Emerson Hospital

he recalls. “He answered every one of them
and didn’t rush me. I like Dr. Schloss very
much; he is very friendly and has a sincere,
caring manner.”
When it comes to prostate cancer, there is
plenty to cover. “The side effects of treatment,
such as imperfect urinary control and
erectile dysfunction, are a big part of the
discussion,” says Dr. Schloss. “Most men
need reassurance.”
Treatment designed to prevent a
recurrence
Dr. Schloss performed Mr. Walsh’s surgery
the following week, after which he spent
three days at Emerson. “The nurses were
outstanding,” he says. “I wrote a letter describing
how impressed I was.” Although
he was weak and couldn’t lift anything, he
slowly returned to the legal work that was
waiting for him.
Six weeks after his surgery, Mr. Walsh had
a repeat PSA test and saw Dr. Schloss for a
follow-up appointment. “I expected to hear
that everything was fine, and I was done
with treatment,” he says. “Instead, Dr.
Schloss told me that my PSA was still high,
and I needed to have radiation.”
director of radiation oncology, and the staff
are committed to delivering treatment with a
high degree of precision. “When we treat
prostate cancer, we regularly perform imaging
to assure that everything is aligned,” Dr.
McGrath explains. “For example, even the
presence of fluid in the bladder will affect
the precision of where we aim the radiation.
We make regular adjustments in order to
treat the patient with the utmost precision.”
Mr. Walsh’s physicians conferred regularly
on his treatment plan. Midway through his
radiation therapy, Dr. Schloss and Dr.
McGrath decided that adding a testosteronelowering
medication would be prudent.
“We don’t want Jim to develop a recurrence
of prostate cancer,” notes Dr. Schloss.
With Dr. Schloss, Dr. McGrath and Jon
DuBois, MD, medical director of the Mass
General Cancer Center at Emerson Hospital-
Bethke, collaborating on his care, Mr. Walsh
knew he was in good hands. He will continue
to see all three physicians periodically.
Dr. DuBois attends the urologic oncology
conferences at Mass General, where patients
are discussed. “The conference allows me
to build relationships with urologists and
radiation oncologists at MGH, which makes
consultations and referrals with our
Emerson patients more streamlined and
rewarding,” says Dr. DuBois.
Much progress has occurred in the treatment
of prostate cancer: during the past 30 years,
five-year survival has increased from 73
percent to 99 percent. “With respect to
advanced or metastatic cancer, the last few
years have seen the FDA approval of more
treatments than ever,” says Dr. DuBois.
“They include molecular therapies and
vaccine technology.”
Dr. DuBois also helps lead the twicemonthly
multidisciplinary oncology conference
at Emerson with Dr. McGrath, Dr.
Schloss and other specialists in attendance.
They review newly diagnosed patients together
and determine the best course of
management.
By November 2014, with treatment well
behind him, Mr. Walsh’s PSA was down to
normal. He is grateful—for the expertise
that was available nearby and the outstanding,
personalized care he received. “When
I look back, it was a better experience than I
could have imagined,” he says. “I wouldn’t
have gone anywhere else.”
Dr. Schloss says he considered all the
factors. “The pathology report after Jim’s
surgery showed that the tumor was locally
advanced, meaning that the surgery did not
remove every cancer cell. His high PSA
level convinced me that having a course of
radiation was necessary.”
“I’m not a ‘woe is me’ guy,” Mr. Walsh says.
“But I got emotional when I heard that I
needed more treatment.” He managed to
schedule himself for the first treatment of
the day and began the six weeks of radiation
at Emerson.
Mr. Walsh quickly became attached to the
radiation oncology staff, who made him feel
comfortable and cared for. “They’re my
friends now, including Dr. McGrath,” he
says. “They’re wonderful people, and
they are doing God’s work. I still stop in
to visit them.”
In addition to providing personalized care
and attention, John McGrath, MD, medical
Benign prostatic hyperplasia:
predictable and treatable
Normal
The symptoms are annoying, but they are predictable. After age 60,
one-third of men develop benign prostate hyperplasia (BPH), enlargement
of the prostate. The annoying part occurs when the prostate’s
growth blocks the urethra, which causes problems with urinating.
“The typical symptoms include a slow stream when urinating, more
frequent urination, the feeling you are not emptying the bladder completely
and having difficulty initiating urination,” Dr. Schloss explains.
In the overwhelming majority of cases, Dr. Schloss is able to assure
men that these symptoms do not indicate prostate cancer. Then, the
question is whether or not treatment is needed. “Early on, the best
approach to BPH is often to monitor symptoms,” he says. “We have
good medications that help many men. When medication doesn’t
work or the urethra appears to be increasingly blocked, I often suggest
a procedure—either electro-surgery or laser—to open the
blockage.”
Enlarged prostate
5