
Mark was referred to a specialist who ran biopsies to confirm and diagnose his prostate cancer. At the time, Mark was seeing a physician at another area hospital. When he received his cancer diagnosis, he knew he wanted to find a specialist with the expertise to take care of him.
Mark was determined to find the physician that fit his personal criteria for treatment goals. “I wanted a teacher,” he says. “I wanted somebody whose knowledge base was current, and if possible, I preferred a woman, because in my experience, women have been the best care providers I’ve had.”
Mark knew he had found the right doctor for his goals when he met Zeynep Gul, MD, a Washington University urologist who specializes in urologic cancers.
Dr. Gul earned her medical degree from Case Western Reserve University School of Medicine, then completed a urology residency at Icahn School of Medicine at Mount Sinai. She completed a urologic oncology fellowship at the University of Pittsburgh Medical Center.
“Being a urologist allows me to form long-term personal relationships with patients, while being able to directly improve their health through surgical intervention,” Dr. Gul says. “Fellowship training in urologic oncology means I have significant experience treating urologic cancers, including prostate cancer.”
Mark’s experience working in health care prepared him to seek the help he needed when he discovered his diagnosis. “I began looking for a urologist who had substantial research experience and an excellent patient outcome record, and Dr. Gul met those criteria,” says Mark.
Mark says that he feared open surgery. “I was a bedpan commando a long time ago, so open surgery was immediately where my mind went,” he says, recalling his time working in hospitals as a young man. Mark had seen many emergency TURP (transurethral resection of the prostate) procedures, and was nervous that he might require a similarly invasive procedure.
Advances in minimally invasive surgery make it possible for many people with prostate cancer to have surgery with smaller incisions, less pain and faster recovery times. “The access to advanced surgical techniques and personalized care at WashU with Dr. Gul gave me peace of mind,” Mark says.
While Mark had the benefit of working in health care for several years to understand how he could navigate his patient journey, other prostate cancer patients might not know where to begin looking to find the attention they need for the best possible outcome.
Excellent Care Record
“Patients come to my attention for two reasons: screenings and high PSA levels,” Dr. Gul says. She explains that Washington University School of Medicine was the first institution to investigate the use of PSA for prostate cancer screening. The combination of clinical expertise and focused research means patients experience highly tailored care, whether surgery is needed or not, according to Dr. Gul.
“Robotic prostatectomy is one of the most common surgeries for urologic trainees to study today,” Dr. Gul says. Her experience learning robotic surgical techniques, and years of performing these procedures for patients with similar conditions, prepared her to successfully treat Mark’s cancer.
After meeting with Dr. Gul, Mark’s concerns about surgery were put at ease. He would be able to have a minimally invasive, robotic surgery, rather than one of the large open procedures he had seen during his time working in a hospital. “She made it easy for me to feel prepared after hearing what the journey of care would look like,” he says.
“One does their best to provide the highest level of care possible, and many doctors make the same recommendations, but one isn’t always able to develop a high level of relationship and establish trust with a patient,” says Dr. Gul, recognizing that urologists have a unique opportunity to form trust with their patients.
“Being able to establish trust is beneficial for both the patient and the physician, because there are some tough conversations to be had and decisions to be made,” Dr. Gul says.
Mark agrees that being able to have that level of trust made it easier to put his care in Dr. Gul’s hands. “I had the best experience I could imagine from start to finish with Dr. Gul,” says Mark.
Follow-ups
It is standard for prostate cancer patients to continue to have follow-up screenings to monitor their recovery after prostate cancer treatment. Since his surgery, Mark’s PSA levels have been undetectable.
“I have regular bi-monthly checkups and so far, so good,” he says. “The reality is that this thing might come back, but as long as we keep monitoring with regular checkups, I know we have a plan to deal with it.”
Advice for Future Patients
“For cancer care, it is a benefit to come to a big academic medical center like WashU for the interdisciplinary aspect, so that at every step the patient will receive the highest level of care,” Dr. Gul says. “It’s useful because everyone knows to work together and we have regular conferences, which are helpful for procedures that are more complicated and for rarer diseases, as well as more routine procedures, like Mark’s.”
Washington University cancer specialists work together as a multidisciplinary team at Siteman Cancer Center, an interventional leader in cancer treatment, research, prevention, education and community outreach. It is the only cancer center in Missouri to hold the prestigious Comprehensive Cancer Center designation and “Exceptional” rating from the National Cancer Institute.
The American College of Sports Medicine and the American Cancer Society recommend exercise prior to surgery for a range of surgical procedures to enhance cardiovascular and musculoskeletal function for recovery. Mark urges men who get diagnosed with prostate cancer to get in shape. “Get in as good shape as possible, “says Mark. “You want to give your body the best chance to heal.”
The American Cancer Society recommends screenings for men aged 40 up whose first-degree family members have been diagnosed with prostate cancer. Dr. Gul encourages men to talk to their doctor about prostate health. “Not knowing is not the solution,” says Dr. Gul, “get screened if appropriate and determine if you have cancer. Come up with a plan with your primary care physician or urologist and make an informed decision.”