One man's journey back to good health
Radiation therapy treated cancer with
no long-term side-effects
By Paul Brent, For Canwest News Service
Bob Shiell, now the managing director of the
Prostate Cancer Canada Network, and President
of PCCN Calgary was diagnosed with
the disease at age 56 and has been cancer-free
for five years.
It happened a dozen years ago, but Bob Shiell remembers getting the news
he dreaded as if it were yesterday: "I get the phone call -- 'Bob, you've got
prostate cancer.'"
Knowing he had a family history of prostate cancer, Shiell had undergone a
yearly prostate examination and tests of the prostate-specific antigen cancer
marker since age 50. His PSA levels were high but still considered "normal" at 55,
and a skeptical specialist told him not to worry after his family doctor thought
he felt something during a digital exam. "In his words -- I can remember them so
well -- 'Oh well, your doctor has really sensitive fingers, come back next year.'"
The next year Shiell's PSA levels had gone from near-cancer territory of 3.9 nanograms
per millilitre to likely cancer of 5.6 npm, and the specialist ordered a biopsy. Cancer
was found in all six samples and his urologist ordered immediate surgery. "He told me
I could probably expect to have incontinence and very likely that I would be impotent,
and that I might need a follow-up course of radiation.
"I was 56 years old and was unprepared to listen to any of that or do any of that," he
said. Shiell turned to the Internet to research his condition, and spoke with other specialists
and fellow prostate cancer patients. Shiell's search led him to a specialist in Seattle who
pioneered a form of therapy called brachytherapy that utilizes tiny radioactive "seeds"
about the size of a grain of rice that are injected directly into the prostate gland.
"Because of my advanced stage, I ended up being on hormonal therapy for four months
[and] I had 25 sessions with external beam radiation" to kill off any stray cancer cells that
might be lurking near the prostate. He then returned to Seattle for brachytherapy.
"I can tell you right now that my PSA is 0.02, has been for about five years, and I
really don't suffer any side effects, so I'm a pretty happy camper."
A prostate is something all men have but few think about until they get the devastating
news that it has been invaded by cancer. Tucked away beneath the bladder and in front
of the rectum, the prostate occupies a strategic niche: Positioned surrounding the upper
part of the urethra, it controls the pathway that urine and semen take to the penis. In its
healthy state similar in size and texture to a plum, the prostate produces seminal fluid
and helps propel that fluid during a man's ejaculation.
The prostate also produces the PSA that is released into semen and which is sometimes
detectable in blood and serves as a marker for detecting prostate cancer.
Use of PSA as a cancer marker divides the medical community. "It is a controversial
test -- not every doctor agrees with doing PSAs," said Toronto general practitioner Kelvin
Bernard, noting the test yields a high rate of false-positive results. A proponent of the
PSA test, he recommends that male patients have a PSA test at age 50. If they are
Afro-Canadian or have a family history of prostate cancer, he recommends PSA
screening at age 40. "Personally I offer it to all of my patients and when I turn 40,
I will have mine," said Bernard.
Preserving sexual function was a key outcome for Shiell, something his first urologist
was unwilling to guarantee. "I had asked him about nerve-sparing surgery where they
try and preserve the nerves that are around the prostate gland to control erections,"
Shiell said. "He said 'No.' He was going to 'cut wide and cut deep.' I don't blame him,
he was looking for a cure. He was interested in saving my life. I was interested in
saving my life and also my quality of life."
Today Shiell is managing director of the Prostate Cancer Canada Network, and plays
a key role in helping the thousands of Canadian men diagnosed with prostate cancer
each year. His network
assists about 120 support groups for the disease across Canada, relaying survivor stories,
the latest news on treatment and lining up expert speakers on the subject.
Although its rates are comparable to breast cancer in women, prostate cancer receives
far less attention and charitable support, perhaps due to men's reluctance until recently
to talk about the disease. It is estimated that 25,500 men will be diagnosed with prostate
cancer in 2009 and that 4,400 men will die of it this year, according to the Canadian
Cancer Society. It is the most common cancer to afflict Canadian men -- a man stands
a one-in-six chance of being diagnosed with prostate cancer.
© Copyright (c) Canwest News Service
