Mike Whitacre Approached His Prostate Cancer the Way a Good Engineer Does: Methodically

As an engineer who does fluid system installation design for Lockheed’s F-35 program, Mike Whitacre is pretty systematic when confronted with an issue. “I want to know what the real problem is. I don’t want to guess at it,” he says. “That’s just my nature. I want to take it apart and look at it.”

So, when Mike’s primary care doctor called him in 2015 and told him his PSA was over 4 and urged him to see a urologist, he kicked into problem-solving mode.

“Immediately, I started researching prostate cancer,” he says. “I had a supervisor at work who’d had prostate cancer and had his prostate removed, so I went to see him because he was 10 years past his surgery and was doing fine. He told me he was treated by Dr. Justin Lee. I did some research on Dr. Lee and learned about USMD Prostate Cancer Center. I was convinced that instead of going to a general urologist, going to a center that specialized in prostate cancer was a better way to go.”

When Mike first saw Dr. Lee in December 2015, he had a urinary tract infection and was taking an antibiotic, so Dr. Lee advised him to come back three months later for a free PSA test. The results came back under at 3.5, so rather than perform a biopsy, Dr. Lee recommended active surveillance. Over the next two years, Mike had his PSA tested every six months.

“It kept going back up from 3.5 to 3.6, 3.7, 3.9 and then in June 2017 it was 4.6. Dr. Lee said, ‘This fluctuating PSA has me concerned. We need to find out what’s going on.’ He told me he thought we should do an MRI.”

Although most insurances don’t pay for an MRI of the prostate before a biopsy has been performed, Mike decided to pay for one out of pocket ($800). “I thought it was worth it because a biopsy might miss the cancer, then the insurance would want to do an MRI later, followed by another biopsy. That’s months of time that goes by, so I decided to the MRI first.”

The MRI showed a PI-RAD 4 lesion. Dr. Richard Bevan-Thomas performed a biopsy that targeted the lesion along with other sections of Mike’s prostate. “It only took about 10 minutes, and I didn’t feel any pain,” he says. “I really enjoyed Dr. BT. He was very knowledgeable and I talked to him about my ketogenic diet.”

Early in his prostate cancer scare, Mike decided to make a drastic change to his diet. “I used to drink seven or eight full-sugar cokes a day and eat pizza—I might eat a whole pizza. I was probably eating 700 grams of carbohydrates a day,” he says. Switching to a ketogenic diet (high-fat, protein, and low-carbs), Mike dropped 50 pounds and managed to improve his triglycerides, cholesterol and blood sugar levels by doing so.  “I feel better. I have a lot more energy.”

While his biopsy revealed the PI-RAD lesion was still precancerous, there were four positive cores. Dr. Lee broke the news that three of the cores were Gleason 6 and one was Gleason 7.

“I knew that sometimes with Gleason 6 they do active surveillance,” Mike says. “I’m the kind of person who can have a bit of anxiety, so when Dr. Lee came in and I saw Gleason 6, Gleason 6 and then Gleason 7 on my paperwork, I actually felt relief. I know that’s kind of unusual, but I knew with a Gleason 7 that I was going to get treatment—and to me treatment was something that was going to fix the problem.”

Dr. Lee explained Mike’s treatment options.

“A lot of doctors sell their specialty,” Mike says. “I see it a lot while reading prostate cancer forums.  A surgeon will say you have to have surgery. A radiologist will say you have to have radiation. They sell their treatment, and they sell their treatment as the only way. Dr. Lee didn’t do that. The first thing he said was, ‘I really recommend that you go and get some other opinions.’ He offered to bring in a radiologist and an oncologist, and he gave me a copy of the NCCN guidelines and told me to go home read it. I also bought a copy of Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer. It’s an excellent book because its objective and talks about all the treatment options, and where you can get help in trying to decide what type of treatment you might need based on your diagnosis.”

After careful consideration of potential risks and side effects, Mike chose surgery. “Although Dr. Lee told me radiation is just about as effective as surgery in terms of cure rates and statistics, I felt like I had one chance to get the cancer out of my body,” he says. “I think if I’d done radiation, I might still be worried about it. Your PSA can start moving again with radiation.”

Mike was also mindful of a family history of the disease.

“I had an uncle who fought metastatic prostate cancer very bravely for 20 years. He never showed the pain he may have been in. I’ve always looked to him as an example of how to face adversity. One of his famous quotes was “today is a good day.” I want to be healthy so I can see good days with my grandkids, be active, and take them hunting and fishing.”

Because Mike’s cancer was located in an area where it has been known to sometimes break through the prostate and metastasize, Dr. Lee told him he was going to take a little more of the nerves than he would normally because he didn’t want to leave any cancer behind. “He explained that it might make my sexual recovery take a little longer, but that I should still get function back,” Mike says. “I’m in my late 50s, almost 60, my primary concern wasn’t so much sexual function as it was urinary continence. Am I going to be continent or am I going to be wearing diapers?”

Mike’s laparoscopic prostatectomy was also complicated by the fact that he had two bilateral inguinal hernias which also required surgery. Coordinating with USMD/MCNT surgeon Dr. Paul Stiefel, Dr. Lee performed Mike’s laparoscopic prostatectomy on Friday, September 22, 2017, immediately followed by Dr. Stiefel’s repair of the two hernias.

Mike spent two days in the hospital, but went home on Sunday and has experienced a strong recovery ever since. “On Monday, I walked to my mailbox. On Tuesday, I walked to the end of my street and back. By Wednesday, I was walking two miles with my cane, my suprapubic catheter and bag. When I went to see Dr. Lee, he said you might be overdoing it a little bit.”

Mike was also pleased about his recovery on another important front: “I was continent from the day the catheter came out,” he says. “I wore pads for about a month, but they were never wet. I just wore them as a precaution at first. I don’t have stress incontinence when I sneeze or run. And I don’t have bladder spasms.

Along with ridding his body of cancer, Mike’s prostatectomy delivered another bonus. “I’d had an enlarged prostate for 10 years, and was having difficulty urinating, but my stream is now like it was when I was 20 years old. I feel better!”

Recovery of his sexual function is still continuing. “Things are actually not bad in that department,” he adds. “It’s not what it used to be, it takes effort, but it’s improving all the time. Dr. Lee gave me a daily 5mg of Cialis right off the bat. I notice a difference when I don’t take it, so I’m going to keep taking that small dosage because it helps with the blood flow.”

Now approaching his October one-year anniversary in with three “undetectable” PSAs under his belt, Mike is thankful for the support he received during his cancer scare.

“I was worried from time to time,” he admits, “but for some reason, from the time I met Dr. Lee I had a lot of faith. He was always upbeat. He always looked at me and said, ‘You’re going to be alright. You’re going to be fine.’ My wife, Roxann, was like a rock. She was always there for me. She went with me when I had my MRI and biopsy and when I was diagnosed. She’s really pretty strong. She agreed with the treatment choice because we discussed it a bit. She thought surgery was a good way to go.

“With surgery one of the big benefits is you get a pathology report on your prostate. And not only of the prostate, but also on seminal vesicles and lymph nodes. Everything was clear. That gives me a lot of reassurance that they didn’t find cancer in any of those areas—it hadn’t spread. The pathology report showed the cancer was totally contained within my prostate. My tumor status was upgraded, but it was still considered contained, and that gave me confidence to know that down the road this will not be an issue. I’m considering myself cured right now.”

Grateful for his clean bill of health, he admits the holidays last year were bittersweet. Along with coping with his prostate cancer diagnosis and treatment, Mike lost his mother after a life-long battle with diabetes just two months after his surgery—and his father passed away the year before. Still, Mike is channeling his good outcome by paying it forward and serving as an advocate for prostate cancer awareness—beginning with his close community of colleagues at Lockheed.

“It’s amazing, there are several hundred men in the bay I’m in and I know pretty much every one who has a prostate issue, who’s had prostate cancer or who is undergoing treatment,” he says. “Men come up to me at work now and say their PSA is up and ask what they should do.”

The engineer in Mike knows good decisions come from being fully informed, and that begins with gathering information. He’s grateful that his primary care doctor established a baseline PSA for Mike back in 2011. “He’d always tell me, ‘The AMA says they do more harm than good, it’s real controversial, but it’s the only way we can check for prostate cancer, so I do them.’ Those annual tests showed the gradual rise in my PSA. They established a record that could be tracked.

“I work with a guy now who thought his primary care doctor had been doing an annual PSA, but then learned he hadn’t done one in six years. He told the doctor, ‘I want my PSA tested.’ It came back over 6, so he asked me what I thought he needed to do. I told him about USMD. He’s working with Dr. Lee now and is going to have an MRI.

“I have another friend whose PSA was all over the place—6, then 12. He had a biopsy that came back negative and his doctor told him, ‘You don’t have cancer.’ I said, ‘What do you mean you don’t have cancer? That just means twelve little needles didn’t hit cancer, it doesn’t mean you don’t have cancer.
I think you should get a second opinion.’

“I’m not going to tell somebody what they should do, but I can steer them to a place where they can get a correct diagnosis from people who know what they’re doing. I’m firmly convinced that even if you don’t use USMD for cancer treatment, or you want to have a treatment they might not offer, if you have prostate cancer, they’re going to find it, evaluate it and give you good advice.”
 
If you’ve been diagnosed with prostate cancer and would like a second opinion or to know more about your treatment options, please contact USMD Prostate Cancer Center online or at 1-888-PROSTATE
(1-888-776-7828).



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