Doctor Faced Decision With Prostate Cancer Diagnosis
More than three years ago, Dr. Michael Rowland found himself facing a personal medical crisis that he had long suspected might be in his future.
It was prostate cancer.
With his diagnosis, Rowland joined a band of brothers that includes one in every six men -- among them his own father, uncle and cousin.
"Prostate cancer is diagnosed more frequently in men than is breast cancer in women," he says. "More men will die from prostate cancer each year than do women with breast cancer."
Because of a family history that included prostate cancer on both sides of his family, Rowland began having screenings with annual prostate-specific antigen (PSA) tests and digital rectal exams when he was about 40. For men without risk factors, the American Cancer Society recommends that the screenings start at age 50.
"My PSA level was slowly going up, and with my strong family history on both Dad's and Mother's sides of the family, I ended up having prostate needle biopsy and my cancer was diagnosed," says Rowland, a general surgeon at Pinehurst Surgical when he was diagnosed.
He then began to think about treatment. Again, family history provided important information.
Rowland's father had radiation treatment after his diagnosis, and now takes regular Lupron injections to control his recurrent cancer. Because of the radiation, he has continued rectal and bladder problems.
Rowland's uncle -- his mother's brother -- died about two years after he was diagnosed with an especially virulent and rapidly spreading form of the disease. "This is the problem," Rowland says. "One never knows the future behavior of his particular cancer, unfortunately."
His uncle's son -- his younger cousin -- had a radical prostatectomy (surgical removal of the prostate) eight years ago and now lives a normal life and remains disease-free.
Rowland considered every available option.
"I had been collecting articles on prostate cancer for a number of years in a drawer and finally got all of them out and re-read them carefully," he says.
He settled on robotic radical prostatectomy.
Unlike traditional open radical prostatectomy, which requires a large incision to provide access to the prostate, robotic (or robot-assisted) radical prostatectomy is a minimally invasive procedure that allows for more precise removal of the gland. Benefits of robotic surgery, Rowland learned, include less pain, scarring and blood loss; a shorter hospital stay and recovery time; and a faster return to normal everyday activities.
At the time, robotic surgery was available only at large medical centers and at just a few of them.
"I did not want to accept 'watchful waiting' and risk my cancer evolving with time into a more aggressive and spreading type of cancer, which is always a risk," Rowland says. "I preferred having the small, early cancer removed so I didn't have to worry about it in the future. Fortunately, the da Vinci robot use for removal of the prostate had recently become available and was highly successful in trained and experienced hands."
After his surgery, Rowland spent 24 hours in the hospital.
"I walked into my office less than 48 hours after the surgery to collect my mail and messages," he says. "I returned to work 13 days after my surgery."
Rowland was so pleased with his surgery and so convinced that the da Vinci system was the best option for minimally invasive surgical treatment that he began what he calls "a crusade" with the hospital's administration and his urology colleagues at Pinehurst Surgical to get the service offered at Moore Regional.
"Drs. (Greg) Griewe and (Robert) Chamberlain were very helpful and volunteered to go and get trained in the use of the robot, and (FirstHealth CEO Charles) Frock was able to help get the hospital board to approve the purchase of a robot for our hospital," he says.
Moore Regional acquired its da Vinci system early in 2006, less than six months after Rowland's surgery. Since then, Drs. Griewe and Chamberlain have performed more than 150 robotic-assisted prostate surgeries at the hospital. More recently, gynecologists Drs. Walter Fasolak and Stephen Szabo have begun using the system for certain gynecological procedures.
"If you have prostate cancer and you choose to have your prostate surgically removed, robotic surgery is definitely the way to go for most men," Chamberlain says.
There are a number of other treatment options for prostate cancer, however, and Rowland has some advice about them and other issues facing men who are diagnosed with prostate cancer.
"Be smart," he says. "If you are a male between ages 40 and 50, start getting yourself tested annually. Know your family history. If you are diagnosed with prostate cancer, educate yourself. Take your time. Do not allow yourself to make a speedy decision about what to do.
"Yes, it is cancer, but realize that there are valid arguments out there to do nothing in some cases, with years of silent and symptom-free disease for some. But if you do this, you need close and continued follow-up. Unfortunately, the clinical course of each case of prostate cancer is different and cannot be predicted."
He also suggests seeking advice from a variety of reliable sources.
"Get good advice from your urologist and your primary care physician, ask lots of questions, talk with your family, say some prayers, and only then make the decision that is right for you," he says.
Since 2005, when Rowland had his surgery, thousands of robot-assisted procedures have been performed, setting a new standard for the surgical treatment of prostate cancer. Rowland himself has experienced a full recovery.
"Today, more than three years later, I remain disease-free and am living a very normal and happy life," he says.
For more information on robot-assisted surgery at FirstHealth Moore Regional Hospital, call (800) 213-3284.
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