{"id":75634,"date":"2024-05-07T13:18:39","date_gmt":"2024-05-07T19:18:39","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=75634"},"modified":"2024-05-31T13:09:24","modified_gmt":"2024-05-31T19:09:24","slug":"olaparib-continues-to-extend-fathers-life-in-prostate-cancer-battle","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/olaparib-continues-to-extend-fathers-life-in-prostate-cancer-battle\/","title":{"rendered":"Nine years after a stage 4 prostate cancer diagnosis, CU Athletics leader still setting an example"},"content":{"rendered":"
<\/div>
\"Miguel
Miguel Rueda with his wife, Andrea, and (l-r) Isabella, Christopher and Gabriel. Photo courtesy Miguel Rueda.<\/figcaption><\/figure>\n

Miguel Rueda\u2019s story over the past decade has been about terrible luck, being lucky, and then making the most of that luck.<\/p>\n

It was fall 2014, and Rueda, then 42, was the University of Colorado Athletic Department<\/a>\u2019s senior associate athletic director at the time and knew the difference between normal discomfort and something else.<\/p>\n

A \u201csomething else\u201d led him to request a physical with CU football\u2019s team physician, University of Colorado School of Medicine and UCHealth Sports Medicine\u2019s physician Dr. Sourav Poddar.<\/a><\/p>\n

Rueda\u2019s prostate-specific antigen (PSA) number came in at about 30 ng\/mL \u2013 well above the normal range. A couple of weeks later, he followed up with CU School of Medicine urologist Dr. Al Barqawi<\/a>. Yet to see that number, he asked, \u201cWhat are you doing here? You\u2019re too young to be here.\u201d<\/p>\n

Men without risk factors (being African American and having immediate family members with a history of prostate cancer, principally) don\u2019t usually test for prostate cancer until they\u2019re 55, and most diagnoses happen with men in their 60s.<\/p>\n

\u201cI don\u2019t want to be here,\u201d Rueda responded. \u201cCan you just tell me why my PSA is so high?\u201d<\/p>\n

A biopsy showed cancer with a high Gleason score throughout the prostate, and further testing found more troubling details. In addition to the typical adenocarcinoma, Rueda\u2019s prostate contained a rare small-cell neuroendocrine cancer which would complicate treatment. And the cancer had spread to nearby lymph nodes, the seminal vesicle, and the bladder. Rueda\u2019s PSA had had skyrocketed to 95 ng\/mL. Few patients in such straits survive five years.<\/p>\n

\"Nine
Nine years after a prostate cancer diagnosis, Miguel Rueda remains on hormone therapy and olaparib, leveraging clean scans and his good fortune. Photo: Sonya Doctorian, UCHealth.<\/figcaption><\/figure>\n

He got the news via cell phone on Jan. 20, 2015. He was driving in his hometown of San Francisco with his wife Andrea, his brother Kevin, and his kids Gabriel, Isabella, and Christopher, who were 12, 10, and 9.<\/p>\n

Barqawi told him: \u201cYou have cancer, and it\u2019s not good.\u201d<\/p>\n

\u201cI can still hear his voice,\u201d Rueda says.<\/p>\n

Multimodal prostate cancer treatment starts<\/h2>\n

Dr. Elizabeth Kessler<\/a>, a CU School of Medicine genitourinary medical oncologist, and her colleague Dr. David Raben,<\/a> a radiation oncologist, took the lead in Rueda\u2019s care at UCHealth University of Colorado Hospital<\/a> on the Anschutz Medical Campus.<\/p>\n

They and University of Colorado Cancer Center colleagues including pathologists, urologic oncologists, and surgical oncologist Dr. Paul Maroni considered options for Rueda\u2019s treatment. The goal was to extend his life. They considered approaches including surgery, radioactive pellets (brachytherapy), radiation, chemotherapy, and hormone therapy.
\nThey settled upon the latter three. Given the cancer\u2019s spread, a prostatectomy to remove the prostate would be no more effective than radiation in treating Rueda\u2019s cancer, they determined. They suggested he seek out a second opinion, which he did, and which met with agreement. The treatments started with hormone therapy plus radiation therapy in spring 2015.<\/p>\n

The goal of hormone therapy, Kessler says, \u201cis to take away much of the fuel source to the prostate-cancer cells by lowering the amount of circulating testosterone in the system.\u201d Radiation therapy, which Raben performed Monday-through-Friday for several weeks, attacked the cancer cells head-on. In late summer, Rueda started what would be six rounds of chemotherapy (docetaxel) that wouldn\u2019t end until just before Christmas.<\/p>\n

Given the diagnosis and the demands of treatment, Rueda transitioned earlier than planned to a new role at CU-Boulder, becoming associate athletic director for health and performance. Mike MacIntyre, CU\u2019s head football coach at the time, floated the idea of helmet stickers or T-shirts in support of Rueda during his cancer fight. Rueda shut it down.<\/p>\n

\u201cIt was a wonderful gesture,\u201d he says, \u201cBut you know, I\u2019ve been behind the scenes my entire life, and I thrive there. I worked really hard, and I loved what I did, but people like me aren\u2019t always comfortable being pushed out into that sort of spotlight.\u201d<\/p>\n

A new drug for prostate cancer: olaparib<\/h2>\n
\"Miguel
Miguel and Andrea for a half marathon in Austin, Texas. Photo courtesy of Miguel Rueda.<\/figcaption><\/figure>\n

The treatment quelled the cancer, and his PSA numbers plunged. Less than two months after finishing chemotherapy, the former high school cross-country runner did his first-ever half marathon in Austin, Texas, and then followed up with the Steamboat Marathon in June and the Portland Marathon in Oregon in October. But by then, despite staying on hormone therapy, his PSA numbers were on the rise, and cancer had spread to lymph nodes in his neck.
\nKessler put Rueda on abiraterone acetate (Zytiga) to further suppress male hormones. But, within months, the cancer was resurgent.<\/p>\n

\u201cOftentimes, men can be on abiraterone and can maintain stability for a couple of years,\u201d Kessler says. \u201cUnfortunately, in Miguel\u2019s case, the cancer was shown to grow in less than one year on it.\u201d<\/p>\n

Here is where good luck finally made its appearance. Raben, the radiation oncologist, had been working with ovarian cancer patients on a drug called olaparib (Lynparza), a PARP inhibitor. The drug impedes cancer cells\u2019 ability to repair their own DNA, which slows or stops tumor growth. Kessler and Raben had also noted a small study published in the New England Journal of Medicine that found the drug, used off-label, seemed to work for prostate cancer patients.
\nCancers with the BRCA2 mutation best known for its complicity in breast and ovarian cancer seemed to respond particularly well to olaparib \u2013 and that mutation was found in Rueda\u2019s cancer (though not in his normal cells, meaning the cancer had developed the mutation despite his not having inherited it).<\/p>\n

Kessler convinced Rueda\u2019s insurance company to cover olaparib, which he started taking six months before focal radiation therapy on the lymph nodes on his neck. By late 2018, Rueda\u2019s PSA numbers had plummeted.<\/p>\n

Making the most of gifted years<\/h2>\n

Six years later, he\u2019s still on hormone therapy and olaparib, which the U.S. Food and Drug Administration approved for prostate cancer in 2020. His PSA is below 0.2 ng\/mL and his scans are clean.<\/p>\n

Rueda has not let his good fortune go unexploited. He talks to his older son Gabriel, now a senior at West Point, almost daily. He and Andrea fly to San Antonio, Texas, to watch Isabella play soccer at Trinity University. Son Christopher is running track and gearing up to graduate from Broomfield\u2019s Prospect Ridge Academy. The Ruedas have skied the Swiss and Austrian alps and traveled together to Spain and Turkey.<\/p>\n

\"The
The Rueda family visited Turkey, where Miguel had been a foreign exchange student, in 2018. Miguel’s dream had been for his family to meet his Turkish host family. Photo courtesy Miguel Rueda.<\/figcaption><\/figure>\n

\u201cI\u2019ve had this conversation with both my daughter and my son recently, for different reasons \u2013 they brought it up,\u201d Rueda says. \u201cI have to be careful how I say this: I\u2019m not grateful for the disease, but I appreciate how much it\u2019s made me a better father. How much it\u2019s made me a better friend, a better husband.\u201d<\/p>\n

He continues to work hard for the CU Athletic Department. He lifts weights and does cardio, which Kessler and colleagues recommend to all patients on hormone therapy. And he\u2019s on a medication to help maintain bone density. But fatigue from having his testosterone supply throttled for nearly a decade does weigh on him.<\/p>\n

\u201cA low testosterone level is going to cause a body mass loss, bone density loss, increased blood pressure, increased blood sugar, increased cholesterol,\u201d Kessler says. \u201cWe’re basically trying to work against all of these side effects that we know occur.\u201d<\/p>\n

Despite Rueda\u2019s disinterest in the spotlight \u2013 and in being known as a cancer patient rather than the person he is \u2013 he\u2019s sharing his story, because someone else once shared theirs. She was a breast cancer patient with a slim chance of survival.<\/p>\n

\"Nine
Miguel Rueda and son, Gabriel, on spring break 2024. Photo courtesy Miguel Rueda.<\/figcaption><\/figure>\n

\u201cI think she was given a 2% chance to live, and she beat the odds, and she was sort of there for me as a person,\u201d Rueda says. \u201cSo, if I can help people with this diagnosis, if I can help others see that it\u2019s possible, I\u2019m going to do it.\u201d<\/p>\n

In January, Rueda formalized his role in helping other cancer patients by becoming co-chair of the University of Colorado Cancer Center\u2019s Office of Community Outreach & Engagement\u2019s CARES group.<\/p>\n

He\u2019s grateful for the years he has gained and the help he\u2019s gotten along the way from family, friends, physicians, nurses, and so many others.<\/p>\n

\u201cI fully believe that there\u2019s a physical part of things and there\u2019s the mental, and that has an impact on the physical. My doctors and caregivers from UCHealth allowed me to have the right mindset that I\u2019m sure has extended my life,\u201d Rueda says. \u201cI never thought I would live nine years, right?\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Miguel Rueda\u2019s story over the past decade has been about terrible luck, being lucky, and then making the most of that luck. It was fall 2014, and Rueda, then 42, was the University of Colorado Athletic Department\u2019s senior associate athletic director at the time and knew the difference between normal discomfort and something else. A […]<\/p>\n","protected":false},"author":23,"featured_media":75636,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[7],"tags":[28,468,6837],"class_list":["post-75634","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-cancer-care-oncology","tag-prostate-cancer","tag-prostate-cancer-treatment"],"acf":[],"yoast_head":"\nOlaparib continues to extend father's life in prostate cancer battle- UCHealth Today<\/title>\n<meta name=\"description\" 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