Guest blog from Dr. Robert Lustig

Dr. Robert Lustig

A few years ago I went to the urologist at the insistence of my wife for a problem not related to my prostate. I was not at all concerned about prostate cancer as my PSA was less than 1. While my presenting problem was minor, the urologist felt a scar on my prostate and recommended a biopsy. Two days after the biopsy I read the diagnosis, PIN(prostatic intraepithelial neoplasia) The next second I was researching the biomedical library . PIN can be a precursor of prostate cancer or may actually regress spontaneously. Six months later a repeat biopsy was performed, normal prostate, a great sigh of relief. I continued to monitor my PSA which increased slightly but remained below 1. Two years later at my follow up my urologist recommend a repeat biopsy. I asked why and he said some of the newest data recommended a repeat biopsy to confirm that there was no malignancy. I went to the third biopsy without too much concern but still checked daily for the biopsy report. I logged onto the computer expecting a normal report but there it was, Prostate Cancer 3+3 Gleason 6. I read the report again. I checked to see that it was my report. Now how to inform my family. My wife is a social worker in the medical field and has spent many years working with cancer patients so telling her my diagnosis and discussing my feelings was easy. But how do I tell my children.? How would they feel? How scared would they be? Their father’s mortality would suddenly jumped out at them. My wife and I spent some time talking about how to tell the children.

I have 2 daughters, at that time 27 and 33. My eldest was pregnant with her first child and due in less then a month. My youngest came home for a family discussion and I explained to her that I had a low grade prostate diagnosed at a very early stage, with a very high rate of cure. I told her that I would be receiving proton beam therapy at Penn and did not expect to miss a day of work I assured her that I would be around for a long time. The three of us agreed not to tell my eldest as the shock might upset her pregnancy.

I do not believe in keeping health secrets but I felt this was only temporary and absolutely necessary. About a month after her delivery we again sat down as a family and told her that I would be treated for early stage prostate cancer. She obviously had similar concerns as my youngest but at least they could talk to each other.

I am one year post proton beam radiation for my prostate cancer. My PSA is 0.28. I never missed a day of work, although I did learn the location of every bathroom in the Radiation Oncology Department at Penn. I still have the “what if the cancer comes back” thoughts, but less frequently. Telling my children I had cancer was one of the most difficult things I ever had to do. Difficult situations occur in life. But they pass and life goes on.

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