Paul's Story Prostate cancer

Paul Trenchard

Paul Trenchard is a world traveler, a gardener with an English sensibility and a 58-year old man who takes his health seriously.

Like clockwork, Paul went for a yearly physical. “At one exam, my physician noted that my PSA had risen from the year before,” says Paul. “I was in age category where prostate cancer is more prevalent, so the doctor suggested that I repeat my PSA blood test in six months, and not wait a year until my next physical. I totally agreed.”

PSA or prostate-specific antigen is a protein generated by the prostate gland. When it is enlarged or malfunctioning, more PSA is produced.

Why was Paul’s PSA rising?

Six months later, Paul’s PSA level continued its upward climb. “My physician recommended that I see a urologist for a biopsy to determine the underlying cause of the problem,” says Paul.

Besides cancer, a rising PSA can also be caused by a condition called benign prostatic hyperplasia, or prostate enlargement, which occurs in most men as they get older. But to be safe, cancer must always be ruled out.

A biopsy and a diagnosis

When Paul’s biopsy results came back positive for prostate cancer, his urologist suggested that he contact William R. Rate, MD, a Penn radiation oncologist. Based on the clinical evidence, Dr. Rate believed Paul was a good candidate for radiation therapy. But not just any radiation treatment.

A one-two radiation punch: IMRT and proton therapy

Dr. Rate sent Paul to meet with Curtiland Deville, MD, Chief of Genitourinary and Sarcoma Services, at Penn. Dr. Deville is an expert in combining proton therapy with Intensity-Modulated Radiation therapy (IMRT) to obtain the best outcomes for prostate and other cancers.

Dr. Deville explains, “Paul’s tumor was small, so a combination of IMRT boosted with proton therapy would be a highly efficacious treatment for eradicating the tumor.”

IMRT uses 3-D computed tomography images of the tumor to generate dose calculations. This method delivers a radiation dose that conforms more precisely to the three-dimensional shape of a tumor by controlling — or modulating — the intensity of the radiation beam. By adding proton therapy to Paul’s treatment, additional kill-power was delivered to the tumor and its margins. 

Treatment success, onward with life

Paul describes the side effects of his powerful radiation therapy as “minimal.” Paul says, “Shortly after treatment ended, my wife and I traveled to California for a wedding. I felt great.”

Dr. Deville, Dr. Rate and Paul also feel wonderful that after treatment, Paul’s PSA dropped to levels that indicate his one-two punch therapy was exactly what this tumor needed to disappear.