As a maintenance technician for Spectrum Health, Tim Lemon can repair just about anything that breaks—window blinds, door locks, toilets, tiles.
You name it, he can fix it.
But after being diagnosed with prostate cancer in April 2015, he discovered something he could not repair: Himself.
Brian Lane, MD, PhD, urology division chief for Spectrum Health Medical Group and a key member of the Spectrum Health Cancer Center, laid out the options. Lemon could undergo radiation therapy, have the cancer surgically removed, or stick with active surveillance of the disease. He opted for surveillance.
“That’s what we’ve been doing for the last year,” Lemon said.
On a recent Thursday afternoon, Lemon and his wife, Missy, arrived at the Spectrum Health Cancer Center to take part in another advanced monitoring system—the new UroNav Fusion Biopsy System technology at Spectrum Health. The system allows doctors to view prostate cancer lesions on a monitor and zero in on precise areas they’d like to target for biopsy samples.
Without the technology, doctors could only take samples in the general vicinity of the cancer. The prostate is a walnut-sized gland situated between the bladder and the urethra, just in front of the rectum.
As Lemon lay on his side on an exam table, Christopher Brede, MD, slipped on a pair of surgical gloves.
“OK, Tim, we’re going to start with an exam,” Dr. Brede said. “Next, we’re going to put the probe in. We’re giving you a little numbing medicine for your prostate. You’ll feel a little poke.”
Dr. Brede concentrated on the monitor as he positioned the probe. He located the first lesion.
“Alright, Tim, we’re going to start taking some biopsies,” Dr. Brede said. “We’re interested in these lesions that we’re targeting.”
Dr. Brede watched the biopsy needle on the screen, then pulled the trigger. A “click” signaled that the doctor had collected a tissue sample from Lemon’s prostate.
Clinical support associate Ajsa Redzic deposited the microscopic tissue sample in a collection jar. This would be the first of 16 samples collected from Lemon’s prostate.
“The procedure provides for a much more accurate diagnosis,” Dr. Brede said. “The hope is to eliminate any unnecessary steps and be more exact in the biopsies.”
The UroNav has the ability to overlay previous MRI images with the live ultrasound view.
“Putting them together gives you the ideal of being able to access the most aggressive-looking lesions with the ability of real-time view and the ability to take tissue samples during real time,” Dr. Brede said. “It’s very exciting.”
The Lemons said they’re thrilled to be part of the new technology, and they hope it will help determine if it’s safe to continue monitoring the cancer, or if they should consider surgery or radiation.
“It’s kind of like a fork in the road right now,” Missy said. “We’re hoping for an answer to help support a decision.”
Lemon credits Missy for encouraging him to get regular checkups after he turned 40. A routine blood test unearthed warning signs for prostate cancer. Doctors monitored the numbers for several years and, unfortunately, the results continued in a dangerous direction.
By 2014, Lemon’s primary care physician referred him to Dr. Lane.
“I didn’t have any symptoms,” Lemon said.
The discovery of three lesions on the left side of his prostate shook his confidence, but worse news was yet to come.
When Lemon heard the cancer diagnosis in April 2015, he felt bewildered, as though his normally strong and healthy body had betrayed him.
He’s always been the “fix-it guy,” the one who works on vehicles, collects Hot Wheels cars, plays ball with his sons and goes camping up north with his family.
Now he’s the one who needed fixing.
An unknown journey
A year after his diagnosis, Lemon is encouraged by the new technology.
“This UroNav will be a great tool to know exactly what’s going on,” he said. “It can pinpoint exactly where the cancer is. It’s reassuring to know with this new technology they can truly diagnose you and give you the exact options of where you’re at with your cancer.
“I think it’s an amazing technology,” he added. “The results let me know exactly where I’m at on my journey.”
Instead of guessing in the dark, he’ll be choosing with the best knowledge available.
“I’m not sure where my journey is going to take me,” Lemon said. “The cancer might grow faster. It might get into my bloodstream and spread throughout my body like cancer can do. I’ve come to terms with it. I believe in God.”
These days, he lives one day at a time, grateful for his family, his job, and this new UroNav technology that will reveal his cancer for what it is and hopefully what its intentions are.
“Some days I think about the cancer,” he said. “Other days I don’t. …You can get in your own head and start thinking about the ‘what ifs’ too much. Even though I’m not happy I have cancer, it’s part of life that was put down for me and part of the life I live.”
The week after his UroNav procedure, Lemon received pathology lab results from his biopsies. Not news he wanted to hear.
It appears the cancer may be growing faster than before.
“We ended up with six positives out of the 20 different samples of the 16 biopsies, four of which were from the two spots where the cancer was and where they were targeting with the UroNav technology,” Lemon said. “Those four spots showed an increased Gleason score, which means the cancer has increased its growth rate.”
Dr. Lane called Lemon and scheduled a meeting to review the pathology report and consider next steps.
Instead of continuing to monitor the cancer, Lemon said it appears he’ll need to consider surgery.
Despite the unwelcome results, Lemon said he feels fortunate the UroNav biopsies could pinpoint the cancer and detect its growth rate with such precision.
“We now have a better detail and description of the cancer,” Lemon said. “I have a much better view of where my cancer is, which was my intent. We’ll consult with Dr. Lane and take it from there.”