UK doctor says cancer treatment made him a new man
Between 2011 and 2015, University of Kentucky doctor and researcher Charles Lutz battled a particularly aggressive form of prostate cancer. He underwent radical surgery that removed his prostate, then months of brutal radiation treatments that savaged his bladder and bowels.
By 2015, he couldn’t take any more radiation. The cancer had metastasized, reaching the bones of his pelvis. His PSA (prostate-specific antigen) blood test, which measures prostate cancer, showed him at a 52, when the average is between 2 and 4. He gave up, a difficult decision for a doctor, but he had a clear recognition of where things were headed. Prostate cancer is still the second leading cause of cancer deaths in men.
As a last ditch effort, Lutz joined a clinical trial at UK for patients with advanced prostate cancer, and with the new drugs that inhibited his natural testosterone, his numbers suddenly reversed. He started getting better and better, and today his PSA is less than 1.
“By mid January in 2016, the cancer was undetectable,” he said. “I was amazed, it was a miracle.”
In a sense, that miracle was where Lutz’s story really started. He wasn’t just grateful to be alive, and he wasn’t just a doctor whose experience of sickness made him a better doctor. He was a totally different person, a happier person, someone who cried at movies and enjoyed going to church. Even as a doctor who has spent his career in the hard sciences studying human cells under a microscope, he couldn’t completely explain it.
Lutz’s office in Chandler Hospital sits next to his lab, a tiny space covered with papers, the walls hung with photos of his five children, his racing bibs from runs, even his varsity track letter jacket from the University of Chicago, where he went to college as a young man straight from Omaha, Neb. A small and antique cuckoo clock sits high above his desk and keeps a steady monotonous time.
In a desk drawer, he keeps a bottle of TAK-700, the experimental drug that saved his life. Under the clinical trial of Dr. Peng Wang, patients took the medicine as an inhibitor to testosterone, the primary male sex hormone.
“The whole idea is that normal prostate tissue is highly dependent on testosterone, so let’s take away all sources,” Lutz, 65, explained. Prostate cancer cells can even mutate to produce more testosterone, in a kind of bizarre molecular survival of the fittest. TAK-700 stops testosterone from being produced anywhere in the body.
Testosterone has been described as one of the drivers of human civilization, lighting up the male brain’s receptors to mate, build muscle and forge empires. Using medication to stop testosterone production anywhere in the body is a process sometimes known as chemical castration. A big step.
Lutz was nervous about possible side effects: fatigue, depression, hot flashes, loss of libido and sexual function. Being somehow less of a man. The alternative, however, seemed worse.
After a few months of treatment, Lutz was thrilled with the results, and pleasantly surprised by the effects. Sure, his libido was shot and he had lost two minutes off his regular six-minute miles. But his PSA had dropped more than 5,000 fold in a matter of months.
In addition to his work as a pathologist who matches organ donors to transplant patients, such as UK’s kidney donor chain, he started a side research project on the effects of testosterone and “natural killer cells,” a lymphocyte that aids the immune system in fighting cancer.
And as time went on, he noticed other changes. It wasn’t just that he was grateful to be alive; many cancer survivors appreciate their lives and loved ones more outside of the shadow of the disease. He actually felt like a different person.
“I was concerned I’d lose my zest for living, but I didn’t,” he said. “Instead, I noticed that I’ve started caring more about people. I think I’ve actually become more empathetic ... I cry at the drop of a hat, these days it’s tears of joy.”
He has leaned on the congregation at the Universalist Unitarian Church he attends, and he still gets choked up when they sing a prayer he has hanging in his office: “Open my heart to be a sanctuary, all made holy, loved and true with thanksgiving, I’ll be a sanctuary for you.”
When Lutz joined that church a couple years ago, he described himself as non-theistic, recalled Rev. Brian Chenowith, a state that describes much of the congregation. “We unite behind our ethical principals,” Chenowith said. “Charlie immediately found a community he wasn’t expecting to find.”
At first skeptical, Lutz now helps prepare Sunday services. “He will be the first to admit that he found religion and never expected to and it’s a great thing to see,” Chenowith said. “He’s found great meaning and it’s helped contribute to the change he’s seen in his life.”
Divorced from the mother of his children, Lutz has fallen in love with a woman he met a few years ago, and declares himself to be “in love as never before. It’s full throttle.”
He remembers people’s names. He’s gotten to know the janitors in his building. He looks back on his life and thinks of times that he could have been kinder, more understanding or more patient, especially as a researcher and doctor, a field in which big egos abound.
“Having testosterone can make you an asshole,” he said. “It makes you more arrogant in general.”
‘The Virility Paradox’
Lutz said he hasn’t studied the research on whether testosterone loss can actually make men nicer. But it’s out there. Earlier this year, Charles Ryan, a doctor and prostate researcher at the University of Minnesota who helped develop protocols for treating prostate cancer, published a book titled “The Virility Paradox: The Vast Influence of Testosterone on Our Bodies, Minds, and the World We Live In.”
As a researcher at a medical school, Ryan said he would often work with students and residents in his clinics treating prostate cancer patients. “They would always say ‘your patients are so nice.’ I would joke and say ‘they don’t have any testosterone.’ Then one day it hit me and I started really looking into the really fascinating things that testosterone does in daily life.”
Ryan has had patients refuse the treatment despite certain death because they are scared to lose this hallmark of masculinity.
“As with all things, the beauty is in the middle, because some men will come along and they will say, they feel a little bit better, an edge has been taken out of their life that they didn’t need,” Ryan said. “Frankly, for some men, they say ‘I used to think about sex all the time and now I don’t.’
“They stop having a libido and then they stop caring about having a libido and that allows their mind to do different things.”
Testosterone and its effects encompass social and hard sciences, but it’s hard to say exactly how and why they intertwine.
“I think in the grand scheme of life, that’s the paradox,” Ryan said. “Perhaps losing part of what makes you a man helps you become more of a human.”
‘A righteous man’
Doctors are often derided for having God complexes, an arrogance that Lutz cops to when messing about with people’s lives.
But now he clings to some concepts he learned from his former wife and five children, who are Jewish. He aspires to be a “mensch,” which he describes as a good man with a special quality, “a righteous person, or someone who’s goodness is so profound that it can change the world.”
“I want to be a righteous man but I can make the world around me a better place,” Lutz said. For one thing, he’s now earmarked $100,000 to the Markey Cancer Foundation in his will, which, he said, seemed like the right thing to do.
For now, he’s enjoying life with his girlfriend, and enjoying work in new ways.
“I’m a 65-year-old teenager,” he said. “My colleagues say I’m sappy and I embrace that. I feel great, everything I worried about never came true. It’s amazing to be given a second chance at life, that’s astoundingly amazing.”
One of his five children, Claudia Lutz, says they’ve noticed the changes in their father as well.
“He’s become a lot more talkative, he talks more easily about his feelings, he’s more excited about his social life and he’s felt a stronger urge to be in touch with all of his kids,” she said. Her father also seems more aware of current issues, such as the #MeToo movement.
“He’s considering these things a lot more,” she said. “It may give him a little more permission to explore those ideas, it’s freeing from ‘I have to act like a guy my age.’”
A little while back, he wrote an essay about the past couple of years that he titled “My Life as an Man.” In it, he wrote that he has only two, low-level fears:
“One is that my prostate cancer will recur and become impervious to treatment,” he wrote. “I now have so much to live for, I would be disappointed if this disease ended all my new possibilities. My other fear is that my prostate cancer will be cured and I will discontinue my current drugs. I’m a little afraid to go back to having normal testosterone levels. Even if I do, however, I think that I’ll be a better person for having lived without testosterone for several years. I wish that I had had a period of being a half-woman earlier in life. If I had, I believe that I then would have become a better man.”