Top Military Health Official Promotes Prostate Cancer Awareness

By John J. Kruzel
American Forces Press Service

Sept. 12, 2008 - As a man afflicted with prostate cancer, the top Defense Department military health official has a unique perspective on the importance of promoting awareness about the disease. Now in his eighth year living with an aggressive form of cancer, Ward Casscells, M.D., the assistant secretary of defense for Health Affairs, understands the importance of early detection. But he realizes the stigma that members of the military culture often attach to certain screening methods.

"It's hard enough to get them to wear a motorcycle helmet," he said in an interview today, which falls almost on the ides of September -- National Prostate Health Month.

The doctor sought treatment in his forties when he began feeling vague discomfort in his pelvic region. After undergoing a colonoscopy, his doctor told him his Prostate-Specific Antigen (PSA) readout -- which measures the protein produced by the cells of the prostate gland, and can indicate the presence of cancer -- was at a normal level.

But by age 49, further testing showed that Casscells in fact had prostate cancer with a PSA level around 94 – well above the healthy average readout of four. In addition, he learned that the cancer had spread to other parts of his body.

Casscells believes that his early tests – a blood test and CAT scan – had been misdiagnosed. He says problems of misinterpretation can be mitigated by patients being prepared to inquire about their health.

"I always have a list of questions, and I don't leave until I get an answer," he said of his regular doctor's visits.

Casscells also urged current and retired military members age 40 to 50 to get a screening, and to consult multiple medical sources. For patients who are deemed "at risk," or who are on "watchful waiting," the doctor recommends changing their diets, becoming more active, increasing their intake of vitamin D. He also emphasized the importance of upping one's exposure to sunlight. "I bought myself a convertible and threw away the sunscreen," he said.

Cancer targeting the prostate is the most common form of cancer developed in men. Accordingly, he said, the onus is on servicemembers to encourage their buddies to seek treatment as their forties approach.

Casscells' story is one of unique intrepidity. After being diagnosed with his potentially terminal cancer, he experienced a common reaction: physical and emotional hardships, some depression, even grief. His response afterwards, however, was anything but ordinary.

The doctor, who had served as the Distinguished Professor of Medicine (Cardiology) and Public Health at the University of Texas Health Science Center in Houston, never missed a day of work. Later, after deploying to Iraq as a doctor in the Army Reserve, he underwent chemotherapy in Baghdad.

After learning that his improved health required a radical change in behavior, Casscells, who described himself as not very athletic earlier in life, adopted a regimen of running and a diet absent meats, despite his appetite for char-grilled burgers. He advocates similar modifications for afflicted, or at-risk, men.

"If I can do it," he said humbly, "anybody can."