Radiation Therapy Helps Keep 9/11 Firefighter’s Prostate Cancer at Bay

As a firefighter in New York City during 9/11, Victor Rosario battled the ravages of terrorism to protect the lives of his fellow citizens. Now, as a seven-year FDNY retiree, he’s fighting a new battle—against prostate cancer.

The World Trade Center (WTC) Health Program provides medical monitoring and treatment of WTC-related health conditions for 9/11 responders and providers. In 2021, a prostate-specific antigen (PSA) test during a routine annual physical indicated Rosario’s PSA levels were at the top of the range of what is considered normal although he had no symptoms. A PSA test is a blood test that is commonly used to screen for prostate cancer.

Within just a few weeks, his PSA levels steadily increased, and a biopsy showed he had prostate cancer. On his urologist’s recommendation, in December 2021, he underwent a prostatectomy—surgical removal of the prostate—to get rid of the cancer. He was 52 years old and the father of three adult children.

In February 2022, Rosario moved to Houston to be with family and continued to take advantage of the yearly physicals provided through the WTC Health Program. A PSA test indicated a PSA level outside of the “undetectable” range, and subsequent tests showed his PSA levels were again on the rise.

“I knew this shouldn’t be happening,” says Rosario. “The doctor in New York explained that after my surgery, my PSA levels should be ‘undetectable.’”

Rosario, then 54 years old, was referred to UTHealth Houston neurosciences radiation oncologist Angel Blanco, MD, associate professor of neurosurgery and director of radiation oncology and stereotactic radiosurgery at McGovern Medical School at UTHealth Houston. As Dr. Blanco explains, removal of a cancerous prostate doesn’t guarantee a patient’s prostate cancer won’t come back.

“If the margins (edge or border of the non-tumorous tissue around the tumor that has been removed) are positive – meaning if the surgery was incomplete and cancer cells were left behind, there's about a 30% chance that the PSA will ultimately rise,” says Dr. Blanco.

To kill the remaining cancer cells and stave off recurrence, Dr. Blanco created a treatment plan for Rosario that included a combination of radiation therapy and a hormone deprivation drug.

In January and February 2023, Rosario underwent 39 radiation treatments, with very few side effects. “I went five days a week, and my treatments lasted about 15 to 20 minutes,” he says. “All I experienced was slight burning with urination and slight urinary incontinence, all of which have gone away.”

He says overall it was a pleasant experience. “Once I got over the initial shock, it was great,” he says. “The nurses in the radiation oncology clinic were so helpful and friendly.”

Rosario is happily getting on with his life. He bought a new house in Conroe, Texas, where he enjoys walking his dog and spending time with his family.

Dr. Blanco commends Rosario for taking advantage of regular prostate cancer surveillance. “If he had just thought, ‘Well, I'm done, you know, they took the prostate out, I'm good,’ and had never been checked, he might have found himself in trouble down the road.”

Rosario credits the FDNY WTC Medical Monitoring program with enabling him to catch his cancer when he did. “I am so grateful for this program,” he says. “Were it not for monitoring, I might not have been diagnosed until the cancer was more advanced.”

According to the American Cancer Society (ACS), about one man in eight will be diagnosed with prostate cancer during his lifetime. Prostate cancer is the second most common cancer and the second leading cause of cancer death in American men, behind only lung cancer. The average age of men when they are first diagnosed is about 66.

The ACS recommends that men who are at average risk of prostate cancer should discuss prostate screening with a health care provider at age 50, earlier if they are at higher-than-average risk.

Learn more about prostate cancer »