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Prostate Cancer

Robotic Surgery At St.Luke's Keeps Prostate Cancer Survivor Robert Cays Running Strong

Prostate cancer survivor Robert Cays has resolved to log 1,200 miles running in 2015, a rather ambitious goal for a 75-year-old. While many people have already abandoned their New Years’ resolutions, Robert is likely to keep his. After all, in 2014 he exceeded his 1,000-mile goal and that is in addition to the many miles he runs along the country roads near his home in Reeders, Monroe County.

Robert began running in July 2008, at age 68, after he was diagnosed with prostate cancer. At the time, he did not suspect that he had cancer. He had no symptoms other than a slow urine stream that he attributed to advanced age. In fact, he had gone to his family physician, Donald Hiemenz, MD, of St. Luke’s Brodheadsville Family Practice for a cold. While there, his doctor recommended he have a screening test that measures the level of prostate-specific antigen (PSA) in the blood. Since the test indicated a high PSA level, Dr. Hiemenz referred him to urologist Frank Tamarkin, MD, of St. Luke’s Center for Urology.

Dr. Tamarkin performed a biopsy, which tested positive for prostate cancer. At that point, the urologist provided Robert with the following treatment options:

  • Robotic prostatectomy using the DaVinci robot, a non-invasive minimally invasive surgical procedure.
  • External beam radiation therapy (EBRT), which delivers a beam of high-energy X-rays to the tumor site to destroy cancer cells while sparing surrounding normal tissues.
  • Traditional, open surgery.
  • Radioactive seed implants, which is also known as low-dose brachytherapy.

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Because Robert’s type of cancer was slow-growing, Dr. Tamarkin encouraged him to take the time he needed to carefully consider all of the possible courses of treatment.

“It’s like you’re serving the patient at a fine restaurant,” Dr. Tamarkin says. “You consider yourself the host, waiter and maître d. You present a menu of options for treatment. You’re not going to offer them something on the menu that isn’t good.”

A work colleague of Robert’s had fared well with robotic surgery and so he chose that option. “I took the diagnosis in stride. I was pretty healthy and rarely saw the doctor,” he says. “I liked the idea of robotic surgery and I just wanted the cancer out of there.”

Diagnosed in July, the surgery was scheduled for December. In the interim, he decided to get into shape. Before then, Robert, who was still working at Tobyhanna Army Depot as an information technology specialist, was active but not athletic. Encouraged by his then 31-year-old daughter, the pair began a running program called, “couch to 5K.”

“You begin by alternating running for 20 seconds and then walking for one minute,” Robert explains. “The first time I tried it I didn’t think I would get past the 20 seconds. It seemed to last forever.” He stuck with it though and found that running lifted his spirits.

Meanwhile, he had several appointments with Dr. Tamarkin prior to the surgery. “He made me feel good – confident – and made my family feel that way too.” His improved fitness, combined with faith in his physician, prepared him for surgery. Dr. Tamarkin explains that robotic prostatectomy is a computer-enhanced, minimally invasive surgical technique. Surgeons access the prostate through small “keyhole” incisions. Seated at a console system with a magnified three-dimensional image of the surgical field, he removed the cancerous tissue using tiny instruments that enabled him to manipulate tissue with great precision and remove Robert’s prostate gland without harming surrounding tissue. Compared with conventional “open” surgery, minimally invasive robotic prostatectomy has reduced blood loss and post-operative pain, shorter hospital stays and a quicker recovery. Afterwards, Robert had only a few small scars.

“I woke up after surgery and was hungry. I wanted a big meal,” Robert says. “Right away, I felt OK. I got up the next day.” His first hospital stay ever, Robert adds that the hospital staff was treated him well and provided him with everything he needed promptly.

After about six weeks of convalescence, Robert got back to running. He and his daughter trained together. The first year, he ran his first 5K (3.1 miles) race, which has since become a tradition each year for him and his daughter. “Believe me, I was happy to get through it,” he says. “Now a 5K is really easy, a 10K is no problem.” Robert now runs 20-25 miles a week. In December 2011, he vacationed in Jamaica where he ran the Reggae Half Marathon, his first half-marathon. Since then he has run several half marathons and one full marathon, and counting.

Robert remains 100 percent cancer free and continues to see Dr. Tamarkin once a year. The physician looks forward to seeing Robert’s three-wheeled motorcycle in the parking lot.

“I’ve known him and his wife for years,” he says. “Robert’s a happy, educated, easy-going guy. He’s kind, gentle and a pleasure to be around.” Dr. Tamarkin has developed a close relationship with Robert because unlike some large academic centers, at St. Luke’s it’s typical for the same specialist to see patients from diagnosis through treatment and then continue to follow the patient for years.

“We have a reputation of providing our patients with a lot of personal attention,” Dr. Tamarkin continues. “I never thought in a million years that I would develop such strong relationship with my patients. When you are in medical school you don’t always get a true picture of what it will be like when you are practicing. It’s really nice.”

As for Robert, he couldn’t be happier with Dr. Tamarkin and the staff at St. Luke’s. He advises others diagnosed with cancer to find a physician they’re comfortable with and begin a fitness program.

“Get out and walk,” Robert says. “Do whatever you can. I really think becoming more fit helped me beat cancer.”