A pandemic success story

Mark Skrien has a family history of prostate cancer with his father and two uncles diagnosed during their lifetimes. So he wasn't surprised in February when lab results showed his prostate-specific antigen (PSA) test, a cancer screening test that looks for signs of prostate cancer, was high. 
During his annual physical, Skrien discussed his lab results and risk factors with Lynsi Romportl, a Family Medicine nurse practitioner at Mayo Clinic Health System in Owatonna. Because of Skrien’s family history and high PSA test result, he was referred to Mayo Clinic Health System urologist Alex Sneiders, M.D. 
Dr. Sneiders explained to Skrien he would need a biopsy to confirm a diagnosis of prostate cancer, which was completed on March 19, following Skrien’s return from a family vacation. 
Skrien’s biopsy confirmed his fears – he had an aggressive form of prostate cancer. "Dr. Sneiders said my tumor was 4 + 5 = 9 on the Gleason scale," says Skrien. The Gleason Score is a 1 to 10 ranking system to determine the aggressiveness of prostate cancer. To Skrien’s relief, the CT scan results showed the tumor had not spread but he would need to start treatment soon.
Skrien was referred to Mayo Clinic urologist Matthew Tollefson, M.D., in Rochester. Normally, this appointment would take place in person, but it was held using telehealth technology on March 30 due to the COVID-19 pandemic. Skrien met first with Elise Tentis, P.A. and then with Dr. Tollefson via Zoom. "It was fantastic," says Skrien. "I could see them on my screen and they could see me. They were very thorough and prepared me for what was going to happen. I got all my questions answered."
The surgical procedure was not possible at that time due to COVID-19. Dr. Tollefson informed Skrien it could be several months before surgery could be completed. He recommended Skrien start with hormone therapy to slow the cancer growth. “Hormonal therapy is frequently used in prostate cancer as a treatment to sensitize the tumor to radiation and provide a way to avoid more toxic treatment (like chemotherapy) for metastatic prostate cancer,” says Dr. Tollefson. 
After hormone therapy, Dr. Tollefson would perform a robot-assisted radical prostatectomy to remove the tumor. During this procedure, Dr. Tollefson maneuvers four interactive robotic arms equipped with surgical instruments toremove Skrien's prostate. The robotic device allows a more precise response to movement of the surgeon's hands, reduces blood loss, lowers pain and results in a faster recovery time. 
One of the questions Skrien had before surgery was how many prostatectomy procedures Dr. Tollefson had completed. "Elise Tentis explained that he performs about 300 of these procedures each year and has been doing so for 10 years," says Skrien. "That was very reassuring at the time. I knew I was in good hands."
The day after meeting with Dr. Tollefson, Skrien received the first hormone therapy injection in Owatonna and waited for his surgery to be scheduled. He did not need to wait long, as he received a call just nine days later from Dr. Tanner Miest, Chief Resident in Urology at Mayo Clinic, Rochester.  
"Dr. Miest said that they had a surgery opening on April 15 or 17 and I just needed to pass a COVID-19 test before," says Skrien. "I jumped at the chance." 
Before the surgery, Skrien completed tests in Owatonna and Rochester including a MRI, two CT scans, and a bone scan to make sure the cancer had not spread to other areas of his body. He also had a COVID-19 test to determine that he was negative for the virus.
On the morning of April 15, Skrien's wife dropped him off at Mayo Clinic in Rochester. "It was surreal, walking into surgery and looking back to see her waving at the door," he says. 
Due to visitor restrictions at that time, Skrien’s wife was not able to accompany him on that day but received updates from staff throughout the day. Restrictions have since been modified to allow one visitor. 
Dr. Tollefson reported that Skrien’s surgery went well and he remained in the hospital one night. Since returning home, Skrien is feeling well during his recovery and walking up to two miles a day. Skrien will return to the Mayo Clinic in three months to repeat the PSA screening. If his levels are in the normal range, he does not expect needing any additional treatment.
When reflecting on having surgery during a pandemic, Skrien has high praise for the care team. "Everyone did a fantastic job in Owatonna and Rochester. I have so many positive thoughts and memories of the staff, from schedulers to nurses and doctors to the staff who served my lunch," says Skrien. "In light of COVID-19 and everything, the whole process was done very professionally and safely."
"Prostate cancer treatment and even screening is very safe today — probably safer than going to the grocery store," says Dr. Tollefson. “Patients should feel reassured that they are entering a very highly screened setting.”