Changing Minds — and Treatment Plans — One Prostate Cancer Patient at a Time
Aug 15, 2013 - 11:22:52 AM
In the past five years, advances in prostate cancer have shown that many forms of the disease are slow-growing and not life-threatening. As a result, doctors often encourage that patients not rush to surgery. This is in contrast to traditional medical advice, which often had cancer patients heading to surgery or radiation therapy immediately after diagnosis.
Trevino is now enrolled in a Cedars-Sinai prostate cancer monitoring program that tracks disease progression and encourages lifestyle changes in men, including diet and exercise. This new approach and new way of thinking about prostate cancer is known as active surveillance. As new symptoms develop, or if tests indicate that cancer is growing, individualized treatments may be made for each patient.
But when Trevino first learned he had prostate cancer, a surgeon who was not affiliated with Cedars-Sinai suggested a prostatectomy, a sometimes-complex surgical removal of the prostate. Trevino's wife and children agreed, but he was hesitant.
"After 29 years of marriage, six children and seven grandchildren, I thought I was prepared for anything, but prostate cancer came as a shock and as a source of confusion," said Trevino, a 65-year-old retired government affairs representative and former educator. "The initial stages of diagnosis were confusing because surgeons not affiliated with Cedars-Sinai immediately suggested prostatectomy surgery. I was ready for information; I wasn't ready for someone to make a treatment decision for me. Being my own advocate was important and so was being informed of all of my options."
After expressing this frustration to his primary care physician, Trevino was referred to Hyung Lae Kim, MD, co-medical director of the Urologic Oncology Program, associate director for surgical research at the Samuel Oschin Comprehensive Cancer Institute and director of Urologic Academic Programs.
"Prior to meeting Dr. Kim, information was being thrown at me from every angle, with little to no explanation or guidance - I felt as though I was learning a foreign language," said Trevino. "Dr. Kim spent 45 minutes with me during our first meeting explaining the basics of prostate cancer, my diagnosis and clearly identifying my treatment options, including active surveillance. That was the careful attention and explanation I had been seeking."
This initial meeting provided confidence to not only Trevino, but his wife and children as well. Now feeling informed and empowered, he confidently enrolled in an active surveillance regimen led by Kim.
"Active surveillance is the merging of watchful waiting and active management into a program that is interactive for the patient," said Kim. "The program allows a man diagnosed with prostate cancer to monitor his disease and have the highest quality of life possible while delaying or even completely avoiding invasive treatments."
Kim explained that the newest thinking is that lifestyle changes that are good for the heart are also good for cancer management.
Armed with this information, Trevino enrolled in a trial - the Men's Eating and Living (MEAL) study at Cedars-Sinai - which aims to understand how diet might affect prostate cancer outcomes.
The MEAL study investigates whether a plant-based diet focused on colorful vegetables, along with a healthy lifestyle, can help decrease disease progression and anxiety in men being treated with active surveillance.
With his dedicated team of cancer specialists, Trevino has been spared overtreatment, surgical complications and the many possible side effects of treatment. For him, active surveillance and the MEAL study have provided both comfort and discipline to his life.
Today, Trevino works out regularly at the gym and takes long, brisk walks to his favorite Los Angeles-area hot spot - the Rose Bowl in Pasadena - while also enjoying his favorite hobby with his wife - salsa dancing. Trevino consumes a balanced diet, including leafy greens, very few red meats and alcohol in moderation.
"Active surveillance doesn't mean you're giving up on your disease," said Trevino. "Active surveillance is meant to change the way you live and the way in which you appreciate your life. These programs should make a man eat healthier, drop the bad lifestyle habits and live life more fully with his family and loved ones."
For more information on Cedars-Sinai cancer clinical trials, please visit http://cancertrialinfo.csmc.
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