NFL Legend Tony Romo’s Dad Was Diagnosed With Early-Stage Prostate Cancer at 50—Now He’s Spreading Awareness On The Importance Of Screenings

In an social media post, featuring photos of himself, his father, and his family as part of Bayer’s “Highlights REAL” initiative ad, Romo says, “Spending time with my Dad means something different to me now than it did years ago.

“It’s about the laughs, the stories, the traditions, and the time together — the things you remember and carry with you. Those are the real highlights.”

Romo, who played with the Dallas Cowboys for 13 seasons then explained that he’s partnered with the pharmaceutics company Bayer, to promote Nubeqa (darolutamide), a drug neither him nor his father takes, in an effort driven by a desire to help bring greater awareness to advanced prostate cancer by sharing real-life experiences.

Nubeqa (also known as Darolutamide) is an oral medication, which belongs to a class of drugs known as anti-androgens or anti-testosterone, that can be used to treat advanced prostate cancer.

The treatment helps slow prostate cancer by preventing testosterone from stimulating cancer cell growth. Doctors may recommend it after surgery or when the disease continues to progress despite previous therapies.

RELATED: Exciting Option For Advanced Prostate Cancer: How The Drug Nubeqa Is Used

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“I’m celebrating my dad, Ramiro, and all the memories we’ve made — and the ones we’re still making,” Romo concluded in his caption.  “To all the dads and families out there, here’s to making every moment count.”

“The good news prostate cancer can be cured when it’s detected and treated early,” Dr. Neal Shore, FACS, the Medical Director for the Carolina Urologic Research Center in Myrtle Beach, SC., previously told SurvivorNet.

Dr. Shore also noted, “The biggest risk factor for prostate cancer is something we have no control over getting older. The usual age for men to be diagnosed with prostate cancer is between 65 and 69 years. If you’re under 50, your risk of being diagnosed with prostate cancer is low, but it’s still possible.”

In an earlier interview with Men’s Health, Romo described his dad as “unbreakable.”

He recounted, “When he first called [with the diagnosis], I didn’t really feel the weight of it, maybe because he’ll never let on that he’s emotionally hurting or going through something. Because he’s a dad, he wants to protect his children.”

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Romo then admitted that his dad’s prostate cancer diagnosis prompted “moments of fear” that he may not have “40 more years” with his beloved father.

“Through it all, I tried to stay positive, but hearing people talk about this topic in whispers made it feel like a big deal, and a scary one,” Romo continued.

“When you find out you have cancer, it’s a lot to process. It’s important to remember that there are options to help manage prostate cancer today and many resources available too, and everyone needs to know that.”

RELATED: Dr. Edwin Posadas, of Cedars-Sinai Medical Center, explains how some men are more at risk for prostate cancer than others.

How Does Nubeqa Work?

Nubeqa is used to treat advanced prostate cancer. It’s also prescribed after surgery or when other treatments have not worked or have stopped working. This medication belongs to a class of drugs known as anti-androgens or anti-testosterone. It works by blocking the effects of testosterone to slow the growth and spread of prostate cancer.

What Kinds of Prostate Cancer Does Nubeqa Treat?

Nubeqa is the latest oral medication approved by the FDA to be used in the treatment of these two kinds of advanced prostate cancer:

• Metastatic Hormone-Sensitive Prostate Cancer (mHSPC). Up to one third of patients with prostate cancer eventually develop mHSPC. This happens when the cancer spreads beyond the prostate to other areas of the body. The condition can be treated with hormone therapy which means that male sex hormones, including testosterone, can be blocked or stopped to slow the cancer growth. However, down the road, many patients end up developing resistance to the hormone treatment resulting in a recurrence of cancer. “Anywhere from 40 percent of patients go into a resistant state,” Dr. Shore says.
• Non-metastatic Castration Resistant Prostate Cancer (nmCRPC). This is a kind of advanced prostate cancer that no longer responds to hormone treatment. Although it shows signs of growth, such as a rising PSA level, cancer cells are only found in the prostate. The cancer has not spread.

Understanding The Side Effects

“Across the board, the bane of chemotherapy is fatigue,” Dr. Shore says. “Nubeqa, which is otherwise well-tolerated, is no exception.”

As Dr. Shore points out: “Fatigue is often compounded by the patient’s advanced age.”

Other common side effects include:

• Arm, leg, hand or foot pain
• Rash
• A decrease in white blood cell count (neutropenia)
• Changes in liver function
• A rise in blood pressure. Check your blood pressure regularly and let your healthcare provider know if the results are high.
• A lowered ability to fight infections. The medication may also make infections you already have, worse. Tell your doctor right away if you have any sign of infection, such as a sore throat that lingers, fever, chills or a cough.

It’s important to get in touch with your doctor right away if you experience any of the following side effects:

• Severe ongoing nausea or diarrhea
• Painful or difficult urination
• Blood in your urine
• Severe headache, blurred vision, pounding in your neck or ears
• Slowed heart rate, weak pulse, fainting, slow breathing
• Signs of blood clot in the lung which can be experienced by chest pain, sudden cough, wheezing, rapid breathing
• Signs of a lung infection which can be experienced with fever, chills, cough with mucus, chest pain, shortness of breath

Get emergency help right away if you experience signs of an allergic reaction to Nubeqa, which includes:

• Hives
• Difficulty breathing
• Swelling of your face, lips, tongue or throat

RELATED: Prostate Cancer Screening: Get The Actual Guidelines For Men, Why Doctors Don’t Agree, And What You Need To Know To Make Decisions

What Are the Current Prostate Cancer Screening Guidelines?

The Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) both recommend that men at average risk between the ages of 55 and 69 years talk with their doctor about the pros and cons of prostate cancer screening.

The American Cancer Society recommends that men at age 50 who are at average risk should begin screening. Men who are at high risk of prostate cancer should begin screening at age 45. Men with a close relative diagnosed with prostate cancer should consider annual screening at 40.

For men 70 years and older, the USPSTF and the CDC say potential benefits do not outweigh the expected harms and recommend that men 70 and older should not be routinely screened for prostate cancer.

SurvivorNet’s Proprietary AI‑Powered Tool Helps Man Battling Prostate Cancer Navigate Worrying Symptoms & Next Steps In Treatment

How Is Prostate Cancer Staged?

The National Comprehensive Cancer Network (NCCN) guidelines divides prostate cancer into one of six risk categories based on how aggressive the cancer looks under the microscope and the chance of it coming back after treatment. These risk categories help guide treatment for the different subtypes of prostate cancers.

The main risk categories for prostate cancer are:

• Very-Low-Risk (VLR) and Low-Risk (LR)
• Favorable- (FIR) and Unfavorable-Intermediate-Risk (UFIR)
• High-Risk (HR) and Very-High-Risk (VHR)

Very-Low-Risk and Low-Risk Prostate Cancers

Prostate cancers classified as VLR or LR represent the least aggressive forms of cancer. This categorization will be diagnosed depending on number of factors, including:

• Your doctor can’t feel the cancer on a physical exam, or it occupies one-half or less of one side of the prostate
• Your PSA is less than 10
• Your total Gleason score is 6

If your cancer is categorized as VLR or LR, your doctor may recommend active surveillance, another name for “watch-and- wait.”

What is Active Surveillance?

Why consider active surveillance? The most common and effective treatments for prostate cancer are radiation therapy and surgery.

Despite their effectiveness, these treatments are associated with side effects. Specifically, radiation can cause erectile dysfunction, urinary frequency and urgency, and changes in bowel habits. Surgery also causes erectile dysfunction but also can cause urinary incontinence and urinary leakage.

Given that these side effects can significantly impact the quality of life it is important to only treat prostate cancer when it is necessary to avoid these potential complications.

How Is Prostate Cancer Surgery Performed?

The goal of prostate cancer surgery is to remove the prostate gland and surrounding tissues (such as seminal vesicles) to eliminate cancer. This procedure is called a radical prostatectomy.

It can be performed using two primary approaches:

• Open radical prostatectomy, where the surgeon makes one large incision to access the prostate
• Minimally invasive (robot-assisted laparoscopic) prostatectomy, where small incisions and robotic instruments are used for the same purpose

Regardless of the technique, the surgery also involves cutting and rejoining the urethra and bladder neck. In some cases, nearby lymph nodes are removed for cancer staging. Nerve-sparing techniques may be used if possible, to preserve erectile function.

What Is A Robotic Prostatectomy?

A robotic-assisted laparoscopic prostatectomy (RALP) is a minimally invasive procedure that uses a robotic surgical system, such as the da Vinci® Surgical System. The surgeon operates from a console, controlling robotic arms that hold surgical instruments and a high-definition 3D camera.

Tiny incisions (usually 5-6) are made in the lower abdomen to insert the instruments. The robotic system translates the surgeon’s hand movements into precise actions inside the patient’s body. The camera provides magnified views that help in identifying nerves and structures crucial to continence (bladder and bowel control) and sexual function.

This technique has become the most common method for prostate removal in the United States and other parts of the world, primarily due to its precision and potentially quicker recovery times.

Who is a Candidate for Active Surveillance?

Not all men with prostate cancer are potential candidates for active surveillance. Active surveillance is only recommended for men with low-risk prostate cancer who are capable and willing to follow a very close and active follow-up schedule. Low-risk prostate cancer is slow growing and is biologically less aggressive compared with higher-risk prostate cancer.

“With low-risk prostate cancer, your risk of cancer getting out of the prostate and spreading to other parts of the body is really, really low,” Dr. Stephen Freedland, a urologist at Cedars-Sinai Medical Center, previously told SurvivorNet when discussing the topic.

RELATED: People With Low-Risk Prostate Cancer Can Rely on Monitoring the Disease

Men who have low-risk cancer can choose this approach and avoid the potential complications that come with treatment with surgery and radiation. Because the risk of the cancer spreading outside of the prostate is extremely low in men with low-risk disease, this approach is an effective option for men.

Active surveillance includes a PSA test, rectal exam and high-quality imaging tests, which can identify minuscule yet important changes.

When Is Active Surveillance Not Enough?

If you have been diagnosed with moderate-risk cancer, it can be a slippery slope. Something about the cancer isn’t low grade enough to be considered low risk, and many men choose to begin active treatment at this point. Active treatment involves removing the entire prostate, radiation or cryotherapy.

Bottom line, active surveillance is only a great option for men with low-risk prostate cancer who can follow a very active follow-up protocol. Active surveillance allows about 50 percent of men to avoid over-treatment and side effects.

The protocol is designed to identify early signs of cancer growth or an increase in aggressiveness and these factors will indicate treatment is necessary.

Prostate Cancer Screening and Warning Signs

When you do get screened for prostate cancer, your doctor will run a few tests.

One of the tests is the PSA test, a simple blood test that screens for prostate cancer. It looks for more significant amounts of protein-specific antigen (PSA) in the blood. An elevated PSA test does not always mean you have prostate cancer. It could also reflect that your prostate is enlarged, which is common, or it could signal an infection or inflammation.

Your doctor may also conduct a digital rectal exam (DRE) to check your prostate for lumps.

Depending on the results of these tests, imaging scans and a biopsy may be ordered.

WATCH: How Gleason Grade Determines Treatment

Prostate cancer does not always behave the same in every man it impacts. The cancer can be considered “low-risk” and can be slow-growing, and treatment might not be necessary. In other men, the cancer may grow faster or more aggressively, requiring more immediate treatment. Because of this, there is some debate about screening.

The United States Preventive Services Task Force recommends that men at average risk between the ages of 55 and 69 years talk with their doctor about the pros and cons of prostate cancer screening.

The American Cancer Society recommends that men at age 50 who are at average risk should begin screening. Men who are at high risk of prostate cancer should begin screening at age 40. Men with a close relative diagnosed with prostate cancer should consider annual screenings in their 30s.

SurvivorNet experts suggested that men consider factors like their family history, genes, and age when deciding whether and when to screen.

Symptoms of prostate cancer may include:

• Urinating more often
• Waking up in the middle of the night to pee
• Blood in your urine
• Trouble getting an erection
• Pain or burning when you urinate
• Pain in your back, hips, thighs, or other bones
• Unexplained weight loss
• Fatigue

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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