Dr. Bevan-Thomas Uses Storytelling and Science to Save Lives

There’s a scene in the film The Graduate that reflects all the confusion and ambivalence Dustin Hoffman’s character—21-year-old Benjamin Braddock—feels upon completing his bachelor’s degree. 

“What are you going to do now?” his parents’ friend asks.
                                                               
“I was going to go upstairs for a minute,” he replies.

“I mean with your future—your life,” she says.

“It’s hard to stay,” he answers.

“Ben, I want to say one word to you—just one word. Are you listening?” another presses.

“Yes, sir.”

“Plastics.”

It’s a scene Richard Bevan-Thomas, M.D., can identify with. Newly graduated with an English degree from Duke University, “I was thinking about writing, but was sort of lost about what I was going to do with my life,” he admits. “I went home to Freemont, California and had one of those epiphany moments.”

A heart-to-heart with his supportive parents, both physicians, helped.  

“Even though majoring in English and writing was a good experience, it let me know I was more suited to something that was more concrete—and that was science,” he says.

Dr. Bevan-Thomas had always done well in science when he attended Cate School, a prestigious private high school in Southern California, so he enrolled in a general chemistry course at the University of California Berkley and, not surprisingly, did well. Comfortable with his new path, he managed to complete two years of pre-med courses in just one year, and was then accepted into the master’s anatomy program at St. Louis University.

“I didn’t really say, “I want to be a doctor.’ I just kept pursuing science,” he admits. “Sometimes your career finds you.”  

After completing his master’s degree, Dr. Bevan-Thomas attended medical school at St. Louis University. Initially, he thought he might follow in his father’s footsteps and become an orthopedic surgeon.

“While I enjoyed the physics of orthopedics, there wasn’t a lot of physiology involved and I was really interested in understanding how the systems of the body work together. I guess I got that from my mother who is an anesthesiologist.”

When it came time to choose his specialty, Dr. Bevan-Thomas first split his time between the orthopedics and urology departments, but an internship in orthopedics changed his course. “A week into it I said, ‘This isn’t for me.’ By then I had become friends with the dean of urology and realized I preferred urology. I decided I wanted to focus on cancer because it requires a knowledge of physiology and anatomy—and because at the end of the day, you can really change people’s lives.”

Now the medical director of USMD Prostate Cancer Center, Dr. BT—as he is fondly known by his patients—has found that his original passion for storytelling has been put to good use while talking with men diagnosed with prostate cancer.

“It’s a scary thing when you get diagnosed with cancer,” he says. “Understanding your patients makes a huge difference in how well you can connect with them,” he says. “First, I tell a man the entire story about prostate cancer, give him an overview of the disease process, and then I individualize it so it becomes a story about his cancer.”

Foremost, Dr. Bevan-Thomas wants men to understand that not all prostate cancer is the same.

“I help men understand that just because they knew a guy who died of prostate cancer doesn’t mean their cancer or outcome will be the same. They’re not like their neighbor down the street who’s been following his prostate cancer for 10 years. People often come in with preconceived notions—which are wrong a lot of times. My job is to bring them back down to earth and say, ‘Here are the facts.’ When a man walks out my door, I want him to know he has a game plan—whether he has terrible cancer or low-grade cancer. The bottom line is you’ve got to know where you’re going to be a week from now, six months from now, or two years from now. I think that really gives men a lot of peace of mind.”

Six years ago, Louis Giamalva—then just 48—was reeling from his prostate cancer diagnosis.
“When I was first diagnosed, it seemed like nobody wanted to look at me,” he remembers. “It was kind of ‘Hi, here are your test results. See you later.’ Being in a doctor’s office and having that happen was probably more disconcerting than anything. It really bothered me.”

Through recommendations, Louis found his way to Dr. Bevan-Thomas. Now cancer-free for six years following a robot-assisted radical prostatectomy, Louis says, “I can’t emphasize enough how much Dr. BT really changed everything. Having him sit down and tell my wife and me, ‘Relax, we’re going to take care of this,’ made such a difference.  He dealt with it in such a positive manner that it made everything so much easier. With him, I got past that ‘I-don’t-know-what’s-going-to-happen’ feeling. I remember walking out of his office and feeling a big sigh of relief. He’d taken all the stress out of the situation.”
 
Long-time Star-Telegram photographer Paul Moseley appreciated Dr. Bevan-Thomas’ knowledgeable and reassuring demeanor after he was diagnosed with prostate cancer in 2014.

“Handling guys is kind of tricky sometimes,” he says. “Some of us are real tough and some fall apart. He has to assess that in an instant. I was kind of in a fog, but he told me about all my options, and explained the biopsy process and all the things that lead to the diagnosis and staging how serious the cancer is. He wasn’t cocky, he was confident: ‘These are the options you have and why each one might be good or bad.’ Just talking to him built my confidence.”

Dr. Bevan-Thomas says he feels honored to care for men like Louis and Paul.

“Louis and Paul remind me of the reason I do this. I’ve been practicing for 15 years now, and knowing that I’ve made a difference in their lives makes me want to go to work the next day,” he says.

Helping men cut through misconceptions about prostate cancer so they can take control of their treatment is one of the most important aspects of his mission. He worries when he hears media reports that misrepresent the nature of prostate cancer or discourage screening.

“Knowledge is power,” Dr. Bevan-Thomas says. “It irks me when news outlets say, ‘Don’t get your PSA drawn’ and ‘Nobody dies of prostate cancer.’ I’ve had patients who have died of prostate cancer—patients who didn’t come to me early enough and that’s really terrible. Those are the ones I lose sleep over. But on the flip side, I’ve had guys come in who’ve had low PSAs and they’ve said, ‘My doctor told me not to worry about a PSA test, but I’ve decided to get one,” and we found that they had a higher-grade prostate cancer. Those are the guys who realized they needed to take their health into their own hands and not just listen to the news because it said ‘nobody dies of prostate cancer.’ Instead, they came to me, we detected their cancer early, and there’s an excellent chance that I was able to cure them.”

Using state-of-the-art technology, Dr. Bevan-Thomas maintains the delicate balance between ensuring an aggressive high-grade cancer doesn’t go undetected in any man, while being careful not to overtreat low-grade prostate cancer.

“I’m not here to whisk men off to surgery,” he says. “I’m here to help men understand their prostate cancer and their treatment options. Many men come to my office and they’ve been given incomplete information. Maybe they have low-grade cancer, and if so, I tell them we can follow it.  Often, they’re surprise and say, ‘Wow, I don’t need to do something right away? My doctor said I need to have surgery in two weeks.’ I tell them no, and that can change their lives because I may have prevented them from needless surgery and long-term side effects such as incontinence, erectile dysfunction or other issues that some men experience after surgery.

“With every patient, I discuss their level of risk—whether they have a high-volume Gleason 6, low-volume Gleason 6 or a Gleason 7, 8, 9 or 10. I say, ‘Okay, you’ve got a PSA of six, so let’s figure it out. We’re going to repeat your PSA, determine your risk for having a focus of cancer, and if we need to consider a biopsy.’”

Dr. Bevan-Thomas cautions men to beware of any physician who recommends a biopsy right off the bat.

“The reason biopsies get a bum wrap is because for a time, everybody with a PSA above 2 or 3 was getting a biopsy,” he explains. “Then everyone with low-grade cancer was getting a prostatectomy or radiation. Now, they’re underestimating the mortality of this disease.”

Dr. Bevan-Thomas has always had a passion for discovering new information and finding the right answers. His fourth-grade teachers once told his mother he asked too many questions. Today, that natural curiosity not only serves his patients well, it’s a quality that they appreciate.

“I hate to apply too much hero status to him,” says Moseley, now cancer-free for two years following his robot-assisted radical prostatectomy. “I know Dr. B.T. probably fears it sometimes, but he’s just going to have to suffer through it—he is my hero.”

A few years ago, Dr. Bevan-Thomas received a homemade card from a five-year-old. “It said, ‘Thank you for saving my grandpa’s life,’” he remembers. “Of all the thank you cards I’ve received, that was a great one because it was from a young kid who got it. His grandfather was sick, and he let me know I was part of keeping his grandpa around. I think about that a lot.”

If you have been diagnosed with prostate cancer and would like to schedule an appointment with Dr. Bevan-Thomas, please contact USMD PCC online or call 1-888-PROSTATE (1-888-776-7828).

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