When Paul Jordan began experiencing a need to urinate more frequently and a slower stream of urine than usual, he figured it was one of the things men learn to live with as they approach 60. The 58-year-old Alexandria, Virginia, resident and financial advisor was healthy and active, leading a busy life. His symptoms continued and after several months, he decided to see his urologist, who performed a PSA (prostate-specific antigen) test, which screens for prostate cancer.
A few days later, he got a call from his urologist. His PSA level was very high, meaning it was likely Paul had prostate cancer and it had probably spread beyond his prostate. A second PSA test also came back high and a biopsy found that he had very aggressive, high-risk prostate cancer that had spread to the seminal vesicles (glands that produce the fluid that becomes semen).
“I was absolutely blindsided and lost,” says Paul. “I called my friend, Dr. Catherine Broome, a hematologist at MedStar Georgetown University Hospital, part of the MedStar Georgetown Cancer Institute. I told her I had prostate cancer and had no idea what to do next. She connected me with Nancy Dawson, MD, director of the Genitourinary Medical Oncology program at MedStar Georgetown. Dr. Dawson was able to see me in just two days. At our first appointment, she spent more than an hour with my wife and me, clearly explaining my diagnosis and a plan to treat my cancer aggressively. I knew I was in for the fight of my life, but with Dr. Dawson in my corner, I also knew I had a really good shot at beating this disease.”
Dr. Dawson, who has been treating and researching prostate cancer for more than 30 years and is a leader in the field, brought Sean Collins, MD, Ph.D., a professor of radiation oncologist at MedStar Georgetown, onto the treatment team.
Throughout treatment, Paul continued to rely on Dr. Dawson’s guidance. To shrink the tumor before radiation therapy, she started Paul on two months of oral hormonal therapy, including abiraterone and relugolix, to quickly lower Paul’s testosterone level because testosterone promotes tumor growth. To ensure Paul was able to get these cutting-edge medications and begin treatment quickly.
As Paul moved through his treatment plan, Dr. Dawson was with him every step of the way. She monitored his PSA levels to check his response to the treatments, ordered genetic testing of his tumor to provide information that would guide treatment if Paul’s cancer returns in the future, and connected him with other resources at MedStar Georgetown, including the oncology clinical nutritionist.
“Especially with complex, advanced cancer, it’s a big advantage to receive care from physicians who have expertise treating prostate cancer and treat a high volume of patients,” explains Dr. Dawson. “It’s important to go to an academic medical center like MedStar Georgetown and get an opinion on your diagnosis and treatment plan. I’m immersed in the treatment of people with advanced prostate cancer and see more than 20 patients a day. That’s a level of intensity and experience you won’t find in many places. Getting the latest treatments, comprehensive, multidisciplinary care, and state-of-the-art radiation improves outcomes. In addition, our patients have access to clinical trials and the latest research through our research engine, Georgetown Lombardi Comprehensive Cancer Center—the only NCI-designated comprehensive cancer center in the Washington, D.C., region.”
For the radiation portion of the treatment, Dr. Collins performed volumetric modulated arc therapy (VMAT) with fiducial guidance on Paul’s pelvis. VMAT is a novel radiation therapy technique that delivers the radiation dose continuously as the treatment machine rotates. This technique accurately shapes the radiation dose to the prostate to avoid damage to surrounding areas. In addition, the fiducial markers (tiny gold implants) placed within the prostate allow for highly accurate treatment.
Throughout treatment, Paul was an active partner in his care. “I became laser focused on my health,” he says. “I switched to a Mediterranean, clean diet and exercised every day to get in the best shape possible. It helped me mitigate the side effects of the medications, like fatigue. Now, even with the medications, I’m high energy. In fact, I’ve never felt better.”
At his most recent appointment, Paul learned that the treatments are working very well. His PSA, which was 84 when he was diagnosed, is now 0.0. He’ll continue taking hormonal medications for two years and have regular check-ups with Dr. Dawson.
“One reason Paul did so well is that he remained active, took care of his overall health, and lived his life,” notes Dr. Collins. “Those efforts combined with receiving care at a high volume center with an experienced, multidisciplinary team of cancer specialists make a real difference.”
Adds Paul, “I am so grateful for Dr. Dawson and Dr. Collins. They’re incredible doctors who care and take the time to listen. There’s no doubt in my mind they saved my life.”