Urology Patient Stories

At only 38 years old, Alex Tamargo battled mysterious symptoms for over six months, before a 7cm cancerous mass was discovered on his kidney. Diagnosed with Stage I clear cell renal cell carcinoma, under the care of Dr. Timothy Clinton, Alex underwent successful robotic surgery, enabling a swift recovery. Read Alex's full story.

For roughly 15 years, James Mayo of Dorchester has been walking five miles a day on a nearby golf course and then around Franklin Park Zoo.

This year, the peaceful 35-mile-per-week habit helped heal James’ mind, body and spirit after prostate cancer surgery.

James, 72, was a security officer with the Federal Reserve Bank in Boston for 22 years before retiring in 1986. His primary care doctor had been testing his PSA levels for many years. Beginning in 2001, his PSA began to rise gradually.

James had his levels checked every six months during those nine years, and finally, in 2010, the PSA reached a level so high that his physician referred him to a urologist for a biopsy, and the prostate cancer was confirmed.

No stranger to cancer, as he lost both a sister and his oldest of three daughters to cancer, James knew that despite the risk of urinary incontinence and erectile dysfunction, he needed to take action.

After an MRI and other diagnostic tests were completed, confirming that the cancer had not spread outside the prostate, Brigham and Women’s Urologist Steven L. Chang, MD, MS, performed robotic surgery in October 2011.

James recalls being in pain for a time after the surgery, but he was only pulled away from his walking routine for two weeks, and then he got right back at it. “The walking helped me a lot,” he said. “It’s given me the strength and the ability to continue. I don’t sit around and think. I do the walking, and that keeps my mind off of the worries.”

The worries were over his recovery, and James said he struggled with continence in the weeks following surgery. Time and doing the Kegel exercises Dr. Chang recommended to strengthen the pelvic floor and the muscles that control urinary function brought about slow and steady improvement.

Roughly six months after the surgery, James said he felt confident with his urinary control, and now, he said he feels he is at 90 percent of his former urinary health. “Every month that comes, it gets better and better,” James said, noting he still does the Kegel exercises.

James feels good, and he does not need to take any medications. “I’m all free of that,” he said. Every three months, James still visits Dr. Chang and has his PSA levels checked; that routine will eventually go to every six months and then back to every year.

"Dr. Chang is a great doctor,” James said. “He is willing to listen and willing to tell you everything about what you have to go through. I like him very much. I was grateful for the quality of his care.”

Russell Gee of Cambridge is a race car driver who often has a Mazda flying at speeds between 90 and 110 miles an hour on the track. He has pushed the limits to 165 mph.

But even Russell couldn’t outrun a prostate cancer diagnosis.

Three years ago, at 63, Russell’s PSA test results were normal, but his primary care physician noticed a lump on his prostate during a routine physical exam.

Several weeks and a biopsy later, the prostate cancer diagnosis was confirmed by Dr. Graeme Steele of Brigham and Women’s Hospital, who came highly recommended by Russell’s friends in the medical field. Russell’s decision making and treatment began.

Russell has a thirst for research and a solid sense of what is best for him and his wife, Linde. Coupled with his fabulous sense of humor, he has come through prostate cancer surgery and treatment in a way that has not changed the quality of his life.

“There are a lot of things you can do to overcome the issues that can occur after surgery,” he said.

The good news for Russell was that his Gleason Score, which indicates the seriousness of the cancer, was not worrisome. So, after the diagnosis, Dr. Steele told him to stick with his plans to go race cars in Mexico, postponing the surgery for three months, until December 2009.

Before the surgery, on Dr. Steele’s recommendation, Russell visited a radiation oncologist and an oncologist – the former to decide whether he would opt for radiation therapy instead of treatment and the latter in case it was discovered that the cancer had metastasized.

Russell also discussed active surveillance with his physicians and, after much consideration, opted for traditional, nerve-sparing surgery over robotic surgery or radiation therapy.

“I wanted that thing out of there. I was healthy enough and young enough,” Russell said.

Immediately after surgery, Russell recalls that incontinence was the biggest obstacle he faced. Exercises aimed at tightening the pelvic muscles, called Kegels, which he started on Dr. Steele’s advice even before the surgery, helped, and so did time.

In terms of erectile dysfunction, Russell said he began taking Cialis daily after surgery and continues to do so, and he also uses a drug that Dr. Steele told him about, which is injected into the penis immediately before sex and produces an erection.

Russell recommends that men facing prostate cancer surgery talk to their doctors about all the interventions that help improve incontinence and erectile dysfunction and experiment with which options are best for them.

“You have to be willing to experiment and find humor in it,” he said. “There’s a lot of things you can do.”

Russell’s cancer had not metastasized outside the prostate, so he never had to go back to the oncologist, and now, he has a clean bill of health, but he does have his PSA levels checked every six months.

He is very grateful with the quality of care he received at Brigham and Women’s, which he calls “a world-class institution,” and values the personal relationship he developed with Dr. Steele.

Dr. Steele came to visit Russell the evening of his surgery and early the next morning, and over the following months, he was patient, fielding frequent text messages from a frustrated Russell, often late in the evening.

“He would always respond. He’d say, ‘You’re doing better than you think you are Mr. G.’ His personal skills are pretty amazing,” Russell said, adding, “I’m not the only guy who feels like they have a personal relationship with him.”

Many men don’t have anyone but their urologist to talk with about their fears after they are diagnosed with prostate cancer, but Tom M. had his own personal network.

When he received the news in August 2011 that his prostate biopsy was positive for cancer, the Lowell resident turned to two brothers and also to three friends who had all battled the disease. He was gathering information with which to make decisions on his own treatment.

Tom is 63 and a retired K-eight school principal. His primary care physician had been testing his PSA levels since he was 50. Starting about four years ago, those levels started rising, and his physician was keeping a watch on things.

In August 2011, the PSA level was high enough that Tom was referred to a urologist for a biopsy that showed he had cancer that seemed confined to the prostate. “He indicated the options I had available to me,” Tom said. “He said my job was to figure out which option I wanted.”

Enter Tom’s friends, who opted for varying radiation treatments; his younger brother, who had traditional open surgery; and his older brother, who also had beam radiation therapy.

On the advice of his younger brother, Tom had a consult with a team of specialists at Brigham and Women’s and met Urologist Steven L. Chang, MD, MS, who he turned to for his care.

Tom was most concerned with choosing a procedure that would eradicate the cancer and would give him the most hope of regaining urinary continence and erectile function after surgery.

After many discussions with Dr. Chang and with his personal confidantes, Tom chose nerve-sparing robotic surgery; he joked, “I found the ‘nerve-sparing’ particularly comforting.” He also thought the recovery could be quicker and the procedure offered the most protection from cancer spread.

Dr. Chang told Tom he could hold off on the surgery for a short time, so Tom scheduled the procedure for January 2012, and he began to lose the 15 pounds that Dr. Chang recommended he drop. He went on long walks with his dog, a Maltese, and he went to the gym several times a week. He also took part in his favorite pastimes, such as visiting the theater with his partner, Mitchell, taking photographs and studying his family’s genealogy.

Surprisingly, Tom had already started doing Kegel exercises, which strengthen the pelvic muscles that control urinary function; he learned about them even before he was diagnosed.

After the surgery, it was the catheter he required for about a week that bothered Tom the most, both because it was painful when he delayed taking pain medication and because it made it difficult to leave home with any amount of confidence. He stayed inside, and he walked laps through the rooms of his home as often as he could.

Tom made quick progress in terms of regaining urinary control and says he was confident about that control at roughly two months after surgery. Tom credits the robotic procedure as well as the Kegel exercises for the rapid recovery.

In terms of sexual function, at Dr. Chang’s suggestion, Tom took a small, preemptive dose of Cialis or Viagra to help increase blood flow to the penis and to thus begin healing. He says he is now at 80 percent of his former sexual function and doesn’t always need to rely on medication.

“I feel very fortunate to be able to say that,” Tom said. “My cancer was discovered early. I was young enough to consider surgery as an option. More importantly, I had a good surgeon and a good treatment plan.”