Prostate Cancer Survivor
|Steve Fleischmann, Seattle, Washington|
Seattle businessman Steve Fleischmann was just 47 and in excellent health when he went to his doctor for a routine checkup. That visit, and the doctor's willingness to follow up on a feeling that "something was odd," Steve says, may have saved his life.
Steve's doctor sent him to a urologist, who diagnosed him with prostate cancer. Based on his own research and conversations with friends, Steve decided to see Dr. Paul Lange, professor and chairman of the Department of Urology at the University of Washington School of Medicine, who sees patients at SCCA’s Prostate Cancer Center, for a second opinion.
Steve and his wife, Patty Haven Fleischmann, visited Dr. Lange together and were impressed not only by his credentials ("He's one of the top three in the world," says Steve), but by the fact that Dr. Lange is a prostate cancer survivor himself. "He's had prostate cancer, so he really understands what a man goes through."
Steve opted for a radical prostatectomy, in which the entire prostate gland is removed, performed by Dr. Lange at UW Medical Center in the summer of 2003.
Surgery is not the only treatment option for prostate cancer, but Steve felt it was right for him. He and his wife have two children and, he says, "I was realizing that I have a family and a business to run with a lot of employees I have to take care of. But what was most important for me was to feel psychologically and emotionally that my cancer was gone."
Dr. Lange used a technique called nerve-sparing surgery, which saves the nerves that control a man's ability to have an erection.
The surgery was a success—"I'm hoping and expecting that he's cured," says Dr. Lange—and Steve has avoided the two biggest side effects of prostate surgery: impotence and incontinence, which he admits he worried about before surgery. "I didn't want to be a 47-year-old man in a diaper," he says.
A man with a mission
Steve owns his own business, employing a dozen people at Fleischmann Office Interiors, a downtown Seattle firm that he calls "the best office furniture dealership in Seattle." He was back at work part-time within two weeks of his surgery, but he is forever changed by the experience.
Steve has always faced the world openly about his disease -- one that most men find almost impossible to talk about. Since his diagnosis, his mission he says is "to be nationally involved in helping men who have been diagnosed with prostate cancer."
He talks with two to three men who have prostate cancer nearly every week and helps them navigate the process of dealing with their disease, the impact his illness had on his family, advice on dealing with prostate cancer, and the lessons other men can learn from his experience.
And men have a lot to learn, according to Dr. Lange, who says bluntly, "Men don't know what the prostate does. They don't know where it is. And they don't like to talk about it. They are terribly threatened by the potency part and their reproductive powers, which they do lose. Men do not like to be vulnerable."
Steve agrees: "Some men never tell anyone [that they have prostate cancer]. It's scary to find out you have cancer. You don't want to tell anybody." But his wife is a marriage and family therapist and she pushed him to be open with family and friends about his illness.
"I pushed him, because I think holding it in is bad," she says. "But he really made it easy for people to be there for him. That love and support was really helpful for him in recovery, and right before [surgery] when he was really anxious."
About a month after Steve's surgery, his wife held a surprise party at a restaurant and invited about 80 people who had supported him through his illness, including Dr. Lange; his internist, Dr. Schuster; and a mentor, retired pathologist Dr. Gil Roth, whose son is a close friend.
Steve's wife Patty calls him "a natural fundraiser." At their first meeting with Dr. Lange, the Fleishmanns said they'd like to chair a breakfast to raise money for prostate cancer research. Such events are commonplace for breast cancer, but Fleischmann believes his breakfast was the first in the country for prostate cancer.
Once Steve had completed treatment, Dr. Lange put him in touch with Julia Ruvelson, director of development for UW Medicine. Together, they planned the event, called "Survivors Celebration," which took place in early December 2003.
"The purpose of the breakfast was to get this disease out of the closet," Steve says. "We asked men who have had prostate cancer to be table captains and to fill a table."
At the December 2004 breakfast, some 600 men attended, and almost $1 million was raised.
In 2005, Steve got Lance Armstrong, who is also a cancer survivor, to attend the December breakfast, and almost $3 million was raised.
Impact on the family
The Fleischmanns are remarkably open about the impact prostate cancer has on couples. Patty developed Bell's palsy, a form of facial paralysis, during her husband's illness. "I took it a lot worse than he did," she says.
She remembers the anxiety she felt on the day of her husband's surgery, and her fear that their sex life would never be the same. "That's not an easy topic to talk about with the person who has the cancer," she says. And she worried about her two children, who were only 2 and 5 at the time. "He had a bad cancer, it wasn't as clear-cut as everyone was saying, and it seemed to never end," she says.
Steve developed his own three-part program to help him prepare for cancer surgery, recover afterward, and do everything possible to keep the cancer from coming back. A positive man by nature, he worked to keep "a positive healthy attitude," which he feels is essential to a good outcome when facing cancer.
He wanted to be in "the best possible physical shape" at the time of his surgery, so for the six to eight weeks between his diagnosis and surgery Steve put himself on a better eating program and got as much exercise as possible. He went to Sun Valley almost every weekend and hiked in the hills.
To aid his recovery after surgery, Dr. Lange recommended that Steve start walking and get off the pain medication as soon as he could. Steve started walking the next day, even though, he admits, it was painful. He was told to expect a six-week recovery period, but was quickly back at work part-time. This speedy recovery is due in part, of course, to his relatively young age (the average age at diagnosis with prostate cancer is 70) but also to his physical and mental preparation.
In addition to walking and hiking to stay in shape, Steve did kegel exercises, the exercises originally developed to help women control incontinence after childbirth, for a month before his surgery, "I did hundreds a day," he recalls. Once his catheter came out two and a half weeks after surgery, he was back doing kegels, and has had no problem with incontinence. Dr. Lange says the research on kegel exercises and incontinence in men after prostate surgery is inconclusive. "But we like to start men thinking about doing the exercises," he says.
As part of his recovery and cancer prevention program, Steve also consulted a naturopath who specializes in caring for cancer patients and went on a vitamin program to build his immune system.
The message for younger men
Only about 10 percent of men with prostate cancer are diagnosed before age 50, as Steve was. Dr. Lange says the youngest man he has treated was 35. But Steve's father had prostate cancer in his 70s, which greatly increased his risk of developing the disease.
A man whose father or brother had prostate cancer faces a risk six times higher than that of a man with no family history, says Dr. Lange. He recommends that African-American men (who are at higher risk than men of other races) and men with a family history of the disease start getting an annual PSA test and physical exam at age 40. All other men should begin checkups at age 50. Screening is especially important because the disease is usually diagnosed before symptoms appear, when it is most curable and there are more treatment options.
When cancer comes back
After Steve’s radical prostatectomy in 2003 for prostate cancer, his doctors kept close watch on his blood levels to make sure that the cancer was indeed gone from Steve’s body. But in March 2007, nearly four years later, the unthinkable occurred—Steve’s cancer came back.
“Getting cancer is one thing,” Steve says. “But getting it back is way more scary. You realize you’re susceptible to getting it again and every ache or pain becomes a fear, a worry.” Even the fear of possible long-term side effects from treatment return, he says, “and the fear that I could die from this some day.”
Steve went back to Seattle Cancer Care Alliance for 36 days of radiation treatment in June 2007.
“I bet most men think they are infallible,” Steve says. “But when they get prostate cancer, they don’t know what to do. I decided to make lemonade from the lemons I got. Sure, I had anxiety, all the way up to the day I had my first radiation treatment, but I’m better now.”
In the months between his recurrence diagnosis and treatment, Steve went full-speed into improving his strength with weight training and talking to a SCCA nutritionist about dietary recommendations to prepare for treatment. After his first experience with prostate cancer, Steve had begun taking several naturopathic medicines to boost his immune system—antioxidants and such. However his nutritionist advised he stop taking these supplements before treatment because antioxidants not only protect healthy cells from disease, but they may also protect malignant cells as well. “So I quit!” Steve says, determined to be on top of this second round with cancer.
Steve believes he was at risk for prostate cancer because his father had it at age 74. “I believe I was going to get it anyway, but I got it so much earlier because of stress,” Steve says. But he says he isn’t worried. “I’m so over-the-top impressed with SCCA, with how much everyone cares and how available the doctors are. I bet SCCA is unique,” he says. “I bet you won’t get the same treatment anywhere else in the country. SCCA has earned the right to boast in my opinion.”
Steve has a lot to share with men and their spouses about cancer, treatment, and recurrence. If you would like to contact Steve, please e-mail him at email@example.com.