PHILADELPHIA, PA — Each year, doctors inform more than 240,000 patients that they have prostate cancer. Former Mayor of Philadelphia Michael Nutter now knows exactly what it is like to be one of those patients.
“I never thought that I would be diagnosed with cancer,” said Nutter. “This was a reality I never thought I would have to face. I am so thankful to be able to call myself a survivor.”
Nutter learned that he may be at risk for prostate cancer after routine blood work taken during a physical at his general practitioner. There are two screening tests that can indicate the potential presence of prostate cancer: a physical prostate cancer examination and a PSA (prostate-specific antigen) blood test. A few years ago, Nutters’ annual blood work came back with a slightly elevated PSA, indicating he was at moderate risk for prostate cancer.
Other than skin cancer, prostate cancer is the most common cancer among American men and the second-leading cause of cancer-related death in American men. Black men are 1.8 times more likely to be diagnosed with—and 2.2 times more likely to die from—prostate cancer than white men.
There are multiple courses of action for managing prostate cancer, including active surveillance, which is careful monitoring of low-grade cancer, and treatment options such as radiation or removal of the prostate (prostatectomy). When a patient’s PSA level is elevated but not yet an immediate threat, physicians often recommend active surveillance to keep track of the cancer’s progression until further intervention is necessary. After consulting with his physicians at MidLantic Urology, Nutter opted to pursue active surveillance until it was recommended otherwise.
Throughout surveillance, Nutter continued living life normally. Prostate cancer most often is not outwardly symptomatic, and many men can live with prostate cancer without any change to their life. Despite physically feeling well through active surveillance, Nutter was privately living with the weight of his diagnosis on his shoulders.
“In September 2020, after feeling quite ill, I went to get a COVID test. The test was negative, but the doctors discovered that the source of my discomfort was a burst appendix. I was immediately admitted to the hospital for an appendectomy,” said Nutter. “I had not been in the hospital since I was 17, so as I was lying there after my surgery, I had some time just to think. The appendicitis was a bit of a scare, but quick actions by the doctors took care of that. It was then that I really focused on the fact that I had been lucky with the cancerous threat to my quality of life…but luck is not a strategy. I needed to face my prostate cancer diagnosis head on, and take action now.”
In October after his appendectomy, Nutter had blood work done, including a PSA test. It was then that Nutter learned his PSA was up significantly again, and active surveillance was no longer an optimal choice.
“Following the diagnosis of prostate cancer, an active surveillance protocol was initiated after taking into account the prostate pathology, lab studies, appropriate x-rays and genomic testing,” said Dr. Laurence Belkoff, Nutter’s urologic surgeon at MidLantic Urology. “Throughout his active surveillance, Mayor Nutter was extremely vigilant in obtaining routine blood work, repeat prostate biopsies and genetic testing to ensure no change in his diagnosis. Due to the diligent monitoring, it became clear last fall that there was disease progression requiring aggressive therapeutic options be strongly considered, specifically a robotic prostatectomy. Undergoing a prostatectomy is a daunting procedure, but in the care of an excellent uro-oncologic surgeon, possible side effects such as urinary incontinence and erectile dysfunction are minimized. Many men are reluctant to undergo treatment because they are unaware of the high success rate of eradicating their cancer and maintaining their quality of life.”
Up until this point in October 2020, Nutter and Dr. Belkoff were the only people who knew about Nutter’s diagnosis.
“I never wanted to burden my loved ones with my cancer,” said Nutter. “My daughter was flourishing in D.C. My wife had been pursuing her passion of competing as a Masters Track cyclist. I always felt that this was my responsibility and burden to bear. And since my doctors and I were monitoring the cancer, I felt that I did not need to worry anyone else unless it was an emergency. But now it was time for me to face this, and I knew I could not do it without the support of my family.”
With his family behind him, Mayor Nutter decided to have a prostatectomy in December 2020. After a successful surgery, he is now fully recovered with no side effects and cancer-free. He is dedicated to advocating for prostate cancer awareness especially among Black men.
“If I can be an advocate and share my fears, my story and my results, I want to do that,” said Nutter. “Prostate cancer awareness is critical. For as much as it is tempting to ignore a cancer diagnosis, you can’t. You either deal with it, or it will deal with you. I strongly encourage men to regularly get their PSA level checked and have their prostate examined – especially Black men. It is scary thing to face, but it is better to know and care for yourself. We need you alive. Get checked, and encourage the men in your life to do the same.”
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