Provision doctor diagnosed with cancer, chooses proton therapy for his own treatment

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This story starts the way a lot of cancer stories start. A visit to the doctor for an unrelated issue. A few tests. And then, while trying to solve one problem, the doctor discovers another – a red flag.

That discovery sparks a journey down a road far too many have traveled. First, more trips to the doctor. Then more tests. And then the waiting. Waiting with fear and uncertainty – hoping for the best, but preparing for the worst. Until eventually, the wait is over and the news is in…

It’s cancer.

And from there, this story continues down a common path. Mulling over questions like “How bad is it?” and “How do I deal with this?” Determining the options and choosing a treatment. And of course, fighting the cancer.

There’s something uncommon about this story, though – the person making the journey. Because he’s literally been down this road hundreds of times before. He knows the roadmap better than most, because he’s guided people through it for decades.

The only difference this time? He’s no longer the guide. This is his journey.

FROM DOCTOR TO PATIENT

James Gray, MD, FACRO, Medical Director at Provision CARES Proton Therapy NashvilleDr. James Gray is a board-certified Radiation Oncologist and the Medical Director at Provision CARES Proton Therapy Nashville. His career includes work with the National Naval Medical Center and the National Cancer Institute. He began practicing radiation oncology in Nashville in the mid-1990s, including membership in Tennessee Oncology, one of the largest privately-held physician groups in the country. He has established his reputation as a pioneer in the industry, performing many advanced procedures never-before-seen in the region.

Accomplishments and accolades, aside, it’s Dr. Gray’s passion and commitment to his patients that define him. He’s spent 30 years studying cancer and helping patients navigate the difficult path of fighting it.

“I get to work with patients in a time of dire need for them. They undergo a diagnosis of cancer, and this is terribly frightening for most people to accept and move forward,” says Dr. Gray. “Helping someone move through that. Counseling them. Making them understand their disease. That’s what brings joy to me – the actual effort of bringing this understanding to those patients and then bringing the best possible care to them. That drives me every day.”

Then, in 2019, he visited a physician to check out a minor health issue. During that visit, Dr. Gray underwent a PSA level screening. Much to his surprise, the levels came back slightly elevated – a possible indication of prostate cancer.

“I realized with that PSA level, I needed to pursue this, and I went to see another physician – an outstanding urologist – and he proceeded with a diagnostic work up. That led to some other lab tests, an examination and then a biopsy.”

Dr. Gray recalled the anxiety he felt during the days following the biopsy. “You’ve got to wait maybe 3 or 4 days to get the pathology results back. I got to live firsthand that trepidation – that worry of, ‘Oh gosh. I hope it’s not cancer.’”

Unfortunately, though, it was cancer. Prostate cancer.

“It put me in a unique position where I’ve actually counseled patients who’ve just gotten this news. I’ve counseled probably more patients in this setting than anybody else in the area. All of a sudden, I’m counseling myself. Now, I’m the patient.”

WEIGHING THE OPTIONS

After receiving the news of his cancer diagnosis, Dr. Gray says he had a 30-year head start on the typical patient. As an established Nashville oncologist, he already had a strong grasp on the answers to questions like, “What does this mean for my life?” and “Am I going to die from this?” However, it was still important for him to remain objective, gather information about the severity of his cancer, then step back and make a clear treatment decision.

The initial decision for most prostate cancer patients is to determine whether the cancer is actually worthy of treatment, or if it would be more appropriate to observe it through active surveillance. In Dr. Gray’s case, he felt the cancer was threatening enough to treat immediately.

The next big divide – the “fork in the road,” as Dr. Gray calls it – is to decide whether to remove the prostate surgically or treat the tumor with radiation therapy.

“For me, that was not a difficult decision,” he says. “Knowing what I know about the likelihood of getting rid of the disease and the likelihood of having any kind of consequences from the treatment itself, I knew pretty quickly that I wanted to have radiation.”

That led to his next decision – choosing a radiation therapy method. There are many options for prostate cancer patients, including traditional x-ray radiation, radioactive seed implants (brachytherapy) and proton therapy.

For Dr. Gray, this was another easy decision. “One of the key advantages of proton therapy is that we’re putting (radiation) into the tumor with as little unnecessary dose to other tissues as possible. That inherently reduces the possibility of side effects – fatigue, difficulty with urination or bowels in my circumstance. So statistically, I am convinced. I’ve seen the data. I know what I consider to be the best treatment for prostate cancer, in my particular setting, was a proton therapy treatment system.”

“And fortunately, I happen to work at a proton system.”

WORK-LIFE BALANCE

They say it’s important to have a good work-life balance in your career. In Dr. Gray’s case, those two worlds collided as soon as the radiation oncologist began his proton therapy treatment in Nashville.

“I could actually go to work every day and receive a treatment – close to six weeks of treatment – but I was just going to work. And for 20 or 30 minutes, I stepped into the patient role, had my treatment, then went back into the doctor role.”

Dr. Gray remembers the transition from doctor to patient being fairly easy, mainly because of the trust he had in the treatment itself, as well as the Provision CARES team performing the treatment.

“For a lot of patients, they have to slowly gain the trust in me as their physician. They have to gain the trust in the people that are going to do their treatment. They have to gain the trust in the technology,” notes Dr. Gray. “I didn’t have those misgivings. I knew that when I was being treated, very bright people were watching over the treatment and making sure it was done right. I know how competent, outstanding and professional those people are, so I didn’t have any qualms about that.”

In fact, Dr. Gray’s positive attitude during his treatment actually helped the other staff members deal with a situation in which their colleague, friend and mentor was battling cancer – and they happened to be the ones treating it.

“I’ve never been in that situation before where you’re treating someone that you know so closely,” remembers Justin Pigg, Radiation Therapy Manager at Provision Nashville. “But to Dr. Gray, he just wanted to be treated like any other patient. He wanted the patient experience.”

“He was really calm and really strong through it, and I think that helped everybody else be calm, as well,” says Valerie Bohannon, the proton center’s Patient Concierge.

That sense of calm among the team was critical, as just about everyone at Provision Nashville had some role in Dr. Gray’s treatment.

“It’s all the way from the top to the bottom,” Dr. Gray says. “Every member of this staff had something to do with making sure my treatment went well. They all wished me well. They all asked me how I was doing. They were genuinely concerned about this.”

And that concern – that culture of care – is what Provision is all about. Dr. Gray hears it from his patients all the time.

“They will tell me how impressed they are from the moment they walk in the door to the time they’re leaving the center. They felt like they’ve been enveloped in care. And I felt the exact same way. It was obvious to me that I was brought into that care – that love – that people wanted me to do well.”

WALKING IN THE PATIENT’S SHOES

Dr. Gray, a Nashville oncologist, completing his proton therapy treatment at Provision CARES NashvilleDr. Gray successfully completed proton therapy in January 2020, placing him in a rare category of radiation oncologists who’ve actually been through the very cancer treatment in which they specialize. He says the entire experience impacted the way he’ll approach his role as a doctor going forward.

“It was enlightening. Going through the treatment myself gave me quite a bit of a different perspective. It’s important for me to understand that my personal experience can be translated only some degree to my patients, but at least having a taste of it allowed me to understand a bit more how they see it – how they experience the whole treatment process.”

That “taste” of proton therapy, as he calls it, will now be another tool for a Nashville oncologist who is passionate about making this effective and successful treatment available to as many people as possible.

“Some people suggested I had to choose proton therapy because I work at a proton therapy center. No, not necessarily. I’m not going to compromise my own good health just to make a point in my professional career. I wanted to have the best outcome, and I genuinely believe my best outcome would be achieved through the use of proton therapy.”

And with 36 operating proton centers across the country, why did he choose to be treated at Provision CARES Proton Therapy Nashville? He says that was another easy decision.

“Why would I leave here when I know I’ve got great people here to treat me. I can get world class treatment by world class people just downstairs from my office. Why wouldn’t I take advantage of that?”

Upcoming Event: Prostate Cancer 101: Understanding the Journey Diagnosis, Treatment, and Survival

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Join us for a free presentation to learn more about the latest developments in prostate cancer. Dr. Wilkinson will discuss the most advanced diagnostic tools and current trends in treatment including multiparametric MRI, genomic classification, when to use active surveillance, and how to preserve quality of life after a prostate diagnosis.

Friday, September 20th from  930-11a

Hosted by: Provision CARES Proton Therapy Knoxville, 6450 Provision CARES Way, Knoxville, TN 37909

RSVP: To reserve your seat, please RSVP to Jenni Turner at 865.321.4539 or jenni.turner@provisionhp.com

Free PSA level screenings offered throughout East Tennessee

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Eddie Check® and the Provision CARES Foundation Team Up for Blood Drive and Free PSA Screenings

Available at 16 different East Tennessee locations across 10 counties on September 12th & 13th.

Unbelievably, One in nine men will be diagnosed with prostate cancer during his lifetime – and one in 41 will die from it. Prostate cancer is second only to skin cancer as the most common cancer in American men and second only to lung cancer as the leading cancer-based cause of death in American men. The American Cancer Society estimates that in the U.S. during 2019, about 174,650 new cases of prostate cancer will be diagnosed and 31,620 men will die from it.

But there’s still good news. If prostate cancer is caught early, the 5-year survival rate is nearly 100%. The numbers say it all: Get tested!  Prostate cancer is rare before age 40, so if you are 40 or older, the first step is a free, simple PSA screening that only requires a blood sample. “PSA” stands for prostate-specific antigen, a protein produced by prostate cells. The PSA test is done to help diagnose and follow prostate cancer in men.  No certain PSA level is called normal or abnormal, and an elevated level does not mean you have prostate cancer – only a biopsy can diagnose cancer. Always discuss PSA test results with your doctor and be sure to have a digital rectal exam (DRE), as about 6% of men with prostate cancer continue to have normal PSA.

In 2004, Rockford-based Nisus Corporation, a manufacturer of green products for the pest control and wood preservation industries, teamed up with area hospitals and MEDIC Regional Blood Center to create Eddie Check, an annual event that adds free PSA screening for prostate cancer to blood drives. It was a simple strategy using MEDIC’s already existing resources to make it fast and easy for men to get a blood sample drawn for the screening. Nisus has a personal stake in the fight; marketing vice president Jim Gorman is a prostate cancer survivor, while company president Kevin L. Kirkland lost his father, Eddie Kirkland, to the disease. In fact, “Eddie Check” is named for Eddie Kirkland.

Once again, Nisus, MEDIC, Provision CARES Proton Therapy, and Provision CARES Foundation join with sponsors WIVK FM 107.7, Sports Radio WNML 99.1 FM & 990 AM, NewsTalk 98.7 FM, WVLT, and Abacus Arts, Inc.

Sites and Locations

Thursday, September 12

Friday, September 13

Am I at Risk for Prostate Cancer

Am I at Risk for Prostate Cancer?

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September is Prostate Cancer Awareness Month.  It is important to know if you are at risk of prostate cancer and whether you should get an annual Prostate-Specific Antigen (PSA) level test.

In Tennessee, as well as the United States, prostate cancer has the second highest new cancer rate overall and is the number one cancer for new cancer types among men.(1)    According to the Center for Disease Control (CDC), there are an estimated 3,110,403 men living with prostate cancer in the US.  Based on their 2014-2016 data, approximately 11.6% of men will be diagnosed with prostate cancer at some point in their lifetime.  According to SEER, there will be an estimated 174,650 new cases of prostate cancer in 2019 with an estimated 31,620 deaths from prostate cancer.  The five year survival rate for prostate

Prostate cancer is most frequently diagnosed among men aged 65-74 with a median age of 66.  However, 9.2% of new prostate cancer cases are among men under the age of 55.(2)

In addition to age, other factors can increase the risk of being diagnosed, including family history, genetic factors, race, lifestyle and dietary habits.

If an immediate family member such as your father or brother have been diagnosed with prostate cancer, then your risk of developing prostate cancer is 2 to 3 times higher than normal.  Your risk increases with each relative that has been diagnosed with prostate cancer.  Your risk will also increase if two or more close relatives on the same side of the family have been diagnosed with prostate cancer before the age of 55.(3)

African American men have a higher risk and are more likely to be diagnosed at a younger age and have been found to have a more aggressive tumor.

There have not been any studies to prove that diet and nutrition has any direct correlation with developing prostate cancer.  However, if a male who is overweight is diagnosed with prostate cancer, they are at a greater risk for developing a more aggressive cancer.

While there can be lifestyle and dietary habits that can increase your risk of prostate cancer, there are a few myths that have been rumored to increase your risk of prostate cancer.   Sexual activity level is a non-factor as well as having a vasectomy.  Alcohol is another non-risk factor for prostate cancer.

If you do have any of these risk factors, it is important to have your PSA level checked annually.  If you do have an elevated PSA level, your doctor can provide information on additional testing to confirm your diagnosis.

Source:

(1) Center for Disease Control.  Prostate Cancer Statistics.  https://www.cdc.gov/cancer/prostate/statistics/index.htm

(2) National Cancer Institute.  Surveillance, Epidemiology, and End Results Program.  Cancer Stat Facts:  Prostate Cancer. https://seer.cancer.gov/statfacts/html/prost.html

(3) Cancer.Net.  Prostate Cancer Statistics.  https://www.cancer.net/cancer-types/prostate-cancer/statistics

Upcoming Events: Prostate Cancer 101: Understanding the Journey Diagnosis, Treatment, and Survival

By

Join us for a free presentation to learn more about the latest developments in prostate cancer. Dr. Wilkinson will discuss the most advanced diagnostic tools and current trends in treatment including multiparametric MRI, genomic classification, when to use active surveillance, and how to preserve quality of life after a prostate diagnosis.

Friday, July 26th from 930-11a and Friday August 23rd from 930-11a

Hosted by: Provision CARES Proton Therapy Knoxville, 6450 Provision CARES Way, Knoxville, TN 37909

RSVP: To reserve your seat, please RSVP to Jenni Turner at 865.321.4539 or jenni.turner@provisionhp.com

Prostate Cancer 101: Understanding the Journey Diagnosis, Treatment, and Survival

By

Join us for a free presentation to learn more about the latest developments in prostate cancer. Dr. Wilkinson will discuss the most advanced diagnostic tools and current trends in treatment including multiparametric MRI, genomic classification, when to use active surveillance, and how to preserve quality of life after a prostate diagnosis.

Thursday, May 9th at 6:30pm or Friday, May 17th at 9:30am

Hosted by: Provision CARES Proton Therapy Knoxville, 6450 Provision CARES Way, Knoxville, TN 37909

RSVP: To reserve your seat, please RSVP to Jenni Turner at 865.321.4539 or jenni.turner@provisionhp.com

Risk Factors for Prostate Cancer

Risk Factors for Prostate Cancer can increase due to Age, Race and Family History

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Early detection of cancer can be the next best thing to prevention. There are several widely known risk factors for prostate cancer that may increase the probability of a man to develop prostate cancer. Age, race and family history are the most common today. According to ASCO Cancer.Net, “Prostate cancer that runs in a family, called familial prostate cancer, occurs about 20% of the time.” Sources say that shared genes, similar lifestyles and environments play a role in developing familial prostate cancer. Hereditary prostate cancer accounts for almost 5% of cases. This type of gene mutation is passed down within family generations. A few characteristics for hereditary prostate cancer could include: (more…)

Dale C. Prostate Cancer

Proton Stories: Why Dale Chose Proton Therapy

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Dale C. first heard about Provision CARES Proton Therapy through a TV commercial. Not knowing he had cancer, he tucked the words “proton therapy” in the back of his mind, hoping that he would never have to remember them. It was February 2015 when he learned he had prostate cancer. Dale had always been proactive when it came to his health. He said, “my mom always taught me to be proactive.” He went in for regular checkups, yearly physicals, and was well aware of his PSA and gleason score. At his appointment in 2015, all test scores came back normal, but he insisted on a biopsy, just to be sure. Both the doctor and Clayton were shocked, his biopsy came back positive. Dale was diagnosed with low risk, non-aggressive prostate cancer and decided on active surveillance.

Two and a half years later, things started to change. His PSA remained normal but his biopsy showed the cancer had doubled in size. “It’s a miracle we found it,” said Dale. “I believe God placed the right doctors, urologists, and friends around me to help me make an informed treatment decision.” He researched prostate cancer and treatment options, from surgery to brachytherapy to protons, and there were two things that were very significant to his treatment decision process: Cure Rate and Quality of Life.

(more…)