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Dennis - Prostate Bed and Lymph Nodes

Dennis - Prostate Bed and Lymph Nodes

Dennis takes a scientific approach to his health. A retired fisheries biologist living in Olympia, he worked for many years with the State of Washington and local tribes on salmon issues, especially habitat restoration.

So, when Dennis’ doctor first recommended doing prostate-specific antigen (PSA) tests, Dennis was interested — from a scientist’s perspective — in tracking how this number would change over the years. In 2009, it hit his “red flag” target of 5.0, and he went in for a biopsy.

“It was fun to watch the first five samples,” says Dennis, “but then I struggled through a total of 13 ‘rubber-band snaps.’” His doctor explained that Dennis had prostate cancer cells scattered throughout the prostate.

Dennis sought out the leader of a prostate cancer support group and had a blunt conversation about treatments and side effects. He also listened to other people’s stories about their experiences and the side effects they had endured. Still, Dennis knew he would take action, because his great-grandfather had died of prostate cancer.

“I picked a doctor who did hands-on robotic-assisted surgery for a prostatectomy,” says Dennis. “After the surgery, my PSA went down to 0.02, or undetectable.”

However, Dennis did not stop having PSA tests just because he no longer had a prostate. “I’m a strong proponent of PSA testing,” he says. “It’s extremely useful in understanding how fast a potential cancer is changing, and I am encouraging my two adult sons to establish a baseline, too.”

When Dennis’ PSA numbers crept back up in 2015, he had radiation at Fred Hutchinson Cancer Center (formerly Seattle Cancer Care Alliance). Following that, his radiation oncologist recommended watchful waiting. But when his PSA reached 5.0 again in 2021, it was time to take the next step. A scan confirmed that his lymph nodes near the prostate bed were enlarged.

That’s when Dennis realized, “I will always have prostate cancer. Now, it is about quality and length of life.”

He went to see his oncologist at Fred Hutch, Dr. Heather Chang, who “drew a beautiful diagram of my treatment options.” She recommended a “gold standard” treatment: proton therapy, combined with Lupron, a chemotherapy and androgen deprivation drug. He also joined a UW Medicine study that added abiraterone (abi) pills to lower his testosterone levels. This six-month approach included two Lupron shots, daily abi pills and a midpoint intervention of 25 lymph node-targeted proton radiation sessions. Since he had already had radiation to the area in the past, only proton therapy allowed his doctor to re-irradiate the area. Proton therapy can be more precisely targeted and minimizes any radiation received by healthy surrounding tissue.

Like many men facing prostate cancer, Dennis was not excited about hormone therapy and its potential side effects, but he valued the providers at Fred Hutch, saying “Over time, I have used Fred Hutch as my second opinion and ultimately my main patient care for prostate cancer, and I’ve realized how fortunate I am to be able to trust their expertise and caring advice.”

Dennis credits not just the physicians, but the entire care team at Fred Hutch: nurses, schedulers and concierges, who were professional, caring and informative. His proton radiation oncologist, Dr. Jing Zeng, especially, stood out to him, and he felt fortunate to have her guidance “I learned a lot from her, and she was so positive,” he says.

Though he didn’t have any side effects from proton therapy, the abi pills made him feel tired. Because the proton therapy facility in Seattle is the only one of its kind in a seven-state region, he “took lemons and made lemonade” by staying in Edmonds rather than commute from Olympia. Dennis made the best of things, exploring the area from Vashon Island to La Conner’s antique stores. Before his proton treatments, Dennis enjoyed conversations with other patients, and he and his wife, Susan, even had a get-together with another couple.

Dennis has a few recommendations for other patients: “Get a second opinion. It’s always helpful to get more than one perspective. Take advantage of the experts we have here in the Pacific Northwest. Ask for an ice pack after a Lupron shot! And continue to stay active.”

To that end, Dennis and Susan will soon be visiting their son in Los Angeles and then taking a road trip to Ft. Benton, Montana, where they will do a three-night canoe trip down the Missouri River. And Dennis is back to his hobby of genealogy, which he uses as an excuse to visit places like England, Scotland, Ireland and Prince Edward Island.

“I will continue to monitor my PSA,” says Dennis. “I hope I never have to be treated at Fred Hutch again, but if the PSA indicates my tiny little cancer cell factory is still operational, I know where to go to get it fixed. Thank you very much for your treatment and continued efforts to improve prostate cancer identification and treatments.”