When new patient files come across Dr. John McHugh’s desk, he takes the time to familiarize himself with their case and works to get to know the patient better.

But in 2007, when a new file hit his desk, he didn’t have to read through the medical history. The name on it was his own.

McHugh is a urologist with Northeast Georgia Urological Associates in Gainesville and regularly operates on prostate cancer patients. When he was diagnosed with the disease, he was very familiar with his options.

Even with his background knowledge, deciding how to treat his cancer — surgery, radiation or surveillance — wasn’t an easy process.

Knowing know confusing the process could be, McHugh decided to turn his medical insights and personal experience into a book, "The Decision: Your Prostate Biopsy Shows Cancer. Now What?"

That book evolved into an accompanying digital application, ProstateMD, which is available online through the Apple iTunes store.

The discovery

"The most common finding of the prostate during an exam is that the prostate is normal," said McHugh, who has practiced medicine in Gainesville since 1986.

The best way to determine early on if there are cancerous cells on the prostate is to screen PSA (prostate-specific antigen) levels in the blood, McHugh says.

"Now we tell men to have a baseline test done when he is 40 and maybe every two years after that if things are normal," McHugh said.

"Back when I started tracking myself, we weren’t thinking that way. I did my first screening at 48, then repeated it every six months to a year after that."

For the next few years, he watched as his PSA levels slowly increase, which indicates possible cancerous activities.

"One morning, after I saw that my levels had gone up, I got tired of wondering, so I asked my (medical office) partner to do a biopsy at lunch," McHugh remembers.

The outpatient procedure is brief. It’s waiting for the results that seems to take a lifetime.

"You begin to ponder the possible outcome of the biopsy and whether it will be positive. You feel a wave of intense anxiety churn across your chest," McHugh said in his book.

"Thoughts of the negative possibilities and how each could impact the people you love, your work and your longevity run rampant in your mind throughout the day and week. Your anxiety increases as the day approaches for the follow-up office visit to learn of the biopsy results.

"You now glaringly understand the truism that life does indeed go on and finally you transition into an attitude of acceptance. ‘What will be, will be.’"

The "Decision"

After getting the biopsy results that confirmed his prostate cancer suspicions, McHugh had to decide how he would proceed.

"Once I was diagnosed, I was faced with about five different options, all of which have consequences that hit at the male ego," McHugh said.

"There are about three different forms of radiation, two different types of surgery and a number of newer treatments. Making a choice becomes a daunting decision."

Outside of worrying about the selected treatment option eradicating all of the cancer, there are other considerations to weigh, like the possibility of being impotent or incontinent.

While working to make his decision, McHugh intuitively used his training to weigh the disease specifics against his medical history and evaluations of the treatment risks versus their curing potential.

Ultimately, McHugh opted for surgery.

"I was young when I was diagnosed. I was 52. I always recommend for people who are young to think about the long term and to be aggressive," McHugh said.

"I have been very fortunate to bypass any complications. Looking back, I know I made the right decision for me."

As an author, his goal is to help others do the same. McHugh says "The Decision" isn’t meant to be a "comprehensive textbook" on prostate cancer.

"It’s an arrow in your quiver, not a standalone," McHugh said.

Instead, it’s meant to be a sometimes humorous compass to help readers navigate through the murky waters of choosing a treatment path.

"I enjoy telling stories. Almost every aspect of my journey from biopsy to the decision making is chronicled in the book," McHugh said.

"Everybody is writing books like a doctor. I wanted something that would be easy to understand, informative and entertaining."

He’s right. If you type "prostate cancer" in the search box of the online retailer
Amazon’s website, it pulls up more than 22,000 results. McHugh’s book comes up third.

Applied knowledge

The success of the book, which was released in 2010, inspired McHugh to develop the ProstateMD app, which was released about two months ago.

"The app contains all of the things that I’ve created since the book was released. There are videos, news feeds, links to my blog and illustrations from my book," McHugh said.

"Everything is in one place, so if you’re away from your desk, you can carry the information with you."

The Gainesville urologist hopes the book and iPhone app not only helps diagnosed patients through their journey, he also hopes it motivates more men to keep closer tabs on their health.

"On the surface, prostate cancer is viewed by the public as a (benign) disease of old men," McHugh said. "There’s some truth to that, but the fact remains that 200,000 new cases are diagnosed each year in the U.S. and 25,000 people die from it each year.

"When men take the misconception and broadly apply it to themselves, they’re making decisions based on the wrong premise. You don’t know if you have the slow growing kind or the bad kind, unless you check for it."

From a personal standpoint, McHugh says the book and digital application have helped him grow as a doctor.

"My wife said early on that (my diagnosis) would make me a better physician. I dismissed it saying, ‘I’m a good one now,’" McHugh said.

"She was right. It has made a very nice difference. It gives me a different perspective that I didn’t have beforehand and a feel for what my patients are feeling.

"My diagnosis and treatment really has made me a better doctor."