STORY BY

David Theis

Life is unpredictable—sometimes painfully so.

Cardiologist S. Ward Casscells, Tyson Distinguished Professor of Medicine at the University of Texas Medical School at Houston had this commonplace observation forced on him in the spring of 2001, when he began experiencing a series of back pains.

“I talked to a couple of doctors,” recalls Casscells, also UT Health Science Center vice president of Biotechnology, “and they treated it with physical therapy.”

When the pain persisted, Casscells insisted on having an MRI, which gave him terrifying—and totally unexpected—news. He had metastatic prostate cancer—cancer that had spread throughout his body. Yet he had had none of the indicators for the disease.

He was 49, so he hadn’t even taken the PSA test, the tumor marker that men are supposed to start running at age 50 (45 for African-Americans). And there is no history of prostate cancer in his family. “Mine was just a crazy gene,” he says.

Even though Casscells is himself a highly accomplished and experienced physician, he went through the same mental and emotional anguish that any patient feels when told they have this potentially fatal cancer. He felt “anger, fear, shock, and denial.”

Nevertheless, he “walked across the street” in the Texas Medical Center to the UT M.D. Anderson Cancer Center, the world leader in cancer treatment. There he was treated by Dr. Chris Logothetis, who put him on a regimen of “three kinds of chemo, one type of whole body radiation therapy, and hormone treatment.”

Like many cancer patients, Casscells dreaded the treatment only slightly less than the disease itself. Chemotherapy comes with an array of side effects, and often causes a patient’s hair to fall out, and his did, “a little.”

The hormone therapy is specific to prostate cancer patients, and for some men it presents an unnerving scenario, as the hormones—leupron, in Casscells case—carry some of the same symptoms experienced by menopausal women. “You get hot flashes,” he says, “ and between the hormones and Japanese diet [prescribed by Logothetis], I was afraid I’d start looking and sounding like a geisha.” But he adds, “I wasn’t affected at all.”

Not negatively, that is. The back pain went away after a week of hormone therapy, and the radiation continued for another six months.

Casscells doesn’t make light of the experience, but it wasn’t as bad as he had feared. During treatment “I didn’t miss an hour of work. I took work across the street and read charts and medical journal articles while I was waiting.”

Hormone therapy does involve loss of sexual function. But Casscells says, “Most guys are concerned about living. They say ‘give me the full dose.’ And their wives agree.”

Because he has educated himself, and encourages other men to do the same, Casscells knows how much progress is being made. He’s learned how much diet seems to contribute to both prostate health and prostate disease. It appears that a diet rich in rice, fish, broccoli, blueberries, green tea, soybeans and tomatoes can help prevent prostate cancer. “The soybeans and the tomatoes—and especially the tomatoes—are helpful,” he says. Vitamin E and selenium also appear to lead to prostate health.

He’s also learned that exposure to sunlight might help prevent prostate cancer. “I’m in the sun all the time now,” he says. Through regular checkups he keeps a close eye out for melanoma, which he says is “easily treated if caught early.”

Conversely, Dr. Casscells regrets that he was ever such a big fan of barbecue. “I ate plenty of fish and vegetables,” he says, “but I wish I hadn’t barbecued so many steaks, hot dogs, and hamburgers.” That’s because there is increasing evidence that “foods cooked at high temperatures” lead to all kinds of cancers, including prostate.

Despite all he’s been through, Casscells is upbeat as he faces the future. He’s had time to “reprioritize” his life, “get things in order,” and “to count [his] blessings.”

And, his hair has come back, just “thicker and curlier.”

Last Updated: 2-03-2003

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