Treated 2003 · Posted 2003 · Updated 2009, 2012 & 2016
Dr. Wepsic is a physician/pathologist with a specialty in cancer biology and tumor immunology. When a cancer researcher chooses proton therapy to treat his prostate cancer, it speaks volumes about the efficacy of this treatment option.
I am a 61 year-old academic pathologist/hospital administrator with Long Beach VA Hospital and Associate Dean for Research at the University of California Irvine. My research specialty is tumor immunology and tumor biology. I have had a rich and very interesting academic career and have published many manuscripts in cancer immunology.
When I was diagnosed with prostate cancer on one biopsy out of ten, had a Gleason's score of 6 and a PSA of 5.3, I was somewhat surprised, but knew I had some work ahead of me. I reviewed various publications on prostate cancer, sought some expert advice from colleagues and friends and looked at Dr. Walsh's book on the Prostate entitled "The Prostate—A guide for Men and the Women Who Love Them." At my "young" age I didn't want to do watchful waiting.
As a Patholgist my first inclination was to "cut it out-examine it and be done with it." I looked at the rate of cure from Surgery, the complications of surgery including the morbidity and mortality. I reviewed Robotic Surgery or Virtual Surgery, which had been implemented at the Henry Ford Hospital in Detroit as it is now being performed at UCI. Following the review I felt the potential for complications of impotency, incontinence, infection etc. seemed to be significant issues. I came to the conclusion that surgery was probably overkill for my early stage disease.
On to the next treatment. I looked into Brachytherapy in detail. Discussed it with colleagues and again reviewed the relevant literature. The "Best Place" to have this form of therapy was in Seattle at the Seattle Prostate Institute. They had an excellent web site which was user friendly, and they contacted me right away. My wife and I went to Seattle, had some great seafood, met up with some of my friends from years ago, and I had a first rate experience of assessment and an interview with Dr. Peter Grimm. He was a pioneer in this field, very personable and clearly a leader in this field. My prostate was right at the edge of being treated at 60.4 grams. I felt confident that I could be cured of my cancer by that treatment modality. I might add that in my discussions I always said that I was weighing the possible treatment options including proton beam treatment. Dr. Grimm felt that either form of treatment would be just find and said to say hello to Dr. Rossi.
I did my homework again on Loma Linda and proton treatment. This included talking with a friend at the Gym about his experience at Loma Linda. He was very happy with everything except the drive from Huntington Beach (62 miles each way). My wife and I met with a doctor and during our discussion we talked about how cells die with proton beam therapy. It appears that with both proton and bracytherapy cells die via a process called "apoptosis" i.e. programmed cell death. There is evidence in the literature to say that this type of cell death promotes stimulation of the immune response. My doctor and I discussed the field of irradiation and my recollection is the field was to be 1.2 cm outside the prostate and to include the seminal vesicles. I felt that this field of treatment was slightly greater than for brachytherapy. The decision was made to go with proton therapy. I knew peripherally about the "infamous balloon" but since I worked for the government for 30+ years I felt some kinship to this procedure and at least I would know when it was coming.
I am half way through the procedure and have treatment early in the morning. This allows me time to go to the Drayson Center for a solid workout. It also allows me to avoid the bulk of the rush hour traffic.
The bottom line for any form of cancer, is that it is important for the doctor and patient to make the best informed decision they can both live within the future. I am very happy I chose proton treatment at Loma Linda University Cancer Center. The facility is first rate; the people are very professional and caring; and the patients have been fun to get to know. 19 more treatments to go, as of March 27, 2003. I am already having separation anxiety but am not sure if it is from the balloon, the patients, the staff or the whole enchilada.
Terry Wepsic - Huntington Beach, California
Letter to Wall Street Journal
On February 1, 2005 The Wall Street Journal published an article on proton beam therapy referring to it as "…a well kept secret in the war on cancer." Dr. Wepsic wrote to the editor of the WSJ, acknowledging the Journal for bringing attention to Proton therapy by publishing the story. Here is Dr. Wepsic's letter:
To the Editor of the Wall Street Journal:
I appreciated your recent article on prostate cancer treatment using Proton Therapy. I am age 63, Yale Medical School Graduate, NIH trained, academic physician/pathologist/administrator/educator who has investigated cancer for over thirty years. I have been the primary instructor for second year medical students, introducing them to cancer biology. I was diagnosed with early stage prostate cancer in December 2002, and received proton therapy at Loma Linda University Medical Center. As a sophisticated consumer who is well insured, I could have chosen any form of treatment at any location in the country. I was shocked to reconfirm diagnosis of my own cancer on the lab's pathology slides. Treatment options included laparoscopic surgery at the Henry Ford Hospital in Detroit, brachytherapy at the Seattle Prostate Institute and Proton Beam Therapy at Loma Linda.
Proton beam therapy is totally different from any other form of radiation therapy. Energy from the proton is released only when they stop traveling. Eighty-five to ninety percent of the protons go to the prostate. Only ten percent go to surrounding adjacent tissue. This is in contrast to an effective dose of sixty percent for gamma radiation. Protons can be precisely targeted by exact positioning of the patient and the beam. Radiation can include the area surrounding the prostate capsule and the seminal vesicles. These are two areas where tumor spread can occur, even in early stages of disease. The protons can be tightly focused, and are at present being used to treat wet macular degeneration of the eye in addition to prostate cancer. The macula is about the size of a large grain of rice. Approximately 33,000 patients have been treated worldwide with proton radiation, including cancer of the brain and spinal cord. The cure rate for prostate cancer is comparable to all other forms of treatment, and the side effect profile for erectile dysfunction and incontinence are lower. Many patients have had full post-treatment recovery, including myself.
Loma Linda has led the way with proton therapy for prostate cancer for over fifteen years. Approximately 150-175 prostate cancer patients receive treatment every day, with two shifts being run in four treatment areas. Treatment takes about eight weeks. Patients and their spouses have positive, enjoyable interactions including golf outings, tourist trips and a weekly support group filled with healing humor and concern. Many of these activities are sponsored by the social work staff at Loma Linda. A very supportive web site has been formed at www.protonbob.com. The web site publishes an informative and educational newsletter for over 2000 members.
The best part of my experience was that my primary physician at Loma Linda Medical Center was a former medical student of mine. I have been "beamed up" as Scotty would say, and I am a better person for this experience. Onward to building more proton centers so treatment advances can occur worldwide.
H. Terry Wepsic, M.D.
Professor Emeritus of Pathology, University of California, Irvine, CA
Research Professor at Long Beach V.A. Healthcare System,
Long Beach, CA
In addition to being a cancer researcher Dr. Wepsic is a sailing enthusiast. A while ago he wrote an article for "Latitude 38" sailing magazine about his prostate cancer diagnosis – in an effort to alert his sailing friends to the importance of early detection of all forms of cancer. Following is a reprint of the article.
I have enjoyed reading "Latitude 38" over a number of years and find a few boaters "pearls of wisdom" in each and every issue. The reading has made me a better skipper. MANY THANKS. When my wife and I traveled to Opua, New Zealand, a current copy of "Latitude 38" served as our ticket to their Christmas Yacht Club Party. Terrific people.
The purpose of my letter has to do with helping sailors have many more happy days behind the wheel or grasping the tiller on a beam reach. We all know about pride of ownership for our boats and how important it is to keep up with the zincs at the heat exchanger, do routine oil changes, clean and clean and clean the boat, check lifelines etc. I keep a logbook documenting service, as every good boat owner should.
Something recently cropped up in my life that had—and may yet have—the potential of altering the number of happy days I have behind the wheel (in my case we have a Catalina 34, hull 109, named "Dazzler" after Jack London's book "Cruise of the Dazzler."
I was diagnosed with prostate cancer at a very early stage. The irony of this is that I am trained as a Pathologist (the person who looks at the slides) and I am a specialist in cancer biology and tumor immunology. I had been having routine PSA examinations done over the past several years and noted a slight increase in the values. Since I knew that I have a 20% risk of having cancer, I went in for the "educated feel" by a urologist and then had biopsies. What do you know, I had cancer on one of the 10 biopsies. I, of course, had to look at the slides for myself and confirmed the diagnosis. I evaluated the basic forms of prostate cancer treatment and I am currently being treated.
We were sitting at a bar at our Yacht Club (Seal Beach Yacht Club) and the topic of "my news" came up. One fellow on one side of me said, "Oh I had prostate cancer," and the fellow on the other side said "Me too." Yes, it is a common disease being diagnosed in more than 200,000 plus patients per year in the US and approximately 31,500 died of it in 2001.
The question I asked myself was "How can I help spread the word to those I care about most—fellow pirates and their wenches—about the need for men to take more "pride of ownership" for their health, and get screened for prostate cancer?" I immediately thought of "Latitude 38." So here it is mates. ALL CANCERS ARE NOT EQUAL. There are small c's, middle C's, and big C's. Examples would be basal cell skin cancers, prostate cancer and lung cancer respectively. MOST CANCERS ARE TREATABLE AND MANY CAN BE CURED. YOUR BODY HAS VERY POOR WARNING SYSTEMS — not unlike the bilge on your boat.
What can you do? First, don't smoke. Tobacco and it's by-products contribute to greater that 50% of all cancers. For cancer screening, it is very clear. Know the signs of skin cancer. After the age of 55 be screened for colon cancer by a Gastroenterologist. After the age of 50 have yearly PSA evaluations performed. If your values are elevated or if there is an increase see a Urologist and have the biopsies. If you are diagnosed with prostate cancer, chose a treatment that works for you. IT IS IMPORTANT TO DETECT ANY CANCER AT AN EARLY STAGE BEFORE IT HAS SPREAD AND THIS IS ESPECIALLY TRUE FOR PROSTATE CANCER.
While you are creating your "personal health care log book" you should go ahead and have your blood pressure and lipids (cholesterol and the sub fractions) checked. I would hate to have you cured of prostate cancer and then have you die of a stroke from high blood pressure.
If you follow my suggestions it is highly likely that you will have more days to enjoy your boat as well as your sailing mates. Isn't that what we sailors want to do?
Over and out — I have to go back to cleaning the boat and checking the bilge…
Update January 2009
This spring, 2009, I will celebrate six wonderful years after treatment at Loma Linda University Cancer Center, utilizing proton therapy for my prostate cancer. I am now age 67. I am fully retired from hospital administration, teaching medical school and doing cancer research, but have maintained a keen interest in the treatment and follow up of a variety of treatments for prostate cancer. Proton therapy still remains the best choice for early stage prostate cancer. The treatment field encompasses the prostate, the adjacent periprostatic capsular soft tissue, and the seminal vesicles. These latter two areas are primary sites of tumor recurrence.
How am I doing almost six years after treatment? The answer is easy, as soul singer James Brown once said, "I feel good, and knew that I would now!" I have had no significant side effects from treatment. Because treatment encompassed the sites where ejaculate fluids are made, the prostate and the seminal vesicles, I have had a decrease in ejaculate material, but all other plumbing issues are up to life's joys and challenges. My PSA nadir is 0.3 and I am pleased with this result. Would I choose proton therapy again and drive the 5380 total miles for treatment? The answer is a definitive YES. I live approximately 60 miles from Loma Linda and had to drive 120 miles each day, roundtrip.
In the past six years, I have had the opportunity to get to know Bob Marckini, who is responsible for the BOB organization. We are so lucky to have a dedicated, "retired" professional, such as Bob, who cares so deeply about each and every individual patient who inquires about prostate cancer or who chooses proton therapy. It has been and will continue to be a pleasure for me to talk with patients about proton therapy for prostate cancer. Many of these patients have chosen proton therapy, and they have been very happy with their choice. This includes many of my personal friends. Bob has written a book titled, You Can Beat Prostate Cancer and You Don't Need Surgery to Do It. It is available from Amazon. The book is very informative, well written and medically accurate. He has done a great service for all people who are diagnosed with prostate cancer. Thank you, Bob, for all of your efforts.
While I am grateful to Bob, I would be remiss if I didn't thank Dr. Jerry Slater, and his team of professionals for developing the technology to create proton therapy. The treatment team includes many others, who in 2003, gave unselfish dedication to my personal treatment, as well as countless others to this day. My life has been positively changed by their commitment to excellence. They certainly have made the Loma Linda Mission Statement, "To Make Man Whole" a viable part of so many lives.
The bottom line? Proton therapy was a wonderful treatment for me, my wonderful wife, and extended family and friends, who share our commitment to fully engage in life. Prospective patients should feel free to continue to contact me. It is a pleasure for me to help them understand this disease and its treatment.
This summer, 2012, I am celebrating nine wonderful years after my proton treatment at Loma Linda University Cancer Center. I am now age 70. My wife and I recently returned from a trip to Spain. These days, we spend much of our time on our sailboat, cruising the waters of Southern California.
I still believe proton therapy is the best choice for early stage prostate cancer. My PSA remains at 0.3 and life is good.
Proton therapy has allowed me to continue to participate actively in life. My beautiful wife Carmy and I have spent a great deal of time on our Partnership Seawind catamaran called "Razzle Dazzle" in Mexico at Puerto Vallarta, Barra Navidad, La Paz, and many other wonderful spots in the Sea of Cortez over the past five years. We continue to travel to see friends and family thanks to my proton therapy treatment 12 years ago. I routinely talk to interested patients about proton treatment and the distinct scientific advantages it has over all other forms of treatment. Early diagnosis and proton treatment remain the best ways to successfully treat prostate cancer.
Gentlemen, my word of advice is to know and watch your PSA and get early biopsies as appropriate. Proton BOB, under the leadership of Bob Marckini and his daughter Deb Hickey, is a wonderful resource to all prostate cancer patients and it is my privilege to be a small part of this effort.
Off to the gym, the pool, the boat, and wine cabinet ... in that order.
Terry Wepsic, M.D.