Treating Prostate Cancer is Personal for Dr. Keith Waguespack

Empathy is a gift. It grows from personal experiences—often including heartache and loss—that shape the way we look at the world and how we relate to others.

Dr. Keith Waguespack was attending Texas A&M University in the 90s on a football scholarship when his family in Port Neches, Texas, suffered a double blow. His beloved grandfather was diagnosed with metastatic prostate cancer.

“Back in those days PSA testing had just become mainstream,” Dr. Waguespack remembers. “After my grandfather was diagnosed, my dad started seeing a urologist, had a PSA test and was ultimately diagnosed with prostate cancer, as well.”  

Home from college for the summer, Dr. Waguespack cared for his dad as he recovered from an open radical prostatectomy. “I got to know his urologist in Beaumont and figured out what a urologist is—most people don’t until they have an experience with one or know someone who has urological problems.”

Dr. Waguespack was impressed with the way his father’s prostate cancer was managed—and ultimately cured—surgically. “Seeing what urologists do while I was still in college put me in gear toward being a surgical sub-specialist,” he says.

A summer research post in a urology lab before his second year of medical school at UT Southwestern in Dallas, Texas, helped him make up his mind and ultimately become a prostate cancer surgeon.  

“We all go into medicine because we want to help people—I think that is a given for anyone who goes to medical school and ultimately takes the Hippocratic Oath,” Dr. Waguespack says. ”The thing that is very rewarding to me, is the ability to use technology and my surgical skills to fix problems. Unlike the management of chronic disease, with surgery we’re able to develop a plan to fix the problem rather than manage it long-term.”
Although he has seen remarkable outcomes for men whose prostate cancer is detected early, his grandfather and dad are never far from his mind. 

“My grandfather ultimately died of the disease, while my dad was cured by surgery. In my own family, I have seen the worst and the best case scenarios for outcomes after diagnosis,” he says.

This very personal perspective shapes every conversation Dr. Waguespack has with his patients.
“Being able to relate to my patients is really important,” he says. “For many men, this is the first time they have had any type of significant health issue. Suddenly, they have this cancer diagnosis and are faced with going through all this treatment. I think about that every time I’m about to walk into a patient’s room and meet them for the first time.

“When they learn I’ve not only experienced this situation while caring for patients, but also with family members, especially my father, it helps us relate to one another. When they know I understand the process they’re going through—the fears they have about surgery, biopsies, having a catheter—it helps develop a level of trust. I have experienced where they are, not only from the perspective of a physician treating them, but as a person who has a close bond with someone who’s been through it all.

“I remember how my dad was when I was taking care of him after he had his prostatectomy. Back then patients had to wear catheters for two or three weeks after surgery. Watching him manage his catheter, seeing his frustration and how it changed his personality because he had so much discomfort has stayed with me.”

Fortunately, catheterless robot-assisted prostatectomies make recovery much less painful, but that doesn’t mean Dr. Waguespack recommends surgery to all his patients.

“I tell them all the time, this isn’t about me. It’s about you, and you need to be informed about all the different options before we proceed,” he says. “Very commonly I see patients who maybe don’t have all the facts or all the options laid out to them when they’re initially diagnosed. It’s a common scenario for me to see a patient and ultimately talk them down from surgery so they can explore their other options. I tell them to wait, stop, slow down, think about all the treatment options we have here. We don’t have to rush into decisions. And with that, patients sometimes realize there is another option that’s better for them.”

When patient Jim Cox first visited Dr. Waguespack, he had his mind set on surgery until they talked.

“He very politely told me, ‘You’re overweight. I won’t operate on you at this weight because you have a 25 percent higher risk of incontinence based on your current weight.’ The first surgeon I met with in Waco hadn’t mentioned that,” remembers Jim.

While he was dieting to drop the 30 pounds Dr. Waguespack instructed him to loose, Jim decided to learn more about his other treatment options. He visited Dr. Peter LaNasa, director of radiation oncology, and eventually decided to pursue radiation therapy.

“I have no problem at all telling my patients, ‘You need to see a radiation oncologist, you need to talk about these other treatment options before we make a decision.’ I think they respect that,” says Dr. Waguespack. “A lot of them realize from that point forward that we have their best interest at heart. And now with active surveillance, diagnosing prostate cancer is just the first step to managing the disease. It’s not all about getting rid of the disease—radiating, removing the prostate, etc.  It’s about staging men and realizing which patients really should not take on the risks of treatment because they outweigh the benefit. Maybe they don’t have to have any treatment done initially at all—or ever for that matter if they continue to be followed and don’t have any progression.”

Regardless of what treatment option his patients may choose, Dr. Waguespack remains committed to them throughout their entire journey.

“Whether I am actually going to operate on a man or direct him to a different therapy and see him after he has completed radiation or another treatment, I want to be completely involved with their care,” he explains. “I want to be their go-to person, their point of contact, their coach, so to speak, throughout the management of their prostate cancer. Taking a personal approach with patients, relating to them in a personal way, not just as a doctor, I think, really helps.”

A while back, Dr. Waguespack received a text message from one of his patients, a die-hard distance runner in his 50s, after he’d finished the Boston Marathon—just six weeks after his prostatectomy!

“His text jokingly said, ‘I just wanted to let you know you caused me to run the slowest Boston Marathon of my life.’ Granted, running a marathon isn’t something most of our patients are going to do, but it shows how resilient we are. This man was able to go through all the emotional strife that comes with prostate cancer—concern about incontinence, changes in his lifestyle, and short-term recovery from surgery—and re-focus his energy on what he loves to do and get back to his passions. The worst thing that happened to him, when it was all said and done, was that he ran the slowest Boston Marathon of his life.

“You can look at prostate cancer from a negative perspective, or focus on the fact that it’s one of the most manageable and curable medical conditions we treat. It comes back to having the patient’s best interest at heart—and that means helping them get back to the things they love.”

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

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