The Edmond Sun

October 23, 2012

Richard Fransen

Mark Schlachtenhaufen
The Edmond Sun

EDMOND — Prior to 2006, Richard Fransen had no medical history and was regularly active, playing tennis and racketball at least once a week.

His father lived a long life, but when he was age 13 he lost his mother to breast cancer.

“With no symptoms, there was no reason for any concern,” said Fransen, an insurance and investment planner. “The monitoring of the PSA as routine.”

In 2006, Fransen’s PSA (prostate-specific antigen) began to rise. PSA is a protein produced by the prostate gland often found in increased amounts in the blood of patients with prostate cancer. The prostate is a gland in the male reproductive system found below the bladder and in front of the rectum.

Fransen had regular checkups with his urologist and they watched the numbers during the remainder of that year and in 2007. In 2008, he elected to have a prostate biopsy performed; he learned he had prostate cancer.

The other measurement used in this type of cancer is the Gleason score. It’s a system of grading prostate cancer tissue based on how it looks under a microscope, according to the National Cancer Institute. Scores range from 2-10 and indicate how likely it is that a tumor will spread. A high score means the tissue is very different from normal and the tumor is more likely to spread.

At the time of Fransen’s biopsy, his Gleason score was thought to be a 7. It was unknown if the cancer cells had spread, Fransen said.

“The reaction to hearing you have cancer can be devastating at first, primarily because you have no idea what to expect,” he said.

It may be no big deal or knowing that prostate cancer can be fatal, Fransen said. He wondered where he fell in this potential range. His next task was to learn as much as he could.

Fransen researched the topic through the Internet, and he leaned heavily on his sister, a board certified MD in oncology and internal medicine.

Fransen learned of choices including surgery (prostatectomy), radiation seeds, radiation therapy and hormone therapy. His conclusion was to have it removed, so he elected a prostatectomy. Then the decision was to do the surgery via the traditional method of open surgery or via lapriscopic. Again, the research began. He elected to have the robotic (lapriscopic) surgery, which was performed in November 2008.

The physician wanted Fransen to begin radiation therapy just to be safe due to two reasons. First, the Gleason score from the biopsy turned out to be a 9 rather than 7. And there was concern cancer cells existed around the edge of the prostate.

He had signed up and almost began traditional radiation therapy (IMRT) when he went by the Procure Proton Therapy Treatment Center that was just opening. He began research and learning about proton therapy and decided he wanted to use that technology.

“Without me learning more about my options and learning more about side effects, I would have been treated differently, and in my opinion, not have had the current success I have had,” Fransen said.

When times were tough, Fransen leaned on friends who provided constant support and his sons; he was not married at the time of the diagnosis. His Bible study group also was there for him. He says he believes that without God’s involvement, there is no way his cancer could be completely gone.

“I feel prayer was an important element of me coping and getting through the tough times,” Fransen said. “My sons were also vital in helping me cope.”

Humor also helps, Fransen said. Having cancer changes your outlook on life. Fransen said he cherishes it more now. A diagnosis of cancer is not automatically a death sentence — don’t treat it that way, he said.

As of his last PET Scan, he was shown as clear of cancer cells. The current progrnosis is no cancer, no treatment. It takes about 1 million cells before they show up on most scans, so he will continue to monitor his health through scans and blood tests.

The introduction of widespread PSA screening led to a dramatic increase in the incidence rate of prostate cancer, which peaked at 237 new cases diagnosed per 100,000 American men in 1992, according to the National Cancer Institute.