Cancer was not a stranger to Colbert English. Having witnessed the disease claim the lives of his mother, sister, and aunt, and seeing his brother survive prostate cancer, the diagnosis in October 2021 wasn’t entirely unexpected. However, the revelation a year later that it had progressed to stage IV was a devastating blow. “Incurable but treatable,” his doctor stated, words that marked the beginning of a challenging journey stemming from a delayed diagnosis of prostate cancer.
Mr. English’s prostate-specific antigen (PSA) levels, a key indicator of prostate health, had been steadily increasing for six to seven years prior to his diagnosis. Alarmingly, his previous primary care physician had not communicated this crucial information, nor had a prostate biopsy, the definitive diagnostic test, ever been suggested. It was only upon moving from Arkansas to South Carolina and seeking a new primary care physician that the issue came to light. During his first appointment, routine blood tests revealed the presence of prostate cancer, a diagnosis that should have been made years earlier.
The path to confirming the diagnosis, determining the stage, and initiating treatment was fraught with further delays. Health insurance network complications initially hindered his access to a urologist referral. Once an appointment was secured, it clashed with a pre-planned cross-country trip to celebrate his 60th birthday, pushing back the crucial diagnostic process once more. Upon his return in July 2022, a swollen testicle and rotator cuff pain led him to the emergency room. There, blood tests reiterated the prostate cancer diagnosis, finally paving the way for a timely consultation with a urologist within days.
The urologist concurred with the initial 2021 diagnosis and the ER confirmation. It was during this consultation that Mr. English received the life-altering news of the advanced stage of his prostate cancer.
I’ve made it my mission to raise awareness about the importance of cancer screenings, especially among men in the Black community. — Colbert English
The Devastating Impact of Delayed Diagnosis
The news hit hard. Mr. English recounts weeping for hours, followed by a surge of anger. He learned about the stark racial disparities in prostate cancer: Black men experience higher incidence rates, increased mortality, and are often diagnosed at a younger age compared to White men. This knowledge intensified his anguish. Why had he not been offered a prostate biopsy and specialist referral sooner? Could earlier detection have altered the course of his disease? This question continues to resonate deeply, fueling his commitment to advocating for cancer screenings, particularly within the Black community. His experience underscores the critical importance of timely diagnosis in prostate cancer and the potential consequences of delays.
Due to a pre-existing condition related to coronary artery disease, standard prostate cancer treatments were not an option for Mr. English. His initial therapy involved monthly hormone-based chemotherapy injections of degarelix. Later, enzalutamide, a nonsteroidal antiandrogen agent, was incorporated to enhance the effectiveness of the degarelix monotherapy.
Throughout his initial treatment phase, Mr. English felt a profound lack of personalized care. He perceived his oncologist as detached, failing to acknowledge his individual needs and concerns. His questions were minimized, his worries dismissed, and his struggle to understand and cope with treatment-related physical changes seemed to be overlooked. Most significantly, the emotional burden of grappling with metastatic prostate cancer appeared to be disregarded. This impersonal experience highlighted the critical need for patient-centered care, especially when facing a serious diagnosis like advanced prostate cancer.
Finding Patient-Centered Care and a Path Forward
Seeking a more supportive and responsive healthcare environment, Mr. English transitioned his care to Fox Chase Cancer Center in Philadelphia in the spring of 2023. This shift proved transformative. His new oncologist reaffirmed the stage IV diagnosis and its incurable but treatable nature. The crucial difference lay in the doctor’s approach: he listened. Despite a busy schedule, Mr. English felt fully seen and heard during appointments. His questions were addressed thoroughly, and the oncologist remained present until all concerns were resolved.
His treatment regimen now includes leuprolide injections every six months, replacing the monthly degarelix injections, in combination with enzalutamide. This approach has successfully stabilized the cancer, offering a measure of control and hope.
Embracing Life and Advocacy
Living with late-stage prostate cancer has fostered introspection and a deeper appreciation for life’s simple moments. Mr. English expresses profound gratitude for his family’s unwavering support, particularly his son and daughter who accompany him to appointments and offer emotional strength.
He now prioritizes slowing down, savoring everyday routines, and finding peace. He acknowledges the deeply personal nature of cancer and the unique way each individual navigates their diagnosis. For Mr. English, this journey has led to a place of acceptance and a renewed sense of purpose in advocating for early cancer screenings and patient-centered care, driven by his own experience with Delayed Diagnosis Prostate Cancer.
Reference
- Lillard JW Jr, Moses KA, Mahal BA, et al: Racial disparities in Black men with prostate cancer: A literature review. Cancer 128:3787-3795, 2022.
Mr. English lives in Philadelphia, Pennsylvania.
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.
