Nestled between the 57-mile Cape Lookout National Seashore lies an isolated barrier island, Portsmouth, a former port town that stretches uninhabited for 13 miles and is accessible only by boat. It’s one of the last few wild frontiers along the North Carolina coast and is preserved by the National Park Service as a museum-like reminder of a long-gone coastal village. On any given summer weekend, tourists can find Ed Burgess and his wife, Rene, helping upkeep the island.
Travelers to this retreat often face an unpredictable journey, heavily dependent on the weather and water conditions, but the view and sea shells are more than worth it. In 2008, much like the tourists who make the trek to secluded island, Burgess found himself in an unpredictable journey of his own – battling cancer.
During an appointment with his local primary care physician in early 2008, a rising PSA was discovered and Burgess was referred to a urologist in Burlington, NC, to get further testing. Shortly after, he underwent a biopsy that confirmed stage 2 prostate cancer. The disease caught Burgess a little off guard, as prostate cancer did not run in his family. For Burgess, it was important for him to still be able to spend his time volunteering with the National Park Service, a calling he found after retiring from a 23-year career with the United States Navy.
“The biggest piece of advice I can give any man is to visit your primary care doctor annually and become familiar with your PSA level,” said Burgess. “Prostate cancer can be treated and controlled when detected early – always know your numbers!”
In June 2008, he scheduled a prostatectomy at Duke. Post-surgery pathology reports confirmed they did not receive clear margins, suggesting that his disease could recur and spread if left untreated. In 2011, during a routine check, his PSA began to rise again and Burgess was referred to W. Robert Lee, MD, a radiation oncologist at Duke Cancer Institute. The cancer was back and this time, he would undergo 33 treatments of radiation therapy. After successfully completing his treatment, his PSA again dropped to 0 and he entered active surveillance for monitoring.
In 2017, his PSA rose again rapidly to 14 and he was referred to Andrew Armstrong, MD, a prostate cancer specialist at Duke Cancer Institute. During his visit with Armstrong, Burgess learned about the ARCHES clinical trial available at Duke. The ARCHES trial prospectively studied and evaluated the efficacy and safety of enzalutamide, an androgen-receptor inhibitor, in conjunction with androgen deprivation therapy (ADT) in men with metastatic hormone-sensitive prostate cancer (mHSPC), as compared to standard ADT alone, which was the standard of care at that time. ADT alone meant simply getting shots of a hormonal therapy such as Leuprolide to lower his testosterone, which has been a typical and effective therapy for the past 30+ years.
“Mr. Burgess was enrolled on ARCHES as this trial was anticipated to improve long term outcomes with more potent combination hormonal therapy, including survival,” described Armstrong. “This trial, and the ENZAMET trial, were recently reported in two separate major publications in 2019 and were positive, showing longer survival time for men without disease progression for enzalutamide/androgen deprivation therapy vs. androgen deprivation therapy alone. Remissions from the combined therapies are deeper and more durable than ADT alone. These results led to changes in the NCCN national treatment guidelines for prostate cancer, and are anticipated to lead to USFDA approval for enzalutamide in this hormone sensitive setting.”
After enrolling in the trial, Burgess has a positive response to treatment. Currently, he is still enrolled on the ARCHES trial and his PSA remains undetectable. Burgess has been in remission now for several years.
“My care at Duke has been outstanding,” described Burgess. “My nurses, Drs. Lee and Armstrong, and everyone I’ve met along the journey have helped me get to where I am today. It wasn’t always easy, but Duke had a plan and I believed in it. They always gave me the support I needed, and I tell everyone ‘my heart belongs to my wife, but my body belongs to Duke’ because I wouldn’t still be here without them.”