Bryan Honorable’s orange-laced athletic shoes flash over the backyard he’d just mowed as he went after a football tossed by his great-nephew, James Jones Jr., 7.
Honorable couldn’t have done either a year ago.
Family filled the sun-lit yard of the home he shares with Crystal Witherspoon and two of his three children, son De’Andre, 25, and daughter Samaria, 17.
Mahaleigh, sporting two tiny ponytails, a sundress and plastic sandals, snuggles in next to her grandmother, Elinda Jones on the back steps of the wooden deck. Jones is Honorable’s oldest sister, and together, they talk about their family’s struggle with—and triumph over—cancer.
This breezy afternoon seems light years away from the day the crippling pain “pushed me over the edge,” and forced Honorable, 52, into an emergency room.
A customer service and tech go-to-guy at the Family Christian Stores corporate office, he’d known something was wrong since the summer of 2013 when he began having trouble urinating.
Following the gospel according to TV commercials, he decided the problem was an enlarged prostate, and he began taking over-the-counter medication. The condition continued to worsen: He woke in the middle of the night and vomited every time he ate anything.
Once in the emergency room, scans showed what doctors believed was leukemia, a tentative diagnosis which tore at old wounds: Honorable’s mother died with leukemia in 2013.
Further tests revealed he did have an enlarged prostate, and his doctor wasted no time bringing in the big guns in the form of Brian Lane, MD, PhD, chief, division of urology, for Spectrum Health Medical Group.
Further testing ruled out leukemia, but Dr. Lane needed to do a biopsy. Honorable’s pain meds were upped, but his body weakened.
A big man who recalls the painful details with an even bigger dry wit, Honorable said:
“I tried to walk my dog one day, and I got up the street, but I was so ill, I couldn’t get back home,” he said. “I’m sure people were looking at me. My dog was even looking at me like, ‘What’s up?’ I mustered up enough energy to get half a block home and we stopped again—same scenario. Eventually I got home.”
It turned out he was allergic to the pain medications, and those were switched.
The biopsy revealed he had stage 4 prostate cancer.
Hormone injections brought Honorable’s prostate-specific antigen (PSA) levels down dramatically, an essential step before surgery to remove the prostate. PSA is a substance made by cells in the prostate gland and a higher level can indicate the presence of prostate cancer.
Other than skin cancer, prostate cancer is the most commonly diagnosed cancer of men, affecting 1 in 7.
“At the same time, only 3 out of 100 American men will die from it,” according to “Making the Choice,” a guide to deciding what to do about early-stage prostate cancer, produced by the Michigan Cancer Consortium.
Dr. Brian Lane, chief, division of urology, with Spectrum Health Medical Group, is a member of its Prostate Cancer Action Committee.
In a compelling argument for early detection and treatment, the Prostate Cancer Foundation reports that, “Because approximately 90 percent of all prostate cancers are detected in the local and regional stages, the cure rate for prostate cancer is very high—nearly 100 percent of men diagnosed at this stage will be disease-free after five years.”
As both surgeon and researcher, Dr. Lane has a unique view of the present and future of prostate cancer treatment, and the impact on patients and their families.
“Patients with low-risk prostate cancer, who will die from something else, need to be counseled as such,” he said, referring to treatment options and strategies that include active surveillance, rather than immediate treatment. “Men with localized prostate cancer (cancer contained to the prostate) usually have good outcomes with localized treatment, either radiation or surgery. Men with advanced cancer may need multiple types of treatment.”
A routine blood test resulted in a call to come into the hospital immediately: His liver and kidneys were shutting down.
He headed in with a just-purchased Subway sandwich in tow. He never got to eat it. He was admitted and doctors performed a procedure to get the urine flowing again and restore kidney and liver function.
Ready at last for surgery, additional scans found the cancer had spread to his bones. At the same time, the cancer began showing resistance to the drug keeping his PSA down, and that started to rise.
Out of options
Honorable was running out of options.
“I was sitting in his office on the exam table when Dr. Lane delivered the news that surgery was not an option because of the metastases,” he recalled. “He said, ‘We can set you up with an oncologist and do chemotherapy.’ He was gonna show me (the scan) but I didn’t want to see it.
Jones, almost a second mother to Honorable since she was in charge of getting him to school decades ago, asked: “What does this mean?”
Dr. Lane told the duo that with the way the cancer had spread, and the way things looked on the scan, Honorable could expect two to seven years.
“He told me if I wanted a second opinion, I was more than welcome,” Honorable said, adding that he wanted to stick with Dr. Lane. “He put his hand on my shoulder and we prayed about it. I almost fell off the table. What doctor does that?”
Dr. Lane recalled that moment and said, “Bryan is a man of faith, and it has served him well. A lot of men would have gone down with incapacitating pain.”
Later, Dr. Lane told Honorable about a clinical trial that might be an option. Reluctantly, Honorable talked with a clinical trial nurse about it.
“I had a bad feeling about the drug study,” he said. “It was a big turnoff and I was gonna say no. Then Dr. Lane came in. I was sitting on the exam table. He came in and sat on the exam table with me, and I really appreciated that.
“I eventually asked him, ‘If this was you, would you do this?’ and he said, ‘Yes, absolutely,’ so I said yes and signed the papers.”
Honorable started the clinical trial, in which he either gets “one wonder drug or two” in combination.
Dr. Lane, the surgeon and researcher, elaborates: “There are a lot of misconceptions about clinical trials: The fear that ‘I’m a guinea pig’ or ‘Why are they researching this? Don’t they know what they’re doing?’”
There’s also a lot of mistrust among African-Americans for historic reasons.
In fact, he said, those who enroll in clinical trials “are helping transform health care by helping us learn the best way to care for patients,” Lane continued. “If we aren’t sure of what order in which to give drugs, or there are two good ones, (a clinical trial) is the way to (find out.) There should be more comfort in knowing that in the end, we will really know what’s best.”
‘I was lucky’
While Honorable began feeling better with the new treatment at the Spectrum Health Cancer Center, scans didn’t show much change at first.
Then came his February appointment with Dr. Lane.
“I get into Dr. Lane’s office, and he brings up my old scan,” he said. “He outlines the cancer on the screen, and I think, ‘What the heck is going on? I don’t want to see this.’ Then he clicks other buttons, and another image pops up that has nothing there. I’m not a rocket scientist, but I know what that means.”
Dr. Lane left no room for doubt: “Bryan, this was a cancer traveling throughout your body. Now we can’t find it anymore.”
Months later, on this sunny day, Honorable sits on his shady front porch next to Witherspoon, with whom he’s shared a life for 28 years. They are surrounded by family, just as they have been during the dark days.
He continues on six daily meds indefinitely as well as regular CT and bone scans, and the perpetual uncertainty those bring.
The treatment is starving the cancer, not Honorable.
“I am eating everything not nailed down,” he said. “My appetite is ridiculous. I eat so much, I need a diet now.”
Honorable is back in the sports he loves, particularly basketball.
“This time last year, I couldn’t do it at all,” he said. “I was lucky if I could even pick up the basketball.”
Today, all of that seems a world away: His oldest daughter, Shameka, 29, rocks her sleeping son, Terence Betts, 2 1/2, who is worn out from the afternoon’s excitement. A light breeze caresses hot skin.
No strangers to cancer, “You don’t have time to break down,” Jones said, even when it hits “the baby boy—the only boy. You scream and then you get over it” and take care of business.
She sat near sisters Brenda Honorable (“I cry everything out,”) and Juvnia Jordan (“We put it in the Lord’s hands and hoped for the best.”)
“He’s here today by God’s grace,” Jones said, noting the importance of a support system for all cancer patients. “Family is important. That’s what we are.”
Honorable’s takeaway from the experience: “If you see clouds with lightning going through them, they’re far enough away to see, but close enough to be a problem. Like the cancer.”
One huge takeaway for them all is a determination to reach for the healing positive and reject the corrosive negative.
“My whole motto now is to live free,” Honorable said. “I haven’t lived free until after cancer. I’m thankful for every day.”
“We’re all here for a short time,” Jones added. “Do we want to waste it? We all have so much light, which we can dim with so much darkness. You can choose to say, ‘I’m not going to go there.'”
Honorable’s advice to others grappling with what he once did: “If you want excellent care, a man happy doing his job, and someone who cares about people, go see Dr. Lane. There is a humanity that is overpowering in his spirit.”
Dr. Lane’s advice: “If you know something’s not right, hiding won’t do you any favors. Sometimes the worst part is the fear: ‘I’m worried it’s cancer,’ or ‘How will I take four weeks off work?’
“Knowing you will be treated as an individual may help some men get off the couch and get to a doctor. It may be nothing, but the only way to know is to get it checked out.”