For almost four months, Bob Breck has been silently dealing with the harsh reality of cancer, behind his smiles. Early detection gives him an edge in recovery, but Bob wants his experience to be a lesson to others never to miss a checkup. Bob was diagnosed with prostate cancer on October 25, 2012.
"I'm still hoping I have many years to go yet, but that initial slap in the face is something you're going to remember for some time," Bob said.
Touro Hospital urologist Dr. Neil Baum said, when Bob got the information, "He handled it beautifully. I reassured him and he was very positive," Baum said.
Bob said he knew when he was told he had cancer that it was not a death sentence. "The majority of men will die with prostate cancer not because of prostate cancer. Something else will get you. I felt relieved knowing that," Bob said.
Because of family history, Bob knew he could be a target. He could read the future just as he does his complex maps. But many men are uninformed, unable to say exactly where the prostate gland is or what it does.
"I know it's somewhere down there, that's about it. I don't know," said one man on Canal Street.
"Where is the prostate and what is it for? Boy, you got me on that one," said another man, scratching his head.
"So what does it do?" asked a baffled passerby.
Dr. Baum explains, "The prostate gland is a walnut-sized organ located under the bladder and it surrounds the tube that transports urine from bladder to outside of the body."
He says there are no symptoms for early stage prostate cancer without proper medical testing.
Bob says his father's cancer was worse than his. "They took out his prostate," he told us. "The surgery itself almost killed him."
His father, Bernie Zabrecky, suffered with the disease. And Bob remembers his grandfather, Albert Zabrecky, was in the later stages of prostate cancer by the time Bob graduated from college in 1969.
"I wasn't surprised to be told I had cancer. What was surprising was the age," Bob said. "I just turned 65, but my father was in his 70's. I thought I had time."
Dr. Baum says 250,000 men will be diagnosed with prostate cancer every year. More than 30,000 will die. Many do not get annual exams.
"I fortunately have been going every year to get an annual checkup," Bob said.
The annual test is a digital rectal exam. Dr. Baum says the exam takes 15 seconds.
"Is it uncomfortable? Yes. Is it painful? Absolutely not," he said.
A blood test is also part of the exam, a simple needle puncture in the arm. It is through the routine blood test that Bob's doctor discovered his cancer. The level of prostate-specific antigen in the blood, or PSA, signals the presence of cancers that doctors cannot feel or see.
The normal range for PSA runs from 0 to 4.0. Baum says PSA's above 4.0, are red flags, requiring further examination and possibly a biopsy. Bob's biopsy revealed stage one prostate cancer.
"Your initial treatment is the doctor will give you some shots. They're hormone shots that get the testosterone level down. That's what feeds the prostate cancer. You are basically put into male menopause. You're gonna have hot flashes that are very irritating." Bob said.
His early stage cancer did not require surgery, but he is undergoing radiation treatments at East Jefferson General Hospital. It's called intensity modulated radiation -- it can pinpoint the prostate and attack cancer cells.
Bob will receive 43 treatments Monday through Friday.
Radiation oncologist Dr. Paul Monsour developed Bob's high-tech treatment plan.
"This is actually Bob's CT, digitally reconstructed," Monsour said, pointing at a colorful screen. "You can see his bony anatomy and the colors represent organs. That's what allows us to deliver radiation with accuracy and treat him in just the area we want, using IMRT."
"They have clouds on the ceiling to look at," Bob said. "I feel like I'm floating in space. You see the machines moving around you but you feel nothing."
"We can treat people who have an advanced disease for a number of years, but it's the ones caught early that we can cure," said Dr. Monsour.
Bob said, in the position he's in, he has a message to get out. "I have a message that, if more guys knew it wasn't a painful thing and that it was easy through the treatments, maybe they wouldn't be afraid to find out their PSA."
We went with Bob to one of his treatments. "I've got to go to work, I've got to make weather," he joked as he sprang off the table after the treatment, going about life as normal.