On the morning of Oct. 15, 2022, Summit Health patient Pat Mahady went for a run. The former senior exercise physiologist, who also is a competitive marathon and trail runner, wasn’t going to let anything break his fitness streak — not even the surgery he’d have that day to treat his prostate cancer.

“I believe that the human body is a survival machine, and it functions best while it’s in motion,” he says.

A screening test leads to a diagnosis

At an annual physical in April 2022, a lab test showed that Pat had a higher-than-normal level of PSA, or prostate-specific antigen. PSA is a substance produced by the prostate. This substance can be measured through a blood test that helps screen for prostate cancer.

Pat’s test result prompted him to contact Andrew Siegel, MD, a urologist at Summit Health. Dr. Siegel recommended further evaluation, including blood and imaging tests.

“Using PSA testing, about 90% of men have a normal PSA,” explains Dr. Siegel. “Of the 10% of men with an elevated PSA, 30% or so will have prostate cancer.”

Indeed, Pat’s MRI revealed a mass on his prostate. A biopsy of the mass confirmed his cancer diagnosis.

Pat then met with Michael Esposito, MD, a urologic surgeon at Summit Health specializing in minimally invasive robotic surgery. Dr. Esposito discussed the option for Pat to undergo a radical robotic prostatectomy, which would remove the prostate and spare the nerve tissue and sphincter muscles that help control urination.

“Robotic prostatectomy is a precise surgical procedure that allows us to preserve the function of nerve tissues related to urinary and sexual function,” explains Dr. Esposito. “Patients who have their prostate removed can still maintain normal urination and sexual activity.”

For this procedure, a robotic camera and surgical tools are inserted into small incisions made in the lower abdomen. The surgeon sits at a console and uses hand controls to guide the robotic tools’ movements while viewing the operation in real time. The camera and hand controls allow for a magnified, three-dimensional view and greater surgical precision.

In addition to its technological benefits, robotic radical prostatectomy allows for faster recovery times, shorter hospital stays, and fewer complications such as incontinence and sexual dysfunction.

A treatment decision and preparation

Pat dove into the details while considering his treatment options. “I researched prostate cancer and read everything one could read about it — surgical choices, radiation therapy, and alternative choices,” he recalls. “I felt that robotic surgery was my best option.”

His research also revealed a familiar topic. “I found that I kept running across a single treatment — exercise,” says Pat. Dr. Siegel gave Pat information about strengthening exercises he could do before and after surgery.

“I knew that a strong pelvic floor was valuable to running, and now I had to focus on it to stay strong and recover well,” Pat continues. In addition to his strength routine in preparation for surgery, Pat added to his fitness streak, including completing a half-marathon.

Dr. Esposito performed Pat’s surgery that October morning, and Pat went home the next day. True to form, Pat resumed his streak by having his wife drop him off one mile from their home so he could walk it.

An unbroken streak and new adventures

Pat saw Dr. Siegel six months later for a follow-up visit. “He has done remarkably well since the surgery, has no detectable cancer, and experienced no side effects,” says Dr. Siegel. Under Dr. Esposito’s guidance, Pat eased back into his workout routine and was running again about two months after his surgery.

Today, Pat’s streak — defined by a mile or more of walking or running daily — continues. He’s also forging some new paths.

Now retired from his exercise physiologist role, Pat and his wife drove cross-country for six months before returning to New York to celebrate with their four children and 11 grandchildren. Along the way, he was able to tackle a bucket list of running and hiking trails and visit as many Major League Baseball parks as possible.

“I can’t think of a better way of keeping my streak going,” he says.

Prostate cancer screening at Summit Health

Talk to your primary care provider or urologist if you have questions about prostate cancer screening. Here is what you should know about the latest prostate cancer screening guidelines from the American Urological Association and Society of Urological Oncology.

• Screening should be offered at age 40 to 45 for those at higher risk, including African Americans, those with a strong family history of prostate cancer, and those with germline mutations associated with prostate cancer.
• For those men at average risk, baseline PSA testing is recommended at age 45 to 50 and thereafter every two to four years for men aged 50 to 69.
• Screening in men older than 70 is recommended only under the circumstance that the patient is in excellent health and after shared decision making.