Analytically oriented, retiree uncovers help for his prostate cancer

BROWN COUNTY — Having spent most of his professional career in engineering, it was common for Columbus native Henry Stitsworth to be around people doing research and reading technical papers.

“I’ve always had that mentality,” said Stitsworth, 72, who was employed by Cummins Inc. for 23 years before concluding his career with a local company that did business with the Columbus-based global power generation giant.

Wired to look at problems analytically until he could identify a solution, starting when Stitsworth repaired televisions for a living after high school, this propensity may have saved his life a half-century later, after he was diagnosed with prostate cancer.

Back in Indiana after spending three years in Minnesota, where the Cummins Power Generation Business in based, Henry and Jane Stitsworth returned to their roots to plan a life in retirement close to nature on a winding road where they built their home in rural Brown County in 2018.

With hummingbirds busily sipping nectar from feeders on the deck and wild animals occasionally poking their heads out from the property’s thick woods, the Stitsworths had created an idyllic backdrop for their golden years.

That is, until an enlarged prostate diverted Henry’s attention starting in the spring of 2020.

Stitsworth initially sought medical help from a urologist in the Indianapolis area, but he wasn’t happy with that doctor’s bedside manner, as well as the physician’s reluctance to perform prostate surgery on someone in his 70s.

With a PSA (Prostate-Specific Antigen) level above 4.0, that test result generated concern over the possibility of Stitsworth’s body containing cancerous cells. And with a subsequent Gleason Grading System test score of 8, Stitsworth’s worries were validated with a July 2020 diagnosis of fast-growing prostate cancer.

Nervous about his Indianapolis area doctor’s preference to use radiation to attack the cancer, Stitsworth listened to the analytical voice inside his head and decided he needed a second opinion. He got one from Columbus Regional Health urologist John Francis, who had experience in the more precise robotic prostate surgery.

Francis was willing to operate on Stitsworth, and explained the risks and recovery expectations. But Francis also wanted his patient to similarly understand plusses and minuses of the other primary option — using radiation to treat the prostate cancer, explained by Dr. Mark Henderson, a radiation oncologist with the Columbus Regional Health Cancer Center.

Stitsworth chose to have Francis perform the robotic prostate surgery, with a pledge from Henderson that he would provide support if radiation were later needed.

Stitsworth’s prostate operation was scheduled for early January 2021 at Columbus Regional Hospital, but the worsening COVID-19 pandemic led to a suspension of elective surgeries at the medical campus.

That frustrated an otherwise healthy Stitsworth, whose brother Stuart — now 74 — had been diagnosed with prostate cancer 25 years earlier.

“I’m still sitting here and things (cancer cells) are still growing,” Henry Stitsworth said. He recalls feeling anxious waiting to treat an aggressive cancer.

But his surgeon’s pledge to remove the prostate as soon as it was possible was fulfilled Feb. 11, when Francis found no evidence that the cancer had spread to nearby organs.

However, three months later, a PSA test result of 3.07 was cause for concern — indicating cancer was still somewhere in his body. Without a prostate, his PSA score should have been zero, Stitsworth said. Tested again the following week, his PSA score had crept up to 3.35.

Digging up research

That’s when Stitsworth tapped into his analytical instincts and started doing his own research on the Prostate Cancer Foundation website, PCF.org. There, Stitsworth learned about a newly approved prostate cancer diagnosis tool known as PSMA (Prostate Specific Membrane Antigen) PET imaging.

“This is exactly what you need,” Stitsworth recalls radiologist Henderson saying regarding the cancer, “because it’s going to show us where it’s at.”

The test was conducted July 12 and Dr. Henderson called with imaging results three days later. Its tracers found evidence of cancer in Stitsworth’s pelvic glands, on top of his abdomen and on his breast bone.

“I didn’t want to hear that,” Stitsworth said.

But had this type of imaging not been given Federal Drug Administration approval, Stitsworth would have had to undergo invasive radiation throughout his entire pelvic area.

“This is such a game-changer,” Stitsworth said. “Without the advancement, I would have had a short lifespan.”

Tempering his optimism, Stitsworth’s PSA score continued to increase — to 4.25 on July 21 and 4.51 on Aug. 4. Any PSA reading above 4.0 is considered high, indicating the presence of cancer.

That’s when medical oncologist and hematologist Stephanie Wagner, the third member of Stitsworth’s Columbus-based team of cancer doctors, recommended that he begin taking a hormone-based chemotherapy tablet called Zytiga that prevents cancer cells from mutating.

Within six weeks of starting the chemotherapy pills, Stitsworth’s PSA result dropped to less than 0.01 on Sept. 13, indicating his cancer had gone into remission.

Costly solutions

The lowest possible dosage of Zytiga, a 250 mg tablet, costs $9,991 a month for four pills each morning. Stitsworth will be taking them the rest of his life.

Wagner, also with the Columbus Regional Health Cancer Center, recommended Stitsworth get a Lupron shot every three months to lower his testosterone to zero, as prostate cancer is attracted testosterone. A third drug, Prednisone, is used to soften side effects from the other two drugs.

Stitsworth estimates cost of his prostate treatment so far has approached $150,000.

“It could wipe out your retirement,” Stitsworth said.

However, most of his medical costs have been covered by health insurance — Humana Medicare Part D and United Healthcare Medicare Part G gap coverage.

Stitsworth also learned from Wagner about a financial-assistance organization that approved his application to pay for the remaining cost of his cancer medication.

While finding the right medical team did cause some delay in his treatment, Stitsworth said it was time well spent.

Dr. Francis was easy to talk with, even during the difficult discussions, the patient said.

“Equally important, he listens. With every meeting, he leaves me with hope,” Stitsworth said. “He even calls me from time to time, out of the blue, to ask how I am doing. What doctor ever does this anymore?”

Stitsworth said radiologist Henderson “was focused on what was right for me and wanted me to think about all options before deciding.”

Wagner demonstrated an easy bedside manner and confidence, declaring “you can live a long life” after weathering the ordeal, Stitsworth recalls her saying.

“They always leave you with hope,” Stitsworth said of his three physicians. “It’s so critical, because you can get down so easily.”

The excellent care Stitsworth received at Columbus Regional Hospital extended to nursing, technologist and support staff, he said, sharing one memorable example as he was being rolled into a surgical room, nervous about his imminent biopsy.

“A nurse wrapped her arms around me as I began to drift to sleep and said she would watch over me the whole time. My anxiety drained away as I fell to sleep at peace. You can’t pay for that kind of care as it comes from the heart, and I will never forget it,” Stitsworth said.

Navigating side effects

The positive results from his treatment have offset side effects Stitsworth has experienced.

The cancer medication Stitsworth takes has compromised his immune system, meaning he would have a hard time fighting off a cold. He plans to get the COVID-19 booster vaccine when it becomes available.

Lowering his testosterone with the Lupron shots has resulted in Stitsworth occasionally experiencing hot flashes.

Additionally, incontinence following his cancer surgery is also a challenge, but he is using exercise to improve that condition — and keeps a package of Depends within reach.

“It’s certainly a humbler,” he said.

He and Jane work out three days a week on the treadmills at the YMCA in Nashville, where the Silver Sneakers program gives them access for free.

“I am losing weight and getting more active as I continue to feel better. Find a way to muster the choice to get up and make things happen,” Stitsworth recommends to others.

When he gets extremely tired by late afternoon, Stitsworth eases into his recliner for a short nap.

“This could be a lot worse,” Stitsworth said. “I’m blessed.”

He gives examples of support he’s felt from his family and friends, including furry ones.

Wife Jane “has been my rock through all of this. She has been my nurse, cook, maid, driver, constant companion, and many other things along with being an ever-bright ray of sunshine,” Stitsworth said. “We have been married for over 42 years, and I have never loved and needed her more than this year.”

The flip side of peace and tranquility living in the country is sometimes feeling too isolated.

“This changed when our grandson and family moved in with us. Now our house is alive with giggles and sounds of sisterly squabbles and we enjoy all of it. One of the best things is having all of us together at the dinner table each evening,” Stitsworth said.

Among them is 6-year-old great-granddaughter Khaleesi.

“She has been good medicine for me as she has a way of pulling me into her exceptional imagination, while at the same time almost unnoticed pulling me up from being down,” Stitsworth said.

Family dog Darla May, an 8-year-old West Highland white terrier named after the 1920s “Little Rascals” character, follows Stitsworth from room to room, instinctively knowing that something is bothering her master.

“She will sit on my lap and look at me and if she could talk would be saying, ‘How can I help?’ Her unconditional love is real help and has a way of bringing me peace,” Stitsworth said.

He doesn’t broadcast his medical highs or lows on social media, but instead relies on a small, close-knit circle of friends who check up on him regularly.

Among them is a former boss, Gary Johansen, vice president for power systems engineering with Cummins, who worked with Stitsworth from 2009 to 2015.

“We just connected as we got into some pretty significant new investments in our engineering infrastructure and lab facilities globally,” Johansen said. “Personally, I found his leadership energizing. Henry also has a deep sense of humility, which I found really refreshing and valuable.”

A workplace trait shown by Stitsworth that has helped during his cancer fight is “an incredible level of resilience,” Johansen said. “He has a resolve to see things through, even when they are very difficult, and he has a deep belief that the outcome will be good if he puts his very best into the situation and has a positive attitude.”

Stitsworth said his spirits are always lifted after he talks with Johansen, often at length.

“As he’s gone through all his difficulties, I’ve just stayed close and made time for him no matter what. And, sometimes we just need to be there for people with an ear. No advice, no directions, just empathy,” Johansen said.

Stitsworth does have advice for others, however, from his cancer recovery journey, such as getting a DNA test.

Ordered by Dr. Henderson, Stitsworth’s genetic test discovered an HOXB13 gene mutation for male members of his family to be highly prone to get prostate cancer.

“I guess I was supposed to have it,” Stitsworth said.

Had he known about the genetic marker earlier, it may have changed his own path. But Stitsworth keeps what-ifs in the past and instead focuses on today and a bigger picture.

“I now have an enhanced vision that every day is a gift,” Stitsworth said. “Life is finite — embrace it while you can.”