Faith over fear: How a lipoprotein(a) test sparked one man’s mission to save others

Bryan Harding may now be retired but he is still working hard—this time, to get the word out about heart health.

Bryan had a long career in marketing and communications, working with organizations such as the American Heart Association and the Alzheimer’s Association, so he felt confident in his knowledge of healthcare, especially when it came to his cardiovascular health.

So, it came as a surprise that while undergoing treatment for prostate cancer, he learned how a protein called lipoprotein(a), also known as Lp(a), was seriously impacting his heart—something he had never heard of before.

Now, Bryan is committed to sharing his journey to inspire others to better understand lipoprotein(a) and its role in heart health, as well as help them advocate for themselves.

This is his story.

An initial prostate cancer diagnosis

Bryan had been seeing a primary care physician and other specialists for years at Baylor Scott & White Health. After a prostate cancer diagnosis in 2020, he was successfully treated with radiation first, but two years later it returned.

When seeing a primary care physician at Baylor Scott & White – Las Colinas and a urologist at Baylor Scott & White – Irving, Bryan was referred to Charles Cowey, MD, an oncologist on the medical staff at Baylor Scott & White Charles A. Sammons Cancer Center – Dallas.

He underwent triplet therapy involving:

• Chemotherapy
• Androgen Deprivation Therapy (ADT), which blocks testosterone production
• Enzalutamide, a newer hormone therapy that prevents testosterone from stimulating cancer growth

For fighting prostate cancer, this combination can be more effective than single treatments alone. And in Bryan’s case, it has led to his prostate cancer being undetectable for nearly two years now.

A new development

During one of his checkups with his medical oncologist, Bryan mentioned he had been having some shortness of breath, which he thought was a side effect of the medication. Dr Cowey immediately referred him to Courtney Campbell, MD, PhD, cardio-oncologist on the medical staff at the Baylor Scott & White Heart and Vascular Hospital – Dallas.

Some prostate cancer medications can increase cholesterol levels, blood pressure or risk of abnormal heart rhythms. Yet all of the “usual” tests and numbers came back fine, except for one test: lipoprotein(a), which was highly elevated.

Even with Bryan’s previous work with the American Heart Association, he realized that he hadn’t ever heard of this test, though he had had lipid panels— tests measuring cholesterol and fats in your blood—for years.

A “normal” result for lipoprotein(a) is typically less than 75. Bryan’s was 320. 

Lipoprotein(a) or “LP little A” as it is sometimes known, is a genetic condition that is not based on lifestyle, and you need to have a specific blood test for it.

Bryan’s lipoprotein(a) results prompted his healthcare team, specifically Subhash Banerjee, MD, interventional cardiologist on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas, to carry out further tests.

The tests revealed blockages in four of Bryan’s arteries. He was immediately scheduled for heart bypass surgery with Alexander Sbrocchi, MD, cardiothoracic surgeon on the medical staff at Baylor Scott & White Heart and Vascular Hospital – Dallas, and has been getting stronger through cardiac rehabilitation ever since.

Bryan credits his broad-based team within Baylor Scott & White, including his primary care physician, oncologist, cardio-oncologist, interventional cardiologist, cardiothoracic surgeon and cardiac rehab team, as all responsible for this intervention and care.

He now has a new mission: getting the word out about lipoprotein(a) and highlighting the need for increased awareness and testing.

What is lipoprotein(a)?

Lipoprotein(a), or Lp(a), is a particle in the blood that combines a protein called apolipoprotein(a) with LDL (“bad”) cholesterol. High levels of Lp(a) are genetically inherited and associated with an increased risk of cardiovascular disease and atherosclerosis—a buildup of plaque in the artery walls, narrowing blood vessels and restricting blood flow.

While lifestyle changes including diet and exercise can help manage overall cardiovascular health, they have minimal impact on Lp(a) levels specifically.

Raising awareness about lipoprotein(a) as a risk factor for heart health

Bryan sees that there is so much to be done to educate people on early detection of lipoprotein(a). He has several suggestions on how healthcare can better get the word out—from leveraging media and social platforms to more educational resources, to policy changes that include routine screenings covered by insurance, to partnering with medical organizations and communities to raise awareness.

Bryan recounts a story from his earlier advocacy work at the American Heart Association.

“In 2003, our data showed that only 23% of women knew that cardiovascular disease was the leading cause of death in women. I was on the core team that created the 'Go Red for Women' campaign launched in 2004, and it's been incredibly successful. Now, well over 60% of women are aware of the dangers.”

Bryan also hopes he can use his skills and marketing experience to help raise awareness for lipoprotein(a).

Here are some ways Bryan says you can be proactive about Lp(a) testing and be an advocate for your own health:

• Know your family history: If you have a family history of early heart disease or heart attacks, ask your doctor specifically about Lp(a) testing.
• Request testing during regular checkups: During your annual physical or when getting cholesterol checked, explicitly request Lp(a) testing, as it's not included in standard lipid panels.
• Be specific with providers: Ask, "Can you test my lipoprotein(a) levels?" rather than just requesting general cardiovascular screening. This test only needs to be done once in a lifetime.
• Check insurance coverage: Contact your insurance provider to understand coverage for Lp(a) testing and any prior authorization requirements.
• Document your family history: Keep records of any early heart disease or heart attacks in your family to share with healthcare providers as justification for testing.

It's important to check your Lp(a) levels to understand your heart health risks. Work with your doctor, use available resources and be proactive about your cardiovascular care.

“One of the things I've learned is you've got to be your own advocate. You've got to educate yourself,” Bryan said.

And his story is a powerful reminder of how effective this can be.

3 key benefits of an integrated healthcare approach

Bryan believes that the collaboration of his medical team across Baylor Scott & White was integral to his care and recovery. Here are some benefits he witnessed:

1. Improved communication and coordination between healthcare providers. When the different specialists treating someone (such as an oncologist and a primary care doctor) can share information and collaborate, it ensures people can receive cohesive, well-coordinated care.
2. Better health outcomes for people. An integrated approach allows for earlier detection of issues, like the elevated lipoprotein(a) levels in Bryan's case, and more proactive, comprehensive treatment. This can lead to better long-term outcomes.
3. Convenience and efficiency. Having all the necessary specialists and services available within one healthcare system makes it easier for people to navigate their care and means they don’t always need to communicate with multiple providers.

“Having an integrated healthcare team has been an epiphany for me,” Bryan said. “Get involved with a comprehensive care center. It makes all the difference in the world if your physicians are talking to one another.”

Bryan’s advice for navigating your medical journey

Because of his experience, Bryan is passionate about helping others. His advice to those on their own healthcare journey:

• Be your own advocate. Educate yourself about your condition(s) and don't be afraid to ask questions or push for the care you need.
• Know and track all your numbers for cardiovascular disease risk including cholesterol, LDL, HDL, blood pressure, A1c, etc.
• Try to get connected with a comprehensive care center or integrated healthcare system if possible.
• Build strong relationships with your healthcare team. Take the time to get to know your doctors and develop open communication. This can help ensure they have a full understanding of your situation.
• Seek out support groups. These can provide emotional support and additional perspectives from those who are in similar situations.

“I've been fighting a battle on two fronts with both prostate cancer and cardiovascular disease, but I'm winning them both,” Bryan said. “But I couldn't have done it if I didn't have the resources, the help, the patience and a positive attitude. My mantra on all of this is ‘faith and science over fear.’”

If you would like to speak to a cardiologist about your heart health, click here to find a specialist.