After Prostate Cancer & Still Loving My Life
By Bob Marcolini

I was born and raised in Brooklyn and never left.  In fact, I moved nine blocks from the house I grew up in to the house I live in now with my wife, Louise, of 47 years.  Three great kids, leisurely drives with Louise, dinner at our favorite neighborhood restaurants and my strong faith have all contributed to my good health.  In fact, up until I had a hip replacement, I was running on the treadmill 60 to 90 minutes every day.

But even though I was in optimal health at the ripe age of 78, I couldn’t rule out cancer in my future.  Three of my five siblings had cancer, including one brother who had prostate cancer.  Only my sister Elena and I are cancer survivors.  Sadly, our other siblings have passed away.  So this dreaded disease runs in our family and I wasn’t all that surprised when I got a diagnosis of prostate cancer.  The good news is I turned 80 in June 2021 and I’m still here!

My prostate cancer journey started with a PSA score that kept going up, starting out at 2.5, which is in the normal range.  I got an MRI in January 2020, just before we all went into pandemic lockdown.  Dr. Jacobs spotted something suspicious and referred me to Dr. David Silver at Maimonides Medical Center, one of the three major hospitals in Brooklyn.

Dr. Silver scheduled me for a biopsy and the results showed a Stage 1 tumor.  Luckily the cancer hadn’t spread and he reassured me that prostate cancer is slow growing, which was fortunate since all elective procedures were put on hold while the hospital was treating only Covid-19 patients.  So I could delay treatment for several months, although not indefinitely.

In January 2021 Dr. Silver sent me for a second MRI after my PSA score jumped to 5.6, and I couldn’t postpone treatment any longer.  That’s when he told me about HIFU, which stands for high intensity focused ultrasound.  Dr. Silver said that HIFU is ideal for patients whose prostate cancer is still confined to the prostate, which mine was.  He is also the only doctor in Brooklyn who does this procedure.  And since I don’t tend to stray far from home HIFU sounded like a good option that I could have done right in Brooklyn.

Dr. Silver explained that HIFU destroys only the diseased part of the prostate, which means that side effects like urinary incontinence and not being able to have sex are less likely.  This is unlike radical surgery or radiation which both are riskier for these 2 side effects.  Also HIFU is done quickly (approximately two to three hours), in a single session and at an outpatient surgery center, away from the main hospital, so I could get in and out quickly, and avoid any risk of contracting Covid.

HIFU uses high-frequency sound waves directed at cancerous tissue through an ultrasound probe inserted into the rectum.  No incisions are made.  No radiation is emitted.  No organ is removed.  HIFU works by heating up and gradually burning just the area of the prostate that has cancer.  Dr. Silver explained that it’s like holding a magnifying glass close to a leaf on a sunny day.  The sun’s rays shine through the lens and gradually cause the leaf to burn.

He also told me HIFU has really increased in popularity, especially during this pandemic, and patients are asking for this because they’ve heard that they can come in the morning, have the procedure and go home before lunch. 

I had thought about radiation.  My brother Pete had kidney cancer which metastasized.  He had radiation and it really just put him under.  For his prostate cancer my other brother Richie had brachytherapy, which is another form of radiation.  It involves planting radioactive seeds in the prostate.  He also really suffered.  So after my daughter researched both HIFU and radiation, and encouraged me to go with HIFU, I made my decision.  Also, as of January 1, 2021, HIFU was being covered by Medicare (and most private insurers.)  Of the entire bill, I only had to pay the $500 deductible charge.

I had no pain after the HIFU procedure, which took about 90 minutes.  Recovery was fine although I did have to have a catheter put in for four days and then I had to have it taken out during a major snowstorm!  I’ve been able to return to the things I enjoy, taking long drives with Louise, shopping for nice accent pieces for our home, and also providing daily companionship and care to a family friend.  And soon I hope to return to the gym.

I would recommend HIFU to anyone looking at treatment for localized prostate cancer.  It’s like you’re waiting for something to go wrong but nothing did!  It’s been fantastic.  I’d rather have HIFU than go to the dentist!



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