Hi, I'm Alex with PCRI. Today I'm sitting here with Mr. Steve Schwartz. I really love
his approach to how he dealt with his prostate cancer. It was extremely proactive, he did
a ton of research, and it's exactly what I wish every prostate cancer patient would do,
and today we're just going to talk about his journey.
Well, it's a little bit of a long story. It all occurred about eight years ago. I'm 63
now, so I was about 55 years old. Felt great, was doing regular PSA tests and saw my PSA
rising from 3 to 4 to 6 to 8; doctor did a digital exam; felt something; sent me to the
local urologist who did a random 14 needle biopsy, and lo and behold that comes back
and they said one of them was a Gleason 3+4, and that I was gonna probably need to do some
type of treatment. Let's go schedule surgery and we'll do it next week and have it removed.
I go, "Woah, wait a minute. I'm gonna do research." My wife had breast cancer, I got involved
in her's. I just believe that you've got to be your own advocate and understand you can
ask the right questions my whole life, whether it's with lawyers or doctors or architects,
I never just accept what somebody tells me, I've gotta understand it. So, I started doing
my own research; started going to various places from a surgeon to have it removed knowing
that if I was gonna have it removed it was going to be somebody that's done thousands
of them as opposed to the local urologist who's done 20. Went and looked at radiation,
went and looked at Loma Linda at proton beam therapy and active surveillance. All the options,
and of course everybody told me their option was the best and if I didn't do it I was gonna
die. So, in the meantime, I'm reading that not all the tests, the people that are reading
your tests, get it the same. So, let's do another one. The next guy comes back 3+3 instead
of 3+4, and I go, "Oh, maybe I can go active surveillance 3+3. I'm gonna get a third guy
to break the tie." The one thing that I have found, nobody agrees on anything in this business.
The one thing that—the only thing—that people have agreed upon is Dr. Epstein at
John Hopkins is the best and so I sent it to him, and he said, "not cancerous, it's
precancerous." Okay, well what do I do now. So now I'm confused completely. And then I
find a neighbor who had gone to a prostate oncologist, Dr. Scholz, who did nothing but
prostate oncology—spoke very highly of him—and he said exactly what I wanted to hear, that
I needed somebody that had no skin in the game. It's still a money game, right? The
surgeon makes money when you have surgery, the people in Loma Linda make money on the
100 million dollar proton beam, the [radiation oncologist] makes money on radiation, and
they believe in their product and financially and morally and everything. So I like the
idea that there was somebody who had no skin in the game. So I go see him and I go, "What
do I have?" So he says it's crazy to be doing random biopsies. Let's start with some imaging.
He did a Doppler imaging for me in his office and he says, "I can see what the doctor felt
at your digital exam," and he goes, "I think that they missed it completely on their random
biopsy." What? The spot that they found that turned out that Epstein says it's nothing
is way over here. It wasn't anywhere near where they felt. And he goes, "I can see this,
we need to do an MRI guided biopsy." Really, why doesn't everybody do that? That seems
kind of, better. He said, "well a lot of doctors don't know how to do it, they don't know how
to get reimbursed for it." And I think he told me like close to 90% of people are still
doing random biopsies. So I go, okay, how many needles this time? Three. Three!? We
did 14 or 13 last time, we're only doing three? Yeah, we know right where it is, we can see
it. So I go, "Okay." We did three, come back 3 for 3, 80% involved, Gleason 8, 4+4. So
to me, that was kind of the whole story. 0 for 13, 3 for 3, it was kind of unbelievable
to me that you could possibly have a situation where people are getting random biopsies when
there's a method to see where you're going as opposed to random. So, that's when I had—that's
when I started to look at treatments because I had a Gleason 8 now, there was no choice,
I sent it to Epstein again, he agreed. Gleason 8, unfortunately, or fortunately. So, we had
to look at treatments. It was very small and so one of the treatments Dr. Scholz—I wanted
quality of life, it was important to me—so he had a guy up in the Santa Barbara area,
Dr. Bahn, who has been for a number of years doing cryo, but a partial cryo where they're
freezing that section of your prostate. They had to check the rest of my prostate, make
sure there was nothing else there. And I did that, the cryo, seven years ago and had virtually
no side effects—sexually or incontinence—compared to what I've been reading about with everybody
else. Longer-term with radiation and shorter-term with surgery. Anyone who tells you the surgery
they were having no problem, if you really ask the people, they all are. So, I did that.
It was great.
Fast forward six or seven years and my PSA starts going up, and so we do another doppler,
do another MRI, they see nothing. And I said, "Does that mean it escaped the barn?" Maybe.
If you want to go check it out, the best place is a doctor in Arizona that has advanced imaging
that sees things years before others can see it—the current technology. You have to pay
out of pocket, it was like $3,000. I flew to Arizona, did that imaging, doctor comes
out and says I see two spots in your pelvis. Nothing on any of your kidneys or liver or
anywhere else, but two little spots but I don't think they're cancer because they're
too small and they don't look like the shape. Oh, that's good. I said (and I've always been
someone to ask questions) I said, "Well, I did an imaging PET scan seven years ago, do
you want to compare the two?" And he said, "That's a good idea." So, he looks at them,
a day or two later he says instead of 90% it's not cancer, he was 90% sure it was metastases.
I go, "huh." I liked it before better, but... So I was a little confused again. I went to
the radiology department at UCLA to get a second opinion, have a look at the imaging,
and they said "highly suspicious for metastasis." So, went back to Dr. Scholz who was of the
opinion which I agree 100% is you hit it hard early and that's one of the reasons why I
did the imaging and spent the extra money was to catch it early and the example he used
was it was a lot easier to put out a fire in a wastepaper basket as opposed to a house
on fire. So, recent studies in Latitude and Stampede had shown just at the end of '17
came out and they showed... Used to be you took Lupron which was to remove all of your
testosterone. That stopped working, you went to the next and the next until you die. Scholz
theory,—he'd been doing it for a while—and these two studies bore that out is that combining
some of these drugs early was reducing deaths by 35, 40, 45%. Huge amounts. Huge amounts.
Changed everything. And so, he decided—he suggested—that I do all three: The chemo,
the Lupron, and the Zytiga. Again, I went to UCLA to get a second opinion and they said—I
said, "look it makes sense to be, you know, Lupron and Zytiga are better than Lupron or
Zytiga alone. So, A + B is better than A or B. And if Lupron and chemo is better than
Lupron or chemo alone... So, A + C is better than A or C, wouldn't A + B + C be even better?"
And UCLA's doctor, Dr. Drakaki, there was really really nice, and she said, "In theory,
but we would never do something until there was a clinical study. I'd like to see a clinical
study on it," but, you know, they would not agree to do anything. Well, I like to think
out of the box, so I like the fact that he's thinking out of the box. It was logical. I
said is there anything in the chemical makeup of these three drugs that would make one not
work? No, no, no, no. It's just a lot of chemicals and whatnot that you may not need. So I did
all three. I did four sessions of Taxotere. I did the Lupron. I did the Zytiga. Also...
What was your PSA at this time?
My PSA was about 10, 9.9 was my beat.
And so I didn't want to look like a cancer patient. I was very concerned. I went to a
place that—I forget the name, it's online—you can actually put a freeze cap on your head;
you wear it for like four hours after, and I didn't lose my hair. Dr. Scholz had said
that people who work out with weights do much better with Lupron and ADT than people who
don't, and so I went to a local trainer meathead guy with a big V that had won awards at Mr.
California. 5' 10" 280 pounds at his peak, but he's not quite that anymore, and I walked
in, I said, "I gotta meet your cuz I'm scared to death I'm going to have no testosterone."
Took my shirt off and I worked out, but not... I just, you know, a little bit now and then,
kibitz a little bit. Go take a sweat, lift a little weight, go on the bike. I said I
don't want to look any worse than this a year from now on this stuff. He said, if you look
like that after a year of my gym, I'm closing the doors. So, since then I've gone and he works me like
a dog. I mean, I work for an hour and fifteen minutes I'd say an average three days a week.
That's it. But I'm lifting weights to exhaustion, you know, 20 of these and he goes, "20 more,"
and every time I swear it's gonna be my last time, but I feel great. I have increased muscle
mass, I've lost weight, I watch what I eat, I'm not having virtually any of the side effects
I'm hearing these other guys have. Reduced Libido? Sure, but not to zero. No real brain
fog and I feel good. I fell probably better than I did before. I wouldn't even—I have
a little bit of stomach problems now and then—but I wouldn't even know that I'm on it probably.
So I feel good and so I've continued that. My PSA dropped pretty fast to 0.02 and it
stayed there for about a year now and so I've been talking with Dr. Scholz and one of the
other doctors in his office and I went to UCLA again for second opinion and the conclusion
is at month 21 I'm going to stop everything and see how it goes. The only negative which
I hadn't thought about when I got only a portion of my prostate out it's gonna be a little
bit more hard to monitor me because with a prostate my PSA will go up even if it's the
cancer not coming back. So, I'm gonna probably have to do regular PSMA tests and that will
have to be my method of monitoring, but my prognosis appears pretty good. Dr. Scholz
said his history of people that go below .1 and stay there and I'm .02—have done extremely
well in his office. So, I hit it with the kitchen sink. It almost feels like HIV like
when they—that the way to stop it is a series of things. That appears to be where prostate
cancer is headed, but, you know, they won't do anything until they have a study on it,
but I'm trying to beat the game. Interestingly, when I did the SBRT on the three spots, there
was no studies that showed that that was helpful and since then the Sabre study, I believe
it is, came out and said that it appears by zapping—the theory was why hit mets that
appeared here and here because if you have those you probably have lots of micro mets,
so it's a waste of time. But, there's also a theory of the abscopal effect where theoretically
it would help your antibodies eat up the other micromets and so they've seen that people
who do that, especially with what I have is less than five mets, that it actually extends
life, so that's the fourth thing I did, and then I also started Zometa and Celebrex which,
surprisingly, in those same Latitude or the Stampede trial showed to reduce recurrence
by 20 to 22%—reduced death by 20-22% when used together, no real impact alone. They
don't even know why. So, that's my story; I'm sticking to it.