Dr. Vestal Helps Men Enjoy Life’s Two Qs: Quality & Quantity

As a boy growing up in Costa Rica, Chile and Texas, Clif Vestal, M.D., was always interested in medicine, although he originally had his heart set on being a veterinarian. After graduating from high school in Rockwall, Texas, he went to Texas A&M University to pursue his dream.

“I was on Christmas break after my first semester and having a conversation with my grandfather. He said, ‘You know, I went through the depression and when the kids got sick they went to the doctor. When the cows got sick, they died.’ It was tongue-in-cheek advice, but I thought he was probably right, so I went back and changed my major,” Dr. Vestal says.

After earning his bachelor’s degree in zoology, Dr. Vestal attended Texas A&M medical school—becoming the first person in his family to become a physician. Early on, he knew wanted to specialize in urology—a decision that one particular member of his family isn’t too keen about.

“My 16-year-old came home from school the other day and asked: ‘Dad, did you have any idea what choosing urology would do to your family? Did you have any consideration about how it would affect us?’ I answered, ‘Not really. Why are you asking me?’”

It turns out the young Vestal was getting teased at school. “They call me Calvin Vesical,” he told his dad. Of course, Dr. Vestal couldn’t have anticipated his son’s perspective when he chose his area of specialization.

“I chose urology because it allows me to practice many aspects of medicine. I perform surgery in urology. I’m involved with patient aftercare. I provide urological oncology. That diversity is the reason I wanted to be a urologist,” he says.
 
Dr. Vestal’s residency in urologic surgery at Scott & White Clinic and Hospital and Texas A&M University Health Sciences Center—followed by a fellowship in urological oncology at the University of Colorado Health Sciences Center in Denver—exposed him to many prostate cancer cases.

“It was a good fit for me,” he admits. “That’s when I decided I wanted to specialize in urological oncology—bladder, kidney, testicular and prostate cancer—with prostate cancer, by and large, the condition I treat most.”

Dr. Vestal’s interest in oncology was also influenced by two very personal experiences with cancer.

“My mom was diagnosed with breast cancer when I was in medical school, and my dad was diagnosed with prostate cancer right after I completed my residency,” he says.

Seeing what his parents went through not only helped determine his life path, it also allows Dr. Vestal to relate to his patients and their families in a personal way.
 
“It makes conversations with my patients easier, and certainly more heartfelt,” he says. “They always ask, ‘What would you do?’ and I answer from personal experience. I don’t have to imagine what I would do. Instead, I can say, ‘This is what I told my dad when he had prostate cancer.’ It makes it more real to them. My family has gone through the same thing your family is going through. I’ve been there, and it’s not the end of the world. My dad went through it and he’s doing fine.

Although Dr. Vestal is a skilled surgeon who performs laparoscopic cryosurgery and brachytherapy, his close connection with patients and their families has inspired a special calling—treating end-stage cancer patients.

“We can’t cure cancer once it has escaped the prostate, but we can prolong survival,” Dr. Vestal explains. “Treatment becomes about slowing its progression and extending life. For many men, all they want is to be there for an important anniversary, a child’s graduation or wedding, the birth of a grandchild, or a family trip. With all the new medicines we now have, we can provide them with hope that they can make that important milestone.”

Dr. Vestal says finds this aspect of his work extremely rewarding.    

“I take out cancers all the time, cure a lot of people and they go about their business and are fine,” he notes. “But with these guys, I see them all the time, get to know their families—it’s very personal. Perhaps they’re not going to live as long as they would like, but for these men and their families, making it to the next big event is priceless. It’s a way I can actually make a difference.”

Today, new oral and radioactive medications, immunotherapies and a variety of regimens are giving men more time than they had two decades ago. 

“We’ve gone from a survival rate of around a year to sometimes up to five years and longer,” he says. “It really makes a big difference in these people’s lives. They’re around a lot longer to do a lot more—to do those things they need to get done.”

Dr. Vestal is especially grateful for prostate cancer patients he’s been treating for 10, 12 and 15 years—including two men in their 90s. While he credits state-of-the art medicines as a huge factor, he knows the bond between doctor and patient plays a key role in helping men with the two Qs—quality and quantity of life.

“As a patient, you put your entire life in the hands of someone you have to trust implicitly. How can you make good decisions about your treatment if you don’t like the guy who’s helping you make those decisions? The connection between the physician and patient is so important. There has to be trust. You need to know your physician cares and is looking out for your best interests—not just doing something because that’s what he or she does. Once patients get over the initial shock of having cancer, they’re pretty astute about what’s going on. They know when someone is being genuine and when they’re not.”

Mutual respect, trust and candor make it possible to make the toughest decision of them all.
  
“A lot of my conversations with patients are end-of-life conversations. When are we going to start? When are we going to stop? At what point should quality of life override quantity of life? At what point is the treatment worse than the disease? The answer is always when you tell me.  When we agree that you’re suffering, then we’ll change, we’ll do something different. I can make all the recommendations in the world, prescribe medications and make everything happen, but at the end of the day, it’s your body. You have to ultimately make that decision. I’m here to help you.”

Dr. Vestal says he is affected by every patient he treats.

“One comes to mind who passed away a few months ago. He had metastatic prostate cancer and I had been taking care of him for 12 years. He underwent radiation and then cryosurgery, but developed metastatic disease and went on hormone therapy. About six or seven years later, he developed castrate-resistance prostate cancer, so we started other treatments. Near the end, all he wanted to do was take his grandkids to the beach one last time, but he’d become bedridden. A new compound came out—radium 23. I said, ‘Try this new drug because it might actually help.’

“Three months later after three treatments, he sent me pictures from the beach with his grandkids. He passed away happy. He did the one thing he wanted to do. I’m glad I could help him and his family enjoy that time together.”

If you’ve been diagnosed with prostate cancer and would like to know more about your treatment options, or schedule a consultation with Dr. Vestal, contact USMD Prostate Cancer Center online or call 1-888-PROSTATE (1-888-776-7828).

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