Fighting Cancer with Precision Weapons
Early in my career I was taught the value of precision weapons, I never thought the same lessons would save my life. After my first fleet tour I was assigned to VX-4, the Navy’s Air-to-Air fighter aircraft Operational Test Command. It was during this tour in 1989, I learned the incredible capabilities of precision weapons. One of those programs was a frivolous new unmanned cruise missile called the “Tomahawk.” It was launched by “Black Shoes” and “Bubble Heads” then flew for hundreds of miles using terrain avoidance technology and could deliver its warhead into the chosen window of a building assigned by mission planners. A precision weapon that “fighter guys” were never going to shoot. During one of the test mission debriefs, I was offered the opportunity to become a qualified mission planner. Being desirous of a week at the Oceana Officers Club, I agreed to take the course and eventually became a qualified Tomahawk Mission Planner.
As operations Desert Shield and Desert Storm were initiated, we found ourselves in need of new precision weapons and lots of them. The rest is history, and it is safe to say most weapons delivered by any force since 1991 have been some type of “precision weapon.” The requirement to minimize collateral damage effects of the weapons and preserve lives of unintended victims while eradicating the enemy, has become the mission of our military.
Fast forward to October 2015 and my annual physical at the Phoenix VA. I had registered in the VA Health Care system to utilize the services and stay engaged with the military community. Since I was living in Phoenix Arizona at the time.
During my physical in October 2015, I requested a prostate screen, as I had every other year since 2011 and was informed of an irregularity in my PSA (Prostate Specific Androgen) blood test. The doctor ordered a repeat to ensure it wasn’t a false positive. If one has a high PSA level, the doctors should initiate a conversation with the patient about what an elevated PSA might mean and together they should agree on a follow-up plan. It is also highly recommended if your PSA level is above 4.0 a biopsy of your prostate should be considered. In discussions with my doctor, I mentioned the urinary urgency had increased. If “holding it” when you drink a little coffee or water on a road trip or have trouble “holding it” at all starts to happen to you, pay attention! That is NOT normal. The follow up blood test results showed a PSA of 14.7. After checking my records, we found my previous year results were 5.1, qualifying me for a biopsy. I was working abroad and when I called for the lab results from my physical in 2014 and was given “the all” clear and was assured that “all levels were within normal ranges.” In reality, I had been living with an aggressive form of Prostate Cancer.
The next step was to attempt to schedule an appointment with the urologist at the Phoenix VA. I was informed by the scheduling department it would take 29 days to see anyone as the schedule was just full. Refusing to accept that answer, I presented myself to the urology department and was offered any of 3 open appointments the following day. After seeing the urologist, I was more than disappointed to be informed that the ONLY option offered at Phoenix was a surgical procedure termed “Radical Prostatectomy”. Having a technical background and an understanding of Precision Weapons it was obvious that anything called “Radical” and having to do with surgery on my body was not a precision approach. It was at that moment I decided to immediately step out of the VA’s care and find a better option of killing this enemy that had invaded my body.
I am lucky and blessed to be related through marriage to one of the world’s leading Radiation Oncologist. Just a day after my “1v1 dogfight” with the VA urologist, I contacted my relative to ask her opinion and presented her the facts from the VA. I knew this was serious when she told me to hold on while she got her partner, on the phone who specialized in treating prostate cancer. The partner had been leading a 5-year study of prostate cancer treatments with a revolutionary machine called “CyberKnife”. After hearing the facts as reported by the VA, I was immediately scheduled for a biopsy at a private hospital. On December 9th, I was given the diagnosis of Prostate Cancer and immediately traveled to Seattle where they would arrange for and conduct my Cyberknife treatment. My specific cancer was classified as a Gleason Score 7 (4+3) with 8 of 12 cores of the biopsy positive for cancer. When researching that score, it is on the near edge of being “bad” but still in the range of curable with Cyberknife.
Immediately I reached out to four organizations supporting those of us with the disease. More importantly, they offer help to those around us who are thrown into the “Cancer Frag Pattern” now labeled as Caregivers. I encourage anyone diagnosed to contact all the following organizations as they all offer knowledge, support, and options many of which are not offered by the VA Healthcare system:
Veterans Prostate Cancer Awareness – www.VPCa.vet
Zero the Cure for Prostate Cancer – zerocancer.org
Prostate Cancer Health Education Network “PHEN” – www.prostatehealthed.org
Prostate Cancer Research Institute “PCRI” – www.pcri.org
After researching options for treatment and in consultation with my doctors, I chose CyberKnife (www.cyberknife.com) at the Swedish Hospital CyberKnife Surgery Center in Seattle, Washington. CyberKnife, manufactured by a company called Accuray Incorporated, is the most modern technology available for attacking this cancer, with a level of accuracy to qualify it as a true “Precision Weapon” against Cancer. Having the ability to radiate the cancerous tissue with an accuracy of less than a millimeter while still tracking the prostate in real-time and adjusting for normal breathing motions cannot be accomplished by any other device. The CyberKnife is like the Tomahawk – it collects and synthesizes data in real-time and adjusts its aim to hit the target every time. The significance of real time corrections through measuring the movement of the prostate is critical in the delivery of radiation while preserving good tissue. While CyberKnife is classified as a Stereotactic Body Radiation Therapy (SBRT), it should be in a category of its own when comparing it to other advertised precise treatment options.
The greatest fear men have when diagnosed with prostate cancer is all about their ego and the misplaced belief they will lose their manhood if treated for prostate cancer. It is true that if one chooses the option of a “non-precision” approach to treat an organ the size of a walnut placed in the center of your body, having nerve bundles running though it that control urinary and erectile functions AND surround the urethra there’s a good chance of collateral damage and problems post treatment. These can range from incontinence, erectile dysfunction, colorectal problems from radiation exposure among other complications. The decision for me was easy, and understanding the concept of using Precision Weapons to kill the intended target while avoiding collateral damage made CyberKnife the only choice
Understanding the process and physics of the CyberKnife made it a simple choice. I learned that the CyberKnife system would do a “mission plan” prior to any radiation. The mission plan was the result of a high-resolution MRI and a CT Scan that produced a 3D image/model of the prostate and all surrounding tissues. It also located and mapped 4 gold fiducial markers placed in my prostate during a very simple outpatient procedure that lasted 15 minutes. The planning software mapped the best approach for the high intensity radiation delivery to the prostate while creating a blueprint minimizing any radiation to surrounding tissues with accuracy less than 1 millimeter. Also, because of the accuracy of delivery, doctors could deliver the treatment in higher doses reducing the number of individual treatments to only 5 versus the 44 treatments it takes to treat with Intensity-Modulated Radiation Therapy (IMRT) another common form of radiation. A simple comparison is treating the cancer with a small but very powerful laser guided weapon verses an entire air campaign with continuous bombing of the same target and only knowing the intended enemy has been eliminated because there is nothing alive in the surrounding area. In my opinion, based on my experience and research, surgery is an out of date approach to the treatment of this disease and should be questioned as to the effectiveness and enrichment of a patient’s quality of life post-surgery. Yes, the urologist can probably cure you of prostate cancer but at what price to the quality of life and the “Male Ego?”
My experience and lack of information provided by the VA led me to recently establish Veterans Prostate Cancer Awareness Corp. a 501 (c) (3) with the following charter:
• Promote prostate cancer awareness among military veterans and active duty military members;
• Educate Veterans and active duty military personnel on proper care and treatment alternatives for prostate cancer; and
• Promote the adoption of the latest technologies available for the treatment and cure of prostate cancer.
I would encourage all of you reading this to learn more about prostate cancer and the need for early and annual screening and options for treatment. One should know their PSA as well as your social security number, your wedding anniversary, date of your graduation from USNA, and your handicap. Please do not hesitate to contact us if you have any questions or know someone seeking options and answers. Please visit the website www.VPCa.vet and pass the word to request a screening of your prostate on your next physical.
Michael A Crosby, CDR ret.
M: 571 215 2715
E: mike.crosby@VPCa.vet