WASHINGTON — Of all the members of Congress, Phil Roe, a Republican from Tennessee, seemed the best prepared for a cancer diagnosis.
When it comes to Roe and medicine, it is hard to separate the personal and the professional: He heads the GOP Doctors Caucus. His colleagues, Republicans and Democrats alike, call him “Doc.‘’ (He is an OB-GYN by trade.) He almost missed his own wedding this May because of a threatened weekend vote on a repeal and replace of the Affordable Care Act. And he was practiced at delivering cancer diagnoses to his own patients.
But Roe also acknowledges that he is a terrible patient — his neurosurgeon, he admitted, still wants to strangle him after his woeful attempts to rest after back surgery last year.
So when the call came from his own doctor on that day last July, informing him he had prostate cancer, he was determined to do the right thing.
“This time I learned my lesson,” Roe told STAT. “I actually, probably, for the first time in my life, I actually obeyed the doctor’s orders.”
For all his insistence that he is like everyone else, members of Congress dealing with cancer are confronted with another layer of decisions and challenges, particularly when it comes to issues of disclosure.
But Roe spoke with rare candor and objectivity about the trials — and the surprising moments of joy — that come in the face of an intensely personal experience that is almost impossible to keep under wraps. He spoke with STAT six weeks after his surgery from his Capitol Hill office about his care, his decision to announce his diagnosis, and his ongoing recovery.
“There’s a great bluegrass song that goes, ‘I ain’t broke but I’m badly bent.’ I’m getting over the badly bent part,” he said, chuckling.
After his diagnosis, Roe was quick to sit down with his physicians both in D.C. and Tennessee, seeking advice about his treatment options.
Before he decided to proceed with a surgery, however, Roe had to make another decision: when and how to tell his constituents. Politicians grappling with health decisions will sometimes wait until after a surgery to share brief details about their procedure — but Roe was clear from the beginning he wanted to be vocal about the process.
“If you have a serious health issue like I did and it’s better to get the truth out,” he said. “The rumor mill starts out — that’s why I was very honest about what I had. … I wanted to let people honestly know what was going on with me, but not to divulge so much as today I had this, tomorrow I had that. Just to say, this is a diagnosis and I’ll seek treatment at home, which I did.”
Certainly the rumor mill factored into his decision — but so did his hope to encourage others to seek treatment.
“I want to get this message out for patients, both men and women to continue to do preventative things. I’ve been very diligent about doing those things,” he said. “People will come up and say, ‘Well, Doc, I had that problem, what do you think I should do?’ and I thought by being a public official, being a little more public with what my diagnosis was, and my treatment, that it would actually encourage people to seek help, and I think it has.”
The decision to disclose prostate cancer is perhaps an easier one than in cases where the outlook is more bleak: Prostate cancer is one of the most common types of cancer in men, and most who are diagnosed with it do not die from it. The five-year survival rate is about 99 percent, according to the American Cancer Society. They estimate there are some 2.9 million men living in the U.S. who have at some point been diagnosed with the disease. In a press release, Roe described his prognosis as “excellent.”
Roe was hardly the the first public official to grapple with prostate cancer. Sitting Sens. Angus King (I-Maine) and Bill Nelson (D-Fla.) and Govs. Mark Dayton (D-Minn.), Jerry Brown (D-Calif.), and Bill Walker (I-Alaska) have all undergone surgery for the disease. Sen. John Kerry of Massachusetts faced a similar diagnosis in the midst of his campaign for the 2004 Democratic presidential nomination.
Other lawmakers, notably Sen. John McCain (R-Ariz.), have this year disclosed their own battles with other types of cancer. McCain was diagnosed in July with a glioblastoma. Sen. Mazie Hirono (D-Hawaii) announced in May she was fighting stage IV kidney cancer. And Sen. Claire McCaskill (D-Mo.) said in August she was cancer-free, after undergoing treatment in 2016 for breast cancer.
Roe chose a robotic prostatectomy, after lengthy consultations with a radiation oncologist brought in to speak with him at the Capitol and a urologist — who, like perhaps nearly every other doctor in the eastern Tennessee district Roe calls home, is “a friend of mine,” he said.
Roe is in fact connected to almost every care provider he saw for his treatment. He was one of the four physicians who founded the State of Franklin Healthcare Associates, the primary care group that helped coordinate his care. And that consulting urologist was an old medical school classmate with whom Roe had “operated hundreds of times.”
The nurse who took care of him during his first night in the hospital? Roe delivered her when he was a practicing OB-GYN.
“It’s East Tennessee, we’re pretty incestual down there,” he joked.
The surgery itself was straightforward and successful, and the congressman left the hospital within about 36 hours, he said. He gave up his pain medication within 72 hours.
Recovery has been harder — especially since his job in Congress requires long hours and a great deal of travel. Roe, who has run the Marine Corps Marathon four times and summited Mt. Rainier five times, hikes regularly on the Appalachian Trail, which runs through his district in eastern Tennessee. But post-op? He’ll sit down for a second, just to wake up to the realization that he’d somehow fallen asleep.
“I’ve never done that in my life,” he said.
“Even now, last week when I came back [to D.C.] I had to take 45 minutes and just mark out time I could lie down and rest in the afternoon, because I knew we were going to have late nights and I needed some time just to heal up,” he said. “I’m still doing that and will be for probably another six weeks. But I can tell the difference between this week and last week, even.”
His staff has also done all they can to facilitate that recovery, even helping him to take about three weeks to rest during the August recess.
“I realized when I was home, that three weeks I had off — I was 14 years old the last time I took three weeks off. I had to have a major cancer surgery to be able to get three weeks off,” he said. “It was good — I did the right thing.”
Easing the recovery, too, are Roe’s colleagues in Congress — he said everyone has been “fantastic” — Democrats, too, just weeks after the bitterly partisan health care vote. Minority staffers on the Education and the Workforce committee, of which Roe is a member, even sent flowers.
Roe joked to a reporter that he shouldn’t share the letter he received from Office of Management and Budget Director Mick Mulvaney — a former congressman.
“He put on there, ‘Hey doc, why don’t you come over and drink some beer and go bowling!’ — and I don’t think my doctor wants me picking up a bowling ball,” Roe said, laughing. “I got a number of things like that from people who, you know, they were out there thinking about you.”
His colleagues were quick to support him in person, too. After a late July floor vote — just as senators were preparing to vote on their own health care repeal package — Roe joined several of his colleagues in a members-only elevator and was almost immediately showered with well wishes.
“I’ll be praying for you every day — as a physician, you know that if you’re going to get cancer, that’s the best kind to get,” said Rep. Mark Meadows (R-N.C.), the genial chairman of the House Freedom Caucus who was, at the time, singularly focused on repealing the ACA. “Love you man.”
“It sounded good?” another lawmaker asked Roe, who was quick to respond.
“Yeah, yeah, it sounded good. I feel good about it.”
He was joking even then. “I’m just hoping that my sheltie doesn’t jump up on me when I have the Foley [catheter] in,” he said as he exited, to laughter.
The Foley’s now out, and Roe’s office declared publicly in August that he is cancer-free. He’ll face another round of tests in November, when his doctors will once again measure his PSA levels. Surgery should have taken those back to zero — but Roe admits he’s still a little nervous.
“That will be a little number I’ll be a little anxious about until I get it,” he said.