Ethan Boger was first diagnosed with prostate cancer in March of 2015 after years of rising prostate-specific antigen (PSA) levels. MRI testing and fusion-guided biopsy confirmed that he had a single Gleason 8 tumor in the left peripheral zone. Before making the important decision about which treatment option to pursue, Mr. Boger studied the medical literature, consulted with fellow cancer patients and coaches, and underwent further testing which indicated his disease was confined to the prostate. Adopting a strategy of maximum information and minimum intervention, he decided to forego the standard of care (radical prostatectomy and/or radiation, brachytherapy seeds, and androgen deprivation) and instead opted for treatment by focal laser ablation (FLA), an investigational therapy that uses highly targeted heat to kill cancer cells focally and with negligible side effects. Although this treatment has been shown to be effective for men with early stage prostate cancer, the long-term outcomes have not been demonstrated. To date Mr. Boger has responded well to the treatment. However, he lives with the uncertainty shared by all prostate cancer survivors: the chance his disease might recur someday.

To reduce his risk of recurrence, Mr. Boger made lifestyle changes including increasing his level of exercise, adopting a healthier diet, adding supplements, and reducing stress. With the understanding that FLA may not be curative, especially for a Gleason 8 tumor, he researched the medical literature and joined an online network of prostate cancer survivors to keep up to date on the latest discoveries. As a result, he was able to have his biopsy samples tested by Decipher, a state of the art genomic test that was not available at the time of his diagnosis, and he has identified investigational treatment options as a back-up plan in case there is evidence of recurrence. Mr. Boger feels that if he can keep his cancer in abeyance for a few more years, there is a good chance that new treatments with fewer side effects, or perhaps even a cure, will be available.

From the start, Mr. Boger had joined his local in-person survivor support group, the Prostate Cancer Information Group, through the Cincinnati chapter of the Cancer Support Community. Over time, he has taken a leadership role in finding medical professionals from around the country to speak to the group in person and through webinars.

With sponsorship from the Cancer Support Community, Mr. Boger became a consumer reviewer for the PCRP. A mechanical engineer by profession, he was able to leverage years of reading and writing advanced technical reports to meet the challenge of reviewing highly detailed applications for research involving the latest innovations in diagnosis and treatment of prostate cancer. Although reviewing a significant number of applications in a field not his own was challenging and time consuming, it was a thoroughly positive and rewarding experience.

As a �rookie� reviewer, Mr. Boger described his experience sitting on a panel surrounded by expert scientists and other, more seasoned consumer reviewers as �breathtaking and inspiring�. He was fascinated by the very innovative proposals under review and excited about the prospect that some of the proposed research could have a real and lasting benefit. �I learned a heck of a lot about the science behind prostate cancer research, too�, he added.

With all the knowledge he now has about prostate cancer, Mr. Boger understands it is a �tough nut to crack�. For the vast majority of men, prostate cancer is a slow growing disease that will not kill, but there are many others whose disease is highly lethal. Because of this dichotomy, he thinks the main thrust of research should be devoted to personalizing treatment and minimizing morbidities. He hopes that the work funded by the PCRP will help the millions of men like him who currently live with the disease and the possibility of recurrence by providing treatments that are curative for all stages of prostate cancer.