Now Scheduling Virtual Visits!
Yelp & Google Modal code

Da Vinci Prostatectomy Allowed Mark to Get Back To His Athletic Lifestyle!

Mark tells his story of a prostatectomy and traveling the road to recovery with the team at Urology Associates


Senior man on his mountain bike outdoors after bladder cancer treatment | Urology Associates | Denver, CO

I want to give shout out to Urology Associates on the great care I received on my recent Prostate Cancer diagnosis and treatment.

Here is my story and a bit of background about myself for context – I am 61 years old, and retired in 2018.  I am very active. I road cycle year round ~5000 miles a year with ~400,000 ft of climbing and do 2-3 weight and stretching workouts a week to maintain my core strength and flexibility.  Also, I am a hiker, back country skier and peak bagger. I have a replaced left hip (2017); right rotator cuff repair (2017 – cycling accident), scoliosis and L4 nerve compression (steroid injection treatment in 2017), AFIB (only one incident – cardioversion after a century ride in 2017), and a left ACL repair (1996). I am 5’ 8’’ and weigh 150 lbs.

My PSA score had risen from 2.5 to 5.0 over 24 months, so at the suggestion of my primary care doctor (Thank you Celinde Strohl!) I got a prostate biopsy. Biopsy  (12 samples) showed >50% cancer (Gleason 3+4) in all 6 samples on the left side, and >20% cancer (Gleason 4+3) in 1 sample in the center on the right side. Left side was a tumor, and its increasing size was creating some issues with urinating, both frequency and flow rate.

My wife and I had a consultation with Dr. Cowan after he did the biopsy. Dr. Cowan did a great job of laying out the treatment options, explaining the pros and cons, and patiently answering all of our questions. We felt no pressure to pick a specific treatment (surgery or radiation), and were encouraged to do some research and meet with both radiation specialists and surgeons. After that meeting, and some follow-up research (my wife and I are both scientists by training), we felt educated, informed, and empowered enough to make our own decision about the best treatment option

Choosing Da Vinci Surgery with Dr Eigner

My advice – do your homework on the treatment; take advantage of the information and consultations that are offered by Urology Associates, certainly not one size fits all. In my decision, the downside of radiation was the combined hormone therapy. I need the Testosterone for muscle recovery, and core strength / back health, based on a bad experience with induced testosterone deficiency while using Diclofenac (anti-inflammatory) for back issues.  After a very honest and informative discussion with Dr. Eigner (surgeon), we landed on the Da Vinci robot assisted laparoscopic surgery at Sky Ridge with Dr. Eigner and his team. Sky Ridge is a Center of Excellence for this type of surgery, which his what is recommended by the Prostate Cancer Foundation.

Very happy with the surgery and the result. Nerves on the right side were spared, cancer had escaped the prostate capsule on the left side, so Dr. Eigner removed those nerves. No cancer in surrounding lymph nodes or other tissue outside the prostate based on pathology. I just had my post-surgery (9 week) high resolution PSA test and it is down to 0.014 (very low score), which means that I don’t need any more treatment at this time, but will need periodic testing to ensure the cancer is not spreading.

If you have had surgery, you know that a lot of your treatment, pre-operative, and post-operative care is not only tied to your surgeon but to the larger medical team, both in the hospital and in the specialty practice. I continue to be very impressed with the PAs, nurses and staff at Urology Associates, and particularly Dr. Eigner’s team. My care at Sky Ridge was excellent. Liz Kelly answered my questions and gave me some good advice and tips prior to my discharge. Anna Willis has been a great advisor and coach in my overall recovery, and is very responsive to my questions, concerns, and suggestions.

My recovery has gone very well, and at 8 weeks, I am back to doing everything I was doing pre-surgery, including bike riding, weight lifting, and core exercises (though February weather has not been very outdoor cycling friendly). I am house cleaning with my wife again (no excuses), and gearing up for some spring home improvement projects!

Also, often after surgery, you never really see the surgery or specialty practice again. I can tell that Urology Associates is in it with me for the long haul on my recovery. From the start, it has felt like real partnership with a reciprocal commitment to my treatment. They are very honest and open about the ED issues that take awhile to work through after prostate surgery (nerve related) and have a treatment plan in place to help me monitor and improve this in my long-term recovery. They are surprisingly easy to talk to about post-operative ED and treatment options.

Weighing the Positives and Negatives of Surgery

Again encourage you to talk to the folks at Urology Associates and let them help you figure out the best cancer treatment option for you!

Pluses

  • Surgery seems to have gotten rid of the cancer, and unless there is some change in my PSA going forward, my treatment is done!
  • Surgery was minimally invasive, fast recovery with minimal side effects. Stopped wearing pads after 4 weeks (incontinence ended – except for stress events)
  • Was able to stay active and see real progress in recovery. Could exercise (walk) immediately, do pelvic floor / core rehab exercises after 2 weeks, do 50% effort weights, core and cardio workouts after 4 weeks, and bike riding (30 miles – 2 hours) after 6 weeks. After 8 weeks back to full effort on core, strength and cardio, and relatively normal bike riding (can’t be  100% sure due to winter weather restrictions).
  • Urination post surgery is amazing, I can empty my full bladder in <20 seconds, which prior to surgery was often a 2 minute long dribble fest.
  • I did not have to do the hormone therapy (associated with radiation) which based on my previous experience with drugs that suppressed my testosterone was not good for me with respect to building and maintaining strength in my back and cardiovascular fitness.
  • Most surprising, I can still have an orgasm (yes, I AM going to talk about this), even though I cannot yet have an erection. I spoke with Anna about this and did some reading and ejaculation, erection, and orgasm, while related are actually independent. Obviously, also requires a partner willing to try some different approaches to sexual intimacy. Reminding yourself and your partner that you were not killed by cancer sort of puts things in the right perspective!

Minuses

  • Surgery is well, surgery. You have to spend time in the hospital, you have to get general anesthesia and be intubated. There are risks of complications like bleeding and infections. You have to have a catheter for 10 days, and put up with the exercise restrictions, incontinence, and erectile dysfunction, which is a longer-term effect; however, considering the complexity of this surgery and all the detailed “re-plumbing and re-wiring” that gets done, the recovery is amazingly fast, and in my case, the results are outstanding!

Could not be happier with the quality of care I am receiving from Urology Associates!

 

– Mark S.

His Successful Prostatectomy Proves All Urologists Are Not Equal

Our patient wrote this story about his life-changing treatment for BPH and elevated PSA with us, after he lost confidence in his previous urologist.


Let me begin by saying that I had suffered with an enlarged prostate for about 20 years.

I was referred in 2012 to a urology practice by my primary care physician. After examining me, the urologist suggested that I have a prostate biopsy, which I refused. I was then prescribed medication to help with frequent urination and was advised to monitor any changes in PSA (prostate-specific antigen) levels along the way. This mode of treatment continued for a number of years with moderate relief.

Doctor getting ready for a prostatectomy | Urology Associates | Denver, CO

Eventually I wound up seeing the surgeon at that practice in February 2017 for a consult.

I was given his opinion, which was to have a robotic assisted laparoscopic simple adenomectomy (nodule removal) of the prostate for large volume BPH (benign prostatic hyperplasia).

I remember afterwards saying to my wife that there was no way that I would elect to have the surgery described, due to a lack of confidence in the surgeon.

The surgeon stated the most significant benefit I would likely experience after the surgery would be somewhat lessened overall frequency of urination and fewer sleep interruptions.

Potential benefit as explained to me did not outweigh invasive surgical risk in my mind.

I said, at the time, that the procedure described would have to be on an emergency basis.

Fast forward to the ER

Well, fast forward to July of 2018. I went to the bathroom one night and was unable to urinate, wound up in the emergency room of my local hospital and was consequently catheterized. This was not good. I asked the doctor in charge if he had a recommendation for a urologist. He referred me to Dr. Brad Bell at Urology Associates, and I made an appointment with Dr. Horne, who is one of the founders of the practice.

I must say that from the initial visit with Dr. Horne I was very impressed. His bedside manner was excellent and the way he explained my options for fixing the problem, which was a simple prostetectomy, was clear and concise. [A prostatectomy is partial or complete removal of the prostate.] When he was done with the exam and subsequent explanation, I felt so confident that I wanted the surgery as soon as possible.

I was scheduled for a follow-up appointment with Dr. Bell and Jakob his physician assistant. I again was impressed with the way I was treated from the front desk to the consultation with Jakob. Dr. Bell was in surgery that day.

Put at ease before prostatectomy surgery

The initial surgery date of September 13 was cancelled due to a urinary tract infection. After taking medication to treat the infection, a surgery date was set for October 24.

I met Dr. Bell for the first time a few days before the surgery and was made to feel at ease and confident that all would be okay. And indeed it was.

Dr. Horne assisted with the procedure.

It is now January 2019 as I write this and my recovery, I am told, was faster than expected.

My overall experience at Urology Associates was excellent and one of the best decisions I have ever made. If I had to do it again, I would in a heartbeat.

Dr. Bell is an excellent surgeon, he genuinely cares for his patients and it shows. Jakob, his right-hand man, is integral to the functioning of the unit. I am so glad to have had the opportunity to meet and benefit from his care. Overall I could not have had a better experience under such dire circumstances.

I am now free from having to map out where bathrooms are prior to leaving my home.

I no longer get up every two hours during the night to pee.

I no longer take prescribed medication for overactive bladder.

I no longer worry about where I am seated in a crowded room or theatre.

Thanks again for all that you do at Urology Associates.

– Clifton B.

On Your Mark, Get Set, Go Become a Cancer Survivor

Elaine shares her story of how faith in herself, Dr. Fagelson and God helped her reach the finish line – now her story serves as motivation for others.


Cancer survivor | Elaine running a 5k race | Urology Associates
Elaine fulfilled a lifelong dream of participating in 5K races.

The past few years have been full of refinement, change and emotional ups and downs.

After the passing of my father, my mother and I became roommates so that I could take care of her physical and medical needs. This was certainly an adjustment, but I have strived to use it as an expression of love and servitude.

Then in August of 2015, I suffered an injury that ruptured a disk in my back and left me in severe pain. I was unable to walk or even stand up for several months. I went through extensive chiropractic care and wellness therapy that not only helped the healing process, but also opened my eyes to the importance of leading a healthy lifestyle.

From there on out, I have made a point to improve my health and wellness. Through it all I got a job promotion, and on top of that I have dropped 77 pounds – and counting! This allowed me to fulfill a long-time dream of participating in 5K races.

Unfortunately, among all of these peaks and valleys, I also heard the words that no one ever wants to hear: “You have cancer.”

From finish line to emergency room

After recovering from my back injury and making a point to improve my health, I was feeling great. I had even started participating in many other races.

When I got home from one of my races, I started to feel sick. I thought maybe I had the flu, but did not think much of it until I went to the restroom and noticed blood in my urine. Even though I did not have any other pain or concerning symptoms, I went to the emergency room right away.

In the ER I underwent a variety of scans and testing that revealed a mass on my right kidney. From there I was referred to a urologist through UCHealth who performed more invasive testing to determine that the mass was kidney cancer.

This is news you just hate to hear in any sentence. It causes the body to be numb. It causes the mind to race. In that brief instant you go through a whirlwind of thoughts that range from What am I going to do? to How do I tell my family? to Is this a death sentence?

Then, just as quickly, you must gather yourself and realize that the doctor is still talking to you. After you hang up the phone you sit in silence, try to collect your thoughts and figure out what the next step will be.

I would be lying if I didn’t say that one of my first thoughts was I’m going to see my father sooner than I thought. But I knew I had to pull myself together. I had to put one foot in front of the other and lean on my loving God. I had to muster the strength to inform those closest to me of the news and make sure to protect those who needed to be protected (my mom). Then, I did the best I could to move forward with my life.

The run for my life

The first doctor I saw encouraged a very aggressive treatment plan that would include eight weeks of chemotherapy and a surgery that would require cutting my back open to remove my kidney. In my heart, I just knew this was not the right plan.

I decided to do some research on my own and trusted that God would help me find a better treatment option for my diagnosis. During my search, I came across a book called The Cancer Killers that explains nutrition, fitness and detoxification advice essential to confronting cancer. I began adjusting my eating habits and lifestyle choices accordingly.

Around that time a friend from my church revealed that she had also battled kidney cancer and shared that she received her treatment at Urology Associates. Not long after, I learned that a co-worker had received care from Urology Associates as well. They both had wonderful things to say about the facility and doctors, so I took a leap of faith and contacted the clinic.

After just one appointment with Dr. James Fagelson I knew that I had made the right choice to forego the treatment plan suggested by my first doctor. Dr. Fagelson was optimistic from the very beginning and took my concerns into consideration. He was also confident that he could use a minimally invasive surgery to remove my kidney, which meant that he would not have to cut into my back.

On August 23, 2016, I underwent the surgery, which was successful. I was up and walking the next day and follow-up tests revealed that the cancer had remained contained to just my kidney. Dr. Fagelson believes that the work I put into getting healthy probably made a difference in the results of my treatment.

As I learned from The Cancer Killers, good health helps healing. Dr. Fagelson also told me that if I had not lost weight after my back injury, the tumor may still be hiding and undetected.

As a preventive caution, Dr. Fagelson had me undergo a bladder scope about three months after my surgery to make sure that additional tumors had not developed. Unfortunately the scope results showed three malignant tumors on my bladder. On January 5 I had a surgery to remove all of those. I am so thankful that Dr. Fagelson recommended this scope, because who knows how long those tumors could have gone undetected if he had not.

Today I am blessed with good health. Recent CT scans have come back clean, indicating that there are no other cancerous tumors in my body.

Racing on as a cancer survivor inspiration 

Cancer survivor | photo of Elaine Brimage after weight loss and cancer free | Urology Associates
Elaine has taken control of her health and wellness by continuing to lose weight and following her dreams.

I thank God every day for Dr. Fagelson and the care that I received at Urology Associates. Every step of the way the doctors and staff have been so sensitive and understanding to my fears and needs. I have truly never felt so cared for in my life, which is comforting when facing something as challenging as cancer.

I strive to use my journey as a tool of inspiration and hope for others. Through this process, I have found a passion for motivating others. I have had the honor of sharing my story at a Cancer Killers workshop and I also write monthly blogs dedicated to uplifting others. It is hard to put the journey of life into words, but I hope I can help others believe in the power that they have to overcome difficulties.

The past few years have been filled with ups and downs, but through it all I have found personal passions and improved my health and wellness. In fact, on April 22, 2017, I will be participating in Pat’s Run, a 5K race in Phoenix, Arizona.

This race just so happens to be on the one-year anniversary of my kidney cancer diagnosis.

I would like to leave you with a poem that I wrote while I was dealing with the challenges of the past few years.

This is my heart today…

To Be Free From Pain

Elaine Brimage II

The heart deals with many emotions
We sometimes don’t know how to channel
And when they all come falling down around us
Fears and tears can also be hard to handle. 

It’s not always easy to find the right words
When someone who cares asks if they can help
But what a comfort to know people care for you
And it makes your heart want to truly melt. 

With the complications and pains we’re dealt
It gets hard not to want to give in
Then we’re reminded of the wonders of His love
And muster up the faith to want to win.

Though the battles may prove to be challenging
Something in us says let’s fight the fight
And when the enemy is attacking against you
You know in your spirit you are doing right.

So, through all the pains and tears
We must remember to look toward the light
Cause in that we find the sun and rainbow
And remember things again will soon be bright.

Simple Cancer Screening Saved Gary’s Life

Controversy over getting a PSA test caused him to pause screening for two years, but a change of heart in year three found prostate cancer.


Cancer screening | Urology Associates CO and the title attribute Cancer screening | Urology Associates CO | doc and patient talkingGary, from Colorado, had a routine going with his primary care physician: Every year they evaluated his prostate specific antigen (PSA) levels that can indicate possible prostate cancer. Every year the cancer screening showed that levels went up a bit.

“When all this came out about PSA not being effective and all that, my primary care physician (PCP) and I had a conversation about that two years in a row,” says Gary, who is 64 years old. “I had a PSA test every year up until then and we looked at the new evidence and said, Well let’s not do it. So for two years I didn’t have the PSA.”

The controversy about PSA cancer screening refers to the United States Preventive Services Task Force (USPSTF) issuing a recommendation in 2008 against PSA screening, despite objections from the urologic community. As a result, primary care providers, like Gary’s, have since offered fewer prostate cancer screening tests.

Urologists, including all of the physicians at Urology Associates, have been raising the alarm to continue PSA testing. And many primary care physicians, like Gary’s, also rethought it all.

“In the third year, my PCP had done enough research on his own, and he said, Let’s put the PSA back in. My PSA levels were at the threshold when things start to go on,” Gary recalls. “We could look back over the years and see a linear rise with my PSA. So he referred me to Urology Associates, and I went to see Dr. Edward Eigner.”

What followed was a digital rectal exam and an ultrasound-guided biopsy of Gary’s prostate, with Dr. Eigner removing 12 samples for laboratory examination. Four showed prostate cancer of intermediate aggressiveness. If you’re going to have prostate cancer, that’s pretty good news because it means they caught it early – thanks to the wise decision to resume PSA testing.

Good choice on prostate cancer screening & treatment

Next came the big decision of how to treat it, whether to treat it. Dr. Eigner told Gary that if he were 10 years older, they might do nothing.

“My wife and I had a pretty extensive discussion with Dr. Eigner at his office at Swedish Medical Center about all the options. He recommended that I look into two options, surgery or radiation therapy using the CyberKnife,” says Gary. “That discussion with Dr. Eigner was a big help.”

“I learned even more online and particularly via Urology Associates’ patient portal. I had several conversations with Dr. Eigner, and he was able to answer questions I had from my reading,” Gary says. “All of it worked quite well: I knew where I was going, what my options were, what the side effects were. I had really comprehensive information from the start.”

Gary decided to undergo CyberKnife treatment at Anova Cancer Care, which has a clinical partnership with Urology Associates.

“I went through CyberKnife and it was easy. It requires just five treatments instead of 40 with standard radiation,” says Gary. “That’s the route I chose.”

He finished the treatments in July 2015. Gary had a minor bladder issue in March that was easily treated.

CyberKnife turned out to be a good choice for Gary. “Since then, my PSA numbers are down,” he says. “Things are going pretty good.”

Gary to men: “Get your PSA tested”

Gary was wary of prostate cancer treatment at first, well aware of the problems that can arise from surgery and the side effects, such as incontinence, erectile dysfunction and others.

“One of the down sides I’d heard was why bother with a PSA test because of all the false negatives and positives. And the biopsy could be more damaging than the cancer itself sometimes,” Gary recalls.

“But that turned out not to be the case. It was really simple. It sounds unpleasant, and it’s not going to be on your top five things to do, but it was not bad,” he says. “I was fine in a couple of hours. With that ultrasound-guided biopsy technique, the doctor can see pretty well. And Dr. Eigner is a quite skilled, dedicated surgeon.”

Once he learned he had prostate cancer, Gary got in touch with his three brothers and advised them they should have a PSA test. All now monitor their PSA level through routine testing.

“It’s our genetic makeup,” says Gary. “I was having prostate issues years ago, and my urologist asked if prostate cancer ran in the family. I didn’t know, so I called my dad and asked, Have you had any prostate issues? He said, I don’t even have a prostate anymore. That’s how I learned it ran in our family.”

That’s one thing Gary says men should know: The medical history of prostate cancer in their families. That puts them at higher risk.

“I take my hat off to my primary care physician for deciding to go back to the PSA testing,” Gary says. “And sure enough we caught it. If not, in 10 years it would have been all over my body.

“Get the PSA test: It’s really cheap and really easy,” advises Gary. He adds that if men see the PSA number rising, they should have a good discussion with their urologist. The doctor will let them know if they need a biopsy.

He says to find a doctor like Dr. Eigner who does ultrasound-guided biopsies to determine if you have prostate cancer. “That’s the best thing a man can do.”

Ready to schedule your own PSA test? Request an appointment

Rising PSA Had Gary Down in the Dumps, But CyberKnife Changed All That

A typical man who avoided prostate diagnostics, Gary turned to CyberKnife when the tests found cancer – and now recommends it to others.


 

Anova Cancer Care patient Gary and his wifeMeet Gary, your typical 69-year-old man. He enjoys being part of his grandson’s quarter midget race team traveling the United States, working part time at Evergreen Day School repairing everything that gets broken and working out regularly using a high-intensity slow motion routine to keep him strong, activities not uncommon for many men his age. Similarly, Gary shares something else in common with thousands of other American men ­– his PSA (prostate-specific antigen) has been rising steadily for years.

In response to this, Gary’s primary care physician was constantly nagging on him to run diagnostics, a reasonable request Gary resisted for as long as he could. Finally, he gave in and his doctor discovered lumps in his prostate. A subsequent biopsy confirmed that Gary had prostate cancer.

“I went home, I did all of the internet research and I basically found out that if you have prostate cancer you have three choices: you end up with impotence, incontinence or death,” said Gary. “After that I was really down in the dumps.”

This wasn’t Gary’s first cancer rodeo. In fact, a few years back Gary had been diagnosed with stage 4 melanoma and given six months to live. Spoiler alert: he fought a hard fight and has been cancer-free since 2004.

This time Gary visited Urology Associates’ Dr. James Fagelson, a urologist who specializes in minimally invasive robotic surgery using the da Vinci system to treat prostate disease and prostate cancer. Despite his expertise in removing the prostate, Dr. Fagelson suggested that Gary speak with Anova Cancer Care, a partner of Urology Associates, about an innovative type of robotic radiosurgery called CyberKnife.

Saving his prostate, saving his virility

The doctors at Anova Cancer Care really convinced me that CyberKnife treatment was the way to go, said Gary. “I had my doubts because it sounded too good to be true, but I really did not want to have my prostate removed.”

After years of a good relationship as Dr. Fagelson’s patient, Gary relied on his opinion as to whether or not he should have the CyberKnife treatment or a prostatectomy using the da Vinci robotic device. Dr. Fagelson told Gary that if he were his age and going through the same ordeal, he would go with CyberKnife.

“That was surprising to me because he’s an expert in da Vinci robotic surgery,” said Gary. “That made up my mind. I did some research, relied on the doctor’s expert opinion and decided to undergo CyberKnife treatment.”

It was a “piece of cake,” according to Gary. He received five rounds of CyberKnife radiation treatment with virtually no discomfort. The staff at Anova Cancer Care gave him kind and thorough explanations, and Gary felt at ease calling in the days after the treatment with questions and concerns.

“When the Anova clinical team tells you to call them with problems, they mean it. You aren’t bothering them. They are there to help and they make that very clear,” Gary said.

“And I didn’t anticipate feeling this good. I’m 69 years old, just got off of my FloMax and my sex life is better than it was before the treatment.”

Gary still fervently recommends Anova Cancer Care to patients considering CyberKnife treatment.

“[The Anova Cancer Care] team are geniuses with the procedure,” said Gary. “I would tell anyone who is worrying about CyberKnife treatment to not even think about it and just do it. Don’t worry!”

For Men with BPH Symptoms, No Drugs, No Surgeries, Just Relief

Two Colorado men experience what life was like before BPH – and Rezūm therapy


Benign prostatic hyperplasia (BPH) is an enlarged prostate and just about everyone knows that to have it means urinating a frustratingly small amount – and then needing to urinate again, and again, and again.

“A traffic jam on the interstate was a nightmare,” says 65-year-old Clarke Omdahle of Littleton, Colorado. “In short, I always planned my daily activities with the closest bathroom in mind.”Men with BPH | Rezum Therapy | Urology Associates

This was difficult for Clarke. After his morning coffee and using the bathroom before leaving work, he would still have to stop and find a bathroom after several miles on his way to work.

BPH symptoms weren’t very nice to 70-year-old Ken Whiteacre either, also of Littleton. “I would get up, mostly in the middle of the night – about 4 to 5 times – to go the bathroom,” says Ken. “It was often very hard to get back to sleep after that.”

Ken and Clarke faced the same scenario: If they didn’t get to a bathroom immediately, it was often too late. “I wore dark colored pants and pads as safeguards after a multitude of accidents,” Ken confides.

Not fun but not unusual. Benign prostatic hyperplasia is the most common diagnosis made by urologists for men between the ages of 45 and 75. BPH is the most common health issue of the prostate. It is not linked to prostate cancer and does not cause problems in all men who have it. But for those who do, it can be tough.

After visiting Dr. Barrett Cowan at Urology Associates, Clarke discovered that although his prostate was enlarged and his PSA was 8.0, which was high, he did not have prostate cancer. That was good news.

Traditional options for managing BPH symptoms include medication, surgery, lifestyle changes and active surveillance. Although these are still viable methods for treating the condition, both Ken and Clarke were looking for new and innovative alternatives. Luckily, they were both patients of Dr. Cowan.

Their Rezūm experience

Ken and Clarke were both looking for an option that wouldn’t require them to have surgery or take medication for the rest of their lives. They were both healthy men who led active lives and wanted to address the issues that BPH was causing them, head on.

Dr. Cowan determined that both men were good candidates for a new treatment procedure for BPH called Rezūm. Urology Associates was the first practice in Colorado to offer Rezūm, which uses stored energy that naturally occurs in water vapor to shrink prostate tissue in men with BPH.

In Rezūm therapy the physician inserts a small device through the man’s urethra that delivers water vapor directly into the prostate tissue that has been enlarged by BPH. The water vapor then kills the enlarged cells and the reduction in tissue relieves most of the bothersome symptoms.

As one of the lead investigators on the clinical trials of Rezūm, Dr. Cowan was very familiar with the procedure. And Clarke became the first person in the state to undergo the Rezūm procedure.

“As usual, the fear of the unknown (and the fact that a bunch of people were messing with my junk) made me pretty apprehensive,” says Clarke. “After the prep work, the actual procedure only took five minutes and it didn’t hurt.”

And it worked. According to Clarke, “I no longer have that nagging urge to find the closest bathroom at all times. The urine flow is stronger and I feel I am completely emptying my bladder.”

Ken also experienced great results after having the Rezūm treatment done.

“I’m down to getting up only about once a night, which is pretty standard for most men my age,” he says. “I feel like I’m pretty lucky compared to other men my age who have to take all kinds of medication for similar issues.”

Today Ken rides his bike, volunteers and does all of the things he enjoys with no problems. “The procedure is very quick and the staff and Dr. Cowan made it very simple and painless,” says Ken. “I was very happy with the Rezūm procedure.”

Clarke recalls his experience working with the Urology Associates staff and doctors to be very professional, supportive and understanding of the challenges he faced.

“I will always remember what Dr. Cowan said to me as I went through testing, procedure and recovery,” said Clarke. “He said, ‘You may hate me now, but you’ll thank me later,’ and to that I say thank you, Dr. Cowan – you were true to your word.”

Hardly Par for the Course Prostate Cancer Treatment

Diligent doctor checkups & radiation seeds removed this avid golfer’s slow-growing prostate cancer


prostate cancer success story | Brachytherapy treatment at urology associatesAs a 62-year-old self-employed retirement and financial planner for the past 40 years, James had a lot on his plate running his own business. Visiting the doctor wasn’t always his top priority.

Thankfully, James’ wife Toni, who happens to be his business partner as well as a registered nurse, made sure he went to the doctor each year. “I owe a great deal of my health and successful prostate treatment to her,” says James.

Seven years ago, following one of those annual checkups, James’ primary care physician discovered elevated prostate-specific antigen (PSA) levels. The PSA level is recognized as the single best indicator for detecting prostate cancer occurrence and severity. His level was high enough to require a visit to a specialist.

James came to Dr. Brad Bell at Urology Associates. The relationship between doctor and patient is key — especially when treating cancer. For James and Dr. Bell, this was the easy part. The two struck an instant bond with each other from the beginning, and James said he felt like he could trust Dr. Bell from the start.

For men in their 70s and 80s diagnosed with prostate cancer, it’s unlikely that the prostate cancer will be life threatening. However, each prostate cancer case comes under different circumstances and with varying patient goals, so it’s still important to assemble a treatment plan that both the patient and doctor agree on.

After his visit with Dr. Bell, James learned that the cancer was slow growing and contained within the prostate. Dr. Bell discussed the options and they decided on a treatment which utilizes radiation seeds placed internally.

Radiation seeds in, prostate cancer out

“I felt really comfortable with Dr. Bell and his strategy for treating my prostate cancer from day one,” said James. “He always explained every last detail, but also in simple terms that were easy to understand.”

In James’ treatment, radiation seeds were inserted directly into the prostate and released radio waves that killed the cancer cells but did not travel far. Treating prostate cancer this way has taken some flack in the past because of the reported incidence of side effects and loss of sexual function.* [see Author’s note]

“I didn’t experience any negative side affects,” says James. “Radiation may not be right for every man, but it certainly was for me.”

James says the procedure lasted a couple of hours and according to both him and Dr. Bell, the procedure went perfectly. “I couldn’t imagine a much easier cancer treatment,” says James. “I was out golfing later that week.”

Today, James’ PSA level is about as close to zero as it could be—a minuscule .01. James still sees Dr. Bell once a year to evaluate his PSA level, which continues to remain low.

“My recommendation is for every man to be aware of how common prostate cancer is and to treat it as quickly as possible,” says James.

*Author’s note: As of 2016, Urology Associates does not offer this treatment to patients and instead recommends CyberKnife technology for a majority of radiation treatments.

Learn more about prostate cancer 

Two Down but Testicular Cancer Free

Pete earned his “racing stripes” from surgery to remove his testicles at Christmas time — and they proved to be a life-saving gift.


Truck on the roadIf people like Pete Bowes weren’t tirelessly at their work, this country would grind to a halt. Pete has driven a 53-foot semi-truck every day for the past seven years!

Like other truck drivers, he often spends days many miles away from friends and family, and doesn’t have the luxury of a “normal” schedule. Pete’s usually on the road during the holiday season when the rest of us are enjoying quality time with our families.

But Christmas holiday 2014 was unlike any other he had ever experienced.

All through that year, Pete had struggled with an abnormal hardening in his testicles. They were also growing smaller and less and less sensitive to touch.

“I knew something wasn’t normal,” says Pete. “You could have kicked me in places that men do not like to be kicked, and I wouldn’t have felt much.”

After visiting his primary care physician about the issues, Pete had an ultrasound scheduled on December 24, 2014 – Christmas Eve. When the ultrasound was completed, Pete began to drive away from the office only to be called back immediately. The results were not good and they wanted to send him to a specialist.

We need to fix this, now

Having been a patient of Urology Associates (UA) in previous years, Pete reached out to and made an appointment with Dr. Edward Eigner – for that same afternoon.

“Dr. Eigner took one look at my history and my ultrasound results, and told me, in a truthful manner, that something was very wrong and it needed to be addressed,” says Pete. “He asked me what I was doing that Saturday, December 26 – the day after Christmas.”

Although uncertain about the specific prognosis, Dr. Eigner understood that if any testicular growth is found, it tends to be malignant testicular cancer and could get rapidly worse.

“It was a worrisome situation. The ultrasound and the exam were distinctly abnormal and there was a real threat of a dangerous issue ongoing,” says Dr. Eigner. “We zeroed in on the threat and wanted to promptly address it.”

Despite the holiday, Dr. Eigner scheduled Pete on the coming Saturday for testicle removal, a surgical procedure called an inguinal bilateral orchiectomy in which both testicles are removed. Dr. Eigner and the staff took the time to carefully explain all of the pre-operational details of the procedure, what was going to happen and what Pete could expect after the surgery.

“The fact that all of this happened over the holidays certainly complicated things. There were lots of staff who had taken time off to spend with their families so it was a little hectic,” says Pete.

“They saw me on a Saturday – the Saturday after Christmas at that. But that’s the level of concern and compassion that was displayed. Dr. Eigner and the staff at Urology Associates were willing to make it work, no matter what day it was.”

Dr. Eigner performed Pete’s surgery on Saturday morning and he was released for recovery that afternoon. Pete recalls both a UA nurse and a physicians assistant calling him to make sure he was comfortable and had everything he needed.

“I was as comfortable as you can be with two four-inch incisions in your abdomen,” Pete adds with a laugh. He now comically refers to the incision scars as his “racing stripes.”

While Pete recovered, UA sent his results to Cleveland Clinic for a second opinion on the pathology report, much like the online second opinion service UA also offers. That’s where things stood for the next few weeks, waiting for the results to come back from Cleveland Clinic.

“They told me that they still didn’t know what it was,” says Pete, “but they knew what it wasn’t – which was malignant.”

Pete found that the diagnosis was a benign tumor due to fibrous scarring from previous trauma. Although the tumor was benign, his testicles had been shutting down for the past few years.

“Throughout that entire process, Dr. Eigner and his staff were there for me and were more than willing to answer any questions that I had,” Pete says. “Ultimately, it was the best news that I could have received in that situation. My ‘kids’ are gone, but I’m cancer-free!”

Active 81-Year-Old Takes Cancer and Kidney Loss in Stride

When diagnosed with cancer, always active and healthy Jean took a step back and relied on her faith to help her through a trying time.


Dr. Bell's patient

Jean Standish is one tough cookie. In fact, she laughs as she remembers receiving the news of her kidney cancer diagnosis early in the summer of 2014 prior to a planned trip to support her grandson who is a professional mountain biker.

Dr. Brad Bell suggested that I try to take it easy on my trip that summer, prior to my surgery, to which my husband humorously responded, Do you have a pill that will make her do that?

He knew that for Jean, taking it easy wouldn’t be easy.

Originally born in Nebraska, Jean and her husband settled in Colorado where they raised two boys. Jean returned to the working world when they were in high school, acting as the business manager for a senior facility for 16 years. She always spent much of her time on-the-go, traveling with her husband, skiing, hiking, camping and she still walks regularly. Taking it easy just isn’t a part of her DNA.

Jean, who lived in Conifer, Colorado, consistently received clean bills of health during her yearly physicals. Which is why she was shocked one May morning in 2014 to discover a large amount of blood in her urine. After receiving a computed tomography (CT) scan from her primary physician, the staff recommended that she see Dr. Bell at Urology Associates in Denver.

With her husband by her side for serious support, Jean visited Dr. Bell.

“He seemed young, but he was extremely knowledgeable and upfront,” recalls Jean. “He told us that it could be cancer, but they’d have to do a bit more checking.”

Jean remembers asking, “How could this be?” After all, she had always been an extremely active and healthy person. Dr. Bell scheduled a biopsy, just in case.

Her faith guided Jean to kidney removal

In June, Jean was informed that her cancer was a renal pelvic cancer (similar to a bladder cancer in which the cancer affects the cells attached to the kidney). Unfortunately, these cells do not respond well to chemotherapy or standard radiation, and surgery remains the gold standard for treatment.

Dr. Bell, Jean and her family reviewed her films and performed a ureteroscopy biopsy of the abnormal cells in the renal pelvis. Upon return of the diagnosis, they discussed her treatment options together. Surgery to remove her entire kidney and ureter (nephroureterectomy) was recommended and monitoring, though not recommended, was also discussed.

It was a tough predicament. At the time Jean was 81-years-old, a risky factor in performing this surgery, because it meant that her health would ultimately depend on the successful function of her remaining kidney.

She thought it over carefully. After relying on the advice and support from her friends, family and acquaintances at her church and on her confidence in the team at Urology Associates, Jean made the decision to schedule the surgery.

“I have a great faith that the Lord is always looking out for us and guides us,” said Jean of her decision.

The kidney removal surgery was performed September 11, 2014. More than a year afterward, her regular check-ins and cystoscopies have shown no problems.

“She came through her surgery with flying colors. No doubt her many years of good health and staying active played a huge part in her successful recovery and ultimate outcome,” said Dr. Bell.

She admits that she experienced her own personal frustration during the recovery and recuperation period. “I suppose I need to realize that I was 81 at the time, not 18,” Jean said with a laugh.

Today, aside from a slightly slower gait and a newly found appreciation for an afternoon nap, Jean still enjoys being active and traveling. In the past few months she has returned to participating in water aerobics and continues to volunteer in the community and at her church.

Through all of the fear and emotions Jean relied strongly on her faith and the belief that she had much more life to enjoy – including five grandchildren ranging in age from 17-25. In fact, every week Jean sends each of her grandchildren in college a care package.

“I like to stay in touch and stay connected since we don’t live near each other,” said Jean. “They may be kind of strange care packages, but I think that they enjoy them and they respond.”

Staying connected and involved, Jean lives her life to the fullest. This woman’s drive and resiliency ensured that cancer was not the end of her story.

Today Jean remains grateful and appreciative of Dr. Bell and his staff for their care and attention throughout the entire process.

“Jean and I, and her family, became a team,” said Dr. Bell. “She is a shining person and I feel fortunate to have been a part of her care.”

He is also personally inspired by Jean’s unwavering dedication and support of her grandson’s biking career. “Jean is an amazing person and exactly who I would want on the sidelines cheering me on,” said Dr. Bell. “Our goal was to get her to her personal finish line so she could get back to cheering for her loved ones at their finish line.”

Kidney Gone and Cancer Free

Diagnosed with kidney cancer, Don Bosson found both comfort and success at Urology Associates.


Don Bosson’s urine was darker than normal one day after he finished his morning coffee. A little concerned, Don figured he was just a bit dehydrated. Physically, he felt fine and went out for a round of golf, making sure to drink more water throughout the day.  When he returned, his urine was still brown – even darker.

“I knew something had to be wrong,” says Don. “I didn’t want to overreact, but I booked an appointment with my internist that week.”

Don’s internist sent him to Urology Associates where within a week he saw Dr. James Fagelson. Dr. Fagelson ordered an MRI, sent Don home and told him he would call him when he had news. Three days later, Dr. Fagelson called with some less than promising words, “We have a problem, how about you come in and we can talk about it.”

The diagnosis of kidney cancer

Don had kidney cancer and was shocked with the reality of his diagnosis. But he and Dr. Fagelson struck a bond immediately. Not only was Dr. Fagelson’s office wall plastered with specialty degrees from impressive institutions, but it also included dozens of photos of his family, children and grandchildren. Don, who was thinking about his family, children and grandchildren, says he somehow felt at ease during the entire appointment.

Dr. Fagelson showed him the MRI results and exactly where the cancer was. “He couldn’t have explained anything better or been nicer about the whole situation. I related to him immediately and I knew I was in good hands after that day,” says Don.

Many people are born or live with only one kidney instead of two. The kidneys are two small organs that sit below the rib cage and work to filter blood and produce urine – essentially cleansing the urine system. The human body can support all cleansing functions with only 75 percent of one functioning kidney. It’s possible to live with just one kidney and many people do, leading normal, active lives.

Just over 61,000 Americans (mostly over the age of 65) are diagnosed with kidney cancer each year. Twice as many males get kidney cancer as do women. Kidney cancer is normally found before it spreads to other organs, however the tumor masses tend to grow pretty large before they are physically noticed.

Kidney cancer typically can be diagnosed without a biopsy, so there was no need for an invasive surgical biopsy of Don’s kidney tissue. Don left Dr. Fagelson’s office with all his apprehension banished.

“He was probably the most reassuring guy I had ever met or spoken to,” says Don.

From cancer to cured in two weeks

Don had surgery to remove his right kidney in the summer of 2015. The surgery, performed at Sky Ridge, was on a Tuesday and he returned home that Saturday. Don says when he woke up from his surgery, he felt as though he had just been beaten up from the surgery, but it only took a short time to recover.

Dr. Fagelson visited Don in the hospital following the surgery to deliver some good news. The pathology from his removed kidney came back and he was able to determine that every last cancer cell had been removed and Don would not need to undergo chemotherapy. Only two weeks following his diagnosis, Don was cancer free.

“Obviously, this was just about the best news I could have received,” says Don. “That speaks to the thoroughness of Dr. Fagelson and the entire team and staff at Urology Associates.”

Don feels completely fine now and has resumed all of his activities. He regularly plays golf, he’s lost weight and is living a healthier life overall than before his diagnosis.

“I couldn’t be happier with my treatment, with my surgeon and with Urology Associates,” says Don. “Getting a successful outcome has everything to do with your surgeon. I would recommend Dr. Fagelson to anybody on the planet. I can’t sing his praises enough.”

Don says that he plans on spending the rest of his retirement playing as much golf as possible and avoiding any more surgeries.