David Diaz joins Dr. Zachary Klaassen to share how his family history of breast cancer led to BRCA2 genetic testing and an early prostate cancer diagnosis. He discusses his treatment journey and the importance of cascade testing, which helped his children identify their inherited cancer risk and take proactive steps toward their health.
Zach Klaassen
Hi, my name is Zach Klaassen, urologic oncologist in Augusta, Georgia, and we are on Prostate Cancer Patient Voices, discussing patient's journey through prostate cancer. And I'm excited to be joined by David Diaz, who is a prostate cancer survivor. And today we'll be discussing his journey as well as the importance of germline and cascade testing. Thanks so much for joining us on Prostate Cancer Patient Voices.
David Diaz
Oh, thank you for having me.
Zach Klaassen
So your story is very unique and a very important story to tell to the patients that are out there in terms of germline testing and somatic testing. A little background for our listeners. Germline means that you're testing the blood for mutations that are inheritable, so what your parents gave you. Somatic testing is for when we test the tumor. And so just tell us a little bit about your family history and what led to that test that you got.
David Diaz
So what led to me getting germline testing, my mother was diagnosed with breast cancer early on, and she eventually succumbed to breast cancer, but she went ahead and did germline testing or hereditary testing. And we found out she was BRCA2. Her sisters were also getting breast cancer, so my aunts. So it was important that we started getting this testing done. She eventually passed away.
And at that time, my wife, I was married at the time, she was a physician assistant and she was like, "You should really get tested." And I was like, "Yeah, okay, I can do a germline." So I did that. As I got that completed, she recommended that I should start getting tested for prostate. And I can remember, I'm 44 and I'm like, "I have no symptoms. I'm healthy-
Zach Klaassen
Peak of life. Yeah.
David Diaz
... I'm good." And she's like, "Well, you should really do that." And like a typical guy, just blowed it off like, "I got time." But I was also good friends with my PCP, and he came and talked to me and said, "Hey, Dave, it's just a simple test." And at that time I was an air traffic controller. I got to maintain my medical clearance every year. The only thing that was missing from that test was a blood test.
And he's like, "Hey, simple blood test." And so I went ahead, I did the PSA, and then the results come back from my germline and say, "Hey, you're BRCA2 positive." Just like my mother, my aunts and her side of the family. And as I'm finding that out, I find out my PSA is 5.2 and I'm like, "Hey, oh." So my PCP is like, "Hey, I'm going to recommend you to urology." I went and they're like, "Oh, it could be anything. It's just kind of a little bit elevated."
We waited like two months, like 60 days and come back. It's on my birthday. I turned 45. I have an appointment with my urologist on my 45th birthday and it comes back 7.6. And she's like, "This is not normal, Dave, but you may have prostate cancer." And it was the first time I ever heard prostate cancer. And from there, my life changed.
Zach Klaassen
45th birthday, urologist is saying you may have prostate cancer. What happened from then? Because I know you've had a lot of biopsy treatment, et cetera. Just maybe walk us through how that journey was.
David Diaz
Yeah, and it happened very quickly. So a few weeks later I go in, get my biopsy, I get the results, I'm hearing new terms, Gleason scores, stuff like that. I was a Gleason seven, four plus three. And my treatment protocol was two years of hormone therapy. I did four rounds of chemotherapy, and then I did 38 rounds of EBRT radiation plus three more that was targeted on my pelvic bone. I shared this because not only that the testing was important to know about my family history, which helped me get the germline testing.
I found out my current cancer, even though it was early, but in late stages, it gave me an opportunity to go after it. And with that, I've been in my journey for nine years. Seven out of those nine years, I've been no evidence of disease.
Zach Klaassen
Amazing.
David Diaz
So it's very important about the testing. Don't get me wrong, my journey was difficult. Go out there, get tested, especially if you have a family history of cancer, any kind of cancer.
Zach Klaassen
The last question I want to ask is just a little bit about cascade testing. For our listeners, cascade testing is essentially if you have somebody like your mother that tested you, you tested your kids now, so it's a downstream effect of that germline testing. Talk about the decision to test your children and how that went about.
David Diaz
So I have four kids. I have two adult boys. They're 32 and 29. And once I found out that I was BRCA2 positive, I sat them down and I was like, "Hey, this is a very devastating gene mutation, especially for women. For men, I think the numbers is like 20%. You might get prostate cancer or something like that, but you really needed to get tested." And they did. And we found out they were BRCA2 positive also. So now instead of waiting, like for me when I was in my 40s, they could start at 35. And not only that, my son who's in the army right now, he has a daughter and he's aware.
Zach Klaassen
That's right.
David Diaz
Once you're aware, you can't put it back in the box.
Zach Klaassen
That's right.
David Diaz
So now when she comes of age, she could get tested and do the things that she needs to do.
Zach Klaassen
Such an important message as well. I think that those conversations are important because it gives them a chance early on to get the testing going. David, it's been a phenomenal discussion. First of all, thank you for joining us on Prostate Cancer Patient Voices. Thank you for your service to our country. Anything we haven't hit on? Anything for our listeners before we wrap up?
David Diaz
You know what? I always end most of my talks with this. Prostate cancer may redefine your days, but it doesn't define who you are. You can have an amazing, productive, functional life with prostate cancer. And I'll end with that.
Zach Klaassen
Great way to end it. Thank you so much.
David Diaz
All right.
This interview was produced with the generous support of AstraZeneca Pharmaceuticals