Prostate Cancer: Eye on the Horizon

The blessing of longevity winds thickly through Mark Saczawa’s family tree. His 94-year-old mother is still here, and many other relatives lived beyond age 95. So Mark’s diagnosis with an aggressive form of prostate cancer in 2016 prompted an equally aggressive response from him and his team at Hackensack University Medical Center to eliminate the disease and restore his chances of matching his family legacy.

Mark, then 56, hadn’t experienced any early symptoms of prostate cancer, which can include urinary urgency or frequency. But routine blood tests showed his level of prostate specific antigen (PSA), a protein that can signal prostate cancer or other problems, was creeping up. A biopsy confirmed a high-volume case of the malignancy, which permeated much of the prostate but didn’t appear on MRI images to have spread beyond the gland.

Taking a proactive approach, the father of two resolutely decided to surgically treat his cancer. Comprehensive online research led him to Michael Stifelman, M.D., chair of Urology and director of Robotic Surgery at Hackensack and a national leader in robotic prostatectomy, an advanced, minimally invasive procedure offering less pain and blood loss and a faster recovery.

Mark’s decision was affirmed by his brother-in-law, a urogynecologist in Florida who knew of Dr. Stifelman’s reputation and counseled him to choose a surgeon who had performed many robotic prostatectomies. Having done more than 3,500 such operations over his career, Dr. Stifelman more than fit the bill.

“I read an article by someone who was around my age when he was diagnosed with prostate cancer and decided not to have surgery,” the Wantage resident explains. “But 15 years later at age 75, it had spread and there was nothing doctors could do. At 75, I’m supposed to have 20 more years to go, so I decided I wanted my cancer taken out. Surgery gave me the best option for longevity and success.”

Unparalleled Advantages

Close in proximity to Mark’s family printing business in Cedar Grove, Dr. Stifelman and Hackensack also provided several other key advantages. The first hospital in the U.S. to implement certified disease-specific programs for both prostate and kidney cancers, Hackensack boasts the most robotic prostate removal surgeries of any center in New Jersey, with more than 5,000 performed at the John Theurer Cancer Center over the past decade.

Dr. Stifelman readily agreed that Mark’s best chances for a full recovery pointed toward robotic prostatectomy. Genetic testing on Mark’s tumor indicated it was more aggressive than initially suspected.

“Three solid reasons, combined with Mark’s age, made us recommend removal of his prostate gland as a primary initial treatment,” Dr. Stifelman says. “It allowed us to sample his lymph nodes, which is typically one of the first places cancer spreads to. If his PSA rises or there’s evidence the cancer is returning, we can use radiation as a backup plan. And lastly, prostate surgery offers a better chance at long-term, durable control of the cancer.”

Mark’s operation in December 2016 included the removal of 45 lymph nodes and was performed through five quarter-inch incisions, offering Dr. Stifelman a 3-D view with 10-times magnification for added precision. The hospital has since become the first in New Jersey to acquire new technology allowing surgeons to perform this and several other complex surgeries through a single incision.

After just a day in the hospital, Mark returned home to his wife of three decades, Linda. Ten days later, he was back to feeling much like himself again and grateful for the compassion of his medical team.

“It’s a difficult thing to be carrying, when you know you have cancer,” he says, “and all the people there made it easy to go through the process.”

Renewed Perspective

Close monitoring after surgery revealed Mark’s PSA levels rising by tiny increments about a year later. Again, he and his medical team sprang into action.

Mark underwent eight weeks of targeted radiation with radiation oncologist Glen Gejerman, M.D., meeting with nurse practitioner Joan Colella to learn the ins and outs of treatment. He also started hormone therapy to lower testosterone levels that could help drive the cancer.

“It’s unfortunate that he had a recurrence, but because we used the latest technology of hyper-sensitive PSA testing, we were able to determine when that happened and give him the option of treating it earlier,” Dr. Stifelman says. “Mark chose to be more aggressive with his radiation treatments and do it up front.”

The guitar-strumming church musician, who’s been playing since he was 8 years old, is now cancer-free and happily back to jamming with his friends. Despite his ordeal, he sees the positive. “I really started to focus on the people in my life and the relationships I cherish,” Mark says. “I don’t take anybody for granted.”

Dr. Stifelman says Mark’s prognosis is a tribute to Mark and to Hackensack’s distinctive blend of expertise and technology and its multidisciplinary approach.

“Innovation is in our DNA,” he adds. “We’re constantly reevaluating ourselves and how we do, allowing us to make sure all patients get individualized care and personalized medicine.”

Next Steps & Resources:

• Meet Our Experts: Michael Stifelman, M.D. and Glen Gejerman, M.D.
• To make an appointment with Dr. Stifelman or a doctor near you, call 800-822-8905 or visit our website.
• Learn about the comprehensive and compassionate cancer care available at a location near you.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.