My diagnosis of terminal prostate cancer 3 years ago was filled with irony. As an interventional radiologist, I have treated hundreds of patients with advanced prostate cancer, and I knew my prognosis wasn’t good. After experiencing some of the common symptoms of the cancer, including voiding problems, I had a positron-emission tomography scan to determine the extent of the disease. As soon as I saw the results of the scan, I knew immediately that my treatment options were not only limited, but also too drastic for me to contemplate.
The test clearly showed I had extensive metastatic prostate cancer. I had a huge mass in my pelvis and metastases in my bones—which was causing intractable pain in my hip—and in lymph nodes throughout my body. My prostate-specific antigen (PSA) level was off the chart at 137 ng/mL. My prognosis was poor: I had a few months at best without treatment or maybe a few years with hormone ablation therapy and/or chemical castration.
I was in trouble. But I didn’t want to subject myself to hormone ablation therapy or chemical castration, the current standards of care for the cancer, so I took the two avenues that offered the most appealing options for me.
Although I have been treating patients with cancer for more than 4 decades, until I became a cancer survivor myself, I really did not understand what patients with the disease experience.— Gary M. Onik, MD
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First, I am a person of deep faith. After years of seeing how prayer helped my patients with advanced cancers, I am convinced there is a higher power at work in the universe, and I trusted that my belief would get me through my health crisis. Second, I had a more earth-bound potential solution at my disposal.
Using Experimental Therapy to Save My Life
Over the past 7 years, I have been researching a novel treatment for advanced prostate cancer using local cryosurgical tumor cell lysis and intratumorally delivered immunotherapy, which essentially creates an in vivo tumor vaccine. Preliminary data of the treatment were presented during the 2020 American Association for Cancer Research Annual Meeting; the study showed the therapy not only was effective in patients with progressive metastatic prostate cancer, but in patients with other life-threatening cancers as well, including bladder, pancreatic, colorectal, and melanoma.1
Although the procedure is experimental and currently in a phase II trial (ClinicalTrials.gov identifier NCT04739618), the preliminary data were encouraging enough for me to want to try the treatment. In December 2018, I underwent the procedure. Within 6 weeks, my prostate cancer symptoms were gone, including the pain in my hip, and my PSA level was holding steady at 1.4 ng/mL.
I’ve been in remission with no evidence of metastatic disease ever since.
A Second Chance at Life
Although I have been treating patients with cancer for more than 4 decades, until I became a cancer survivor myself, I really did not understand what patients with the disease experience. Now that I’ve walked in their shoes, I am a much more empathetic physician. When I tell patients I know how they feel, I really mean it.
And although I’m always honest with my patients about their prognosis, I never want to leave them without hope. Even if it is not possible to cure patients, I can always offer supportive care, including pain management, and console them with the thought that new life-saving breakthroughs are making their way through the pipeline. And, most important, I can give patients my guarantee that I will never abandon them.
There is no question that cancer has made me a more empathetic and better physician. It has also made me more determined to find effectives therapies for patients with advanced cancers. I’ve been given the miracle of a second chance at life, and I won’t waste it.
Dr. Onik is Director of the Center for Recurrent Cancer in Fort Lauderdale and Adjunct Professor of Mechanical Engineering at Carnegie Mellon University, Pittsburgh. He lives in Fort Lauderdale.
Editor’s Note: Columns in the Patient’s Corner are based solely on information The ASCO Post received from patients and should be considered anecdotal.
REFERENCE
1. Onik G, Bostwick D, Vaughan DJ, et al: Regression of metastatic cancer and abscopal effects following in situ vaccination by cryosurgical tumor cell lysis and intratumoral immunotherapy: A case series. Cancer Res 80(suppl 16):6540, 2020.
