Survivor’s Message: ‘Get Checked Early’ With A Family History of Prostate Cancer

Michael Justiz is a man in constant motion. His work as an independent commercial producer, a regular workout schedule, and family life with his wife and two kids keep him busy – but never too busy to take care of his health.

“My family history is extensive when it comes to prostatecancer,” he says. “My father had it, my grandfather had it, and my youngerbrother was diagnosed with it at age 42. It was something I was very cognizant of, and so I’ve been diligentabout going to my doctor.”

(Watch now: The Baptist Health News Team hears from prostate cancer patient Michael Justiz and Marcio Fagundes, M.D., medical director of radiation oncology at Miami Cancer Institute. Video by Carol Higgins and Anthony Vivian.)

While the most common risk factor for prostate cancer isage, the second is family history.  Infact, onestudy found that men with both a brother and father with prostatecancer had about three times the risk of being diagnosed as the generalpopulation.  So Justiz and his urologist metregularly to monitor his status with physical exams and PSA (prostate-specificantigen) level tests.

After years of watchfulness, in 2018, Mr. Justiz heard thewords he’d hoped to escape: “You have cancer.” If there was a bright side tothis news, it was that the disease had been diagnosed early, while stillconfined to the prostate.

“Once I went through the denial phase, I ended up going intothe ‘okay, what the heck are my options’ phase,” he says.

Surgery was the first option presented to Mr. Justiz. But havingseen the difficulties his brother went through after surgery, he was determinedto find a less invasive alternative.

“When I started researching, I had no idea there were somany radiation options out there. I heard about 40-day regimens, 20-days, andthen I heard about a five-day and I said — wow, that’s got my interest. Iasked everywhere and found out that Miami Cancer Institute offered the five-dayas an option if you qualify.  My amazingwife, Joanne, was the one who found Dr. Fagundes.”

“Radiation treatments can be delivered over a prolongedperiod of time, that would be the more conventional way of doing it,” says MarcioFagundes, M.D., medical director of radiation oncology at MiamiCancer Institute. “Now, in many cases we can do five sessions, whichis called SBRT: stereotactic body radiotherapy.”

After finding that Mr. Justiz was a good candidate for SBRT,the next step was determining which radiation modality to use.

“Miami Cancer Institute has all of the latest radiationtreatment modalities including protons, TrueBeam, CyberKnife and MR Linac, sowe can actually individualize the choice for each patient by determining which modalitywill produce the best radiation plan for the patient’s specific cancer,”explains Fagundes, who decided that MR Linac would be the best tool to use inthis case. “These different modalities work indifferent ways. MRI Linac, for example will actually visualize the prostate asthe beam is being delivered and if the prostate moves, the beam will be helduntil the prostate is back in the correct position and then the radiation deliverywill continue.”

Mr. Justiz wasintrigued by the technology behind the machine. “It’s an MRI machine with aradiation gun inside, so basically you’ve got smart bombing that can targetspecifically just the prostate and not damage the surrounding soft tissue,which to me sounds like a really smart thing to do. I think at the time therewere only 5 of these machines in the country, and Miami Cancer Institute hadone, right in my neighborhood.”

To further reducethe risk of damage to healthy tissue, Dr. Fagundes suggested the use of a softgel-like material, called SpaceOAR, which is placed prior to radiationtreatment and gradually absorbed by the body after treatment is completed. 

“The results ofstereotactic body radiotherapy are very good because we’re using very highdoses in just five sessions,” says Dr. Fagundes “To do this in the safestmanner, we use rectal spacer gel to push the rectum away from the prostate to furtherminimize dose to the rectum and essentially eliminate the risk of any severerectal injury from the treatment.”

Says Mr.Justiz, “The thing about the MR Linac is the treatment is longer than theregular radiation treatment; you’re in the MRI tube for up to 45 minutes. Butwhen you know that you’re only going to be doing five of them, it makes itmuch, much easier.”

Mr. Justiz’sradiation treatments didn’t slow him down a bit. Just days after finishing thefive sessions, he was able to fly to Washington State for a long-planned familyholiday celebration, something that would have been out of the question with aweeks-long treatment regimen or surgery.

Now, nine-monthspost treatment and cancer free, he’s passionate about sharing his experiencewith others.

“Ifthere’s one word I can share with men out there with a family history ofprostate cancer, it’s diligence,” says Mr. Justiz. “Run, do not walk to yoururologist. You’ve got to get checked out, and if you’re diligent about it, youmay just be early enough to get the easier treatment. The later it’s caught,the more difficult the treatment becomes and the less your chances of survivalbecome. So get checked early because that could be the difference between lifeand death.”