The Best Defense (Inside NACDL)

Inside NACDL

Access to The Champion archive is one of many exclusive member benefits. It’s normally restricted to just NACDL members. However, this content, and others like it, is available to everyone in order to educate the public on why criminal justice reform is a necessity.

“Inside NACDL” is dedicated to providing the NACDL membership with updates on a broad spectrum of NACDL matters, including staff changes, new benefits, innovative programs or policy initiatives. I try to make this column as useful and informative as I can. In that spirit, I want to detour from NACDL matters and address something quite different, something personal that should matter to all NACDL members and those who care about them.

Last March, without warning, and without any symptom whatsoever, I was diagnosed with prostate cancer. The diagnosis was made as a direct result of having had a routine Protein Specific Antigen (PSA) test. After a period of bewilderment, I did what most good trial lawyers do when preparing for a case — I immersed myself in as much information as I could get. I learned some astonishing things that I want to share with you.

First, I learned that prostate cancer is the most commonly diagnosed non-skin cancer among men. Nearly 219,000 cases are expected to be diagnosed this year. Tragically, nearly 27,000 men will die of the disease in 2008 alone. But remarkably, and this is the reason why I felt compelled to write this column, among those who are diagnosed early, there is nearly a 100 percent cure rate. The problem is that countless men, even those fortunate to have medical insurance, do not bother to get a PSA test — a simple five-minute blood test.

In its early stages prostate cancer produces no symptoms. Therefore, without the PSA test, you may not realize that this cancer is growing relentlessly, until it is too late. On the other hand, the PSA test is not a panacea. There are many false positives and negatives. That is, for many men a reading beyond the normal range may be the result of other relatively harmless causes. For others, the PSA may remain within the normal range even though cancer is present. Another important thing I learned is that the rate of increase of a PSA reading may be as significant as the actual number. But, of course, if you have never been tested, you will not be able to assess the rate of increase. Indisputably, a PSA test is a defensive procedure. It will alert you to the possibility of a potentially catastrophic disease so that you can make informed decisions about whether to pursue other diagnostic options.

In my case, a relatively low reading, just outside the normal range, coupled with a sharp increase, is the reason I was sent for the additional tests that confirmed the disease. That brings me to the final thing I learned: when discovered early, there are many treatment options, with new refinements all the time that increase the success rate and minimize side effects. After considering the options, I settled on robotic assisted laparoscopic prostatectomy, performed by one of the leading practitioners of the procedure, Dr. Ash Tewari at New York Presbyterian - Cornell Medical Center. I spent just over 24 hours in the hospital and only a week at home. All signs point to a complete recovery.

So to all NACDL members, whether you are a man or a woman with a man in your life whom you care about, please assert the best defense. Get screened. Talk to your doctor to determine when you should start PSA testing and how often you should do it. And do not hesitate to contact me if you think you can benefit from discussing any aspect of my experience. I am happy to help.

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