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Arland Hotchkiss never dreamed that working for the USDA Agricultural Research Service as a plant physiologist might save his life. However, as a federal employee, Arland had a benefit of annual physical exams. Since he turned 40, he had an annual PSA blood test, which helps doctors determine a man's risk of prostate cancer. At the age of 50, with no family history of prostate cancer, Arland was never concerned about getting the results. Until 2008, when his levels reached an all-time high.
"My PSA levels were cyclical (between 1.2 and 1.8), but in January 2008, it was 2.4 and had doubled in a 2 year period," shared Arland. "Taking my doctor's advice, I was tested again 6 months later." Although his PSA was still elevated (2.7), it was not alarming but Arland's urologist suggested he get a biopsy.
"We felt the results would be negative given my age and lack of family history."
On their 25th wedding anniversary, Arland discussed the news with his wife, Julia. "We felt the results would be negative given my age and lack of family history," Arland recalled, but they were wrong. After a 2-week wait, Arland and Julia learned that his biopsy tested positive for the earliest stage of prostate cancer. They decided to get a second opinion.
Arland requested that his pathology slides be sent to Fox Chase Cancer Center, where pathologists with special expertise would review his results. He consulted with both David Chen, MD, a surgical oncologist, and Eric Horwitz, MD, a radiation oncologist at Fox Chase, to review his treatment options.
"I was skeptical that I had cancer," admitted Arland. Using the Internet, Arland researched his Gleason score (6), which typically indicates early stage prostate cancer. He asked to meet with the pathologist, Dr. Harry Cooper, where they reviewed the slides of the prostate biopsy together using the multi-headed microscope. "Once I saw it with my own eyes, and had Dr. Cooper explain the significance of the immunolableling to me, confirming it was cancer, I knew I had to have treatment." That was September 2008.
Arland decided robotic surgery was his best option.
Arland decided robotic surgery was his best option because of his age and because it was the least invasive treatment with minimal side effects.
Arland did not feel the urgency to have surgery immediately. In the early fall, he was scheduled to present at a meeting in Canada, as well as take his men's tennis team to the national tournament in California. "I wanted to do both of these things," Arland said. "Plus, I needed some time for my family and me to come to grips with the fact that I had cancer." He decided to have the surgery right before Thanksgiving so he could recuperate over the holidays.
"The nurses were outstanding."
In November 2009, Dr. Chen performed a da Vinci® robot assisted prostatectomy on Arland. He only had to stay one night in the hospital. "The nurses were outstanding - from the operating room, to the PACU, especially Beth Ellert, to the floor nurses," said Arland. "They were very attentive to my needs and gave me lots of personal attention."
"Dr. Chen was terrific. He listened to my concerns and answered every question."
Recovering at home, Arland walked around the neighborhood every day (even with the required urinary catheter and drainage bag), and was back on the tennis court in exactly 2 weeks. "I felt good enough to go out and hit tennis balls," Arland shared. "I went back to work part-time after 3 weeks and was full-time in 6." He did not experience incontinence or impotence, which are temporary side effects that commonly occur following prostate surgery.
Arland is a proponent of early screening. He believes that his 10-year history of PSA results, which were relatively low as far ask cancer risk goes, provided his doctors with enough data to predict that he might have the earliest stage of prostate cancer detectable with a biopsy. His surgeon felt he would not have experienced symptoms for another 10 years. At this time, Arland is considered cured and will not require further treatment.
By having robotic surgery, Arland was able to return to his normal routine within a few weeks.
Arland and Julia were very happy with the results that robotic surgery provided. Julia explained, "Being physically active is really important to Arland, and we were concerned that it would take him a long time to return to his exercise routine and the activities he loves, including running, working, playing tennis and being a Scout leader." By having robotic surgery, Arland was able to return to his normal routine within a few weeks, and Julia believes that contributed greatly to his physical and emotional recovery.
While Arland still gets regular follow-up blood PSA tests, he and his family have been able to move on in their lives without the fear of prostate cancer. In fact, the Hotchkiss family did not let their dad's cancer diagnosis interfere with their annual trek to Iowa to celebrate Christmas with Julia's family, less than 2 months after his surgery. "We usually drive straight through," said Julia. " But we decided to stay overnight and give Arland a rest." The bonus was that their 17-year-old daughter, Brett, shared the task of driving!