Prostate Cancer Survivor
- Diagnosed with prostate cancer at age 60 in 1998
- Treated with surgery in 1999
- Referred to SCCA with increasing PSA levels in 2001
- In remission until 2008 when he received treatment on a clinical trial
Dr. Jim Conaty is a retired orthopedic and hand surgeon from Spokane, Wash. He retired in the summer of 1998 at age 60. A year later, after an annual exam revealed a rising PSA, he had a biopsy and the retired doctor learned he was to become a patient with prostate cancer.
“I saw a urologist in Spokane who said surgery was recommended in my case and he referred me to a surgeon and hospital in St. Louis. I went there in August 1999,” Jim says.
For a year his PSA was undetectable and his margins were clear. But as can happen, his PSA began to rise. His doctors in Spokane and St. Louis said it was time for radiation to attack the residual tumor they suspected. But Jim’s PSA rose four-fold after having radiation therapy for just a few weeks.
“It was sometime around 2001, and my urologist recommended me to Dr. Celestia Higano, a medical oncologist at Seattle Cancer Care Alliance,” Jim says.
Jim traveled across the state and met with Dr. Higano and her team. They prescribed a combination treatment of Casodex (bicalutamide), a class of medications called nonsteroidal anti-androgens that work by blocking the effect of androgen (a male hormone) to stop the growth and spread of cancer cells, and Lupron (leuprolide acetate), a drug that blocks production of testosterone by the testicles.
“This worked great,” Jim says. “It drove my PSA down and kept it down for six years, and then it started to creep back up.”
By sheer luck, Jim’s recurrence came along just as a Phase I/II clinical study began for a new hormonal agent called MDV3100. “The first person ever treated with MDV3100 was treated at SCCA,” says Dr. Higano. “Jim was one of the patients treated in this early trial.”
Based on the data from the early trial with MDV3100, Medivation, the pharmaceutical company that developed MDV3100, initiated two Phase III trials also conducted at SCCA. The AFFIRM trial treated men who had already received chemotherapy and recently showed that MDV3100 prolonged life over placebo. (The results were presented at the February 2012 Genitourinary American Society of Clinical Oncology meeting). MDV3100, now known as enzalutamide, was approved by the Food and Drug Administration in August 2012 to treat advanced, castrate-resistant prostate cancer.
The PREVAIL trial is studying men who have not yet received chemotherapy. Results of that trial are not yet available.
Jim began MDV3100, an oral drug taken once a day, in January 2008 and remains on MDV3100 today. His PSA has been nearly undetectable and his lymph nodes have been stable ever since.
“I’m 73 now and find this particularly remarkable because of my PSA doubling in just a few weeks before starting the drug. Usually that means a poor prognosis,” Jim says. He told the research staff that he was very grateful to have been given the opportunity to be alive to see the birth of five additional grandchildren since the recurrence of his prostate cancer.
Jim notes that, “The professional staff and physicians at SCCA are sensitive and courteous. The model of team care in the prostate group is very good and should be a template for the future of medicine.”
Jim especially appreciates the level of knowledge SCCA staff exhibit, citing his nurse practitioner as “excellent” and “extremely informed.”
“The dedicated professionals at SCCA are focused and at the crest of the wave,” he says.
Jim says that cancer hasn’t really changed his life that much.
“My dad died at 60 of colon cancer, my brother at 56 of adenocarcinoma of unknown primary, and my maternal grandfather of prostate cancer. I wasn’t anticipating a long retirement,” he says.
The side effects of his treatments haven’t been too bad. He gained more weight than he liked while on the study drug and androgen suppression “has its own issues,” he says. “But I’m surviving nicely with my loving, caring wife Patty.”
So, while Jim continues on with his longer-than-expected retirement, he’s enjoying doing things like working with wood…building furniture for his children and grandchildren, sailing, playing golf, and reading.
“My retirement has been made positive by Dr. Higano and Seattle Cancer Care Alliance,” he says.