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Mical’s Stage 2 Prostate Cancer Story

Mical’s Stage 2 Prostate Cancer Story

Mical R. feature profile

Mical was initially diagnosed with stage 1 prostate cancer at 37. They learned after prostatectomy it was an aggressive stage 2.

He had no symptoms, and he wouldn’t have found out at an early stage if not for a guardian angel of a doctor who decided to include the PSA test in his regular blood work.

Now, Mical uses his voice and his story to advocate for prostate cancer awareness, especially in the Black community, conversations about family health history, and the importance of early screening.

  • Name: Mical R.
  • Diagnosis:
    • Prostate cancer
  • Staging: 2
  • Symptom:
    • No symptoms, caught at routine physical with PSA test
  • Treatment:
    • Radical prostatectomy (surgery)

Since being diagnosed with prostate cancer, my focus has shifted, and I’ve become super passionate about spreading awareness and advocating for more awareness, certainly in the Black community.

As a Black man, I feel that if I had certain things on the awareness side, then my journey could have looked a little bit different.

Mical R. timeline

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Mical R. dining out with family

Pre-diagnosis

Tell us about yourself

I have a twin brother. I’m a family man. I have two daughters. I’ve been with my wife for 18 years. We’ve been married 16 years.

I was a teacher for many years. I still work in higher education as an instructor. I’m passionate about reading and writing. That’s all I’ve ever taught, English language arts. Love writing.

Since being diagnosed with prostate cancer, my focus has shifted and I’ve become super passionate about spreading awareness and advocating for more awareness, certainly in the black community. As a black man, I feel that if I had certain things on the awareness side, then my journey could have looked a little bit different.

I’m doing my part so that men don’t have to go along not knowing the disparities and not knowing that black men are two times more likely to be diagnosed and 2.5 times more likely to die from the disease. It’s become my life’s work to do this.

I would have thought that if I had cancer that I would have been able to sense it.

Initial doctor’s appointment

[I’ve lived] in Houston my whole life aside from college. My whole family moved to Austin [when] I got a job promotion. That was 2017.

In 2018, we finally got settled. We [needed] to find a doctor because prior to moving, I went to the doctor every year. I was accustomed to going to my annual wellness visit at a minimum. My wife is from Austin. My in-laws recommended this primary care physician because they’ve been her patients for 15 to 20 years, so she came highly recommended.

My wife and I couldn’t get in. We kept calling to try to get an appointment. They were booked up. My mother-in-law said, “I’m going to text her and say, ‘Hey, I’m trying to get my son-in-law and my daughter.’” The doctor responded, “You tell the front desk that I said make it work.” That’s how I arrived at this doctor. This is key for me.

[On] my very first visit, she [needed] to know [my] family history. At that time, the only family history I knew was that my aunt, my mom’s only sister, had been diagnosed with breast cancer just weeks before. My paternal grandmother had recently died of stage four lung cancer — breast cancer that metastasized to her lungs.

This was a regular checkup. She did the blood work. But unbeknownst to me, she also tested my PSA levels. When the blood work came back, everything was great but she noted, “I’m concerned about your PSA levels.”

That was the first time I ever heard the word. I actually had to Google. What is that? I was just going for my annual physical, to establish this relationship. I had no symptoms at all, not one. I was very healthy [and] young.

I Googled it and I never got alarmed because I didn’t have symptoms. I always felt like whatever the concern is, it’ll be ruled out because I feel great. I would have thought that if I had cancer that I would have been able to sense it.

She told me, “I want to put you on an antibiotic for a month,” because she initially thought it was prostatitis, which is a prostate infection. I did the antibiotics for 30 days. She retested my PSA. She said, “I’m not satisfied. It came down a little but not enough. I want to put you on an antibiotic for another 30 days.” I did the 30-day round again. After that 30 days, when she tested my PSA, the levels had gone up higher than they were initially.

I cannot remember what the number was. It wasn’t crazily high but it was higher than it should have been. It was cause for alarm. In a period of two months, from whatever it was initially, it went up. It didn’t go down so that’s alarming.

At that point, she said, “I think we should send you to a urologist so that they can have a further look.” I did everything she told me to do. I went to the urologist that she referred me to.

They did a biopsy. A week later, I found out. At that time, they told me it was stage one prostate cancer. But we ended up finding out after the surgery that it was an aggressive stage two.

I always tell people that I used to think that I moved to Austin for a promotion, but I really think I moved to Austin to save my life.

What makes that doctor so good?

What makes her so great for me [is] that she comes highly recommended and they love her so that helps me feel more comfortable. [The] first time that I ever met her, I felt like [I’d] known this lady forever.

She’s intentional about being present, really listening and engaging, talking to me about other things, just getting to know me, and not making me feel like I’m one more [patient]. We know doctors are busy but I’ve been to so many doctors where I feel like [there’s] no time to connect so that’s what’s made her so special for me.

I call her my guardian angel. Essentially, she’s the person that diagnosed. She’s the reason that we’re here because I can almost bet that if I hadn’t met this doctor, there was no reason for me to get this PSA test if I wasn’t of age. I had no symptoms. It’s nothing but God.

If I didn’t meet this doctor, I can guess how things would have turned out.

I always tell people that I used to think that I moved to Austin for a promotion, but I really think I moved to Austin to save my life.

The night I found out my diagnosis, I called her and I said, “Hey, I just wanted to update you. It’s cancer.” She said, “Let’s pray,” and we prayed right then. She’s not a black doctor. She’s a white woman. Some people might assume maybe there was a cultural… no, she’s a white woman.

I call her mom, honestly. She 100% gives me that energy. I asked her, “What made you take my PSA levels? What made you do that?” She said, “I’ve just been noticing in the five years prior that younger and younger men are being diagnosed.” She’s probably just been reading literature. She’s up on the latest news and that’s what made her do it. And I’m grateful for it.

What did you know about prostate cancer?

I never thought anything. I’m sure I saw a commercial or something but a personal connection, never. I don’t know that I even knew anyone who had prostate cancer, besides maybe someone on TV.

It couldn’t hurt if you did the test and [if] it’s fine, then it’s fine.

Importance of knowing your family’s medical history

She said that because she noticed that younger and younger men [of color] were being diagnosed that it couldn’t hurt, which is true. It couldn’t hurt if you did the test and [if] it’s fine, then it’s fine. I also assumed that telling her about breast cancer on my mom’s side and my dad’s side may have just helped to make that decision.

This just goes into — and I can only speak for the black culture — we don’t discuss family history. We really don’t discuss things at all, but we certainly don’t discuss family history.

After I had surgery, I was back at work [and] I was on the phone with my dad’s only living brother. [I] found out that [he] had prostate cancer five years before me. My parents actually knew that he had it and they knew I had it. But even at the point [when] they found out I had it, they still didn’t tell me.

Men just don’t like to talk about this stuff, period. Men are not crazy about going to the doctor. Even if a man knows something’s going on, some men won’t go.

That also goes into why I choose to be such a big mouth about it because we’re just not doing ourselves any favor. This is not helping to move the needle forward by us keeping it to ourselves. We have to stop being such a taboo thing.

Mical R. Kitchen King apron

Men just don’t like to talk about this stuff, period. I’m just speaking for men. Men are not crazy about going to the doctor and this is a disease that affects men. I think specifically for prostate cancer that would be one of the leading reasons why most men feel like it makes them less of a man or they just don’t feel comfortable sharing it.

I’ve met so many men who I know have prostate cancer because I had it. But if I didn’t have it, they probably would have never told me that. I try to speak out for all of them because, at the end of the day, nothing is more authentic than an actual patient experience.

Doctors can get on here and they can say all of the amazing words. No one told me about this [and] I was going to the doctor. That’s a separate issue for some men because some men refuse. Even if a man knows something’s going on, some men won’t go to the doctor. But I was going to the doctor. And so for me, if I was aware of that health history, then I could have been advocating for it well before when this doctor just chose to do it.

If I didn’t meet this doctor, I can guess how things would have turned out. I would have still been going to the doctor but no one would have [chosen] to check it so it would have looked dormant until stage three or four. I’m so grateful for the way it happened and I have to do the work and be boots-on-the-ground grassroots because my life is essentially spared.

Getting a biopsy

Before this, the only surgery I’ve ever had was when I was in college to have a lymph node removed from [the] left side of my chest. When they said I needed to have a biopsy, I really didn’t understand what that was until I was there and it was happening.

They biopsy portions of my prostate. I can’t remember how many pieces they took, maybe four or five. Then based on that, they were able to see that cancer was present. At that time, it was stage one. But we later realized once they dissected my prostate after surgery that it was an aggressive stage two.

In black men, it can lie dormant and it can also be aggressive, which was exactly what happened to me.

Diagnosis

Getting the official diagnosis

It was seven days from the time I had the biopsy. The thing is, I don’t know if it was God keeping me sane, but I genuinely went through all of that — from the time that I met that first primary care physician all the way up to the results — whole time in between, I never ever got rattled. I never wondered, “Could it be?”

I consistently felt great. I felt good. I feel like I’m pretty in tune with my body. If there was something going on, I would have had a symptom, right? But it wasn’t until after learning more about this disease that it presents itself in different ways.

In black men, it can lie dormant and it can also be aggressive, which was exactly what happened to me. I had no symptoms but my cancer was an aggressive form, which is something that’s just wow.

I needed to go back to the doctor to get my results. Prior to that day, I had already gone to this urologist twice. The first visit was the consultation to talk to me about everything and then the second visit was the actual biopsy. Both times, I pay the co-pay.

On the third visit, I know that I’m simply going to pick up results. That morning at work, I was just talking to my colleagues. “I don’t think I should have to pay another co-pay because I’m really I’m not getting a service rendered. I’m just picking up results for a service.” They’re like, “No, I don’t think you should.” I’m like, “Yeah, I don’t think so either. I just want to call the doctor’s office just to make sure.”

I call the doctor’s office and the lady who I spoke with, I had a sense that she was a black woman. She reminded me of an aunt. I explained to her, “I’m just getting results today.” I don’t think I have cancer so this is also leading the way I’m dealing with it. “I just need to pick up my results today and I’m just trying to make sure if I have a co-pay.” She’s like, “No, you shouldn’t. You know what? This is what I’ll do. I’ll send an interoffice request for your results and then they’ll send them down to me. So call me back in an hour because I’ll have them by then.”

In an hour, to the minute, I called and she probably was so busy between the first time I talked to her and now that she hadn’t even checked her emails. She’s like, “Let me look. They haven’t sent it yet. That’s weird. I don’t know why they haven’t sent it. Listen, I’m going to go up there and get it and I’m going to call you back.”

She calls back and says, “Hey, I was just thinking you should probably just come in.” As soon as she said that, that’s when I got scared because I felt, even though I hadn’t talked to her that many times, we had just built this rapport where she agreed that she’s going to give me the results and now she’s calling me back and telling me to just come in. The inflection in her voice, the energy, all of it, just made me say, “Okay.” I didn’t ask her why. I didn’t say, “What made you change your tone?” I just said okay and I got scared then.

I came home that evening and I told my wife. We were actually driving to the urologist for that appointment. “Babe, I called earlier. I talked to a lady.” I said I was trying to make sure we shouldn’t have to pay another co-pay. She’s like, “Well, no, we shouldn’t.” I said, “Yeah. The lady was supposed to just be getting me my results. But then she just told me I should just come in. I don’t know why. That just felt weird to me.” That’s what I told my wife and that was the first time I got scared.

She calls back and says, “Hey, I was just thinking you should probably just come in.” As soon as she said that, that’s when I got scared.

Mical R. with wife

Before that, I was just moving through whatever I was being told to do because, in my mind, we’re going to rule it out. All of this is going to rule it out. We get to the urologist’s office. When I walked back up [to the front desk], as I was approaching the counter, the lady says, “Okay, your co-pay for today is…” I don’t remember what the amount was. My wife [went] right up to the counter and she’s like, “I don’t understand why we have to pay a co-pay. We’re just getting results, that’s all we’re doing. Maybe we have to see the urologist but it’s not really a visit. We’re just getting results. The service was rendered.” The lady goes, “Let me go check.”

The lady comes back to the desk with a piece of paper and slides [it] under the little window. I looked at the sheet. It was graphs and charts. I don’t know what it was. She said, “Oh, that’s your results.” At that time, I’m certainly thinking now she’s sliding me my results that it’s got to be negative.

My wife demanded that the urologist at least come and hand us the sheet of paper himself. The lady at the front desk walked away, came back, and she said, “Okay, the urologist said he’ll see you in a moment.”

We sit in the lobby for about 15 to 20 minutes. A nurse came and got us, took us to a waiting room, and we waited there for about 10 more minutes. Then he walked in. It was me, my wife, and my daughters were with us too. We were all together so we were all in the room. My daughters were younger. They were playing at our feet. They were in their own little world.

He came in, he’s talking, and I don’t know if it was so traumatic that my mind just deleted it because I completely never heard him say it. One reason I knew he must have said something bad was because my wife was crying.

I looked at her. “What did I miss? Can you repeat what you just said?” He said, “Yes, you have stage one prostate cancer.” My immediate reaction to him was, “Wow. You knew that I had prostate cancer and you were going to let me take that sheet of paper home and figure that out on my own?”

I knew right then that on this journey, that wouldn’t be my urologist. He was very embarrassed. He was trying to explain it away. “I see so many patients every day and right before I came in here with you, I was seeing another patient and he was crying on the floor.” It’s terrible.

It’s amazing to this day, it just is… wow. I didn’t pay that co-pay.

‘Wow. You knew that I had prostate cancer and you were going to let me take that sheet of paper home and figure that out on my own?’

Looking for a new doctor

I came home that night [and] called my primary care because she’s the one that referred me to him. I said, “Hey, this is not going to work. I have cancer.” She referred me to a new urologist.

I think I’m [savvier] in that space because I’ve been going to the doctor so I immediately know I’m not going to be able to work with this urologist. I’m also going to make sure I file a complaint with the Board of Urology. Certainly people in my community, they’re not going to know those types of things. Some people in my community would actually still stay with that doctor just because they feel like I don’t have any choice.

I left that urologist. He’s in the rearview mirror. Met with the new urologist. My wife came with me. He was in a little rolling chair. He rolled it right up in my face and he’s talking to me, looking at me right in the eye. He’s just talking to me. The energy was just so tense. He needed to leave the room to get some paperwork and as soon as he walked out, my wife and I looked at each other. “That’s him.”

Treatment

Radical prostatectomy

I was diagnosed in November and I had surgery in June. When I was initially diagnosed, I was told it was stage one by that first urologist. Then after surgery, I was told that it was stage two so it could be one of two things. It could be that I was misdiagnosed at first or it could be that it just progressed during that time. What I’ve learned about the disease since then [is that] it’s plausible that it could have actually just progressed during that six-month period.

My team of urologists had actually advised me [that] because [of] my health and all these different factors, they wanted me to do it within a year from diagnosis. I chose to do it in six months. I probably could have done it sooner but that was during the summer, I was off from work, and that was the reason I chose to do June.

I could have done it later. I’m glad I did it but my urologist told me, “You’ll be fine. We don’t suspect that it’ll escape the prostate in this time and metastasize.” That’s why it wasn’t a real urgency to do it December or January because I was told that as long as I do it within a year, I’m good.

Deciding when to do the surgery

I’ve heard of many men who also found out they had it and they just waited even longer. They just didn’t want to confront it.

Do I want to lose my prostate? No. But I know that I have this disease and I want to get it out as soon as possible. I could have done it sooner. I just chose to wait until June specifically because I know I was going to be off. I wouldn’t have to use vacation time.

If I worked all year and didn’t have that as an option, I would have gotten it done soon.

Make sure you have people there to support you because that does help.

Advice for going through surgery

I don’t know if sometimes when things are just so traumatic or stressful, my mind doesn’t allow me to be as rattled as I probably could be. It’s not like I was going in there happy. I had my family with me. I felt comfortable. My parents were there. My brothers came. Everybody who I love was there so that helped a lot.

Make sure you have people, who you care about, there to support you because that does help. When I opened my eyes and saw those people around me, that did help because I knew I had a long journey ahead. They told me that I woke up cracking jokes.

The day of surgery wasn’t really stressful. It felt like everything moved fast. I had to go the day before to do registration. I remember my wife and my youngest daughter were out of town on a Girl Scout trip and they were coming back that night. My mother-in-law actually took me.

I remember getting there that morning. My daughters were with me and we were laughing. One of my best friends came into town [with] his wife from Houston and they were cracking jokes. My dad came.

Right up until the time when they told me we’re going back to surgery, I remember just laughing with my family. I know I was nervous but I just have to stay in that space.

Mical R. with daughters family quote

Even before surgery, I just knew it was going to be a success because I knew, without a shadow of a doubt, I was in good hands.

Preparing for surgery

They really did a fantastic job preparing me. Up until the day of surgery, I had learned so much through them.

[During] the period between diagnosis and surgery, I connected with Us TOO, which is an organization for prostate cancer survivors, and they have a chapter in Austin. I learned a lot through them as well.

I felt so comfortable and I think that goes into the comfort level with your doctor or your HCP because I just had no doubt. Even before surgery, I just knew it was going to be a success because I knew, without a shadow of a doubt, I was in good hands.

I feel that changes the trajectory of the healthcare experience when the patient has that real, authentic connection with any doctor that they have to deal with.

Knowing you’re in good hands

I’m an intuitive person. I got my college degree in communications. I’m all about how we engage and how we deal with one another.

From the minute I met that second urologist, it was so evident that he was on my side. It almost felt like I was his only patient if I could just explain it that way, honestly. I felt like he didn’t have any other patients to see after me. I didn’t feel like he saw anyone before me. I didn’t get that feeling of next, next, next. Never. He seemed like his calendar was just open, like he didn’t have [anything] pressing. He was just really locked in and listening to me.

All of that really helped. I feel that changes the trajectory of the healthcare experience when the patient has that real, authentic connection with any doctor that they have to deal with.

Certainly in my culture, there’s nervousness there. It just comes from so many years of mistrust so more doctors need to be intentional about how they engage all patients but certainly patients who look like me because we know we need to get over that hill of mistrust. I just think that Dr. Giesler — who is my urologist, who I love and I talk to him to this day — did that so well.

I know a patient who actually feels like they never had prostate cancer. They feel they were being used as a project. I’m sure they did [have prostate cancer], but they feel this way and it’s primarily because they don’t trust the doctor. Stop the mistrust.

We know that that’s a real thing, like Tuskegee. In a lot of men’s minds, they still feel that that holds true today. I’m not here to say whether it does or doesn’t; I don’t believe it does.

My point with this patient is I’m pretty sure that the reason he feels this way is because he has a severe mistrust of his urologist and the team. I often wonder if he did have a trusting relationship with them, would that change how he felt? Would he still feel that he didn’t have prostate cancer? I’ve never heard someone say that and because I know that he has that mistrust, I’m pretty sure that’s what makes him feel that way.

If you do have cancer or anything else, it’s always better to know earlier than not.

Recovering from surgery

After surgery, I had to wear the catheter for seven days. For me, the catheter was the worst part. It wasn’t fun. Everything else, I could deal with. The catheter was terrible.

On the seventh day, I had to get the catheter taken out. I’m pretty sure it has a lot to do with the fact that I’m healthy and I’m younger. But when the catheter was taken out, I was at my daughter’s softball event that same day. Now, that’s not to say that I was just ready to go sail the seven seas but I was able to attend that. I had a little donut pillow that my wife bought me and I was sitting on that. I was able to walk from the car.

The catheter was the worst. It’s just so bad. They gave me two different bags. One bag I would wear when I’m at home, overnight when I’m asleep. Then another bag, I could be more mobile. It was attached to my leg.

I don’t think there’s anything that helped. I was just ready to get the thing off. All of the rest of it, it’s fine. But the catheter was not my favorite part.

Mical R. with wife flowers

I was back at work I would say six weeks. Maybe seven.

Every patient story is different. I’ve talked to other black men, patients who were maybe three or four years older than me and maybe weigh a little bit more, [and] their outcomes were a little bit different. I go days without remembering that I had prostate cancer. Everything functions on me the way it did. I don’t have issues with incontinence. I’ve never had to wear a diaper. None of those things.

I’m telling you all the positives about my specific scenario just to motivate you to go get checked because if you do have cancer or anything else, it’s always better to know earlier than not. We just have to get away from assuming that we can just ignore it and that it’s just going to resolve itself because that’s not the case.

You can still have an amazing life (wink, wink) after a diagnosis or after surgery. I’ve been disease-free since June of 2019 and I’ve never felt better.

It’s key that we talk about it in families. As a prostate cancer patient or survivor, I make sure everyone in my family knows that I have prostate cancer.

Prostate cancer awareness

If family health history have been discussed, then I would have known about prostate cancer. As a man, because I was going to the doctor, I could have just added that into the conversation.

My doctor visits, when health history is brought up, just like I was aware of my aunt having breast cancer and my grandmother having breast cancer stage four and I share that with the doctor, I could’ve also shared the prostate cancer.

It’s key that we talk about it in families. As a prostate cancer patient or survivor, I make sure everyone in my family knows that I have prostate cancer.

As a black man, as a prostate cancer survivor, I’m just here to tell men everywhere — but certainly, men who look like me — that doctors are here to help us.

I have a twin brother and an older brother who have still not gone to the doctor. I speak out for them. My brothers know I had prostate cancer and they came to my surgery. They know now that our uncle had it. My twin knows that because we’re genetically the same, that makes him at an even higher risk but yet they still haven’t gone.

I had people ask me before, “Why do you think that? Why do you think it is that men don’t wanna go to the doctor?”

When I think about it, the only word I can think of is fear. It could be a fear of the unknown or just don’t want to be poked and prodded. I don’t want people asking me personal questions. I don’t want to have anyone in my intimate space like that. It’s all these factors. Meanwhile, there are questions lingering with your health that go undealt with because of the fact that this fear continues to keep you frozen.

As a black man, as a prostate cancer survivor, I’m just here to tell men everywhere — but certainly, men who look like me — that doctors are here to help us. They are. If you go to a doctor and you don’t like the way they make you feel, I want you to know that you have every right to find another doctor. You shouldn’t have to go to a doctor that doesn’t make you feel comfortable.

It’s okay to speak up when you’re in doctor’s visits if you feel that the doctor is not meeting your needs and meeting you where you are. You need to know that you can certainly speak up and make the doctor aware of that.

If the doctor is still not being intentional about meeting your needs, you have every right to seek out another doctor. That’s something I really want to make sure that I hammer home because a lot of people don’t realize that as the patient, we actually have the power. We have more power than we think we do.

Let’s not be afraid to advocate for ourselves in the healthcare space and to speak up and ask questions so that we can change the narrative.

I used to go to doctor’s visits with my grandmother and the doctor would say something and I’d ask my grandmother, “Are you okay with it?” “Yeah, it’s fine, it’s fine. The doctor said it then that’s what it is.” I’m like, “But are you okay with it?” There’s just this thinking that the doctor knows it all. I don’t know anything.

I’m here to tell you no. You’re there to educate the doctor on who you are. I always say you have to teach people how to treat you and the same applies when you’re with doctors. Let’s not be afraid to advocate for ourselves in the healthcare space, speak up, and ask questions so that we can change the narrative.

If you go to a doctor and you don’t like the way they make you feel, you have every right to find another doctor. You shouldn’t have to go to a doctor that doesn’t make you feel comfortable.

How to address the fear

Two things. First, more unconscious bias training so that doctors and healthcare providers have the tools and know how to engage the black patient.

On the patient side, this is something that needs to be talked about in church meetings, fraternity meetings, in places where black people feel most comfortable because that’s going to essentially be what’s going to get them there. They also need to be hearing it from actual patients, actual black men who who who went through this, who are survivors and can speak to what it might look like in terms of the journey and speaks to the point of early detection.

Once we can get them there, we need to be assured that doctors are going to know how to engage them. It’s not just to start. It’s to stay.

You have to be very calculated. [If they feel like it’s falling on deaf ears again], it might even be worse. “Oh, you got me here and now, see? This is why I don’t even go to the doctor.” Then you will never hardly be able to get them to go after that. This is a combined effort for sure.

This needs to be talked about in places where black people feel most comfortable because that’s going to essentially be what’s going to get them there.

Mical R. with wife at SXSW 2022
Engaging black patients in a better way

Understanding how we communicate and that connection is critical. Perhaps walking into the room with a black patient and choosing to just talk about regular things. I am not cancer.

I’m only speaking for black people because I’m a black person. We want that because that’s going to be the best way to help us feel comfortable. There is this cloud looming over healthcare when it comes to how black people perceive any capacity of healthcare. The HCPs and people on that side must be vigilant and diligent about making sure to flip that in their daily interactions when they’re meeting with patients.

That’s not just going to happen overnight that’s why training is so important because some doctors need to be trained [on] how to do this. When it comes to tactical recommendations, how would that look? Maybe pamphlets that are provided to HCPs so that they understand, little tips and tricks, and ways to engage the black community.

Getting them there is half the battle but keeping them there is probably the bigger part. “I like those shoes!” “Wow! I like your hair.” A rule of thumb is to treat patients like they’re your parents or your family members even if clearly we’re not of the same culture. Most black people in that healthcare space, we’re tense. We’re uptight. We don’t know what to expect.

My situation is a little bit different because I’ve been going to doctors longer but I’m always wondering. Is it going to be a good experience? Is the doctor going to treat me like a person or like a patient? Yes, we’re going to be a patient but we want to be treated like people. I think that goes for all of us.

When the doctor feels that this needs to be stated, [if] there’s still a little bit of a disconnect, it’s even okay to say, “Listen I know you may have had bad experiences before but not here.” Declaring that [and] then following through in your actions. That can be enough, honestly.

A lot of doctors might take it personally because they feel, “That’s not me.” Most people realize it’s probably not you. It’s the system but this is how you could separate yourself from the system and say, “You’re here with me now. I’m going to take care of you. I don’t know what happened to you previously but you won’t have that here.”

While Tuskegee did happen, we must do our part in ensuring that it doesn’t happen again and the best way to do that is to show up.

Mical R. squad shirts
Information on and access to clinical trials

I knew what clinical trials were but I didn’t know how [they] all worked. I wasn’t up to date on all the particulars. I knew in general but there needs to be so much more work done in terms of educating the black community on clinical trials and providing access because they don’t even know.

There are so many clinical trials. You can go to clinicaltrials.gov and they’ll show you. But so many people don’t know that. I only learned that rather recently. You can just log on to clinicaltrials.gov, look through the list, and see what’s upcoming, what’s done, [and] what’s still open presently.

Providing access [and] making people aware that that website exists because, like many other things, it makes the black community feel like we’re being purposely left out of these clinical trials.

Efficacy comes into play because we haven’t been included in these. We might be taking the drug and then it doesn’t react the right way because we don’t have any data to show that that would happen.

I want black men and men in general to know that they can be an advocate for themselves. You have a voice because at the end of the day, you are the patient.

Clinical trial, that’s a big buzzword right now. There is a push to try because so much more awareness is being shed on prostate cancer that we may be moving the needle forward in that area.

I would say certainly at the HCP level, in the doctor’s offices, and [in] advertisements… “Did you know that clinical trials are available?” Providing the website so that people can look through that on their own.

I just think so many people don’t know that clinical trials are available and that black people can participate in them. It’s important that we have a seat at that table so that we are able to do our part in the research phase of these different medicines to show how they can help our community.

As a prostate cancer patient, as a black person, I would just tell black people in the community that, yes, Tuskegee definitely did happen. We honor that. But it’s important to know what clinical trials are, to understand how beneficial they are, and to know that that’s not a likelihood now. We’ve done so much better in terms of education and awareness. While Tuskegee did happen, we must do our part in ensuring that it doesn’t happen again and the best way to do that is to show up.

Early detection is the way you can ensure that you have the best quality of life. If my cancer wasn’t found as early as it was, my reality wouldn’t be what it is now.

Being an educator in a different space

When I was diagnosed in 2018, I could have never imagined that I’d be doing this work professionally. I’m meeting with doctors, talking to doctors, and working to spread awareness on a national level and that’s just a feeling that I can’t explain.

I’m able to transfer my skills into this space, having been a teacher for so many years and still actually teaching in higher ed. It feels good to merge my passions with my skills, to do this work, and to be alive and well enough to do it.

At the end of the day, the best thing you can do for yourself is to go to the doctor.

Words of advice

I wasn’t able to go in and advocate for prostate cancer necessarily. I did go to the doctor annually. Had I known about prostate cancer, I am sure that I would have.

At the end of the day, the best thing you can do for yourself is to go to the doctor. You have reasons to be around, whatever they are, whether it’s family or kids, or job. You have a reason to live and you have a reason to live your best life.

Early detection is the way you can ensure that you have the best quality of life. I know that if my cancer wasn’t found as early as it was, my reality wouldn’t be what it is now. I go many days without even realizing that I have prostate cancer and I think that’s just a testament to early detection, certainly because the cancer was able to be contained.

Early detection starts with going to the doctor. You’ve got to go to the doctor. You’ve got to move past those feelings of not being comfortable at doctor’s offices.

No one knows you better than you do so your best bet is to go to the doctor and speak up. If you feel something’s going on, then make sure you tell the doctor about it. But even if you don’t, I would advise all men. Nothing wrong with going in and requesting a PSA test.

Self-advocacy

For me, [the doctor] is going to have to be somebody that gets to know me in an intimate way. I want to feel comfortable with him. That goes along with why I speak out too. I want black men, and men in general, to know that they can be an advocate for themselves, that it’s okay. You can say, “No, I don’t agree with this.” You have a voice because, at the end of the day, you are the patient. That’s pretty much the story with the way I was diagnosed.

Black men are twice as likely to be diagnosed and 2.5 times likely to die. The disease presents itself in more aggressive ways and it remains silent in its earlier stages.

Importance of early screening

I was 37 [when I got diagnosed]. The truth is most doctors aren’t going to be screening for this until you’re 40. I tell men that are about my age that I run into. You can tell the doctor that you would like to have this blood test.

In all cases, if there’s a family history, you should certainly be getting screened. That’s why it’s so important to talk about things because if you don’t, then you’re not going to even know the history to be able to advocate.

Black men are twice as likely to be diagnosed and 2.5 times likely to die from the disease so just being a black man makes it much more important that you get this checked. In black men, the disease presents itself in more aggressive ways and it remains silent in its earlier stages.

For all those reasons, you need to go to the doctor. If you’re not 40, I would say still go to the doctor.

Another real barrier is this macho thing about the whole DRE, the digital rectal exam. First of all, if you have to get that done, you just need to do it. It’s for your life. With advances in technology, that’s not the first option now. The first option is the blood test and obviously, if the blood test reveals something, then that will be probably the next step. I try to make sure men know that because it seems minor, it seems trivial, but I promise you that a lot of men won’t go to the doctor for that reason. I’ve heard that so many times.

Mical R. Christmas with family

God wants you to depend on Him but he wants you to depend on people he’s placed here to do the job as well. The best thing I can tell you is quite simple. Go to the doctor.

While I’m talking about prostate cancer specifically, the overarching message is you need to be going to the doctor because you can’t get screened unless you go to the doctor. You need to be going to the doctor to get a baseline in terms of your health in general.

As a man, you definitely should be getting your PSA checked. If the doctor doesn’t do it, you should be requesting it. Even if you’re not 40. You could be 30. I would still say get your PSA checked because at least you have a baseline. You can do surveillance. It helps you to be more mindful and to be more vigilant about your health.

I still had a part to play in it because I went to the doctor. It was a blessing that it was this particular doctor but still, the fact that I went, I was able to be discovered.

You’ve got to get there. You have to get to the doctor.

Always look for support. If you don’t have any family support in terms of prostate cancer, there [are] support groups [and] mentors that can be provided to you. In terms of health care in general, you can jump on Google, you can research support groups that might be specific to something you’re dealing with. My reality is prostate cancer but I want to really reiterate that health care is of the utmost importance.

If you’re going to get your general health up, make sure that you’re aware of the latest as it relates to your general health. If that includes realizing that they need to do surveillance with regard to prostate cancer or breast cancer, do what the doctors tell you to do. Please don’t ignore what they’re telling you.

If you’ve got the diagnosis, don’t ignore it. We’ve got to get away from that.

I grew up in a Christian household. I love God. I know God. But I also know that God put doctors here to help us. God wants you to depend on Him but he wants you to depend on people he’s placed here to do the job as well. The best thing I can tell you is quite simple. Go to the doctor.

No one knows you better than you do so your best bet is to go into the doctor and speak up. If you feel something’s going on, then make sure you tell the doctor about it.


Mical R. feature profile
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Prostate Cancer Stories

Paul G. feature profile

Paul G., Prostate Cancer



Symptoms: None; elevated PSA levels
Treatment: Prostatectomy (surgery), radiation, hormone therapy
Tim J. feature profile

Tim J., Prostate Cancer



Symptoms: None; elevated PSA levels
Treatment: Prostatectomy (surgery)

Mark K., Prostate Cancer, Stage 4



1st Symptoms: Inability to walk



Treatment: Chemotherapy, monthly injection for lungs
Mical R. feature profile

Mical R., Prostate Cancer, Stage 2



Symptoms: No symptoms, caught at routine physical with PSA test
Treatments: Radical prostatectomy (surgery)

Jeffrey P., Prostate Cancer, Gleason 7



Cancer Details: Diagnosed at 59, biopsy had not detected it
1st Symptoms:None, routine PSA test, then IsoPSA test
Treatment:Laparoscopic prostatectomy
Categories
Continuing the Dream Diversity, Equity, & Inclusion Medical Experts Prostate Cancer

Leanne Burnham, PhD Prostate Cancer | The Patient Story

My Dad Was Diagnosed with Prostate Cancer. Now I’m Fighting It.

Dr. Leanne Burnham: A Caregiver, Patient, and a Doctor’s Journey

Motivated by her father’s prostate cancer journey, Dr. Leanne Burnham, scientist and community program coordinator at the City of Hope, dedicates her time and expertise so that communities of people of color could better understand prostate cancer and its specific risk factors.

Not only has Dr. Burnham been been a caregiver to both parents with cancer, she’s a lymphoma survivor, herself.

Her mission has been to raise more conscious and open conversations among families about their risks of cancer. That makes her a perfect fit in her department: Division of Health Equities at City of Hope.

Dr. Leanne Burnham is doing such amazing and inspiring work, not just in prostate cancer diagnosis and treatment clinical trials but also in patient self-advocacy, support, and other important socio-cultural factors around cancer. Explore our entire conversation below.


Introduction: Dr. Leanne Burnham

I am Leanne Burnham. I was born and raised in Akron, Ohio. Home of Lebron, we like to say. I live in California now. I am a wife and a mom of three. I have a 17-year-old, a 12-year-old and a 10-year-old. 

I’m a scientist at the City of Hope, that’s what I do. I do experiments at the bench for sure. We call it at the bench when we’re in the lab, but I also do a lot of community work and work in clinical trials.

Prostate Cancer

What is prostate cancer?

There’s a lot to unpack. But first of all, women don’t have prostate, so it’s just a male disease.

Another thing that seems silly to say, but the prostate and the colon are two separate things. A lot of times people think they’ve had a colonoscopy means they’ve gotten their prostate checked. But that’s not the case.

According to the American Cancer Society, prostate cancer is one of those diseases with a 100% cure rate at five years if you catch it when the disease is still localized or confined in the prostate.

That’s amazing because not a lot of cancers are like that. Many people would hear, “Prostate cancer is one of the better cancers to get,” or they hear, “Prostate cancer happens to older men,” which is true.

It’s a disease of age, and there have been some studies that by the time men reach their 70s and 80s, many men, if not most, have prostate cancer at some point. But prostate cancer isn’t what ultimately kills a lot of men that have it.

For that reason, a lot of people tend to not get so stressed when they think about prostate cancer and their risk of it.

But it’s important to realize that the second you have prostate cancer cells escape out of the prostate and spread in the body, you go from a 100% cure rate in five years to there is no cure.

There’s no in-between, so all of the treatments we have once the cancer cells have escaped are to prolong life or improve quality of life.

We’ve got some really great treatments out there. We’ve got cutting-edge treatments nationwide that are really extending the lives of many patients, and they’re living great lives. But I’m at the City of Hope, so, of course, I’m partial. 

It is also important to point out that, yes, prostate cancer is very curable, it happens a lot to older men, but that doesn’t mean it doesn’t happen in younger men.

It doesn’t mean that there are no aggressive forms in younger men. It certainly doesn’t mean that if you have prostate cancer, you’re just going to be cured and be fine because it’s not that way for everyone.

Diagnosing and Staging

First of all, you start with a PSA test. That’s testing your prostate-specific antigen, which is a protein secreted by the prostate. It’s circulating in your blood, so that’s one of the first markers they can test and say, “Hey, something is going on with your prostate. It might not be cancer, but something is going on.”

After a PSA test, men will get a biopsy, then they get a Gleason score. Pathologists look at the tumor under the microscope and assign a score based on how cancerous the cells are looking.

The higher your Gleason score, the more aggressive your cancer is.

There are genetic mutations that not everyone has access to, but some physicians provide that for their patients. Especially if they have a lot of family members that have had prostate cancer.

You can look at the genetics and see if there are some mutations that make the tumors more aggressive. What makes it hard to pinpoint treatments for prostate cancer, and to find a cure ultimately, is that prostate cancer tumors are very heterogeneous.

If you’re taking a sample from one part of the prostate and another sample from another part of the prostate and you’re looking under the microscope, they look different. There are different genetic mutational landscapes in those tumors.

Prostate cancer cells are very smart. Every cancer cell is smart. I’ve had cancer but I also have tremendous respect for the cancer cell, its ability to navigate its way and go undetected by the immune system, its ability to receive treatments and figure out ways to resist those treatments and form mutations.

The ability of resistant cells to keep growing is truly amazing. Cancer cells find a way, I tell you, but the key to its science is when they find a way, we have to tackle that new way.

»MORE: Read more prostate cancer stories

What inspired you to focus on prostate cancer?

It was totally unfamiliar to me. I don’t really have a family history of cancer at all. My dad was relatively young. He was like 50 at the time. He worked out a lot, he ate very well, he was going to Mustard Seed (organic grocery store) and things like this.

One day, he called me as I walk out of a physics class. I picked up the phone but he wasn’t talking; he was just crying.

I was like, “What in the world is happening?”

I just heard him crying on the phone, and he said, “I have prostate cancer. You’re the first person I’m telling. I haven’t told your sisters, so if you can come to the house when you get out of class and I’m going to talk to all of you guys. I’m just letting you know.” 

At the time, I was a premed student, so he was reaching out to see if I had any advice, which I didn’t know about prostate cancer at all.

That experience really kicked off my passion for understanding what was going on with him. But beyond his diagnosis of prostate cancer, I started to notice that Black men in our community were getting that, as well.

It was just something I hadn’t noticed before, so I’m like, “Oh wow, this person at church has it. Oh wow, this person at the grocery store has it.” Different men were getting prostate cancer in their 40s and 50s. It was younger than what I would have thought.

So since I was a student and I had some shadowing opportunities and some research opportunities, I decided to get those hours at Cleveland Clinic, which is number one in urology in the nation, and that’s where my dad is a patient.

I went, and I was able to spend quite some time there. I was with a physician one time when he walked into a room with a Black patient with prostate cancer, and when he walked in the hallway with me, he said, “I hate these cases.”

He said, “Because every time I see a Black man in their 40s, or 50s with prostate cancer, it’s almost like it’s a different disease than other prostate cancers.” He was like, “You have to treat it so much more aggressively. It’s just a different ballgame.”

That’s when I thought, “Wow. I never had thought about it. Was there a difference in race and all that?”

From that point, when I went on to Loma Linda University to get my doctorate, I decided that I was going to focus my dissertation on prostate cancer and Black men specifically, and looking at reasons why their tumors might be more aggressive.

Prostate cancer in Black men

There are so many reasons why that is, and there’s been a lot of research that goes into looking at the multifactorial reasons behind that. We do know that Black men are much more likely to get prostate cancer.

Different numbers float around.

The American Cancer Society says that Black men are 76% more likely to be diagnosed. We do know that Black men are much more likely to be diagnosed at younger ages. When they show up to the clinic, they’re at a more advanced stage.

We also know that they are more than two times more likely to die from prostate cancer.

But what’s new on the forefront that we have found in the past five years doing clinical trials that include Black men is that when Black men are given cutting-edge treatments that are out, they actually respond better to treatments than men of other ethnicities, which is really exciting for any disease that you look at.

You can look at breast cancer, colon cancer, or others. If you have a certain demographic that is most high risk and doing the worse, if you can show that if you give them medications, they’ll do better, that’s a win-win for everybody at the end of the day.

Disproportionate risk to prostate cancer

Watching him go through his surgery and radiation and seeing his medications and things that he was on made me realize how private prostate cancer can be.

I really have never even talked to him about this, so dad, don’t get mad when you watch. I noticed some issues come up that maybe men would be embarrassed about. That was the first time I saw it with him.

Now that I’ve worked with hundreds of men with prostate cancer, that appears as a common theme.

Men are scared of certain treatments. They don’t want to have the side effects and don’t necessarily feel comfortable talking to people. They feel isolated sometimes.

That was the first time I saw my dad not be such a superhero. He became more human at that moment. Maybe he was embarrassed or nervous. I wasn’t used to seeing him like that.

DNA and genetic component

In terms of different reasons why he got prostate cancer younger, or Black men in general, for sure, there is a genetic component. I’ll start with the things you can’t change.

You can’t change your DNA. The reason that Black men in the United States specifically are at increased risk for aggressive prostate cancer is because their DNA happens to trace back to the DNA of West African men.

This makes sense because, in the history of the US, the transatlantic slave trade, Black people in the US came from the western portion of Africa. Not surprisingly, men in West Africa have very high rates of aggressive prostate cancer as well, so that DNA matches.

There are certain variations on certain chromosomes that we know that are more likely to occur in Black men than other ethnicities that makes them more likely to get aggressive prostate cancer.

Role of Vitamin D

In addition to that, my boss, Dr. Rick Kittles, the Director of the Division of Health Equity at the City of Hope and an internationally known geneticist and prostate cancer researcher, has shown for a decade that there’s a link between vitamin D deficiency and prostate cancer risk.

People may have heard about COVID going on, like, “If you’re vitamin D deficient and have COVID, that’s not a coincidence.” Vitamin D deficiency leads to a lot of pathogenic trends.

With prostate cancer specifically, we know that vitamin D deficiency leads to tumor aggressiveness. But how that relates to Black men is that our bodies make vitamin D from the sun, and our bodies are dependent on sunlight.

The more melanin you have in your skin, the less vitamin D your body can synthesize.

If you have darker skin, and then in our lifestyles now, we’re not outside in the sun as much as we used to be, we’re much more likely to be vitamin D deficient.

In the African-American population, about 70% are vitamin D deficient or insufficient. There’s a vitamin D link to prostate cancer as well, then we know that there’s diet and lifestyle, of course.

It’s always good to have a healthy diet, of course. But we’re doing studies at the City of Hope right now where we’re looking at the link between charred foods, like barbecue or grilled foods, and the ability of the consumption of that to contribute to more aggressive tumors.

Socioeconomic factors

There’s also socioeconomic status, which goes a lot of different ways. But first of all, it controls your access to healthcare that you have.

Of course, if you have better access to healthcare, you’re going to have earlier screening, maybe a better team of doctors who will treat your case with a precision medicine approach, and you’ll have access to newer cutting-edge treatments.

But the other part of socioeconomic status that we’ve really dived into in 2020, given our nation’s culture, is looking at discrimination, especially in healthcare and medicine and in science really.

We know that stress kills, literally. And there are studies out there, and I published on it, on how much cumulative stress somebody’s taken on over their lifetime. We know it occurs more often in Black people.

If you have that cumulative stress, it dysregulates your HPA axis. It dysregulates how much cortisol your body is making and how your body responds to that cortisol and looks at glucocorticoid receptors. But that’s real science; we don’t have to go all into that.

Comparing cancer cells in Black and white men

Basically, what I’ve shown previously is that when I treated Black prostate cancer cells that I was growing in the lab with cortisol and compared them to Caucasian cells. I had Black cells and I had White prostate cancer cells.

The Black cancer cells grew more aggressively, and they upregulated these genes in these proteins that made them more likely to resist therapy. You could have this cumulative stress that would dysregulate your stress hormone system, making you more likely to get cancer. Then once you do get cancer, it makes you less likely to respond well to treatment.

That’s a very interesting concept that’s being studied right now. There’s a lot of research dollars going into that nationwide. I’m not working on that anymore, but I can’t wait to see like the results that come out of that.

Ignoring the risk factors

This is something that infuriates me, for sure. I’ve also published on this.

First of all, in Southern California, where I live, we did a study looking at more than 400 men and found that with 54% of Black men, their doctors never even talked to them about prostate cancer screening. We have to start with that.

A lot of men are not even getting screened when they should. That is because prostate cancer screening recommendations for a while we’re saying, “Okay, screen every man at 50,” and then in 2012, the US Preventive Taskforce said, “We’re not screening men at 50 anymore.”

The problem is that it really hurt Black men, and that recommendation was based on studies that looked at 200,000 men that did not have prostate cancer.

They had done the PSA test to see if it was indicative that they would get prostate cancer in the future, but the studies say over 95% were men of European ancestry.

This recommendation is applied to everyone, but it didn’t consider a racial difference in prostate cancer risk.

The American Cancer Society and Prostate Cancer Foundation says that if you’re Black, and you’re 45, you need to get your PSA tested. If you’re Black, and you have family members that have prostate cancer, you need to get tested at 40.

This is the recommendation, and then you go to the doctor and your doctor says, ‘Actually, no, you don’t need to be screened.’ That’s a big problem.

That happens so many times. Of course, if you go to the doctor and the doctor says you don’t need to test, who would want to get the test? You’re just like, “Okay, I’m good. I don’t need to get the test.”

That’s the first thing. But then once you do get the test and you get your PSA results back, there are differences in how those numbers should translate based on race.

For a while, the number that men would look at is four nanograms per milliliter of your PSA. If it’s higher than four, then maybe you want to do some follow-up.

It’s actually 2.5 for Black men, according to the American Cancer Society. Dr. Rick Kittles has published that, actually. You can look at numbers of 1.5 in Black men and it can be predictive years down the road that it’s going to transform into prostate cancer.

A PSA of 14 is quite alarming and then by the time he was diagnosed, it was 64, as far as I can remember.

When you go to the doctor, and you have an elevated PSA, and a high Gleason, I can’t tell you how many times where I’ve had people reach out to me and they’ll say, “Hey, my Gleason score is seven and my doctor says that I should do watchful waiting.” I say, “Did they look at you? Do they know that you’re Black? Did they get the memo?”

It’s not a one-size-fits-all blanket approach sometimes. You really want to make sure that your physician, first of all, is referring you to a urologist. I would definitely say, go to a urologist at that point and have them help you make the decision and hopefully with somebody that’s well-versed in how this disease affects men differentially.

Watching out your genetics and mutations

You hear about BRCA mutations of breast cancer. Not surprisingly, if you have a high risk of breast cancer in your family, that also translates to prostate cancer.

They’re both hormonal cancers, but particularly, if you have BRCA mutations that run in families, we can treat patients with those mutations with PARP inhibitors. There are different kinds of PARP inhibitors that are in clinical trials right now. You’d have to check and see what’s available for you.

Oftentimes, we know that these mutations lead to more aggressive tumors. But sometimes, it’s like hitting the jackpot because then you have access to an additional line of therapy compared other patients that don’t have those mutations.

Genetic Testing

I think it would be individualized, and that the urologist would discuss with the patient their family history and just get a sense of how high their risk is. I don’t believe that it’s offered to everyone. Just because you want it, I’m not sure that you can necessarily get it or your insurance would cover it.

You could always pay for it out of pocket, but not everybody has that luxury. But if you have multiple family members that have prostate cancer, it is definitely something worth looking into.

Ongoing studies on PARP inhibitors

Dilemmas and decisions

I love working on clinical trials, because to me clinical trials, how I try to explain it to people, is like a VIP access to cutting-edge treatment.

Many people can be afraid of clinical trials because you might think that you’re going to be a guinea pig. There’s a lot of mistrust in clinical trials in the Black community, for sure. Number one, because of the Tuskegee syphilis experiment that was just a trial gone completely wrong for 40 years.

There’s a lot of mistrust about clinical trials and who’s funding it and who’s behind it, and if I will be a guinea pig or get a placebo.

A lot of people have an idea that they’re going to get a placebo when in actuality, if you participate in a clinical trial, you are either going to get standard of care, which is what’s offered in the clinic to anybody that have your particular disease, or have the option get the VIP treatment on top of the standard of care or in place of the standard of care.

The VIP drugs don’t get to that stage just like that. It’s years and years in the making so by the time it’s to that point, we, scientists and physicians, feel very confident that this is going to work.

Thus, it is important to point where it’s at in a clinical trial and that there are different phases of clinical trials too. There’s phase 1, phase 2, phase 3. Obviously, the later the phase, the more people have used that drug in that disease setting before. So you can decide if you want to do a phase 1 trial or feel better with a phase 2 or phase 3.

Stratified Clinical Trials

With clinical trials, they typically, in the past, have not included a lot of minority populations—Black, Latino, Asian, Native American, for sure. So it really does a disservice to everyone because you need to know how a drug would work in the context of different genetic variations.

One drug may work really well in one demographic, and it might not work as well in another, so we really try to accrue.

This means recruiting and enroll Black men in prostate cancer clinical trials, which makes sense because they’re more likely to get the disease and die younger.

It’s important to look at these new VIP cutting-edge drugs and Black men could really benefit from them. As I mentioned before, some recent trials enrolled a lot of Black men. We call it race stratified clinical trials.

There were a few studies where one was looking at hormone therapy, one was looking at chemotherapy, and one was looking at immunotherapy. In all three of them, the Black men that participated in the trial had longer survival than men of other races and ethnicities.

When we looked at that, scientists like me who do health disparities research were like, “Wow, that’s so encouraging.”

At the City of Hope, we have a team of scientists and physicians and clinical research nurses, and statisticians who come together and think about diseases and ways to help people who suffer the most from that disease.

Talazoparib clinical trial

Alongside Dr. Rick Kittles, Dr. Tanya Dorff, who’s the Director of the Genital Urinary Program there, and Dr. Zijie Sun, who’s another prostate cancer researcher, we designed a clinical trial to use a PARP inhibitor called talazoparib. It’s a newer-generation drug that Pfizer makes.

This trial is also sponsored by Prostate Cancer Foundation and we’re going to be using PARP inhibitors in a racially diverse group of patients so we are going to have a third of the patients be white men, a third of the patients be Black men, and a third of patients be Asian-American.

The Asian population is very heterogeneous, so I just hate to throw it all into one.

Many Asian-American men actually do better with prostate cancer than white men. Black men do the worst. So we want to see how this drug works in different races. But we’re not just picking races just to see; there has to be some sort of a scientific reason.

Racial Differences in Androgen and Androgen Receptors

The reasoning there is an interplay at the cellular level between PARP and androgen receptor. Androgen receptor has some variations that affect its function.

Androgen and androgen receptors are crucial for prostate cancer cells to grow. That’s why if you get prostate cancer, one of the treatments is hormone therapy because we want to block androgen and the androgen receptor.

There are racial differences due to genetics where different trinucleotide repeats that exist in the antigen receptor. There’s different links, so they’re shorter repeat links and there’s longer repeat links.

Asian men, not just American, tend to have longer repeats, and African-American men tend to have shorter repeats. The repeat length may affect the men’s response to this PARP inhibitor with the talazoparib. We’re going to see.

The study just kicked off this past month and we’re starting to accrue patients. It would be one more drug in the arsenal because as I said, this is going to be offered to patients who already have metastasis.

They can do different drugs that are out there, but this PARP inhibitor could be something that’s extra added to their hormone therapy, and that’s what we’re looking at. We’re looking at the Talazoparib specifically with Abiraterone acetate at this point in time.

Developing targeted therapy according to race

That’s something that we could check in the future. We could look at their androgen receptor, look at your trinucleotide repeats, then we could say, look, you’ll be a great candidate for this drug in the future beyond clinical trials.

But it’s not going to target the shorter. It’s the same with everyone. We think that there may be differences in response in the androgen receptor and the trinucleotide repeats within that receptor, within that gene. But we don’t know what to expect.

It may work well for everyone, but if there is a difference, we want to tease that out.

This is a two-year study, and we assess the study. You don’t just start the study and then just let it go and check at the end. You’re constantly tracking your progress as it goes, so we should have a good idea by the end of the year.

Building trust in clinical trials

That to me is the most important part of it.

In the past 20 years, there has not been an increase in the number of Black physicians accepted into medical school. That’s the problem. It’s not making it through medical school; it’s getting accepted into it.

A study came out of Oakland last year that showed how much better the outcomes were and how much more the diseases were addressed when Black people went to Black physicians.

We look at it in Black maternal death rates and infant mortality, and we know that just by the presence of a Black nurse or a Black physician in the room, the mortality rates go down, just by them being in the room.

That is a lot to unpack on why that is, but there is a trust factor when you have cultural competency in the room. Race doesn’t have to match all the time as long as your physician is culturally competent and sensitive to different communication styles and cultural contexts. It can work just fine, but we know that there are still many barriers, for sure.

When they go into the office, the patients feel the bias going both ways. There’s bias on the part of the patient, and then there’s bias on the part of physicians.

»MORE: Learn more about the process of clinical trials from one program director

First of all, increasing the number of minority physicians, in general, would help. But what we like to do is to have a diverse team—diversity, in terms of race, gender, age, and occupation. We have physicians, nurses, scientists, and many of us who work within the Division of Health Equities at the City of Hope have personal ties to how we even got into this.

I got into this because of my dad, and so I’m speaking to Black men, and they’re saying:

  • “Oh, I feel fine. I don’t have any symptoms.”
  • “Really? Because my dad didn’t have any symptoms either.”
  • “Oh, I don’t know if I get that done. I’m not going to have a normal life.”
  • “My dad had that, and he’s doing great.”

That works on these teams who have personal ties, and so it comes across as more genuine, for sure.

We’re not just going to collect samples for research and just leave. We are there to help the men. We do actual prostate cancer screening in the community.

I know people freak out. We don’t do digital rectal exams in the community, but we do the blood tests, we provide the men their results and then we offer follow-up care and it’s not just at the City of Hope.

We partner with community clinics for men who may not have insurance or under-insured to make sure that they get that follow-up care, especially if their numbers are low enough that we think it could be caught early.

That’s really the goal of everything that we do. But, yes, the mistrust is a real thing and we try to tackle it that way.

Another way to really increase minority enrollment in clinical trials is just to provide access in communities of color.

Not everybody can travel to your main clinical trial center. I know at the City of Hope, we’re very fortunate to have community sites in Pasadena, Antelope Valley, or Santa Clarita, Pomona.

There are different locations to make it easier for patients to go from their neighborhood to a closer location to get treatment, which helps.

There’s financial incentives as well, and that can be controversial for sure.

Some of our trials offer them, and some of them don’t. But a lot of times, when you’re a cancer patient, getting to clinical trials is expensive. You and your caretaker have to call off work, you might have to get lodging, have transportation costs, and so a clinical trial can provide some financial incentive to help overcome that. It can really open the door for a lot of people.

Telemedicine as a tool

Telemedicine definitely has its pros and cons we’ve all learned during quarantine, for sure.

That translates to prostate cancer as well. If you don’t live close and have the technology and the app you need to communicate with your provider, it can give you access to perhaps more than you were exposed to before.

City of Hope Work in Communities

It’s our community-based prostate cancer program directed by Dr. Rick Kittles. I am lucky and blessed that he allows me to be the project coordinator for that. I work under him to recruit licensed phlebotomists. We recruit volunteers.

It is not hard to recruit volunteers because these events are the highlight of our week. They’re so fun. We get so much more out of these events.

Anything that we give back, we receive back in the energy of the individuals that we meet and we touch.

First of all, we provide education.

Let’s say we’re at a church. Usually, the pastor will let us get on stage for five minutes to say what we are doing and why it is important.

We know in the literature that, unfortunately, the men who are most at risk for aggressive prostate cancer don’t think that they are. So the first piece is letting people know they belong to the high-risk group.

Then a lot of men are afraid of the digital rectal exam. We let them know that it’s the PSA test now. You can get the DRE when you go to the doctor, but since 2017, you lead with the PSA. 

A lot of times, when they find that out, they say, “Oh, okay. You don’t have to do that. Then I’ll do the blood test.” That’s the next part of it.

We also let them know that most of the time, with prostate cancer, you don’t have any symptoms. Men will be at Taste of Soul or the Long Beach Jazz Festival and are sitting there with their drinks and their cigars, and they’re, “I feel great. I feel great.” On the other hand, you might frequently be urinating at night.

We go into the communities, educate, interact, do the blood tests, and then follow up within two weeks. And we tell them, “Don’t freak out. That doesn’t mean you have prostate cancer. But either way, you just want to stay on top of your prostate health.”

We send every person an individualized letter. By individualized, it’s an official letter from the City of Hope. It gives them their PSA level. Based on their race and age, we translate to them what that means for them. Not everybody’s letter is going to look the same.

If they are at a younger age but they are showing a 2.5 or a 3 PSA, we’re like, “You really want to follow up and get this double-checked.” We follow up within two weeks.

If a man has very high PSA levels, we will call to make sure they got that letter. We tend to follow up after a few weeks for everyone who has elevated PSA, anyway, just to see, “What have you done with that?”

Many men find out and haven’t told anybody and they’re nervous to take the next step. So we help them with that.

Then we have social workers that help to navigate them getting to their next follow-up person. Whether it’s at the City of Hope, we would love to offer the different treatments that we have there.

But not everyone can travel that far, or maybe their insurance doesn’t allow them to. We partner with community clinics in the LA area where patients can go there as well.

Lessons from Community Work

I’ve learned how much people trust their doctor without knowing their personal risk. They trust their doctor knows their risk. It’s scary how often it doesn’t necessarily seem to be the case.

I’ll talk to men sometimes, and they’ll say, “Oh, I had that test done.” Then I’ll say, “You went and got the blood test?” They’ll say, “No.” Then I find out they’re talking about the colonoscopy. That’s one thing.

A lot of times, I hear, “I got all my blood work. My doctor does all my blood work every year.” Then I’ll say, “Well, did they include that in your blood work?”

A lot of times, it’s not included. They’re checking your blood sugar and your enzymes but not the PSA. Now that you have medicine apps on your phone, they’ll say, “No, I did it. My doctor ordered it.” They’ll pull it up. I say, “If you don’t mind, let’s look and see. What was your PSA?” Then it’s not in there, and then they’re like, “What? My doctor was not testing?”

It’s endearing how a lot of people do trust their doctor. Then it is sad to see sometimes they’re let down, but it’s like, “Now you have the tools. Now you email your doctor, and next time you’re in there, you let them know that you want to have this test, but actually, you don’t have to because we’re going to do the test now, and we’re going to give you a letter, and you can show your doctor.”

Hopes and prospects in prostate cancer research

I think we’re so close. When I got into this when my dad was sick, his doctor told him at that time, “Oh, you have a set amount of years.”

He’s passed that amount of years, and he’s doing well. We know he’s not curable still, but I hope to change that. When I got into this, I said, “I’m going to find a cure for my dad,” many people say. That’s the goal of a lot of scientists. They have a loved one, and that’s why they got into it in the first place.

I’m at a place at City of Hope where we have so many clinical trials, so many cutting-edge treatments, and we’re seeing patients that are really doing well. I just feel like we’re just at the cusp of it.

I’m just like, “Dad, hold on. Just hold on. We’re at the cusp of it.” I do think that it’s around the corner. I don’t think that it’s something that’s decades away. I think it’s sooner than we think and I’m really hoping that’s the case.

Being on both sides: Survivorship and cancer research

I was in science before I got cancer. My dad had cancer first. Then I was in science. But I was walking around with cancer for six months myself, and then I had to do chemo in the whole nine yards.

After that, it just completely changed my thought process and my approach. It changed my outlook on life, first of all. Everything I did became urgent. I don’t know if I’ll be here tomorrow. Everything is urgent.

One in two men is diagnosed with cancer, one in three women. I walk through life like, “Listen, it’s morbid as it sounds.” I’m like, “It’s not a matter of if you’re going to get cancer. It’s just like, ‘When? At what age?'” It’s just so common. We really need to get a handle on something, and I’m so glad we have so many scientists really dedicated to that cause.

It changed my outlook on life, and then it changed my outlook on scientific approaches. I used to sit in scientific meetings, and it’s like, ‘Oh, we can use this drug. Let’s try this and that.’

Sometimes I would open my mouth and say, ‘These are people. Imagine what all of those drugs are going to feel like.’

I know with my lymphoma, I had four chemo drugs at each session. That just was not fun. The idea of like, “You really want to be able to treat your patients with the least invasive method. You don’t want to go so hard on the pain all the time. You want to find something that works, but it’s not so toxic to the patient.”

Then I also think I know what it’s like to walk around with cancer and not know that you have it. You think it could be anything else, and that applies to a lot of people.

When I’m out in the community and people will say, “Oh, I don’t feel like I have cancer.” Sometimes you don’t feel like it, but sometimes you get used to those nagging little symptoms that have formed over a few weeks or a few months. You never want to go off of how you feel when it comes to screenings. 

Another thing, because I’m a cancer survivor, I have to go to my oncologist. But that’s always so weird to me. I’m in the lab and working in the hospital then, “Oh, it’s now my turn to go to the oncologist.” It’s just always weird.

When I went, they said, “Listen, we want to do a colonoscopy on you.” I was young. I wasn’t 40 yet. I’m like, “Fine. Another test.” So I did it. When I woke up, they said, “You know what? We found several pre-cancerous polyps.” I was like, “What?”

I was so happy that I did that colonoscopy that young. If I hadn’t had lymphoma, they wouldn’t have thought to do it that young. Now I know. I don’t wait as long as other people. Now I’ll be referred for a colonoscopy much more frequently than anybody else.

Don’t put off symptoms. If your doctor thinks that you have a reason to be screened for something, don’t be afraid because trust me, you want to be diagnosed at an earlier stage and save yourself some of the hassles, please.

Especially with prostate cancer because it’s curable if you catch it early. That’s literally life or death. You want to screen for that sooner rather than later.

Approaching conversations on cancer risks

I try not to freak out on him all the time. He’s 17 so it’s like, “Oh, everything’s fine.”

Just the other day, he texted me and said, “Oh mom, I’m having an allergic reaction to like 30 things.” Then I responded, “Oh my gosh, what are your symptoms?” Then he didn’t respond. Then I’m calling his girlfriend, calling every everybody to see, “Is he gone into anaphylactic shock?” I just assumed the worst all the time.

He’s used to, “Oh, mom’s just freaking out,” but I look at every symptom as like, “Oh my goodness.” He did have some swollen lymph nodes at one point. I thought it’s lymphoma because it’s hereditary. But it was not the case.

I don’t really talk to him because I take action. We’re going to see what happens when he becomes an adult and has to make decisions independently. 

At that point, he knew his grandfather, who’s my dad. He was like, “Oh, well, he has cancer, and he’s okay.” I don’t know if he thought, “Oh, she has cancer. She’ll be okay.”

He saw my hair fall out and he saw me being sick and tired from the chemo all the time, and he seemed okay.

On my final PET scan, the day that I found out that there was no evidence of disease, I sat him on the couch, and I showed him the picture. Because at that point, my son is a little nerd like me, so he knew like, “Oh my mom. I’ve seen her cancer cells. There’s two nuclei instead of one.” He knew what the cancer cell looked like.

I said, “Let me show you the PET scan. This one, this is the before, and this is the after.” He said, “[gasps] there’s nothing there.” I said, “Yes.”

His shoulders just dropped. It’s like he sighed. I didn’t realize, in that moment, that he had been walking around like this for months.

»MORE: Parents describe how they handled cancer with their kids

I saw it, and I was like, “Oh my gosh. It’s the little boy Beck that I remember that’s worried for you.” I don’t think he worries about it anymore right now. It doesn’t seem like it. That’s going to be something interesting to navigate as he will not be missing any screenings.

Normalize these conversations

It’s super important. I hope it changes with younger generations because my sister-in-law just beat triple-negative breast cancer last year during COVID, and she’s only 40, the same age as me. 

When she was asked about family history, it was difficult to think who had what cancer? I know it’s the same with me. People died, and you don’t really know what they died of.

I hope that really changes moving forward and we become more open to sharing. I know in my family and my husband’s family, prostate cancer is not limited to one person. It’s rampant. The more you talk about it, the more you normalize it.

It’s difficult because a lot of older generations may have had prostate cancer, treatments are not the same as they were then. Maybe you hear horror stories, and then the younger guys are like, “Oh, I really don’t want to do it.”

We really try to stress that the testing is different, the treatments are different, the outcomes are different. The side effects after the treatments are different because things are improving. It is important to talk about it as a family to know that your individual risks are based on your family members.

Patient Self-Advocacy

I am just so grateful that Al Roker shared his story like that. A lot of people know him, and they’re going to think, “Wow. He had this, and he’s doing well. I can get a screening for this. If I get that diagnosis, it’s not the end of the world. I can come through it on the other side.”

It’s important, and I recognize that importance. When we’re out in the community, I recognize my limitation. I’m a woman. I don’t have a prostate.

I can talk, turn blue in the face, but it’s not a one-person job. I make sure I show up with people who have been previous patients because men want to see somebody they can relate to that has been through and come out on the other side.

»MORE: How to be a self-advocate as a patient

I really think support groups are a great thing as well for men who have been diagnosed with prostate cancer. Just seeing men talk about it and be open about it definitely helps with anything in life, for sure.

We see it with the COVID vaccine now, too.

One person in the family gets it, you talk about it, now the cousins get it. I was the first person in my family. Now everybody’s gotten it. But it’s taken weeks and weeks to get to that point. That’s an example of you just talk about it and then it normalizes it for everybody else.

Message to Black men cancer community

Well, that’s something I hear in the community a lot too. Men will say, “Oh, I don’t want to have this treatment because I’m afraid that I won’t be able to have sex anymore.” That is true for a lot of different treatments.

One thing I tell men, it’s funny, but it’s not, but I’ll say, “Listen, if you don’t treat it at all, you won’t be able to have sex anyway, and you’re definitely not going to have sex when you’re six feet underground. It’s just not going to happen.” I make sure that they know that, but that’s just more on the joking side.

There are nerve-sparing surgeries offered now where results are not the same as they were 10 years ago. Your chances of regaining that function are so much better. Al Roker spoke about how he was able to regain that function. So don’t let that hinder you.

At the same time, I’ve been a patient, and I firmly believe that it’s the patient’s choice. Some patients decide, “I don’t want to do any treatment.” It’s their life, and that’s totally fine.

I’ll never forget when I spoke to a man who had a very elevated PSA and a Gleason of 9, and he was like, “I don’t want to have anything done.”

He was in a support group, and other men—it was a room of all black men —were telling him, “Oh, I had this treatment, and I had that treatment,” and at the end of the day, he was like, “I just would rather just see what happens, and I’m just going to live with my decision.”

You just have to respect that at the end of the day. I don’t know if I could have done that before I was a patient myself.

That is an example of you just wanting somebody to be able to make an informed and educated decision.

If you know all that and that’s what you want to do, do you boo. Because you’re going to have to live with that. You should be allowed to make your own choice.


Read Other Prostate Cancer Stories

Paul G. feature profile

Paul G., Prostate Cancer



Symptoms: None; elevated PSA levels
Treatment: Prostatectomy (surgery), radiation, hormone therapy
Tim J. feature profile

Tim J., Prostate Cancer



Symptoms: None; elevated PSA levels
Treatment: Prostatectomy (surgery)

Mark K., Prostate Cancer, Stage 4



1st Symptoms: Inability to walk



Treatment: Chemotherapy, monthly injection for lungs
Mical R. feature profile

Mical R., Prostate Cancer, Stage 2



Symptoms: No symptoms, caught at routine physical with PSA test
Treatments: Radical prostatectomy (surgery)

Jeffrey P., Prostate Cancer, Gleason 7



Cancer Details: Diagnosed at 59, biopsy had not detected it
1st Symptoms:None, routine PSA test, then IsoPSA test
Treatment:Laparoscopic prostatectomy

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Categories
Cancers Prostate Cancer

Theo’s Gleason Score 7 Prostate Cancer & Early Stage Kidney Cancer Story

Theo’s Gleason Score 7 Prostate Cancer & Early Stage Kidney Cancer Story

Theo shares his story of getting diagnosed with relapsed and metastatic prostate cancer, undergoing surgery, and radiation.

Having rampant cancer in his family and the African-American community, Theo lends a voice to advocate awareness, early diagnosis, and open conversations.

Explore his story below to hear all about his experience and very timely message. Thank you for sharing your story, Theo!

  • Name: Theo W.
  • Diagnosis (DX)
    • Prostate cancer
    • Early kidney cancer
  • Age at DX: 52 years old
  • 1st Symptoms
    • PCP, PSA of 72
  • Treatment
    • Surgery
    • Partial nephrectomy
    • Radiation

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


Life outside Cancer

I’ve always adopted the mantra: You get to live a day at a time, and you get to choose how you live it. That’s really all we get.

I’m happily married to my wife of 42 years, Beth. We have three daughters. Leanne is the oldest. Randy is a middle child. She’ll tell you the dreaded middle child. Lauren is the youngest. We now have seven grandchildren.

I run a business in Akron, Ohio. My business is to manage money for people that are about to retire or are retired, make sure they have enough for the rest of their lives, and leave a legacy to some institution or some people.

Learning about prostate cancer

I have no symptoms of anything whatsoever. My doctor is also a dear friend of mine and who also happens to suffer from prostate cancer.

During my routine annual exam, he said, “Theo, your PSA is elevated. I’m going to refer you to a urologist.”

I went to the urologist. He got the results of a blood test. He asked me a few questions and said, “Let’s do another blood test in about three or four days.” We did another one, and my PSA rose again from 12 to 14 very quickly. So they did the biopsy.

I remember where I was and what I was doing when I got the phone call on a Saturday morning from my doctor at the Cleveland Clinic. Incidentally, my wife had been diagnosed with melanoma the day before.

We’re in the car, and I get the phone call. He says, “Theo, it’s prostate cancer. Let’s set up a time to talk. I want you to interview me, the surgeon, talk to a radiologist, and determine a plan of action.”

I think it was the following week that we went to the Cleveland Clinic. That began the process of my prostate cancer journey.

Getting diagnosed

It was 2003 when I had the first biopsy. That biopsy was inconclusive. It said I did not have prostate cancer.

But it was not the Cleveland Clinic then. It was a local hospital and doctor here in the Akron area, a local nephrologist. Knowing what I know now, there should have been some type of phone call. I left that doctor’s office, and there was no follow-up appointment of any kind.

Normally, I guess there should be a three-month or six-month routine biopsy scheduled. I missed a couple of years of getting my annual exam from my primary care physician. So when I went to the primary care physician, he said, “Your PSA is up in the 60, 70s range. You need to see a urologist.”

My doctor, my primary care physician, being a person that had prostate cancer himself and was able to keep his numbers low, possibly should have been more alarmed about it and said, “Get back there every six months.”

I was instructed by no one, and at that point, I didn’t know enough about the disease on my own to say get back in there every six months.

I was diagnosed in 2009 at 52. High end of intermediate risk and the low end of high risk. No staging. That’s with aggressiveness, and that’s pretty aggressive, especially at 52.

Family history of prostate cancer

No. My dad did not. His dad did not. My brother did not, and he’s an older brother. This came out of left field on us here.

Receiving the bad news

He looked at me and said, “Don’t panic.” He literally said, “Mine has been up close to 1,000.”

He took a new prime shot and took them the rest of his life, and his PSA remained low. He did not die from prostate cancer. He lived into his early 90s. 

I thought about two things. He’d always told me in my early 30s that I had an enlarged prostate. In my mind, I said, “Maybe that could be part of the PSA issue. No one is being really urgent about it, getting back in there after 2003.” 

I was hoping, so I said, “Maybe it’s just a high PSA because of that.” Of course, I was very nervous that it could be prostate cancer.

»MORE:Patients share how they processed a cancer diagnosis

Describe the biopsy

Be grateful that times have changed since my biopsy then. Currently, they give you a shot literally in the prostate that numbs it, and so it’s not painful. That was not the case with my biopsy. There was nothing.

I think they do three to four snippets per quarter. It’s in quadrants. By the time you hear the clip, it’s too late. It’s a very painful, uncomfortable but short procedure and process, which has changed now.

Getting the results

We got the call. The surprising thing is neither one of us broke into tears right away.

We ran a stoplight, actually, when I received the information. We looked at each other. I think one of us said, “What are the chances of both of us having cancer at the same time?” That’s how our relationship is. She tells me even to this day, “If cancer doesn’t kill you, I might.” That’s the kind of relationship we have.

We finished our errands. Of course, we kept the conversation going and talked about what the next steps may be and that we had to call the girls. They were naturally pretty devastated. The ones that were close to home came over as quickly as  they could.

We just started plotting out when and what. They were all for surgery. My whole family was. I quite frankly was not interested in surgery at all [and] wanted to do the radiation instead because it was less invasive.

At the end of the day, I never really had peace about it. I opted for the surgery.

Breaking the bad news to the family

It’s difficult as the process was literally to put everybody on speakerphone and called everyone.

We did joint calls with all of our close friends, our pastors, our family, and our parents. That really took a few days because at that point, there’s some crying on your own you’re doing. You’re physically exhausted, and you’re saying, “We’ve talked to eight people today, and let’s just pick this up tomorrow.”

»MORE: Breaking the news of a diagnosis to loved ones

Just make sure you talk directly to your closest friends, whether it’s phone or face to face. You do not want them to find out secondhand at all. They show up, and they go way beyond the call of duty to make sure you’re okay.

What support was most helpful?

You have to make the assumption that people want to help. I’m more of the person that is the helper and less likely to call and say, “Help.”

We would meet a group of guys at Einstein’s for breakfast. Leanne can tell you about this. She says, “I don’t believe you have 10 to 12 guys that meet every morning and just talk. No, guys don’t do that.”

Because I was at home with a catheter, I couldn’t get out. One friend says, “Is there anything I can do for you?” I said, “Yes. Go to Einstein’s, get me a cup of coffee and a bagel, bring them to my house, and sit with me and have breakfast.” That did as much for him as it did for me.

People just want to help. That story is an example of you needing your friends and your friends needing you. The opposite end, for kids, it could be scary.

Antonio, Leanne’s son, was five. He walked into the library and saw me in my bathroom, sitting there. I think Leanne had to tell him, “It’s okay to go over there and sit in his lap. He’s fine. He has cancer. Number one, he’s not going to get on you. Number two, he’s not fragile at this point. It’s perfectly okay to go sit in his lap.”

He was very cautious. With kids, when you see them, you need to tell them, “I’m okay. Come over here and give me a hug.”

Why was that an emotional moment for you?

I’ll tell you exactly why. “I want you to look at this chart.” He literally put his head down and wouldn’t look at me.

I took the chart, and I said, “Is this me right here?” He says, “Yes.” I said, “I’m at the high end of intermediate risk and the low end of high risk.” I said, “This is saying the average life expectancy is 11 years?” He says, “Yes.” I said, “Explain that to me.” He says, “Well, eight years will be great, two years you’ll be on hormones, and last year you’ll be miserable.”

The very first thing I thought was, “Antonio is five. Where will I be when he’s 16?” I did the calculations, and I said, “I’ll live long enough to see him turn 16 and get his driver’s license. If I make it that far, I’ll be fine.”

That was my first thought. Will he be driving? Will I get to see him drive? Will I get to see him become a 16-year-old?

Of course, we’re beyond that now, but that was my first thought when I calculated those numbers.

First of all, if they’re really close to you, you’re more forgiving.

Most times, people don’t need to say anything. Just an, ‘I’m sorry. I feel bad. I’m here for you. If there’s anything I can do, let me know. This is terrible. This is devastating. I don’t know what to say. I don’t know what to do. I feel horrible.’ Leave it at that, for the most part.

Treatment Decisions and Surgery

I have a very good friend in Chicago who incidentally was also going through prostate cancer. This gentleman was retired. I called him up.

He was at his vacation home. He said, “All the treatments are pretty much the same success level. If I were you, I would strongly consider radiation, because by the time you add up all the side effects, that one in your situation with your PSA number, that’s what you should do.”

Monday morning at eight o’clock, my cell phone rings. “Hi. I’m Dr…. head of urology at the Cleveland Clinic.”  

I said, “Well, doctor, he told me that you said radiation makes the most sense.” He goes, “No. I don’t think so. I think here at the clinic, you need to do surgery because if you do surgery and you have a relapse or recurrence, then we can do radiation.” He said, “We do a nerve-sparing surgery so you don’t have issues going down the road.”

Once I heard that, I said, ‘I don’t know where this is going, but I’d rather have more than one shot at it if this is not going to go well.’ That’s what I did. I did the surgery.

Fears with surgery

You’re always concerned about your sex life going forward. But a nerve-sparing surgery makes it more possible for a man to maintain an erection, to have sex. That’s a big concern for a lot of guys.

I did have one of my buddies tell me, “Hey, at the end of the day, your wife may prefer just a lot of cuddling, and you will be alive.” That was great advice. 

Cleveland Clinic made sure to tell me that. It was also one of the discussions that I had with the second opinion doctor. He kind of felt like if you went with the radiation, then you would have less issues later, and it would not affect your sex life now. That was his reason for it.

He says, “If we’re going to come up with the same success rate, then why impact your life in that way now?”

Then again, as I said before, for me, it was more important to do the surgery, and then the added bonus was when he said they could do the nerve-sparing. I said, well, okay, then that’s it. That makes it less of an issue.

Describe the surgery

My doctor said, “This is going to be a pretty routine surgery. We will be using robotics. That will help with less bleeding and a much quicker recovery.”

I am told that my father accosted him when he came out because the surgery ended up being about six or seven hours. It was substantially longer than it should have been, and my father just was not too happy about that.

He told me the recovery would be three to four days and I’d be out of there. He said, “You’ll have a catheter for several weeks. Come back, and we’ll take that out.”

He said, “You should be off and running, for the most part. You can start back to work in a month and a half or so.” He felt that the surgery would be pretty routine, with very few complications. That ended up not being totally true.

But you never know until you get in there. So I’m glad he did. Things took a little longer, the surgery and the recovery. Getting out of the hospital took longer than normal.

How long was the surgery?

Three to four hours.

He always talked about the nerve-sparing, and one of my seminal vesicles actually had cancer, so he had to remove that, and then the margins. When you do the surgery, you remove lymph nodes and they usually do a few, but they ended up doing 10 or 11 removals of those. That’s what took the time.

The recovery was supposed to be four to five days, but I stayed for eight days in the hospital.

How you were able to get through?

My issue was my creatinine levels were higher than they needed to be, and so they were worried about kidney function. It took a while to get those belts under control.

My advice is, if you’re in a hospital, you need to have your family guard how often people come and go.

They really have to look out for you in terms of your rest and be able to delicately say, “He’s glad you came to see him, but he really needs to sleep right now, because I’m sure you know you do not get any rest at the hospital.”

Every three to four hours, someone’s coming to do something to you, and so therefore the only time you get a rest is when you get out of the hospital.

They’re going in at all hours of the day and night, checking your blood pressure, checking all the different stuff you’re hooked up to.

Post-surgery care

One of my main issues is I could not pass gas. When I finally did, no one was in the room but me. I got my phone, and I text to my wife, “It’s a girl.”

She said she read it out loud and everybody knew what it meant, and everybody out there just erupted, and they want you to go. I tried prune juice, everything, and nothing worked. They said you cannot leave, and so that was the last thing I had to do before I left. After that, I went home.

Taking it lightly helps. You just have to.

I did have another kind of strange experience. There was one person that I have a temporary rift with. But sometimes when you’re sick, they feel a need to come around and try to fix it all before.

She told me that someone wanted to come, and my blood pressure went up. She had to kindly tell them no, and that’s difficult. But I will say people will come to see you for the right reasons, and people will come to see you for the wrong reasons.

»MORE: Read more patient experiences with surgery

Dealing with extended period of time at home

I think I ended up going two weeks longer than I should have, but I thought the catheter was great. You don’t have to get up to go to the bathroom, because you’re sore after surgery.

Every time I tried to lift myself off of a chair, it’s just painful. So with that, I didn’t have to get out of bed and go to the bathroom at night. I was reluctant to let it go, but I had to.

When I found out it didn’t come out the day it was supposed to, it quickly became irritating because I was mobile. I was in less pain, and now it became an inconvenience because I can’t go running around outside, although I did around the house. I was living in the country at the time.

The last week or so was really, really hard. “Just get this thing out.” Initially, it was very convenient.

I was supposed to have it for two weeks. I think I had it double that. If it was supposed to be a week, it was two. But I’m pretty sure it was close to a month that I had that catheter.

I have to just be careful of infection, just have to keep it clean. Other than that, I didn’t have any issues with it whatsoever.

Radiation therapy

First of all, I made a very dear friend in this process. I was going to my first radiation treatment, and I got out of my car in the parking deck. I’m about 6’7, and Black obviously, and there was this 5’7 White guy who got out of his car. We both went through the door out the deck.

We went to the building for cancer treatment. We got on the elevator. He said, “Are you following me?” I said, “It depends on where you’re going.”

He said, “I’m going to start my radiation treatment for cancer. You’re the last person I want because you should not be following me.” I said, “I actually am following you because that’s where I’m going, too.”

We’re dear friends up to this day. I had a buddy who got treatment sometimes around the same time.

It was treatments every day, Monday through Friday, for seven weeks.

At that point in time, my youngest daughter worked downtown near the clinic. She would just show up unannounced. I never knew what day she was coming, what day she wasn’t coming.

She wouldn’t tell me. She would show up, and I would be in there for probably 20 to 30 minutes. It wasn’t long. Out and back in the car, and back home or back to work.

It was an inconvenience from a travel standpoint, but there was a certain amount of comfort.

The hospital is about a half hour from my house. It was a highway drive mostly. It was a good time.

Until this day, I get comfort when I drive under the main campus of the Cleveland Clinic. Seven weeks out, you know you’re done, you ring the bell, and you just hope your PSA doesn’t climb.

Describe the process of radiation

For prostate cancer, you just get on the table. They put a tarp over you. You pull your pants down to your knees. You’re on this flatbed, and the radiation machine just goes around.

It actually tilts and goes around and hits specific areas that they’ve targeted and certain margins outside of where they think the prostate cancer may have spread to.

You see the same three or four nurses, so you develop relationships with them.

That’s really the process. You’re done, and you leave and go back to your life.

Side effects

I had no side effects until the last two weeks.

I would have some burning during urination. Women have urinary tract infections, so they may be used to that. 

That was my first experience. It gets to the point where you tell yourself you don’t want to drink water because you don’t want to have to go to the bathroom, but you have to.

You let them know, and then they give you things like pills you can take to help with that. They did work. It was very surprising when I first started, and I was very glad to take those pills after I got to.

The doctor did tell me that could happen. I was actually surprised that it took as long as it did and thought maybe it wouldn’t, but it did.

Outside of that, no burns, no rashes, no irritations of any type.

The issue with me was when they checked my PSA after the surgery, and it started to rise again. That’s evidence that I have a recurrence. We don’t know how far.

They looked at the surgery and said, “Let’s do an additional margin of X.” They feel they can go so far before they start affecting the lymph nodes. Once they affect the lymph nodes, then you have a whole different set of side effects.

The radiation itself was targeting a specific area with the idea of not having issues with your lymph nodes down the road.

Signs of recurrence

I think when it got up to about two was when they said, “Okay. Hey. We need to start doing something,” Because, at one point, it was almost undetectable right after the surgery. Then within two weeks, it started declining.

Addressing the recurrence

It was, “Hey. Let’s start every three months and see where this goes.”

Unfortunately, it went from two to four and from four to six, and then they said, ‘You’re going to be dealing with this the rest of your life. You need to talk to a medical oncologist.’

I went to his office, my wife and I. He reared his chair back and put up his cowboy boots on the desk, and he says, “Do you know why you’re here?” I said, “Yes. I have prostate cancer, and my PSA is still climbing.” 

He goes, “Do you understand that from now on, we’re monitoring this and that you are going to be dealing with this the rest of your life?” I reluctantly said, “I do.”

He started out, and he just wanted me to know the gravity of it. “We’re just going to be maintaining this for the rest of your life.” That’s when it really hit me.

When the doctor said, ‘You’ve got eight good years, two years of hormone treatments. Your last year is miserable.’ That’s when it hit me. I said, ‘This really could be me.’

Managing a chronic disease

That’s the case; it was a chronic disease. He told me what we would need to introduce, when, and what things they would use, and then went on through [to] talk to them about clinical trials.

He said, “For now, we’ll monitor it.” Then that’s what starts the CT scans, the bone scan once a year, and I’d heard about kidney cancer also. I was getting the chest X-rays, and then all ended up fine. So I’ve got to stop the checks.

2nd Cancer

Getting diagnosed with kidney cancer

I was diagnosed with kidney cancer five years after the radiation. They removed it, and of course, the concern is if it returns, it could spread to the lungs. So I have to do the scans, basically chest X-rays, because I was already getting a CT scan.

That kind of doubled for both the kidney issue and the prostate issue. I had to get the X-rays, and five years and that was done. That was totally successful, and I had a recurrence there. I’ve had some cysts on my kidneys that I didn’t know I had until then, and so they’ve watched them. That’s how they discovered it.

It was at a very early stage.

In fact, I had a colonoscopy and was out to dinner, getting ready to go to a Todd Rundgren concert. My side started hurting me, so off to emergency I went. Didn’t go to the concert.

They said, “You have cysts on your kidneys. That’s not why you have pain, though. You have pain from the gas that is stuck in your body from your colonoscopy. But you have cysts in your kidneys and probably want to get those watched.”

That’s when I started getting them washed, and not too long after that, they figured that it’s all the colon cancer and not the kidney cancer.

I had a PSA check every three months, every half a year, every six months a CT scan, and then every 12 to 18 months a bone scan. That’s just because they’re watching to make sure it doesn’t spread to the bones.

So far, it’s been all good.

PSA levels so far

It’s crazy. They continue to climb until 2019. It got to 52. Since 2019 it has gone up and down, which is really strange.

It sits at 57 now, so I called my doctor, because I was supposed to have a bone scan in December, and said, “I don’t see a bone scan on my chart. Shouldn’t I be having the bone scan about now?” He said, “Well, think about it. In 2019, your PSA was 52, and now it’s 57. Percentage-wise, there has been very little movement. I don’t see any reason to do one right now.”

There’s a couple of philosophies, and his philosophy is if hormone treatments after metastasis do not prolong your life any more than taking hormone treatments before metastasis, why subject yourself to the side effects?

That’s what we’ve done. I have not started hormone treatments at all, and they have not found any metastasis at all.

I did mention my dear friend, who I’ve met, the little 5’7 guy, and he’s a worrywart. He started his hormone treatments when he hit 10, and so it’s different for different people. I talked to him often, and he tells me, “Theo, I’d be a nervous wreck.”

I said, “I know you with time, and I’m glad you’re taking hormone treatments. It’s different, and the doctors are different. I have a different oncologist now than I did then — Dr. Timothy Gilligan. He’s a white gentleman, but he specializes in prostate cancer for African Americans.”

I really feel like I’ve got an individualized treatment plan that is geared towards the quality of life, according to the risks that the patient wants to take. You just have to say, ‘Hey, I don’t feel like taking any additional risks by not starting these hormonal treatments.’ I just don’t. I haven’t.

I think Lan said there’s a Dr. Pan. I can’t really recall the guy’s name, but he knows a doctor that’s out there at the City of Hope, and the previous doctor ended up taking a job somewhere else. Then I just got on the Cleveland Clinic website and fell upon his name and then called him and said, “Hey, I need you to come to be my doctor.”

Homeopathy and naturopathy

What supplements do you take?

I have a bunch of supplements that I take, but the real key is a machine called a HOCATT. It’s designed to get in there for about a half hour.

They shoot oxygen and carbonics into your nose, which drains you, but more importantly, they raise the temperature. It gets very hot, and the idea is it stimulates your white blood cells because it says my body has a fever. I need to run and attack anything that is suspect, and I get that.

I go every Friday at 2:30 or 3, what’s called my spa treatment at the end of every week.

They told me it will raise my PSA temporarily, so I don’t want to get my PSA check when I get out of this thing. Overall, it should slow down the process and give my body the best fighting chance that it has.

I also take vitamin D and fish oil.

Deciding on integrative treatment

I just did it and then told them, and fortunately, Cleveland Clinic is adopting some of that on their own at this point. He’s perfectly fine. There’s no, “Hey, you know what’s in these supplements? Do you know what you’re taking? Is this going to counteract what we’re trying to do here?”

No resistance, judgment, or anything of any kind from him at all. It’s been great.

When to start hormone therapy

For him, it’s just whenever the bone scan shows metastasis. It’s cut and dry with him. I did ask him a question. I didn’t want to ask him, “Doc, at what point in time are you pretty sure you’re going to find something?” But he said at 50.

The next time I see him after, I asked him. I’ve been over 50 for a while, especially if my next bone scan is clean. I said, “What does that say?” I don’t know what that says, but he says, “Most people were going to find something when they start getting a PSA of 50.” I’ve had scans since it’s been 50 in 2019.

Managing “scanxiety”

I don’t do very well with that one because of my charts. If I get my PSA checked today, I know I’m probably going to get an answer within 24 hours.

If I get up to go to the bathroom at 3:00 a.m., I’m checking my phone, and there’s a certain amount of anxiety. Once you do the password, I get an email that says ‘test results.’ That’s also stressful.

I had a very dear friend who died from prostate cancer. It was caught in the latest of late stages and did a lot of experimental stuff.

He told me the best advice I’ve had. He said, “You have to thoroughly enjoy the highs.” You’ll have the highs and you’ll have the lows. But you got to celebrate every high you’d get.

Whenever my PSA stays the same or goes down, I keep a chart. I look at that graph, and I look at how fast it goes. If it doubles in three months, you’re in trouble. I’m always looking at what rate is it doubling? Is it nine months? Is it 10 months? Is it a year? That affects me emotionally.

You don’t really want the information, but you do. It’s a mixed bag there. I don’t do a good job of handling that part of the anxiety.

»MORE: Patients describe dealing with scanxiety and waiting for results

Caregiver support and survivorship

You keep your plans and your dreams until you can. From a caregiver’s standpoint, being the guy messes with my wife’s security.

We do talk about that. Her statement now is, “You may end up living longer than me.” That could be true.

I don’t know. We don’t know. You have to have people, whether it’s a spouse or a good friend or both, that you really can talk about everything you’re feeling.

We’re both type A personalities to the point that if I get up in the middle of the night to go to the bathroom, I’ll come back and my pillow will be on the floor, and she’ll say “Go make some money.”

I’m like, “It’s 4:00 a.m. I can’t. Let me sleep for another hour or two.”

Humor has a lot to do with everything in terms of hightailing. Find somebody safe with whom you can express how you really feel and will let you express that.

I don’t get a lot of sympathy, and I don’t want a lot of sympathy. I don’t feel like I need it. There may be a time that I do.

Life is normal, because as long as you are able to, you still get to choose what you’re going to do and what your outlook on life is going to be in the end.

Some friends and I have a saying, “Your tombstone should have three dates on it, not two dates: the date you were born, the date you stopped living, and the date you died.” Hopefully, the last two will be the same day.

My wife has been the best thing for me. Because if I wanted to have a pity party, which I typically don’t, I couldn’t have one anyway.

Having children as support

Leanne and I are a lot alike, and we do things without really talking about it a lot.

She didn’t really tell me she was going to start doing the research. I found that out almost secondhand. That was the inspiration for it.

I remember when she was in prep school in high school and brought home straight A’s the first semesters as a freshman, and I asked her, “Do you feel any pressure to get straight A’s?” She said, “No. This is okay.” “Good. That’s all I want to know.” I’m floored.

She’s never been afraid of things. She likes the limelight. I’m just impressed by her all the time. I’m just, “Damn. She’s an impressive woman.” That’s why I’m proud of her, that she is on a mission.

Advocating in the community

We do now, but nobody talks about it until you get it. Then all of a sudden, out of the woodwork comes, “Well, I had prostate cancer three years ago.” “Well, I had prostate cancer four years ago.”

You’re walking around with all these guys, 3 out of 10, 80% African American, which have had it, and nobody knows anybody else has had it. Now there are support groups, that type of thing.

Not having it in my family, I was not that exposed to it.

Then having a doctor that had prostate cancer that was doing okay and died in his ’90s and not from prostate cancer. There just wasn’t as big of a fear of it, but then once I got it and you start looking around, you’re like, “Whoa, wait a minute, this is everywhere.”

At the Cleveland Clinic, they told me they had a kid in his late 20s, a Black kid that had prostate cancer. Do you start checking in your 20s? They say no. I learned about the process after I was already in it and the numbers after I was already in it.

Conversations in the Black community

Men generally, but especially men of color, don’t go to the doctor. A lot of them don’t. Some of it is because they don’t have insurance. Some of them are macho. Some of them fear the doctor. They don’t want a rectal exam.

I think getting out there, like getting your blood drawn. If you can do that, and you could start doing that when you’re 40, it’s going to save your life. I think the education process.

 You’ve got to look at the hand of the government with the Tuskegee issues, saying, “I don’t know if I can trust.” Which, by the way, is a whole other story with COVID, because I’m finding more middle- and upper-class white men not wanting to take it, which is strange to me.

A lot of my Black friends have gotten the shots. I’ve had my first shot. That’s a whole ‘nother story.

Just the lack of trust for doctors, the absence of African-American doctors.

Again, I’m 63 now, and so I’m talking for my age group. It may be different for people 20 years younger than me, but those are some of the reasons.

My mom to this day calls me when my dad goes to the doctor and asks me to go, because he does not want her in the room while he’s in there with a doctor.

The last two times, I told her, “Yes, that’s the macho thing.” It’s the “keep her in the dark” thing so if I get bad news, she doesn’t have to think about it.

I just convinced her, “You just barge in there and hear what the doctor has to say.” That’s what she’s doing now. She’s 91, and he’s 88. There’s just this fear of doctors.

What needs to change?

I asked Leanne about that at one point in time. Can’t some medical association or some medical say, “Hey, all the doctors in Summit County, and such, every African-American that comes in here, tell them that we have to do a blood test. We have to draw blood as part of your health. Not just for PSA.”

I don’t know if that’s an oversimplification, but it should be almost demanded that doctors do that for people that are at risk. Because that is the first step. It’s the least costly; it’s the least invasive. It’s the least threatening thing you could do that gives you the information you need to take care of yourself.

Prostate cancer is one of those cancers that are very treatable if you can catch it. My prostate and kidney cancer was that example. They caught it quickly, did it, and I’m done with it.

Cultural differences and doctor training

I think it’s a great conversation. The way that conversation in a perfect world should have gone is, “Theo, your PSA is at 14. That’s high. You are a candidate for getting prostate cancer. However, the success rate if we find it early is you basically get to live your life as if you never had it. As scary as this sounds, Theo, I need you to come back every three months. Do this so we can catch it and do something about it, and then you can have a normal life.”

I would have been scared to death walking around feeling I’m a walking prostate cancer. That’s a whole different psychology, but coming out on the other end of that with less risk at the end of life. That’s a difficult discussion that the doctor should have with the patient.

Opening the conversation of risks to kids and grand kids

I have not, but I will. I’m 62; 20 years puts me at 82 if I live that long. 17 put him at 37. I’ve done the math.

We’ll have the discussion before he’s a candidate for getting diagnosed with prostate cancer. Whether that’s him and I talking over an ice cream cone, or me telling him goodbye in his life. I feel there’s time, but having had this discussion with you, I’ll approach the subject with him now. Why not?

The critical part is you’re at a higher risk than most because I’ve had it. It is 100% curable if they catch it on time. Just stay in front of it. Promise me at 35-36, if not sooner, that you’ll get an annual exam. That if you do not hear from your doctor about a blood test by a certain age, you’ll ask for it.

Normalizing the conversation

We’re all interested in living as long as we can. Part of that is taking steps to assure that. One of the easiest things you could do is just go get an annual physical exam.

When you get one, ask for a blood test to find out what your PSA is. I don’t care what number they give you. You want to know that number today, more than you want to know that number tomorrow.

Diversity in clinical trials

I think I would try, and my doctor, Dr. Timothy Gilligan, that’s another thing. He is well on top of clinical trials and will suggest one at the appropriate time.

I am all for anything that could prolong and improve the quality of life.

With prostate cancer, chemotherapy does not. Chemotherapy with a lot of cancers is curative. I don’t feel that I would opt for that if they said, “We can give you three more months.” I’d rather have the quality of life.

Now, if I can go into his office and he tells me, “You have to start chemotherapy,” all bets may be off. I may be retracting everything [I’m] saying right now because, at the end of it, everybody wants to live as long as they can.

I’ve seen a few people elect not to get chemotherapy. I looked at them, and I said, “They went out the way they wanted to go out; they looked the way they wanted to look.”

I’m also concerned about what view will your grandchildren have of you before you die? What will you look like? I know that could be vain, but I am concerned about it because those imprints stay on your life for the rest of your life.

I think we should go online and look for doctors that talk about doing clinical trials and specialize in dealing with African-American prostate cancer. They’re out there. I had four that I was looking at, and that’s why I chose him.

All of us get a day at a time. Relationships are the most important thing in this world, period, and that’s it.


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Categories
Prostate Cancer

Al Roker’s Gleason Score 7+ Prostate Cancer Story

Al Roker’s Gleason Score 7+ Prostate Cancer Story

From TV Star to Patient Advocate

Famous Weather Anchor Shares Prostate Cancer Story, Gleason Score 7, and Passionate Plea: “Please Get Screened!”

Al Roker is a celebrated TV journalist, personality, Weather & Feature Anchor for TODAY and the co-host of 3rd Hour of TODAY, and now a prostate cancer thriver and patient advocate.

Diagnosed at 66 years old with an aggressive form of prostate cancer, Al was able to catch it early through a routine PSA test at his annual physical. After surgery, the husband and father has no evidence of disease, and has used his celebrity to send a clear message to other men to screen for prostate cancer with the PSA test and digital exam.

This message is especially important for African-American men to hear, as they are disproportionately impacted by prostate cancer. Thank you, Al, for sharing your incredibly powerful voice to uplift others.

  • Name: Al Roker
  • Diagnosis (DX)
    • Prostate cancer
    • Gleason score: 7+
    • Aggressive
    • September 2020
  • Age at DX: 66 years old
  • 1st Symptoms: None, detected by routine PSA test and digital exam
  • Treatment
    • Prostatectomy: surgery to remove prostate, surrounding tissue & lymph nodes
    • Laparoscopic (robotic) surgery
  • Follow-Up Protocol
    • First 5 Years: PSA test every 6 months
    • 5+ Years Out: PSA test annually

This interview has been edited for clarity. This is not medical advice. Please consult with your healthcare provider for treatment decisions.


First Tests & Scans

How did you know to test for your PSA?

You just knew about it. It was one of a battery of tests that your doctor always took along with the digital exam which everybody knows Moon River kind of thing *sings song*.

I knew about the PSA. It was just like your cholesterol and your blood pressure, and it was just one more metric that you measured your health by.

What was your Gleason score

I had a 7+ Gleason score. That wasn’t terrific obviously, but again it also speaks to having access to good healthcare. They could have easily said, “Well, let’s just watch this,” but it was like, “No. Let’s do an MRI.” 

TODAY — Pictured: Al Roker on Monday, June 10, 2019 — (Photo by: Nathan Congleton/NBCU Photo Bank/NBCUniversal via Getty Images via Getty Images)
What were the scans and biopsies you underwent for diagnosis

Did the MRI. Didn’t show any target areas. It was like, “Let’s [still] do a biopsy.” That’s when we found the cancer.

It wasn’t really until I did the genetic testing on it at Sloan Kettering that it was like, “Oh, this is pretty aggressive.” There was a lot more than the biopsy showed. 

How were the MRI and the biopsy

Look, it’s not a walk in the park per se. The MRI is a little easier. If you’ve ever been in one of those MRI machines, you’re lying there, you’re still. It’s, I don’t know, about 45 minutes, almost an hour of constant noise.

To be perfectly honest, it wasn’t so bad for me. I think I literally took a nap till we were done because I’m always up early.

The biopsy, you have to get anesthesia and all that stuff. That’s never pleasant, but it’s important, so you put up with it.

I’ve been through so many surgeries in the last several years that it was like, “Okay, what’s one more, here we go.”

The most annoying part about it is really the IV needle, but other than that, you’re under anesthesia so you don’t really realize it. Then you wake up, and boom, you’re done.

Getting Diagnosed

The benefit of “aggressive” doctors

I was very fortunate. I had access to good doctors, and that’s not to say other people’s doctors aren’t good or anything like that.

I had doctors who are good and aggressive. As aggressive, if not more aggressive than the cancer itself. I think that if it had been more of a wait and see, my patient story might have been a little different.

Describe the appointment when you got the diagnosis

It was one of those things where I did the biopsy and made an appointment for follow-up at the same time. I didn’t really think anything of it. I just assumed. I guess I thought that if there was a problem, they were going to call.

My doctor came in and closed the door, and he said, “I always like to have these meetings face to face.” It was my first like, “Oh. Wait. What? What does that mean?”

Then he went into it. Truly, I was thinking, it wasn’t even really about the cancer as much as I was like, “Oh, my god. My wife is going to kill me.”

Obviously, she’s very compassionate. She wouldn’t want me getting that diagnosis by myself. Realistically she’s thinking, “What’s the doctor going to think about me as a wife not being there to be there with her husband to get this potentially life-changing news?”

I took in what he said but I just kept thinking, “She’s going to kill me.” If the prostate cancer doesn’t, she will!

How did you break the news to your family

I called my wife and said, “Okay, I’m on my way back.” She said, “What did the doctor say?”
I had waited till I was almost home. Then I said, “I’m just around the corner. Let me get home.”
She goes, “I don’t like the sound of that.” I said, “I’m literally 30 minutes away. Then we can talk.” She was upset obviously.

We waited till the weekend to tell our kids. I’ve got a 33-year-old daughter from a previous marriage, and then we’ve got a 22-year-old who’s in college in Paris, and our 18-year-old son who lives with us here. The family Zoomed and I explained.

They were very upset, obviously. I said, “It’s okay. Doctor said, yes, it’s aggressive. I’m not going to sugarcoat this, but he said we caught it early.”

»MORE: Breaking the news of a diagnosis to loved ones

At that point, I hadn’t decided on treatment. In my heart of hearts, I’d decided I was going to have surgery, but I wanted to do due diligence only because I’m one of those people.

I had the idea that’s just in there and, “Well, we’ll do the radiation, and the CyberKnife, and there’s the focal thing, and then we have to wait to see that it…” I’m like, “No. Let’s just get rid of this.”

My son, Nick, is very sweet. He’s a sweet boy, and he’s got some learning issues. He was really upset and was kind of reacting.

We realized it was happening right about the same time as Alex Trebek. He was conflating pancreatic cancer with prostate cancer. I think he thought I was a goner. It’s like, “Nope. Dad’s going to be around a while longer to bother you.

It was tough on my middle girl because, at the time and still, she was stuck in Paris because of the pandemic so she couldn’t come over. They’ve been very supportive and happy that everything’s turned out okay.

»MORE: Parents describe how they handled cancer with their kids

Surgery (Prostatectomy) & Follow-Up

Describe the surgery (prostatectomy)

I had the surgery done at the beginning of November. I had a shoulder replacement in August, and I’m still doing rehab on that.

Whereas the most difficult part of this has been, you come home and you’ve got a catheter for a week, which it’s not the worst thing in the world, though not the greatest thing.

It was less of a problem than I thought. There are the issues of a little incontinence, a little erectile dysfunction, but that’s rectified itself. 

What’s your follow-up protocol

Then in January, went for the bloodwork. The PSA level was below .05. Now every six months, I go get a PSA test and every six months thereafter, bloodwork, knock on wood.

ßIt’s five years with no problems, and then it’s once a year. You do bloodwork once a year anyway.

How did you process the news of no evidence of disease

Dr. Vincent Laudone was my surgeon, and he’s obviously a real pioneer in this area. Somebody like that has done a whole ton of these. He was very optimistic after the surgery.

We were doing pathology during the procedure. We took out the lymph nodes surrounding that area, didn’t see anything. I was already cautiously optimistic. You’re still waiting for that blood work. Once you get that, it’s a real weight off, and then you’re like, “Okay.”

Now the clock starts again for the next six months. You probably get a little anxious right before that, but here we go.

Survivorship: How do you manage waiting for the next test results

I always keep thinking that five minutes before the doctor walked in, I felt one way. Then five minutes or 30 minutes later, when I’m walking out the door to get in the cab, it was like always this kind of weird because I don’t really feel any different, but somebody says, “Oh, by the way, you have cancer.” Those three words.

Then all of a sudden, you don’t feel differently, you are different. It’s the same with this. You’re still going to be living every six months, but you’re alive. I don’t really think about it. It’s a good feeling.

»MORE: Patients describe dealing with scanxiety and waiting for results

Al the Advocate

What’s your message to men who are reluctant to get screened for cancer

I wouldn’t understand it. Listen, if you have problems finding healthcare or something like that, maybe, I guess. If you’re a guy who goes to the doctor once a year for the physical, you’re already there.

What’s the big deal?

Again, it’s that finger moment (digital exam). That was funny because all along doctors said whenever I had the exam, “It doesn’t seem swollen. You’ve got a small prostate,” which was great. If you’re going to the doctor anyway, why not?

What’s your message specifically for Black men, who are 50% more likely to get diagnosed with prostate cancer and 2x as likely to die from it

You can ignore it at your own peril, but if you love your family, love what you do, love the people around you, you’ve got to do this.

There’s no stigma to it. Just get it done. Make sure you’re going to be around for your family.

It is imperative.

There’s more research being done, but until that happens, you have to make sure you’re going to do what you can to minimize your risks of disease.

This is a disease that we’re more likely to get. You just have to do it. There’s no ifs, ands, or buts about it.

Can the messaging to the African-American community be better

I don’t know that it’s so much the messaging as it is access. Look, the current healthcare system is, I’m not saying this in a negative sense, but it’s a little bit of a factory to it.

Doctors, unfortunately, have to move their patients through. I’m not saying that these are not dedicated doctors and they don’t care about their patient’s health, they do, but by the very nature of the way the healthcare system works now, you can’t spend a lot of time [with each patient].

The importance of access to healthcare for communities of color

The problem with prostate cancer is, there are generally no outward symptoms, but if there are, you’re pretty well down the line with the progression of the disease.

I think making sure that in communities of color, where there can be medical treatment deserts, just like there are food deserts and pharmacological deserts, pharmacy deserts.

We have to make sure that there is access for this.

Al with his family (source: @alroker)
How important is it to get more diversity in clinical trials?

You look at what we just went through in the pandemic, when obviously, communities of color were far more impacted by the pandemic.

But when it came to the vaccine, there was a very huge push to have a real diversity in the folks who were tested so that we knew that this was safe across all ethnic groups, male and female, things like that.

I think from a research standpoint, especially given that this is far more impactful to men of color, the studies have to reflect that, as well.

What’s the importance of the patient story of people like us speaking out of industries listening to patients?

People have to, especially the medical industry. It’s, in a sense, kind of cut and dry, especially when it comes to diagnoses, treatments, medical interventions.

You tend to forget that these are people. I don’t think it’s a malicious forgetfulness. It’s just data and medical research treatment, there are a lot of data points, but those data points come from people.

That’s why personal stories are important.

Al Inspired Others to Share Their Stories

Clarence Seegars’ Prostate Cancer Story

When he read about Al Roker’s prostate cancer diagnosis, Clarence Seegars sent a message of support on social media. He wanted Al to know that he would be okay.

Hearing about it also inspired Clarence to share his own powerful story of getting diagnosed with prostate cancer.

Read Clarence’s Story

Pictures Courtesy of: NBC News, Al Roker


Thank you, Al, for sharing your story!

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Prostate Cancer Stories

Paul G. feature profile

Paul G., Prostate Cancer



Symptoms: None; elevated PSA levels
Treatment: Prostatectomy (surgery), radiation, hormone therapy
Tim J. feature profile

Tim J., Prostate Cancer



Symptoms: None; elevated PSA levels
Treatment: Prostatectomy (surgery)

Mark K., Prostate Cancer, Stage 4



1st Symptoms: Inability to walk



Treatment: Chemotherapy, monthly injection for lungs
Mical R. feature profile

Mical R., Prostate Cancer, Stage 2



Symptoms: No symptoms, caught at routine physical with PSA test
Treatments: Radical prostatectomy (surgery)

Jeffrey P., Prostate Cancer, Gleason 7



Cancer Details: Diagnosed at 59, biopsy had not detected it
1st Symptoms:None, routine PSA test, then IsoPSA test
Treatment:Laparoscopic prostatectomy