This piece is part of our first-annual Health Care Heroes series, where we spotlight people doing amazing things in the health care and medical fields. Read the rest of the stories here.
“IT’S LIKE FOUR Titanic ships sinking every week in the world.”
Ash Tewari, MD, is describing a number that weighs on his heart a little bit. As a pioneer in robotic prostate cancer surgery and director of the Department of Urology at Mount Sinai in New York City, he spends his life in the operating room saving lives. But about five percent of the time, he says, “we feel we got to the patient a little too late. And that ‘too late’ usually happens because patients didn’t understand they could have prostate cancer.”
This form of cancer, which affects roughly one in eight men, tends to quietly brew in the body. Guys don’t even think about getting screened for it because they feel healthy. Or they do think about it, but don’t get screened for a bunch of other reasons: The hassle of making an appointment for a blood test. Fear. Not even realizing they’re supposed to talk to a doc about when to start screening (assuming they’re seeing a doc at all).
“The only way I could make a dent on that, in my mind, was not to expect men to change and show up at our door [to be screened],” says Dr. Tewari. “It was to show up at their own doors—golf tournaments, NFL events, churches, and community centers.” So he rolled out a testing facility on wheels. It’s a giant blue bus—basically a mobile doctor’s office with a lab-meets-living-room vibe—and since its launch in April 2022, the Mount Sinai Prostate Cancer Screening Mobile Unit has tested more than 13,000 men in the New York City area. An additional bus in Atlanta, in collaboration with Emory University, rolled out last September and saw 1,000 men in its first three months alone. The project has morphed into the Million Strong Initiative, which aims to screen 1 million men within 10 years.
Early detection is important with any cancer, and with prostate cancer, smaller tumors mean less interference with your sex life. Since prostate cancer tends to grow toward nerves that control erections, “the longer we wait, the more nerves will be damaged. [The men] can get cured, but it’s still at the cost of sexual dysfunction,” explains Dr. Tewari. And that’s even with a type of robotic surgery he developed that spares nerves more effectively than was previously possible. “Not everyone who gets screened has cancer,” he says. “If they do have prostate cancer, approximately 95 percent of patients live a long life, and 50 percent don’t even need treatment—they can undergo active monitoring. But that can only be done if we know what’s going on.”
Still, there’s a difference between a guy having access to testing and actually walking into the bus. Dr. Tewari knew the bus was going to need the right people outside—the friendly, knowledgeable, persuasive kind of person you can’t say no to—to convince guys to enter and have a blood draw, a friendly conversation, and a snack. (And no digital rectal exam, in case you were wondering.) The blood test—a PSA test—looks for proteins in the blood created by the prostate. High levels of these can point to prostate cancer.
Dr. Tewari was pretty convinced he had the right staff in one of the bus’s first outings. It was a weekend morning in Harlem, and the very large bus tried to park on a narrow street. Another bus came by and tried to pass. There was some…frustration, to say the least. “The driver parked his bus behind ours and basically walked into our bus and said, ‘You don’t understand how to park this. I’ll teach you how to do it.’” By the time he was done, the team on the bus had convinced the other driver to get a PSA test…which ended up saving his life. His PSA was elevated, and when he went to a doctor for additional testing, the cancer was found and treated.
If you’re a guy between ages 45 and 79, you’ll be encouraged to hop aboard. You might get a little extra nudge to do it if you’re Black, since Black men have 67 percent higher rates of this cancer than other racial or ethnic groups. And don’t just send your dad in: The incidence of later-stage prostate cancer has started to trend upward in guys under age 55. Guys in the bus spend about five minutes registering and getting a blood draw, then about 20 to 25 minutes having snacks, learning about the prostate, and then consulting with a health care provider on the bus’s staff about what the results show. If their PSA looks suspicious, the staff will set up a follow-up appointment at Mount Sinai (or people can set up an appointment with their own provider). For people without insurance, Dr. Tewari explains, Mount Sinai has programs to assist in obtaining coverage.
If guys do get diagnosed with prostate cancer and need surgery to remove the tumor, innovations Dr. Tewari has pioneered can make it more comfortable and more successful. “Cancer doesn’t happen in isolation, it happens to a human being,” he says. So it “made sense” to him, as he puts it, to devise a robotic prostatectomy technique that minimizes pain and discomfort after surgery; to develop a new understanding of the nerves involved in erections so they could better be spared and function could be maintained; and to find new ways to tailor surgery to each guy’s biology for better outcomes.
When asked how he feels about trailblazing these major shifts, the doctor who is “humbled that urology is a calling” appreciates that his work has moved the field forward and that he has received many awards, but shies away from basking in praise. “There’s a lot to be done rather than just feeling good about what has been done,” he says. He’s also researching the gene-related cause of prostate cancer to improve diagnosis and treatment, and exploring how to help prostate tumors respond better to cancer vaccines.
Outside of the hospital, Dr. Tewari knows that prostate cancer treatment doesn’t stop when the cancer cells have been removed. He says that guys need a team of people around them who can help tweak their diet, their workout, their medications, and their sexual rehab. Patients need a doctor they can talk to, and he’s known for rising to the occasion. “Sometimes you have to be a psychiatrist and sometimes you have to just be a friend,” he says.
Through his approach and accomplishments, Dr. Tewari continues to remind us that “being healthy” isn’t just about being cancer-free—it’s about feeling comfortable enough to step up and get screened to make sure everything’s ok. His work highlights how access to care changes lives. And it shows the way to other medical professionals that thoughtful and compassionate care doesn’t just save people’s lives, it makes them better.
Describe your job in three words.
Care. Innovation. Empathy.
Best career advice you've ever received?
Go for your passion. Things will be little bit tricky every now and then, but go for it.
Robotic surgery: Yay or nay?
Multiple yay.
Describe the future of AI in health care in three words.
Promising. Responsible. Collaboration.
Morning shift or night shift?
I'm a 5 a.m. guy.
Guilty pleasure after a long shift?
I love sweets, but I can manage it. The portions have gone down. And sometimes you eat with your eyes rather than with your mouth.
Marty Munson, currently the health director of Men's Health, has been a health editor at properties including Marie Claire, Prevention, Shape and RealAge. She's also certified as a swim and triathlon coach.
