Chapel Hill resident Bob Slater recalled getting diagnosed with prostate cancer at the age of 68.
Slater is now 71.
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“You don’t feel anything, you just get a test result that tells you something is wrong,” Slater said. “I had a history of going to see a urologist.
“My father died of prostate cancer so I knew it could be something genetic, so I went to the urologist every six months.”
Slater spoke with WRAL News on Monday, one day after Joe Biden’s office announced the former president has prostate cancer with the cancer cells having spread to the bone.
“[I’m] sad for him,” Slater said. “I wouldn’t wish this on anybody. That’s my primary emotion, but I’m glad they caught it.”
Early detection is key to surviving prostate cancer
The prostate is part of the reproductive system in men. It makes fluid for semen. It’s located below the bladder and it wraps around the urethra, the tube that carries urine and semen out through the penis.
When caught early, prostate cancer is highly survivable, but it is also the second-leading cause of cancer death in men. About one in eight men will be diagnosed over their lifetime with prostate cancer, according to the American Cancer Society.
Duke Health Genitourinary Medical Oncologist Dr. Hannah McManus said sometimes people experience pain or urinary symptoms. McManus noted that patients often don't have symptoms.
“From the information we have for former President Biden, he had some symptoms that led to this workup, and really knowing when something doesn’t feel right in your body and talking to your care team to make sure you’re getting the appropriate workup, I think is really important,” McManus said.
McManus said prostate cancer tends to happen to older people.
“Most people with prostate cancer are going to be in their 50s or older,” McManus said. “I’d say the average age is probably mid to late 60s.
“That risk of prostate cancer continues to increase as you get older. That said, we do sometimes see younger people with prostate cancer too, so it doesn’t mean if you’re in your 40s this is an impossibility, but it is generally something we see in older-middle age. “
McManus said doctors typically recommend people speak with their doctor by age 50 to begin discussing the possibility of screenings.
“Sometimes [we recommend] even earlier depending on risk factors, and continuing that as long as you think someone has a life expectancy that would allow them to benefit from early screening,” McManus said. “Often, that’s up to 70.”
McManus said most prostate cancer diagnoses are “localized, early cancers that are picked up on routine screening that aren’t causing an individual any symptoms.”
WRAL News asked McManus what the medical concerns are as prostate cancer spreads.
“Whenever a cancer has spread outside of the organ it started in, and prostate if it has spread outside the prostate to a place like the bones, that is what we classify as stage IV or metastatic cancer,” McManus said. “That’s a really broad grouping to mean any degree of spread outside of those areas.
“Stage IV prostate cancer can be very effectively treated, but in most circumstances, (it is) not something we consider curable and is often a long-term diagnosis to treat in that context. If it’s just contained in the prostate, we can often think about sort of a fixed-duration treatment to hopefully cure and get rid of the cancer forever.”
Slater offered this advice to men as they age.
“Go see a urologist,” Slater said. “Don’t sit in a cave and ignore it.”
Bob Slater’s journey with prostate cancer
Slater said he is very active, playing tennis and ice hockey.
“You just think cancer is something that happens to other people, but that’s not the way it works,” Slater said. “It strikes everybody.”
Slater said his treatment options were between proceeding with radiology treatment or having surgery.
“Obviously, they’re very well-educated and skilled and tend to think their solution is the right solution,” Slater said. “I went with surgery, and the surgeon did a wonderful job.”
Slater’s surgery was in September 2021. He said he had clear margins, which meant no cancer remained in his prostate area.
Slater shared that just months later, he learned his cancer had spread to his lymph nodes prior to surgery. Doctors recommended he begin hormone therapy.
“I had a blissful summer of thinking I was cured from surgery, and then, a blood test showed a PSA, which should be zero and mine was 2-something,” Slater said. “The devastating news was the cancer had escaped and is now in the lymph system.”
Slater said an oncologist told him he’d have a “very truncated life.” He said he’s in “perfect health” otherwise.
McManus explained how he and the Duke Health doctors treat prostate cancer.
“The main way we treat cancer that’s spread outside the prostate is with medication therapies because that way you’re reaching all of the cancer,” McManus said. “The primary basis of that is hormonal therapy: Medicines that tell the body not to make testosterone.
“For most prostate cancers, that is their initial food supply, and we can starve those cancers by removing testosterone. For most patients, at least for some period of time, those hormonal therapies can be very effective to shrink the cancer and delay its growth or spread.”
Slater discussed his thoughts on his screening and catching it.
“I wish I would’ve caught it earlier,” Slater said. “That’s the key to this whole thing is the disease is largely curable, you just don’t want it escape the prostate.”
Slater urged others to take ownership of their situation, advocating for people to get an MRI, if necessary, sooner rather than later.
“I’ve got two grandchildren, and I want to be around for them,” Slater said. “There’s a lot of things to live for.”