To say that John Goodman tries to stay healthy at age 63 would be an understatement. The longtime Vail resident works out six days a week, doesn’t smoke, and loves running, yoga, cycling, surfing, snowboarding, and more.
For Goodman, that lifelong commitment to health also meant staying on top of his PSA numbers — a yearly blood test result that measures the amount of prostate-specific antigen in the blood. The higher the number, the greater the risk for prostate cancer.
“My doctor told me if my PSA ever goes over four, or if it goes up more than a point in a year, we'll look at next steps,” Goodman says. “It kept elevating bit by bit when I was in my 50s, and then at age 59 it went up to 4.2, and it went up over a point in a year.”
Becoming his own advocate and advanced surgical techniques
Some primary care doctors recommend a wait-and-see approach, with a retest in another year, but Goodman — a lawyer who has been trained to ask questions — pushed for more testing. After an MRI revealed a possible tumor, he was referred to University of Colorado Cancer Center member Paul Maroni, MD, who in early 2021 performed a fusion biopsy — a procedure that combines MRI images with ultrasound images in real time to pinpoint any suspicious areas in the prostate — to confirm the diagnosis of prostate cancer.
“The fusion biopsy uses advanced technology to take an MRI, then uses the information from the MRI to guide the prostate biopsy,” says Maroni, associate professor of surgery at the CU School of Medicine. “That helped us diagnose a meaningful cancer and led to his treatment and hopeful cure at his relatively young age.”
As he awaited cancer surgery just weeks later, Goodman went through days of darkness, particularly as he worried what the surgery might mean for physical and mental health, as well as his sexual function.
“I felt like something that could kill me or make me impotent or incontinent — I wasn't strong enough to deal with that,” he says. “I talked to my therapist, and I talked to my wife, and I said, ‘I don't know that I can do this.’”
Luckily for Goodman, Maroni is experienced in performing prostatectomies on patients with just such concerns. Much as he used the MRI to inform the biopsy, he also used the imaging as he was leading the surgery.
“We use the MRI to help guide the surgery so that we can make decisions about nerve sparing based on where the lesions are,” Maroni says. “If they're away from the nerve tissue, we feel comfortable about trying to preserve the delicate nerve tissue that allows for erectile function.”
Successful surgery
There was talk of radiation and chemotherapy, but in the end, the surgery was all Goodman needed to remove the cancer. Now, three-and-a-half years after the operation, he is cancer free and back to full-time law practice and the active lifestyle he enjoys.
He is grateful to his wife and sister for being his support system, and grateful to Maroni for giving him his life back.
“My PSA is now nondetectable. I count my blessings,” he says. “I email Dr. Maroni all the time with pictures of my gift of life, including recent news that my daughter is engaged and my son just graduated college. I’m sexually active, and I'm not incontinent. My body works, and I'm grateful for it.”
Paying it forward
Goodman is now an advocate for other men to get their PSA levels checked and not be afraid of the digital rectal exams or biopsies that can help doctors diagnose prostate cancer early.
“He's encouraging his community in the mountains to get screened for prostate cancer, and he's made himself open as a resource for people to talk to if they're worried about their prostate cancer or in a similar situation to him,” Maroni says. “If they're conflicted or uncertain about what to do, he can help guide them about what the process is like.”
Goodman even worked with a health clinic in Vail to update its awareness campaign about prostate cancer, urging the marketing team to change the imagery from old men playing checkers to something younger skewing.
“Now you see a young man in his 40s with a kid; he looks like a typical guy going to a brewpub in Denver or Boulder,” Goodman says. “It’s about changing the public's awareness of prostate cancer risk.”
It’s an approach with which Maroni agrees: “It's construed as a disease of aging, but we make the biggest difference in men when we diagnose it earlier.”
John Goodman and his wife enjoy surfing.
Goodman is now passionate about paying forward the care he received at the CU Cancer Center, which included support groups and psychological counseling. He and his wife have started an organization and Instagram page, Sea Beyond Cancer, through which they are inviting other cancer survivors to the sea near their second home in Mexico to take a “break” from cancer and spend time near the ocean. The first trip is scheduled for February 2025.
“When you're in the water, even if you're not a surfer, you feel the power of being in the ocean,” he says. “You can stand on the shore, you can lie on a stand-up paddleboard and float, or if you're like me, you can surf. During those moments, you're not thinking about your scan, your test, your results, your biopsy, or your treatment. And the spouses, partners, and families are going through the same fear, the uncertainty, the abject horror of a cancer diagnosis. We want to have a space where partners and spouses and family members can discuss with other people what it feels like when your loved one has a cancer diagnosis.”
