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Second opinion answers important questions for patient with prostate cancer

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Patient Story Chris Knapp 1 ext jpg

Chris Knapp had no reason to question his health. He had been healthy all his life. The last doctor he had seen was his pediatrician when he was age 12. That was decades ago.
 
But when Chris started having problems with urination in early 2022, he knew he needed help to figure out what was wrong. The problem was he couldn’t find a doctor who was taking new patients near his home in Coldwater, Michigan. Appointment books were filled with a backlog of patients from the COVID-19 restrictions.
 
After months of searching, Chris finally found a nurse practitioner at a local hospital who could do an exam. She recommended Chris get lab tests, including one to check his PSA, or prostate-specific antigen.
 
An elevated PSA level signals potential problems with the prostate. For men in their 60s, like Chris, a PSA level above 4 nanograms per milliliter (ng/mL) may indicate inflammation, an enlarged prostate or prostate cancer.
 
“My PSA score came back at 29.6, so I knew I was in trouble,” said Chris, who was 67 at the time.

No time for second guesses

Questions were mounting for Chris as he made his way through urology appointments, a digital exam, biopsy, bone scan and CT scan. He knew the test results showed he had prostate cancer, but how bad was his problem? What options did he have? Could he avoid surgery?
 
Chris was never one to shy away from the hard truths, whether as the owner of a sheet-metal fabrication business or in his personal life. Give him the facts, help him understand the complexities, and he’d figure out a way to make the best decisions possible.
 
But with his cancer diagnosis, he felt left out of the decision-making process. Chris heard doctors tell him what they were going to do, without any consideration for his preferences or how he wanted to live his life. It just didn’t sit right with him.
 
“I knew I needed to find help somewhere else,” he said. “I started trying to educate myself on who had the newest technology and who was up on the newer procedures.”
 
Chris narrowed his choices to two cancer treatment centers that were close to home and reached out to both for a second opinion.
 
“I wanted to talk to the doctor about options,” he said. “I figured between those two, I should be able at least get some answers.”
 
The first consultation left Chris with more unanswered questions and growing concerns about how the progression of his disease was affecting his body. Even though the cancer facility was only 20 minutes from home, Chris felt it was the wrong fit for him.

Treatment plan tailored to personal needs

A completely different experience unfolded for Chris when he met with Radiation Oncologist Irina Sparks, MD, at Goshen Center for Cancer Care.
 
“She answered every question I had,” Chris said. “Everything was explained 100 percent.”
 
Dr. Sparks reviewed Chris’ scans and tests with him to make sure he understood the stage of his cancer and his treatment options. Then she laid out a plan to continue the hormone suppression therapy he was on and get started on six weeks of radiation therapy.
 
Other doctors had told Chris he would need radiation therapy five days a week for nine weeks.
 
“I was told I’d need 44 treatments, but she explained that Goshen had a new machine that accomplished the same thing with 28 treatments,” Chris said. “I had a sigh of relief!”
 
Goshen is the only cancer treatment facility in Indiana to offer Ethos™ adaptive radiation therapy. The image-guided therapy delivers highly personalized treatment for patients with pelvic cancers, including prostate cancer.
 
Chris left his hour-and-a-half long consultation with the information he needed to make a clear decision about where to get the best treatment for his cancer.
 
"There was no doubt in my mind that Goshen was where I belonged," he said. “It’s like going to a tailor where they measure and fit you with exactly what you need.”

Right place, right treatment, right choice

Chris began radiation therapy at Goshen in January 2023, nearly a year after he started his search for answers about his health problems. Every step of the way, Chris kept asking questions and getting answers that helped him understand how treatment worked, why it mattered and what would happen next.
 
Even the radiation therapists he saw every day during treatment were part of his go-to circle for information. They were always ready to talk with Chris, explain how equipment and technology worked, answer his questions and ease his mind.
 
Over the six weeks of therapy, Chris gained a genuine appreciation for the care and consideration he received from the radiation therapy team. He could always count on them to greet him with a smile and make his time in the radiation clinic as comfortable as possible.
 
Chris even got to select music to hear during his radiation sessions.  His choice – Comfortably Numb by Pink Floyd.
 
“They inspired me to get up every morning and go in for my appointments,” Chris said. “They will be a part of my family for the rest of my life.”

Beyond active treatment: Care continues

One big question kept nagging at Chris as his radiation sessions ended. How would the doctors know the radiation worked?
 
Chris understood that he would have follow-up visits and the doctors would monitor his test results. But he still struggled to understand how radiation kills bad cells and leaves good cells alone. Had the radiation really run off the cancer as planned?
 
Dr. Sparks explained there’s always uncertainty about whether or not cancer is completely gone. She reassured Chris that he would have regular surveillance visits with his doctors. He also would get his PSA level checked regularly.
 
New symptoms or an abnormally elevated PSA level would raise a flag that cancer may be back. If that happened, Chris’ doctors would further evaluate his condition with an enhanced PET/CT that looks for cancer recurrence.
 
The advanced imaging technology can detect prostate-specific membrane antigen, or PSMA, in cancer cells that may have spread in the body. Goshen Hospital was the first diagnostic imaging center in Indiana to offer PSMA PET scans for patients with prostate cancer.
 
Again, Chris was amazed at the expertise and personal attention he received at Goshen. A month after his radiation therapy ended, a follow-up lab test showed his PSA had dropped to 0.16 ng/mL. Another month later, Chris’ PSA was undetectable (<0.07).
 
The results gave Chris peace of mind that he had made the right choices for his treatment.
 
As Chris moves along on his cancer journey, he takes comfort knowing he can call anyone at Goshen any time if he has a question. And he knows he’ll get an answer.
 
“It’s just an extraordinary place,” he said. “I tell anyone who has cancer, it’s worth your time to go to Goshen and get a second opinion.”
 
Goshen Center for Cancer Care offers a free information packet to help you understand your cancer diagnosis and treatment options. It includes “Ten Important Questions to Ask Your Oncologist,” a reference guide to help you feel well-informed and confident in your cancer journey.

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