“I was impressed by his willingness, as a surgeon, to recommend an option that did not involve surgery,” Bill said. “That made a strong impression on me and increased my confidence in Fox Chase.”‐Bill Coren
After decades of living with Crohn’s disease and two previous bowel surgeries, Bill knew his medical history had to be part of his prostate cancer treatment decision. A second opinion at Fox Chase helped him find an approach that addressed his cancer while taking his individual concerns into account.
Bill Coren has spent much of his life helping young athletes keep moving forward.
A longtime educator and accomplished cross-country and track coach, Bill spent 35 years teaching middle school and decades coaching student-athletes. Now 76, he is retired from the classroom but still coaching cross-country and spring track.
So, when prostate cancer suddenly presented Bill with an important decision about his own health, he approached it thoughtfully.
His urologist had been monitoring his prostate-specific antigen, or PSA, through regular blood tests. When the number continued to rise, Bill learned that he had prostate cancer.
“Obviously, I was in shock,” he recalled.
But prostate cancer wasn’t Bill’s first experience navigating a complicated medical condition. He had lived with Crohn’s disease since he was 10 years old and had undergone two previous bowel surgeries. That history immediately influenced how he thought about prostate cancer treatment.
Facing a treatment decision
The first specialist Bill consulted recommended surgery. Bill was prepared to have an operation if it was necessary, but because of his history with Crohn’s disease and two previous intestinal surgeries, he remained concerned about having another operation in that part of his body.
“I kept asking whether my previous intestinal surgeries could present a problem,” he said. “I was willing to have the surgery if I needed it, but I wanted another opinion.”
That decision led Bill to Fox Chase Cancer Center, where he met Alexander Kutikov, MD, FACS, a urologic oncologist and the Co-Executive Director of the Fox Chase–Temple Health Urologic Institute - which provides advanced treatment options and highly specialized care for patients with both cancerous and noncancerous urological conditions.
What happened next immediately stood out to him.
Dr. Kutikov is a surgeon, but he did not assume that surgery was automatically the best option for Bill. He shared Bill’s concerns about the potential complications another operation could present and was open to treating the prostate cancer with radiation instead.
“I was impressed by his willingness, as a surgeon, to recommend an option that did not involve surgery,” Bill said. “That made a strong impression on me and increased my confidence in Fox Chase.”
Dr. Kutikov referred Bill to radiation oncologist Mark A. Hallman, MD, PhD, and the physicians discussed his case. For Bill, that collaboration reinforced the sense that the recommendation was being shaped around his individual circumstances rather than around one particular type of treatment.
Finding the right approach
Dr. Hallman understood why Bill was concerned about surgery. He also made sure Bill understood that radiation came with its own potential risks and side effects.
Bill appreciated the straightforward conversation.
“There are no guarantees when you’re dealing with cancer,” he said. “What I wanted was a doctor who understood my concerns, explained my options and gave me confidence that we had thought the decision through carefully.”
Ultimately, Bill moved ahead with high-dose-rate, or HDR, brachytherapy, a form of radiation therapy that delivers radiation directly to the prostate for a limited period of time.
He received the treatment in two sessions. A spacer was also used to help reduce radiation exposure to the rectum — an important consideration because of Bill’s medical history.
Going into treatment, Bill was unsure what to expect. He had been dealing with medical procedures since childhood, but prostate cancer was entirely new territory.
The experience turned out to be easier than he anticipated.
“It was much less invasive or intrusive than I expected,” he said.
Bill tolerated the procedures well and says he has had very few problems that he can connect to the treatment. His PSA dropped to 0.01 and has remained there through his recent follow-up testing.
For his particular situation, Bill says he is very happy with the treatment decision he made.
Care that continued even after cancer treatment
One of the things Bill has come to appreciate most about Fox Chase is that his experience did not end when treatment was over.
He continues to stay in touch with Dr. Hallman and the care team. If he sends a message through the patient portal with a question about a symptom or medication, he says he typically hears back quickly from Dr. Hallman, a nurse or another member of the team.
Those details matter to Bill.
Having lived with Crohn’s disease for most of his life, he has spent decades interacting with physicians and health care systems. He knows how important it is to feel that doctors understand the individual person behind the diagnosis.
“They have many patients, but they understand that patients are human beings,” he said. “I never felt rushed at Fox Chase.”
For Bill, that sense of trust extends beyond any single physician.
“I think it is the entire system,” he said. “They have the right people in place.”
Back on the track
Today, Bill’s PSA remains at 0.01 on his recent follow-up tests, and he says he has had very few problems that he can attribute to his prostate cancer treatment.
More importantly, cancer has not taken him away from a role that has been part of his life for decades.
At 76, he is still coaching cross-country and spring track.
“I expected some lingering fatigue or other issues after treatment, but I don’t have any side effects that I can connect to the prostate cancer treatment,” he said. “This treatment gave me a new lease on life.”
Looking back, Bill is especially glad that he kept asking questions before deciding how to treat his cancer.
His experience does not mean that HDR brachytherapy is the right choice for every person with prostate cancer. Every patient’s situation is different. But Bill believes patients should understand their options and find physicians who consider their individual circumstances rather than approaching every case in exactly the same way.
For Bill, that meant finding a team willing to consider not just his prostate cancer, but the medical history and life surrounding it.
And these days, much of that life still takes place alongside a track where he wants to be.