Prostate cancer is the most common cancer in men, second only to skin cancer. The American Cancer Society predicts one in seven American men will be diagnosed with it in their lifetime. Because it is often slow-growing, doctors recommend some men take a wait-and-watch approach. But Tim Smith's cancer required a more aggressive treatment. And the Flowery Branch grandfather found himself facing some tough choices.
Smith was just beginning to enjoy being a grandfather, spending time with his daughter, when a series of blood tests picked up a problem.
Over two and half years, his PSA - or prostate-specific antigen - levels, which can be an indicator of prostate cancer, went from "a little high" to "high" to, this spring, "much too high."
That is when Tim's doctor asked him to come in for an exam. Smith says, "That was April 28th, when he found a knuckle-sized nodule in my prostate. And then the 30th, two days after that, they're doing a prostate biopsy."
That biopsy revealed Tim had cancer on both sides of his prostate, and, he says, it was considered "aggressive."
So, he came to see Dr. Scott Miller, Director of Laparoscopic and Robotic Surgery at Northside Hospital and Georgia Urology.
Dr. Miller remembers their first meeting. He says, "He went through the typical process from 'Oh, my goodness, I have a disease.' to 'Oh my goodness, I've got to do something about this disease.'"
Tim went online to research his options.
He could have surgery to remove the cancer and his prostate gland. Or, he could undergo less invasive radiation to destroy the cancer, but leave his prostate intact.
Dr. Miller talked him through the pros and cons of each scenario. Miller says, "When someone undergoes any type of treatment, whether it's surgery or radiation, they do have some risks of having certain side effects, such as sexual dysfunction or urinary control problems, or difficult urinating."
Radiation was less invasive. Tim just had to show up for outpatient treatments designed to gradually destroy his cancer. But, he wanted the cancer gone. And, because he's just 53 and healthy, Dr. Miller felt he could surgically remove Tim's cancer with a much lower risk of damaging side effects.
So, Tim chose a robotic surgery, with Miller using real-time monitoring to avoid damaging nerves around Tim's prostate. Miller says, "I think probably the driving force of him choosing surgery over radiation is the idea that he wants to know where he stands after the prostate removal or after the prostate treatment."
Tim Smith says, "With the robotic surgery, you can get a little more precise. They get better visualization. I've got seven small holes across my stomach, and stuff like that, but they're minimal."
The 4-hour procedure went smoothly. His daughter came home to help him out. After two weeks, Tim is hopeful, but still healing.
He says, "It's still functionality we're trying to restore. It's still a healing process. It's an issue right now. Candidly."
Newly single, Smith says he feels good about moving forward. He's hoping his surgery will stop the cancer without affecting his sexual function. Smith says, "I want to have another good twenty years.. It's halftime now. So, I'm looking forward to the second half."