Living with Prostate Cancer

“Well, you presumed right!” my 34-year-old urologist said as he walked into the examination room and shook my hand.
I don’t know what stunned me more, a doctor admitting I was correct about anything or learning that I had prostate cancer
For years, I had been monitoring my PSA, watching it creep up from mere noise level to a reading of 2.5.
At the tender age of 64, however, it jumped to 3.25, the dreaded increase of 0.75 in one year.
You see, there are three major causes for the appearance of Prostate Specific Antigen (a marker found in the blood).
Least worrisome is an infection called prostatitis
A notch higher is the sleep-disturbing enlarged prostate professionally referred to as Benign Prostatic Hyperplasia
Last of all (no pun intended) is the dreaded “C” word. This third situation has one interesting effect; it throws off the PSA marker 10 times as rapidly as the previous two developments.
Consequently, upon receiving the news of my major PSA increase, it seemed best to schedule a sonogram and biopsy.
The former is merely an imaging of the gland and, in my case, seemed to foretell a good story. The average normal prostate is the size of a walnut; mine was a pecan.
As for the biopsy, it’s not a procedure that any manly man would enjoy, but taking 12 needle “core samples” and sending them to the lab is the best bet for a positive, or, hopefully, a negative reading.
Immediately after conducting these tests, my doctor exhibited some early bedside manner.
“Well I’ve seen PSAs well over 6 where the tests came back negative.”
“Hope you’re right, doc, but it appears it isn’t an infection or an enlargement, so I’m here because you do robotic rather than anatomic surgery.”
Well it is what it is, and being a bit of a pessimist, my strategy was to work the equation backward. Plan for the worst, determine the preferred treatment and then find an experienced specialist. Contrary to popular belief, there are a lot of ways to deal or not deal with prostate cancer
In several European countries, the normal course of action, or, more correctly, non-action, is called “watchful waiting.”
Here’s the theory: This form of cancer is normally non-aggressive and slow-moving, hence some other malady is going to get you first. Frankly, I now shudder when hearing the presidential candidates speak of universal or socialized health care.
Past doing nothing, there is an array of medical procedures ranging from a mildly invasive implanting of radium seeds, through eight weeks of daily quarter-hour sessions of pinpoint radiation, to radical surgery.
My choice was to have the problem totally removed by utilizing a fairly recent device from Intuitive Surgical Inc. called the da Vinci robot.
At the end of the last decade, the da Vinci was designed for battlefield situations. The thinking was that using this technology, the surgeon could be somewhat remote from the casualty.
It seems to have morphed into a way of avoiding the impact of a large abdominal incision. Rather than making an 8-inch cut from the navel south, probes are inserted in six small punctures.
Here’s the bottom line: After radium seeds, you are out and about after two days. After surgery you are back to work after a week or two.
OK, here’s the lecture: The chance of a 60-year-old male having prostate cancer is about 16 percent; at 80 the odds increase to 80 percent.
However, if you get annual checkups including the PSA test, you will have an early, early warning if anything is amiss.
Well, that’s my story, and it seems to have a happy ending.
But as my surgery grows more distant, I always like to present my surgeon a small gift during the periodic follow-up visits. The last time, he asked me why I do this.
My reply was, “Doc, I brought you some hunting socks, and you saved my life. Seems like a fair trade to me.”