Bernardo Loose

"I'm so grateful to continue enjoying life," says Mexico's Bernardo Loose, pictured here with his wife Ursula, more than 11 years after receiving treatment for prostate cancer.

Bernardo and Ursula Loose live in the agricultural town of Los Mochis, Sinaloa, on Mexico's Sea of Cortez. Although he's retired, "I don't have much free time," says Bernardo. "There's always something to do."

For much of Bernardo's life, that 'something to do' involved activity in and around the water. As a young man, he was on Mexico's pre-Olympic swimming team. Although sidelined by a hand injury, Bernardo continued swimming for the exercise.

Always health conscious, Bernardo received a complete check-up every year from Dr. Jose Espinosa, his personal physician in Los Mochis. However, in early 1994, Dr. Espinosa found a prostate nodule during a rectal exam. A biopsy revealed it to be prostate cancer, high on the scale and very aggressive.

Decisive Action

"In Mexico, we don't have a lot of experience dealing with localized cancer," Dr. Espinosa explains, "for the reason that patients rarely come in for regular examinations, which would help us to detect the cancer before it has spread. So when we do find cancer, it's usually an advanced disease. Thankfully, because Bernardo was so diligent in his medical exams, we found the cancer early, and it was important for him to receive effective treatment right away."

Bernardo first sought treatment at a medical center in Tucson, Ariz. The center's physicians proposed "downstaging treatment," or the administration of medicines designed to lower the stage of the disease. However, Dr. Espinosa recommended that Bernardo receive a second opinion from Dr. Robert Ferrigni, chair of the Department of Urology at Mayo Clinic in Scottsdale, Ariz.

Bernardo and his wife Ursula dutifully drove the 700 miles (1,200 kilometers) north from their home in Los Mochis to meet with Dr. Ferrigni. After confirming the diagnosis, Dr. Ferrigni advised decisive action. "If it hasn't gone through the bones," he said, "we'll operate immediately." However, Dr. Ferrigni noted, there would be no way to know the full extent of the procedure until exploratory surgery was actually in progress.

During radical prostectomy, the surgeon completely removes the patient's prostate gland and local lymph nodes, while trying to spare muscles that control urination and sexual function. Additionally, because most testosterone is produced in the testicles, surgical castration is also an effective form of therapy, particularly in patients with advanced prostate cancer.

"There are many different therapeutic options," Dr. Ferrigni explains. "We try not to be too zealous for any one treatment, because often the treatment that's right for one person is not right for another. This treatment seemed to be best in Bernardo's case."

"Bernardo called me and asked what I thought," recalls Dr. Espinosa, "whether he should receive downstaging treatment in Tucson, or an operation at Mayo Clinic. And I said, 'Go for the surgical treatment.' I've worked for many years with Dr. Ferrigni, and he definitely offered the better treatment option."

"Let's do it," Bernardo told Dr. Ferrigni. "You'll find out what's needed when you open me up."

A Great Success

Just days after arriving at Mayo Clinic, Bernardo was in the operating room. During surgery, it became clear that the cancer had spread to Bernardo's lymph nodes, so Dr. Ferrigni performed the radical prostectomy.

"The operation was a great success," Bernardo says. "Recovery was a little difficult. I was still working at the time, and my business partner had to take over direction of our company. But eventually things returned to normal. I've never been sick, never needed any medicine. And I'm able to keep active with my sports!"

As part of his follow-up care, Bernardo returns to Mayo Clinic every six months for tests to ensure the cancer has remained at bay. One of those tests is the prostate-specific antigen, or PSA, test, which analyzes the amount of PSA in the patient's bloodstream. A small amount is normal, but high levels may indicate prostate infection, enlargement, inflammation, or cancer.

"I think that everyone should get the PSA test," Bernardo says. "I tell my sons, at least every year, and when they are 45 or 50 years old, every six months.

"In Mexico, it seems that people who have cancer are ashamed to talk about it," Bernardo continues. "I don't know why. I believe you should speak openly with your family and friends, because if you talk about it, it helps." To that end, Bernardo's participated in several media campaigns to raise awareness of prostate cancer in Mexico.

Over 11 years worth of follow-up care, Bernardo has also forged a close friendship with Dr. Ferrigni. "Every year, Dr. Ferrigni comes down to Los Mochis and goes sports fishing with me and my family. It's deep fishing on the ocean, for marlin, sailfish, and tuna. He's a better fisherman than I am!" Bernardo laughs.

"I believe you should enjoy life while you still have life. And I'm so grateful to Dr. Ferrigni for helping me to continue mine. I appreciate him so much."