When Dan Manetta, 61, of Williamsport, had a routine prostate-specific antigen (PSA) test in the spring of 2024, he didn’t expect anything of it.
He was a former military officer who had always been active. He wasn’t overweight and had no history of cancer in his family.
His primary care doctor didn’t like the elevated numbers he was seeing, though. He rechecked Dan in the summer. By then, his PSA had gone way up.
“He sent me to the urology department at UPMC Williamsport,” Dan says.
There, Dan saw urologist David Kurz, MD. He checked Dan’s prostate and found some abnormalities.
“The next move was a biopsy,” Dan says.
Dan has always paid attention to his health, especially since his father died of a heart attack at 66. “My doctor has always kept close tabs on my heart. I even had an angiogram a few years ago.”
But cancer? He didn’t see that one coming.
A Prostate Cancer Diagnosis and Three Options
“They used about a dozen hollow needles to get the biopsy,” Dan explains. They needed samples from all areas of the prostate to determine if there was cancer and if it had spread.
It wasn’t painful because he had general anesthesia, but the wait was stressful.
The results weren’t what he and Dr. Kurz were hoping for. The biopsy showed that a significant portion of his prostate had cancer.
A Gleason score helps calculate how aggressive the cancer is. The score can range from 1 to 10.
“Mine was 7. That’s the number at which you have to do something,” Dan says.
Dr. Kurz presented Dan with his options. He had three: surgery to remove his prostate, radiation, or chemotherapy. All three had pros and cons.
If he had been older, maybe surgery wouldn’t have been necessary. Prostate cancer tends to grow slowly. The other treatments may have been enough to slow it down.
But because he was on the younger side, chances are the cancer would’ve gotten aggressive if it had spread. Plus, he was healthy and fit for surgery.
Of course, surgery had its cons as well. The two biggest ones were leaking urine and erectile dysfunction (ED). Dan worried about both.
His doctor explained that the urology team works closely with UPMC Rehabilitation Institute. After surgery, he could work directly with a pelvic health physical therapist to improve any lost function.
Prostate Cancer Surgery and Recovery
Dr. Kurz performed Dan’s surgery on Nov. 7, 2024. He operated laparoscopically, using a robotic technique where he made six small incisions about the width of a nickel.
“When I asked him how many of these he had done, he said hundreds!” Dan said. That inspired confidence in Dan.
He was under general anesthesia the whole time and wasn’t in too much pain when he woke up.
Dan’s care team got him up to walk shortly after he was out of recovery. “They wanted me walking right away,” he says.
He only spent one night in the hospital. Going home, doctors restricted him from lifting anything heavier than a gallon of milk. He also had to have a catheter for a week. He was never happier than when he finally had it removed.
Physical Therapy After Prostate Surgery
When a patient decides to undergo a radical prostatectomy, Dr. Kurz sends them for a one-time preoperative visit with one of UPMC Rehabilitation Institute’s pelvic floor physical therapists. Dan worked with Amy Vandermark, DPT, WCS, CAPP-OB, CCCE, a board-certified specialist in women’s health physical therapy, at the Eastern Lycoming YMCA location in Muncy, Pa.
“During Dan’s preoperative visit, we discussed the upcoming surgery and early postoperative exercises like breathing, managing intra-abdominal pressure (which is imperative to decreasing urinary leakage), belly draw-ins, constipation management strategies, and strategies to get the bladder back on track after the catheter has been removed,” says Amy.
“This visit allows the patient to ask more questions and creates an open line of communication for additional support throughout their cancer journey. We also introduce pelvic floor exercises such as Kegel exercises at this visit.”
After surgery, the immediate goal was to control his bladder and urine flow. Dan started spending hourlong sessions with Amy, where she tailored physical therapy to his needs.
This included using tools such as ultrasound showing how the pelvic floor and abdominal muscles work in real time and functional tasks helping to improve continence.
Dan began practicing Kegel exercises on his own. Amy also showed him how to massage the incision areas on his abdomen to avoid scar restrictions.
He wasn’t allowed to do exercises like crunches yet, but she showed him other things he could do.
Working with Amy helped a lot. In two weeks, Dan was 80% back in controlling his urine, and within four weeks, he was 100% back.
“I was very concerned about that,” he says. “I’m a business consultant and I teach. I didn’t want to be standing in front of clients or crowds unable to control my bladder.”
He had also worried about ED, which physical therapy was able to address.
“My goal is to provide a safe environment for my patients to open up about their sexual health concerns,” Amy says.
“Erectile dysfunction is multifactorial, and pelvic floor rehabilitation is one piece of the puzzle. The collaborative care that urology and pelvic rehab provides early after prostate surgery helps patients get on the right track.”
Back to Doing What He Loves
Dan finished his physical therapy in January 2025. He’s back to doing everything he loves.
That includes hiking, skiing, hunting, fishing, and working out. “I’m essentially back to normal,” he says.
If he’s changed at all, it’s a renewed appreciation for life, for taking good care of one’s health, and for staying proactive.
“I’ve told my two grown sons and my two younger brothers to keep an eye on things,” he says. The PSA likely saved his life, given he had no symptoms.
His follow-up PSAs have all been clear. For now, he’ll get them quarterly and then annually.
Sometimes men can neglect these things, he admits. “But we can’t help the people who depend on us if we don’t help ourselves.”
He also can’t say enough positive things about his care team.
“I’ve traveled all over the world, but I love living in central rural Pennsylvania,” he says. “We are so fortunate to have UPMC here, with some of the best providers around.”