My Personal Journey
This web site and blog is being created because I “have been there.” I will start this “About” page with my story. I think it is a good starting point because it is important to show you I have no ulterior motive except to educate people om the topic of men’s health and especially Prostate issues and Prostate cancer.
Initial Diagnosis and Treatment
My story begins about 7-8 years ago. I had an annual check up and as always the doctor did a PSA test (much, much more on this unhelpful test later in blog posts). My PSA had drifted up over 4.0 (the mythical normal reading for PSA). Thus my Primary Care Physician (PCP going forward) demanded that I be referred to a urologist. So the odyssey began.
The first meeting with the Urologist, he wanted to do a second PSA test, but not before he did a robust digital exam. I am sure every man reading this knows what that means! I had done enough research by this point that I could protest and say, “the literature on PSA testing and Dr. Ablon (Richard Ablon, the PHD that discovered the existence of a Prostate Specific Antigen, thereafter known as PSA in 1969) is quite clear”. I will also later have much more on Dr. Ablon and hopefully a published interview I am seeking. I digress and back to the topic!!
Medical Procedures and Challenges
What Doctor Ablon and the literature clearly said is that certain things should not be done prior to taking a PSA reading. Refrain from sexual activity for at least 72 hours. Do not ride a bike for at least 72 hours. Do not do a heavy physical workout for 48 to 72 hours prior to the test. Knowing these facts, why did “my” Urologist do a robust digital exam just prior to drawing blood for the test?
My idea on the above is very simple. There was money involved. An unfortunate fact of the medical industry in the 2000’s is there are not many doctors that do not have profit motives! The Urologist pretty well insured that I would have a PSA reading above the “mythical” normal level. He was right too!! Never argue that the Educated are not, well, Educated!!
My PSA reading came back slightly above the 4.0 Maginot line for PSA. OH MY gosh what now, more testing or the dreaded biopsy!!? Luckily the Urologist opted to do a 4 square test. It came back with a 13% chance that I had Prostate Cancer. The Urologist was confident that the numbers were not so bad and he decided we could do a follow up PSA test in a month and see what it told us about my situation.
Re-Evaluation and Follow-Up
A month later I showed up to his office having not worked out in a week. I did not ride my bike (which I did quite often back then) for 3 days prior to the appointment and I did not have any sex for the prior week!! The results of the PSA test? My reading dropped well below 4.0 so I was good. The Urologist allowed me to return to taking testosterone supplementation (I never thought I’d enjoy taking a shot, especially one I administered to myself every week; but I did)!! Of course he was also very adamant that if I had another elevated PSA, we would be doing biopsies!! Luckily I followed my new “protocol for annual checkups going forward” as stated earlier in this paragraph. It served me very well for almost 10 years but as has been said “all good things must come to an end” and for me it did in May of 2023!!
Recent Developments and Decision Making
In April of 2023 I did my normal annual check up with my PCP. It had now been many years since my “Cancer” scare and I got lazy. I had a hard workout with weights on the day before my checkup AND I rode my bike all week! YOU IDIOT, do you just like living dangerously or are you just stupid? Just stupid I guess! My PSA came back at 4.4. Panic…danger Will Robinson, so on and so forth! MY PCP said let’s wait a month and do a follow up PSA test before we panic (sorry doc but you may be a little late on that one)! The follow up came back a bit higher at over 5.0. Here we go!!
Diagnosis and Treatment Options
Once again I was referred to a Urologist to get an advanced opinion. I did not go to the same Urologist from 7-8 years ago but a younger Urologist who to this day I see regularly and really like! He did a third PSA and it was elevated to about 6.6. Now the fun really begins.
He decided I should do an advanced MRI to determine if it was potentially cancer, a benign Prostatic Hyperplasia (BPH) or something else causing an enlarged Prostate. By the way, an enlarged Prostate at 55-60 years of age is fairly common so I was still being optimistic! The MRI was fairly painless, until the results came back. The Urologist saw enough to be concerned that cancer was a possibility and I now needed a biopsy! This is a fairly painless test…as long as you are not the patient…so expect a bit of discomfort. (The next time I am told that will be followed by me inserting my foot so far up the perpetrator’s posterior regions that Marcus Welby could not get it out (If you are younger that 50, ask an old guy what that means or drop me a line and I’ll explain)!!
I will not bore you with any further details of the biopsy process, except to say yikes! My next call was Dr. Pickard (the excellent Urologist I mentioned above) saying we need to talk. Talk? How about we find a tall cliff and practice being Wiley Coyote?? We met in his office a couple of days later to discuss his findings. The Reader’s Digest version? CANCER with a Gleason Score of 3+4! Not the worst result as a score of 8 would have been devesting and a score of 6 would have been a bit of a relief. But as they say in the funny pages, It is what it is so what now??
I was presented with my options and since my Gleason score (more discussion later in posts) was 3+4, which is better that 4+3 so I refrain from simplifying to 7!! I was not in the category of “watchful waiting” or just observation. We’ve got to do something and something in the next year. Wait what do you mean in the next year??
Prostate cancer grows very slowly so we all have to adjust our thoughts on time and what is fast and what is slow! In the world of Prostate cancer a year is not a long time but we did not want to drag our feet too long. I was presented with 2 options for my situation. Surgery to remove the prostate or Radiation to kill the cancerous cells.
I had been a surgical consultant for a couple of companies in my work career and I spent a lot of days observing and technically advising surgeons on Electrosurgical techniques and specifically “vessel sealing” products. Thus I know enough to be dangerous and I know what I saw in the operating room!!! Suffice it to say “Homey ain’t getting no Prostatectomy!!”
My Urologist suggested I talk to the Radiologist with their practice that would do the Radiation if that was my choice and their surgeon if I chose a Prostatectomy! That seemed logical. The surgeon only uses a robotic approach in his practice which is a much better approach to the old “open” procedures I observed. But alas, the surgeon failed my means test as he could not guarantee that I would not end up impotent or incontinent. Strike 2 and 3. You are out! Politely stated, of course.
Next I met the Radiologist to discuss his options. I really liked the Radiation Center when I toured the facility. They have a facility that is dedicated to a Men’s Health and specifically for Prostate Cancer. It is used for nothing else so I was sold as this was the best of the 2 options I had!
There was a protocol for 45 treatments, which was preferred or I could do 28 treatments, depending on what my insurance would approve. Luckily or unfortunately depending on if you are a glass half full or half empty kind of person. It was a 28 consecutive days around Thanksgiving rather than a 45 day process that would involve Thanksgiving and Christmas so I was glad for a 28 day course of action.
Treatment and Post-Treatment Journey
I did my treatment and I have the certificate from the Urology Clinics of North Texas to prove it!! I am not going into the treatment specifics or the side effects, but if you are looking at this situation and want to discuss it, I will talk anytime. I am just not going to bore everyone with my sob, or hopefully, success story. The Jury is still out on that one!
Moving Forward
As I write this web page I am 6 months and one week post treatment. It is really odd because when you typically complete a course of treatment there is a declaration of success or failure. With radiation treatment for Prostate cancer, when your treatment is over you get to ring the bell…and go home. It is kind of anti-climatic because I cannot tell you that I am cured, but I can hope and pray! And pray a lot, I do!
I am now on the treadmill of waiting for the next 5 years. I see my Urologist every 6 months to do a frickin’ PSA test for the first 2 years and then we move to an annual test. The goal is that my PSA falls to below a reading of 1.0 by then end of the 5 years, then I can be declared cancer free. Awkwardly my first PSA test in January of 2024 was 0.8!! So can I just move on now? I will do it all again in August and expect the PSA reading will stay low. That is my next move in this chess game.
Advocacy and Community
That is my story and as a result of this ordeal I am starting this web site and blog. Men need it and they need an advocate. The so called “science” and various opinions are mind boggling. Someone needs to take the lead and shepherd us through this mess. I am going to be that person.
If I can help one man avoid this quick sand, it will be worth it. If I can influence anyone to protect themselves and help navigate through the tons of data around men’s health and Prostate issues, this will all be worth it. In future posts as I move from creation of the web site and move to posts on the blog, I will explore many issues around prostate issues and men’s health.
Engage and Share
Follow me and help on this journey. Please comment on any post. Add your personal insights and by all means let’s please get some female opinions and ideas. We are all in this together.