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Staying Vigilant: Awareness of Family History of Prostate Cancer Led Patient to Early Discovery and Treatment

May, 2015—Greg Jager’s prostate cancer journey began more than 20 years ago, when his father was diagnosed with the disease. Since that time, beginning in his 30s, Jager decided to stay vigilant about his own prostate health.

“Every time I’d go in for my annual exam, I’d remind my doctor of my history, and they’d do a PSA test,” says Jager, 51, referring to the screening done for men known as the protein specific antigen blood test, which measures the levels of a protein that often goes up when prostate cancer is present. “I kept doing this year after year.”

In October 2013 he learned his PSA was up to 2.6 and was told by his doctor that for a man his age, under 4 was good, but because of his family history, they would test again several months later. When he returned in August that year, his PSA level had risen to 3.1 and furthered his growing concern.

“In November, my brother called me and said he was diagnosed with prostate cancer,” recalls Jager, whose urologist then ordered a biopsy. “The biopsy came back with a confirmation of cancer.”

Although he knew the potential for cancer was there, Jager says he couldn’t believe it. He felt young, didn’t feel sick, ran a growing business and has two children that keep him very active. “I immediately knew where I wanted to go. I’ve known about the Siteman Cancer Center NCI (National Cancer Institute) designation and what that means,” he says. “The only choice in my mind was to go to the best people.”

Jager was referred to Gerald Andriole, MD, Washington University urological surgeon at the Siteman Cancer Center at Barnes-Jewish Hospital and Barnes-Jewish West County Hospital.

“Dr. Andriole is world-renowned in the research, procedures and treatment of prostate cancer,” says Jager, who received care at both hospitals.

Dr. Andriole says Jager was at higher-than-average risk for prostate cancer due to the strong family history in his male relatives. “When we see that history, we actually interpret and monitor PSA levels much more carefully than we do for a man who is of average risk for prostate cancer,” he says. “So, if you’re a man of average risk, we might say don’t get a PSA until you are 45 or 50. On the other hand, if you have an above-average risk because of your family history or you are an African-American man, you should start testing much earlier, at the age of 40, and the test should be repeated every year, especially if it is relatively high.” 

For men in their 40s, a PSA above one warrants yearly testing. On the other hand, a PSA <0.5 can be repeated less frequently.

Once Jager’s biopsy confirmed cancer, he was anxious to begin treatment. He shared with Dr. Andriole that he had common concerns like many of his patients, not only about survival but also possible side effects that might limit his function.

“What Greg chose to do after his biopsy was to get a MRI scan of the prostate,” says Dr. Andriole, who adds that this new technology involves stronger magnets and specialized software to help the surgeon identify exactly where the cancer is located in the prostate.

“That information is critical for the conduct of the surgery. The gratifying thing in Greg’s case is that yes, he had a cancer, but it was nowhere near any important structures,” Dr. Andriole says. “We knew with very good confidence that when we were removing his prostate, we could do nerve sparing and we could stay away from his sphincter muscle apparatus. We were able to maximize the chances that he would have a good functional outcome and not compromise whether or not the surgery in fact cures the cancer.”

Jager had surgery at Barnes-Jewish West County Hospital, a place he says feels like home thanks to its size and convenience. “I had the advantage of world-class care in West County, only a 10-minute car ride from my home,” he says. “I was there for two days and I was home. It was such an advantage for future visits to be able to get there, get out and go home. It was convenient and had a community feel to me. It helped my mind not feel like I had cancer.”

Now a cancer survivor, Jager says he would tell any person who has a fear or anxiety about having their prostate examined, that it’s not bad. “If you have a history, you have to do it. If I had not done it, who knows what stage it could have been in, who knows if I’d be here,” he says. “My experience with Siteman Cancer Center has been humbling. They all know what they are doing, and they saved my life.”

View a short video of Greg’s story.

To schedule an appointment with a physician at Barnes-Jewish West County Hospital, click here, or call 314-542-WEST (9378). 

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