Alonzo Rouw reveals prostate cancer diagnosis and surgery

Count Hall of Fame center Alonzo Mourning as the latest high-profile person to reveal that he had been diagnosed with prostate cancer and had surgery to remove his prostate in mid-March. The former Charlotte Hornet and Miami Heat star had stage 3 prostate cancer with a Gleason score of 8, which represents a high-grade, aggressive form of cancer.

It seems that every month for the past few months, at least one public figure has had a public revelation about being diagnosed with prostate cancer. On April 12, 2024, former Director of the National Institutes of Health (NIH), Francis Collins, MD, PhD, published an article in The Washington Post entitled,”Why I’m Disclosing My Prostate Cancer Diagnosis.” The following month, on May 23, 2024, that is what the article written by Gillian Telling was for People magazine with the title: “SeinfeldMichael Richards reveals battle against prostate cancer: ‘I would have been dead in eight months’ without surgery.” It looks like Mourning has now filled the June slot.

The 54-year-old Rouw told Adrian Wojnarowski, reporting for ESPN, that is, blood test scores for prostate-specific antigen (PSA) ‘increased’ at the end of 2022. This led to an MRI of his prostate, which showed some suspicious findings, which in turn led to a biopsy of his prostate. The biopsy provided the final unfortunate diagnosis that Mourning had prostate cancer.

The tissue from the biopsy also allowed the pathologist to determine the grade of his cancer based on how the cancer cells looked under a microscope. This is important because it shows how aggressive the cancer can be and helps determine prognosis and treatment. Pathologists assign the sample a Gleason score, named after Donald Gleason, MD, who devised the scoring system in the 1960s. Each cell can take on a grade of one to five, with grade 1 cells representing normal-looking prostate tissue. In contrast, cells assigned a grade 5 hardly resemble normal cells and are instead high-grade cancer cells.

The Gleason score then results from adding the grade of the most predominant cellular pattern to the grade of the second most predominant pattern. So if the most predominant pattern was a grade 4 and the second most predominant pattern was a grade 3, your Gleason score would be four plus three, or a seven. That means a Gleason score can range from two to 10, with each cancer sample ranging from a six to a 10.

So the lowest grade of cancer you could have would have a Gleason score of six. A Gleason score of seven means an intermediate-grade cancer, and anything eight or higher would be a high-grade cancer. Because the grade can reflect the aggressiveness of the cancer cells, the presence of grade 5 cells can significantly increase the risk of prostate cancer recurrence after treatment.

The good news is that many prostate cancers grow relatively slowly. So the hope is that you can catch it before it spreads to other parts of the body. Shortly after Mourning was diagnosed with prostate cancer, his urologic oncologist ordered a PET scan to see where the cancer might have spread. Wojnarowski quoted Mourning as saying: “My partner, Mariona, is waiting for me outside the PET scan, and we are extremely nervous. I sit in the machine with my arms above my head and my thoughts racing – waiting for the technician to read the scan.” That can be like waiting for the final score of a very, very important match without being able to do anything about it.

The mourning continued by saying, “We ended up in a cold waiting room waiting for the technician to come in and finally he looked at us and said he had good news: the cancer is still in the skin. [prostate] capsule and has not spread.” That meant his cancer was still at stage 3 instead of stage 4, which is when the cancer has spread beyond the prostate area to the lymph nodes or beyond. While stage 4 cancers can still be treated and controlled, you can no longer remove all the cancer through surgery, meaning survival rates can be significantly lower.

As with any form of cancer, the sooner you detect and treat prostate cancer, the higher the chances of survival. The challenge is that prostate cancer usually does not cause symptoms until it has reached the later stages. That’s why PSA screening is so important. A seven-time All-Star, NBA champion and Olympic gold medalist, Mourning was a picture of health before his diagnosis. He had also successfully undergone a kidney transplant, so he was already connected to the healthcare system. The diagnosis came as quite a shock.

Wojnarowski also quoted Mourning as saying, “What scares me about this disease is that there are so many men walking around who feel great and who have cancer inside them, but they don’t know it.” Mourning added: “The only way to find out is to get their blood tested and their PSA checked. There are 3.3 million men in the US with prostate cancer, and many don’t even know it. I was one of those guys.”

With Mourning, Collins and Richards talking openly about their experiences with prostate cancer, the hope is that more men will talk more freely about what is the second most common cancer diagnosis among men. Many men can be a bit squeamish about discussing such issues because worrying about diseases may not seem macho. Plus, the prostate is close to a lot of oh-no-we’re not going to talk about it. Prostate cancer surgery can, in turn, affect urinary and sexual function, topics that lead men to try to shift the conversation to something like, “Hey, did you see the basketball game last night?”

But a manly man is a term that can apply to grief. Anyone who watched Mourning play during his illustrious fifteen-year NBA career knows what a force he was. And by drawing more attention to this disease, he’s proving that he’s still quite a force.