‘I wouldn’t have had a clue’: LMH pathology supervisor’s prostate cancer might have become incurable if he hadn’t been tested
photo by: Jeff Burkhead
As LMH Health’s anatomic pathology supervisor, Scott Mersmann looks for signs of cancer for a living — and last year, spotting the signs early probably saved his life.
In May, Mersmann found out that he had an aggressive case of prostate cancer, so aggressive that he says it probably would have been incurable if it had remained undetected. And that might have happened if he hadn’t gotten regular cancer screenings and taken the results seriously.
“Working in cancer diagnosis my entire adult life, it made it easier to understand that one day it could be my name on the slides,” he said. “It’s easier for me to understand and absorb because I know and understand more about it, though it’s still a surreal experience.”
Every year, as part of his annual health screenings, Mersmann would get tested for his levels of prostate-specific antigen, or PSA. If there’s more of it in the bloodstream, that can be the first step in diagnosing prostate cancer. And over time, Mersmann’s PSA levels had been slowly rising.
Most men without prostate cancer have PSA levels under 4, according to the American Cancer Society, and about a quarter of men who have levels between 4 and 10 will turn out to have cancer. When Mersmann’s level rose above 4 in early 2021, he started to get a little nervous.
Because he’d been diagnosed with lymphoma in 2020, he was already seeing an oncologist, and so he went and got his PSA checked twice more in the next several months. First, it went up; then, it went back down.
“Based on that, I thought things were fine,” he said.
Then, at his screening last year, his PSA jumped to 6.54.
He wasn’t experiencing any other worrisome symptoms, but he decided to make an appointment at Lawrence Urology Specialists anyway.
“I had some enlargement of the prostate, but that’s to be expected in most males at some point,” he said.
“If it wasn’t for the PSA screening, I wouldn’t have had a clue that something was wrong.”
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In April 2022, Mersmann had an MRI to find out whether there was any cause for concern. There was: The MRI showed a mass. Mersmann had a biopsy done in May, and a day later he learned that it was cancer.
But it wasn’t just any cancer, he said. It was the kind of aggressive cancer that you’d expect to see in a 75-year-old man, not in somebody in his 50s. It also wouldn’t be expected in someone with a PSA level as low as his.
And it was spreading — although it hadn’t gotten too far.
“I already had a metastasis into the seminal vesicle on one side,” he said. “If I hadn’t paid attention and followed up, I probably could’ve had widely metastatic disease, making the cancer treatable, but incurable.”
In July 2022, Mersmann had surgery to have his prostate removed. The expectation after that was that Mersmann’s PSA would fall to an undetectable level.
But that didn’t happen. Mersmann still has some PSA in his bloodstream, meaning the cancer is still present somewhere in his body. To find it, he will need to undergo a specialized PET scan that looks specifically for prostate cancer, and then treatment with radiation and androgen deprivation therapy, or ADT.
“I’ll work with a medical oncologist to manage the ADT, which wipes out all of the testosterone in the body, as it’s thought to be a driver for prostate cancer,” he said. “I’ll have symptoms similar to what women go through in menopause — extreme fatigue, hot flashes and irritability — which is pretty common for people who have recurrences or persistence.”
Mersmann is hopeful that the treatment will eventually reduce his PSA to undetectable levels.
“Cure is a subjective term,” he said. “As long as my PSA is undetectable for the rest of my life, I’ll be prostate cancer-free.”
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Mersmann has worked in the lab at LMH Health for nearly 30 years, so even before his diagnosis he knew the value of screening and testing better than most people. And his case shows that sometimes, regular screenings can be the only way to detect a problem before it gets out of hand.
Now he hopes that sharing his story will inspire more people to get their routine tests — and possibly save their lives.
“Spending my adult life working in health care, particularly in pathology, I feel a sense of responsibility that outweighs my preference to remain behind the scenes,” Mersmann said. “My recent diagnosis and successful surgery — all predicated on PSA screenings — serve as an example of how screening works.”
“My advice — get your damn screening tests and don’t ignore your results,” he said. “It won’t make your cancer disappear.”
— Autumn Bishop is the marketing manager and content strategist at LMH Health, which is a major sponsor of the Journal-World’s Health section.