Dr. James E. McAndrew

Prostate cancer may silently reside in a man’s prostate, giving no clue of its presence. Nevertheless, doctors can discover it and have several tools to successfully treat prostate cancer if the disease is detected early.

On his 60th birthday Mike Landess, of Tyler, who worked for years as an award-winning broadcast journalist around the country, was diagnosed with prostate cancer following a biopsy.

Landess underwent treatment, a kind known at the time as targeted focal therapy in conjunction with an ultrasound 3D computer image of the prostate to pinpoint the location of the tumor. Doctors froze his tumor with argon gas to kill the cancer. A laser is currently used in the procedure.

Since then, Landess has regular checkups. Now 73, Landess has been cancer free for 12 years. He said, “It (prostate cancer) doesn’t have to be a death sentence. More often than not, prostate cancer can be treated if it’s caught early.”

Landess said, “Prostate cancer is not something that you want to let go because once the cancer gets out of the prostate itself and is not encapsulated anymore, it can spread to your entire body.”

No matter who diagnoses prostate cancer, Landess recommends getting a second opinion and acquiring information available today on the variety of ways for the latest treatment options.

“Make sure that you have all the best information and feel confident in the information you’ve gotten from your doctor about what choice you make and talk it over with your family,” Landess said.

About 1 in 9 men will be diagnosed with prostate cancer during their lifetime, according to the American Cancer Society. And this year the society estimates almost 175,000 new cases of prostate cancer and a little more than 31,000 deaths from it. As Tyler gears up for this year’s Zero Prostate Cancer Run/Walk, several survivors shared their stories with the Tyler Morning Telegraph.

‘I Still Feel Great’

Melvin Dean, of Bullard, who is a technical project lead for Brookshire Grocery Co., remembers it was stressful when doctors told him he had prostate cancer back in 2013. In his late 50s at the time, Dean said, “You never think about having cancer.”

Dean had no symptoms of prostate cancer when it was discovered that he had it.

When Dean went in six years ago to see his internist for his annual physical exam, the doctor found during a screening that the level of a chemical called prostate-specific antigen (PSA) in his blood had shot up from previous years.

Produced only by prostate cells, the chemical is released into the bloodstream. Cancerous prostate cells tend to leak more of the chemical than normal prostate cells. Physicians use a simple blood test to measure the level of PSA and then divide men into low- or high-risk groups for having prostate cancer.

Faced with a suddenly high PSA report on Dean, his internist first prescribed antibiotics in case Dean had an infection.

But after a couple of weeks on antibiotics, Dean still had a high PSA level. The internist then recommended Dean see a urologist and the urologist recommended a biopsy.

According to the American Cancer Society’s website, the actual diagnosis of prostate cancer can only be made with a prostate biopsy.

Dean’s biopsy showed cancer of the prostate, but that the cancer was contained within the prostate.

A surgeon removed Dean’s prostate in October 2013 and he has been cancer free since then.

“I still feel great,” said Dean, who likes to go riding on his mountain bike.

Dean’s advice to other men now is, “Have your physical every year and have your PSA checked every year to see if there’s a change in it. I tell my brothers to have your PSA checked. I thank God I don’t have cancer anymore and that it was contained inside the prostate.”

Dean said, ”If it wasn’t for the PSA check, I would have never known it.” He speculated, though, that symptoms probably would have developed if his cancer had gotten further along.

‘Put Your Pride Aside’

Roderick Russell’s doctor had been monitoring his PSA and noticed last April that it was suddenly trending upward. The physician encouraged Russell, 42, of Tyler, to see a urologist, who scheduled him for a biopsy.

It showed 11 of 12 sections of Russell’s prostate was filled with cancer. Russell underwent a prostatectomy surgery in late June. The hardest part of the ordeal was the initial shock, he said.

Still recovering, Russell, an information technologist at UT Health East Texas, seeks to bring more awareness to other men about prostate cancer and encourages more men to take the initiative and get themselves checked.

“They should definitely get checked,” Russell said. “A lot of men are scared of the whole test, but I say, ‘put your pride aside.’ Go get checked and find out the facts. Also find out your family history because that can contribute to it. Take the necessary steps to get yourself healthy.”

‘Don’t Put This Off’

But in the case of Casey Manuel, who works with the store brand team at the Tyler office of Brookshire Grocery Co., his PSA blood level was low and not indicating cancer at all.

It was his physician’s annual physical exam that turned up the possibility that Manuel might have prostate cancer eight years ago. “The doctor discovered irregularities with my prostate, so she sent me to a urologist,” he said.

The urologist performed a biopsy that showed cancer and treated him with radiation to kill the cancer cells.

Manuel, who was 59 at the time, said he breezed through 48 rounds of radiation therapy spread over five days a week with two days for rest. He had no side effects and the therapy was a quick procedure. “I was back in the office in less than an hour,” he said.

Now Manuel stresses to other men the importance of going to the doctor and having regular physical examinations.

“If they catch it early like mine, I’m pretty sure it’s a 100 percent cure rate,” he said. “I’m fine. I look forward to living a long productive life without cancer.”

Manuel added, “Guys don’t like to go to the doctor, but go to the doctor. Have your regular physicals. Don’t put this off. They should always get a physical every year so the doctors can find it early if it’s there. It’s highly treatable.”

Having a physical exam was especially important in his case because his PSA remained low even while he was going through radiation, Manuel said.

‘PSA is a Very Good Tool’

Since Dr. James D. McAndrew, 58, is a urologist and has a strong family history of prostate cancer, he was monitoring his PSA closely. It began to rise 2 1/2 years ago, which led to a biopsy and a diagnosis of prostate cancer.

McAndrew had radical robotic surgery to remove the prostate completely.

Until his PSA had started going up, there were no symptoms of cancer.

“That’s the whole thing about prostate cancer,” McAndrew said. “Early on, when it’s the most treatable, it usually has no symptoms, so PSA is a very good tool (for alerting about the possibility of cancer).”

McAndrew also was aware that he was at high risk of prostate cancer because his father, grandfather and uncle all had prostate cancer. Men with a family history of prostate cancer, which usually means a father or brother, have a higher risk for the development of prostate cancer, McAndrew said.

Prostate cancer tends to be more common the older men get, but men with a family history of prostate cancer or African American men are at a still higher risk of getting it, the urologist said. African American men are at higher risk than white, Asian or Latino men, he said. They tend to get it younger. And more often, it has a more aggressive course in African American men, McAndrew said.

“African American men should start getting their PSA checked once a year after they turn 40,” McAndrew said. “Other men should start at least at 50 getting their PSA checked.”

Men are scared and tend not to go to the doctor and not have their PSA checked, McAndrew said. By not getting the PSA blood test, men may not get to choose what their step is if a determination is made later that they have prostate cancer, he said.

Some men may have a low-grade cancer that only needs to be monitored, while other men need more aggressive treatment, McAndrew said. “If you don’t even know things are going on, you don’t have a choice. It’s best to get the blood test and see where you are,” he advised.

Usually a family doctor or internist doing a routine exam or PSA blood test diagnose that a patient may have prostate cancer. The family doctor or internist usually refers the patient to a urologist for further evaluation and maybe a biopsy.

“Sometimes it comes back clear, which is great news. Other times, we find cancer and the urologist will counsel the man on treatment options. Then there is a joint decision where to go from there,” McAndrew said.

Treatment is customized for the individual man, based in part on how aggressive the cancer looks, their age and family history.

Twitter: @Tylerpaper