Miami OB-GYN Associates’ Dr. Edward M. Fidalgo knows what it feels like to face the threat of cancer and the pain of infertility at a young age.
About 11 years ago, he was diagnosed with prostate cancer. The National Cancer Institute reports that about 16 percent of men will receive a prostate cancer diagnosis in their lifetimes. About 3 percent will die, and about 70 percent of the deaths will occur in men older than 75.
Fidalgo was 35. His son Eduardo was 6 months old and his daughter Carolina was 4.
“I was so worried about not being around to raise them,” Fidalgo said. “And I knew my wife wanted more children news like that can be tough for a man and his ego.”
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Fidalgo said he owes his life to a lab technician who suggested he undergo a simple blood test that measures the Prostatic-Specific-Antigen (PSA) protein. The test has been around since the 1990s.
“I was young back then, so I would never go to the doctor. I would take care of myself,” Fidalgo said. “It was a regular screening, so I went to draw my own labs.”
At the Mercy Hospital lab, a woman named Rosa who was drawing his blood said she took out an extra tube. It was early in the morning. She asked him what he wanted to do with it. He was in a rush, and said she could throw it away. But she had a different idea.
“Why don’t you get a PSA like other men do?”
He agreed. And to his surprise, it came back “super high.” The presence of cancerous cells increases the level of the PSA enzyme, which helps to liquefy semen. Fidalgo went to a urologist, a doctor who specializes in urinary tract diseases and the male reproductive organs, to show him the PSA results.
“The guy was like, ‘It’s probably an inflamed prostate’ and gave me antibiotics,” Fidalgo said.
Months later, Fidalgo had repeated the PSA test several times and the results were still high. Getting a biopsy was the next step.
“The biopsy was the worst. They do them through the rectum. They insert a big probe and a needle,” Fidalgo said. “They have a machine that shoots the needle 12 times, and they take out the samples.”
The pathology report revealed he had a rare form of cancer and his prognosis was poor. Fidalgo turned to the director of Johns Hopkins Hospital’s Jane Fucanon Brady Urological Institute, Dr. Patrick C. Walsh, for help.
Walsh is the author of the best-selling books The Prostate: A Guide for Men and the Women Who Love Them, and Guide to Surviving Prostate Cancer. He is best known for his pioneering work with nerve-sparing surgical techniques that reduce the risk of impotence and incontinence.
“I had surgery on a Valentine’s Day. Luckily it had taken over the prostate, but it had not spread out of the prostate,” Fidalgo said. “Since it had not broken through, it was a Stage 1.”
The PSA test saved his life, so Fidalgo was outraged last week after the U.S. Preventive Services Task Force issued new guidelines recommending that physicians stop issuing routine PSA tests as part of men’s checkups.
According to the task force, one life will be saved for every 1,000 men screened over a 10-year period. The panel concluded the number of lives saved did not outweigh the risks of wrong diagnosis, unnecessary biopsies, and harm of harsh treatments that could result on incontinence and impotence
“It’s indignant! It’s incredible that they would deal with people like that,” Fidalgo said. “I am the face of that one guy who got saved because they did a PSA test.”
A Johns Hopkins University survey published in the Archives of Internal Medicine revealed that more than 60 percent of doctors said the guidelines would make them “much less” or “somewhat less” likely to order the PSA test for all men.
“It’s not right. Patients should be treated as people, who can make informed decisions about their health,” Fidalgo said.
The American Urological Association has also released a statement opposing the task force recommendations.
“I don’t go parading to my patients or to people that I survived prostate cancer,” Fidalgo said. “But if my story can create awareness for men in some way, then it’s worth talking about it.”
Part 8: Facing my fears after mastectomy
Part 11: Radiation therapy gives her hope
Part 12: Finding strength from others
Part 14: A new outlook on 2012
Part 17: After radiation therapy ends
Part 21: Too much fear, too little trust
Part 26: High hope for new drug
Part 27: Religion is an unavoidable topic
Part 28: Treatment changes social life
Part 33: Facing up to infertility
From the Editor: Journalist confronts cancer, takes readers along