Hill Country Courage
By Ginya Carnahan, Photos by Hattie Barham

ONCE GIVEN “SIX MONTHS TO LIVE,” THIS TEXAS HOMEBUILDER AND EQUESTRIAN IS LIVING LIFE BOLDLY AND COUNSELING OTHERS.

“Texas Hill Country” is found at the crossroads of West, Central and South Texas, in an area of beautiful but rough topography. As the name suggests, there is an abundance of hills, some 400-500 feet high. The Hill Country is rocky, dry land prone to hot summers and flash flooding. Utopia, Texas, a census-designated place (CDP), is tucked away in the Sabinal Canyon, 80 miles west of San Antonio.

 At the time of the 2000 census, Utopia had 241 people, one multi-purpose gas station, 6 churches, a general store and a feed store. The city encompassed 3 square miles. The 2010 census lists Utopia’s population as 227. This is where Mark Hall lives today and where he was in September 2005 when he was diagnosed with prostate cancer.


Go West, Young Man
In 1980, Mark migrated to Texas from the Northeast and started a home building business. He raised 3 lovely daughters from his first marriage and had established a wonderful life in this rural Texas town. At age 53, he married Nancy. Just weeks after their wedding, she suggested that he get a PSA test and colonoscopy to stay on top of his health.

When his second ever PSA came back at 3,400, it shocked everyone. Mark was healthy, athletic and had no symptoms or history of prostate cancer. The first urologist he saw found a Gleason 8. The PSA had risen to 3,945 in just 1 week. The look on the doctor’s face when he gave the news said it all. He told it like it was.

Then began the process of searching out specialists, looking for just a glimmer of hope. One doctor wanted to put him on chemo immediately, while another doctor was overheard telling his colleague that he could not see any good outcome. Mark saw seven specialists, including a team at MD Anderson. His Gleason 8 cancer had spread to his lymph nodes. Mark felt that he had about 6 months to live.


The Power of Faith
Mark, a strong Christian, found solace and support from his Methodist Church family and his friends, but worried most about the impact on his daughters and on Nancy. “I told Nancy that Texas has a ‘Lemon Law’ for vehicles and that there should be a ‘Lemon Law’ for spouses, too.” Nancy’s previous husband had died in a scuba diving accident and Mark didn’t want to subject her to the almost certain loss that seemed to be in the cards. But 13 years later, Mark is in a durable remission and he and Nancy are still happily married.

How did he get from “six months to live” to where he is today? Mark says he accepted the harsh reality of the diagnosis but decided to fight with all his resources. He looked at his life and focused on the great moments and accomplishments. At the same time, he made peace with his situation but refused to give up. The backing of his faith community gave him strength.

While running his construction business, Mark made time to research prostate cancer treatments. He had a list of prostate patients from a holistic medical source and was methodically going down the list talking to anyone who would answer the phone. A man in Colorado recommended Dr. Charles Myers, a medical oncologist in Virginia who was seeing men with advanced prostate disease. Mark had run into Dr. Myers’ name on a different pathway just a few days before and decided to follow up.

After a visit to Myers’ American Institute for Diseases of the Prostate (AIDP) in Earlysville, Virginia, Mark was prescribed a triple androgen blockade to try to reduce his disturbingly high PSA. Dr. Myers told Nancy in private that Mark’s only chance was to get into a remission rapidly. Dr. Myers was going to be as aggressive as possible to try to achieve that outcome. In 2 months, there was significant improvement and after 6 months a remission started.


How to Live a Normal Life
Like many others in the Hill Country, Mark and Nancy are dedicated horse people. They both compete in a sport called Eventing. Often compared to human triathlons, Eventing involves riding on both flat surfaces and jumping fences. It comprises three phases: Dressage (a pattern of precise movements ridden before a judge), Cross-Country (demonstrating speed, endurance and jumping ability over varied terrain and obstacles) and Show Jumping (testing stamina and recovery of horse and rider after the cross-country phase). As Mark’s PSA began to fall, he was able to continue to compete in the sport he loved, taking honors and championship awards along the way.

“My prostate cancer responded well to the hormone blockade for a few years, but there came a time when we wanted to do more,” Mark remembers. Dr. Myers recommended radiation as the next step. It would be used to “de-bulk” the tumor. “Dr. Myers recommended that I go to Dr. Michael Dattoli in Sarasota for a course of intense radiation.”

“I was concerned about being away from work for so long, so I investigated some treatment centers in San Antonio and Houston as well,” Mark remembers. However, a visit to Sarasota and a thorough evaluation by Dr. Dattoli, including a 3-D color-flow Doppler ultrasound and the ability to incorporate advanced imaging done in the Netherlands, convinced him that this was where he could get the most individualized treatment and the best chance at a good outcome.

Mark’s treatment protocol began in January 2009 with 6 weeks of daily radiation, followed up after a 3-month rest period with brachytherapy (seed implant using Palladium-103 isotopes) and finally 2 weeks of radiation targeting the lymph system. “We worked it out that I could fly to Sarasota on Monday mornings and fly home on Friday evenings, which allowed me 2 days each week to manage my construction business.” His radiation plan was paired with a comprehensive hormonal therapy regime, tailored by Dr. Dattoli.

Mark remembers the time as one of concentration and focus. To prevent travel time, continuing business responsibilities and effects of radiation from taking a toll, Mark stayed physically and mentally active. He doesn’t recall feeling ill or depressed during that period – only very busy!

Mark’s PSA remained undetectable for years after the radiation. In 2014, when it had crept back up to 30, another round of hormone blockade drove it back to undetectable. In November 2015, Mark underwent Provenge Therapy. His PSA has remained undetectable for the past two and a half years.


Sharing and Teaching Others
Mark keeps an eye on his PSA with regular tests, and as the years go by he feels stronger and stronger. His experience is one that he openly shares with others. As the 9th year anniversary of his Dattoli treatment approached, Mark reached out to Journey and offered his story as a means of helping other men facing a difficult and frightening diagnosis. While his experience is far from the normal or usual, he is very generous with his time, listening to other frightened people and offering advice and encouragement. A few weeks ago he received a call from a woman who asked him to talk to her son about prostate cancer. The mother needed a man to talk to her son, as only another man can. Mark’s golden rule advice for all men: Get a PSA test to establish a baseline and do your research thoroughly before jumping into any treatment.

Today, Mark is in the process of building his largest custom home project in Utopia, just 10 minutes from his own house. During our telephone interview, he was driving home from a meeting with a landscaper. As he approached his driveway, he explained that he would have to be excused for a minute or two as a couple of friends were waiting for him: two Labradors and a little poodle. Other friends were in the field – 4 horses, including Mark’s big gray Percheron/Thoroughbred event horse. And his best friend, wife Nancy, was in the house. Life is good for Mark and Nancy.

Mark believes that keeping a good attitude is at least as strong as finding the right doctor and treatment for overcoming cancer. Because of his good fortune and blessings, he feels an obligation to share the gift of hope with others.