‘Out of the 4.0 box thinking’ benefited South Texas patient

San Antonio (May 27, 2004) – Like many Americans, Edgar Smith loathes the words “prostate cancer.” His father had it, he had it, and his two brothers had it. That’s why he strongly encourages men to have themselves checked and to understand their options.

“My youngest brother, Harry, passed away March 6 and he died very sadly,” Smith said. “He was in hospice care. I remember it was bad, and it was so sad. I have that picture in my mind. I told myself, this doesn’t have to happen with early detection.”

Early detection of prostate cancer includes a digital rectal exam (during which the physician feels for prostate abnormalities), the prostate-specific antigen or PSA test, and prostate biopsy. The PSA test measures the level of one protein in the blood. Physicians often consider that if a man has a PSA of 4.0 nanograms per milliliter (ng/ml) or lower, he does not need a prostate biopsy, during which tissue is taken from the prostate to be examined for cancer by a pathologist.

Smith said he benefited from “out of the 4.0 box thinking” on the part of his physician, Dr. Javier Hernandez, and his surgeon, Dr. Ian M. Thompson, professor and deputy chair of the department of surgery and chief of urology at The University of Texas Health Science Center at San Antonio. Smith had a 0.9 ng/ml reading for two years, but because of his family history Dr. Hernandez suggested a biopsy, which was positive for prostate cancer. “It looked like I was doing really well, but I wasn’t,” Smith said.

His cancer was of the aggressive variety but had not spread. Dr. Thompson performed a prostatectomy on Smith at University Hospital, the Health Science Center’s teaching hospital. “If I had not seen the docs, I would not be in as great a shape,” Smith said.

Smith, 69, is retired from the Texas Workforce Commission and lives in Floresville near San Antonio. He said he has already told his two sons about the importance of checkups for prostate cancer.

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