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News: Seeds of Hope for Prostate Cancer Treatment

Consider the index finger. We use it to hold a fork, write with a pen, dial a phone, and don’t underestimate its use in the hunt-and-peck method of typing. John Vayo, though, sees it as much more, because his index finger literally saved his life.

A few years ago an annoying bump popped up on his left forefinger, and through several weeks of home remedies he finally got it to disappear. However, in December of 2004 the sore reappeared. John was a wrestling coach, and this was wrestling season, so the offensive bump just had to stay put. No time to see a doctor. Finally he went to see an orthopedic surgeon, thinking it was a problem with the bones in his hand.

Dr. Steven Mellitou told him it was a ganglion cyst, and would have to come out or would continue to grow back. As part of his pre-operative preparation, John had to see his primary care physician, Dr. John Albanese. Says John Vayo, “Since Dr. Albanese had me in the office he suggested that I get a PSA test as part of my pre-surgical blood work. He was taking advantage of having me as a captive audience, and I hadn’t had a PSA (Prostate Specific Antigen) test for several years.” 

The PSA test is to find any elevation of Prostate Specific Antigen that would suggest a risk of prostate cancer. PSA is normally found in men, but an elevated level becomes an issue. John’s PSA test showed a moderately high level, enough to warrant further medical follow-through.

His next stop was with Dr. Ricardo Nabong, a urologist. Dr. Nabong found the prostate was enlarged, so a biopsy would be necessary. The prostate gland is part of the male endocrinology system, and is located just beneath the bladder. It is normally the size of a walnut. If it becomes enlarged it can interfere with urination and male sexual function. According to the National Kidney Foundation, more than half of the men over age 60 have prostate problems, but these can occur in the forties and fifties, too.

Dr. Nabong did a biopsy of 8 different spots on John’s prostate gland. One of the spots was malignant, and the cancer was aggressive.

Cancer cells are “graded”  to help determine what results of treatment could be, and John scored a 9 out of 10 on the Gleason Scale. This measurement tool looks at the patterns of cancer cells and gives them a score for the two most prevalent patterns. These are clues in determining treatment. The Gleason Scale takes the two numbers, for example a 2 for one pattern and a 4 for the second pattern resulting in 6 on the scale. John’s score of 9 meant drastic treatment was necessary.

He met with Dr. Terrence Bugno of Centegra Sage Cancer Center , and Dr. Jeffrey Schaefer, also of the cancer center. “They were very reassuring,”  John says, “and discussed every aspect of the procedures with my wife and me.”  Total surgical removal of the prostate was one choice.

The newest option, prostate cancer seed implant, was about to be introduced at the Centegra Sage Cancer Center , and John was a good candidate for this procedure. Rather than have his prostate surgically removed, John opted for the seeds implant, and began preparations for the operation. This was May, 2005 and the procedure would be in October. Prostate seed implants have been done since the 1980s, but were not very successful because the doctor could not see the prostate gland during the procedure. Today they are done using ultrasound, which allows the doctor to see the prostate gland and implant the seeds with precision. This gives much better long-tterm results.

The “Ëœseeds’ are actually radioactive pellets, as thin as the lead in a mechanical pencil, and the length of less than half of a dime. According to Laura Beamer, clinical nurse specialist and nurse practitioner at the cancer center, “The procedure takes place in an operating room, and the patient is asleep, however, there is no incision. Using thin needles, about 75 to 100 seeds are implanted in the prostate gland.”  This is a once-in-a-lifetime procedure.

That summer John began Lupron injections and external beam radiation at Centegra Sage. The Lupron is a slow time- release chemotherapy, and the radiation lasted five days a week for five weeks. The entire procedure took only about five minutes each day, plus 10 to 15 minutes of prep time.

A Johnsburg resident, he was “” ¦ grateful to be driving just a few minutes from home to the cancer center for my one-minute treatments. It would have been exhausting to endure a long drive to a location 50 or so miles away. In no time I was at home relaxing each day.”  At the end of the five weeks, Dr. Bugno told John to let his body rest in preparation for the upcoming surgery. John and his wife, Joyce, were enjoying their retirement from over 30 years of teaching, and indulged their passion for antiquing and his vintage toy collection.

“So much more was possible because this groundbreaking procedure was here. My wife could be with me. I could feel normal even though the whole situation had shaken me to my core.” 

In October the seeds were implanted and his wife took him home the same day. “I was up watching TV that afternoon,”  he says. “I was tired, but felt pretty decent within two days. Best of all, there was little or no pain.” 

John Vayo was the first seed recipient at Centegra Sage Cancer Center and is grateful this option was available so close to home. He is especially glad Dr. Albanese wanted that PSA test because otherwise it would have been too late by the time John had any symptoms. “I wasn’t experiencing problems or pain. They’re not kidding when they tell you to have an annual PSA test, especially after age 50.” 

People use the index finger to point the way in giving directions. John’s pointed him to a second chance at a rewarding life with his family, and he’ll never take it for granted again.