After a few years of slowly rising prostate specific antigen (PSA) counts, Tom Ficklin heard the words he was hoping he never would: “It’s time for a prostate biopsy.” Although the most important thing to Tom was his health and survival, he still wishes someone had discussed better pain management options with him before he had the biopsy. But when the results came back positive for cancer, his focus shifted to treatment options.
Tom was given a choice between radiation and surgery; he chose external radiation, and the procedure took place very quickly thereafter.
“If I were to do it over again today, I might wait a little while longer for treatment, do some reflecting, get a second opinion, and research whether there were any clinical trials I could join.”
Tom’s PSA had risen from 2.4 to 4.0, but 4.0 does not usually indicate an advanced case of prostate cancer. “The biopsy was important because a PSA test alone cannot tell you whether your tumor is slow growing or advanced, but if you have a slow growing prostate cancer, you have a little time to consider options and opportunities with your doctors or clinical researchers,” said Tom. “My doctors were proactive and wanted the best for me, but unless it’s an emergency situation, it is OK to pause and ask questions.”
Tom was passionate about health long before his prostate cancer diagnosis. From 1975 through 1978, he was director of health and education for the Urban League. He also authored and edited health articles for local publications. In 2011, a few years after his surgery, he completed a CARES fellowship with the Connecticut Health Foundation. And today, Tom is president of Ficklin Media, established in 2008, and hosts his own radio show, addressing personal and community health and social issues in the black community. “Still, looking back, when a doctor tells you that this is what you need to do, people don’t always feel comfortable with asking about other options. Just do it” he said.
Tom had a long-time relationship and great trust in his primary care doctor but felt that the specialists worked a little bit faster than he would have liked. Oncologists and cancer surgeons are so used to just knocking these things out as quickly as they can, sometimes they forget to talk to patients about the impact the treatment will have in terms of physical and psychological side effects,” Tom said. “Find one doctor who can be your rock and get someone to be your health advocate if you find it difficult to ask questions yourself,” he added.
Side effects of prostate cancer treatment can include incontinence and impotence. “Radiation treatment also causes fatigue, but that was less difficult to deal with, relatively speaking” Tom said. “The impact of side effects on the male ego can be significant, it can be a psychological assault, and there are young men who get this too, and might really struggle. But living is better than dying, and there are low-cost solutions like suction pumps and Viagra that many men find very effective.
Reaching out to friends and family for support, sharing his personal experience, and taking advantage of his hospital’s integrative services—including massage, tai chi, yoga and one-on-one spiritual exercises—were also important factors in his recovery.
Right after his surgery, it suddenly occurred to Tom that he should reach out to a friend he hadn’t spoken to in 50 years. “Turns out, he had just come through prostate cancer himself, and had had the Davinci procedure. Some might call it a coincidence that I thought of contacting him at that time. I like to think it was something more.”