Hello Prostate Cancer

by Steve Mason

If you're a 40 year-old male, you have a 40% chance of having prostate cancer. At age 50 it's 50%; at 60, 60%. If you're a male or you're a female who's close to a male - a husband, father, brother, son or friend - you might want to continue reading.

The Prostate Specific Antigen (or PSA) is a simple but effective blood screening test. A suspiciously high number can lead to a biopsy, radiation therapy and surgery - all this with possible side effects that include impotence and/or incontinence and/or death. Of 1,000,000 men treated over the past 20 years, 5000 died directly from complications. But isn't it good to catch cancer at an early stage even before there are any symptoms? Yes, No and Maybe.

It's been said that prostate cancer is a disease men die with, not from. In other words, it's usually so slow growing that something else, such as a heart attack or stroke, will get you first. The down side of such thinking may be that Metastatic Disease will be the "something else" and you don't even want to think about cancer spreading into your bones and throughout your body.

So let's put a face on this – mine. I had my first elevated PSA just over ten years ago. Being educated and informed, I decided to wait and see. It went up over time but it went up slowly. Then it jumped four points in one year and I knew it was time, perhaps it was already too late, to seriously consider my options.

A reason for putting it off for so long was that it's very hard to picture yourself twenty or so years down the road. I just naturally assumed I'd be close to a vegetable at this advanced age and nature would take its course. Not so. I'm as vital as I ever was and, truth be known, a whole lot happier. Clearly, I wasn't indifferent to the end generally and I certainly wasn't ready for my end specifically.

Having the biopsy, which I dreaded, wasn't that bad. It felt like the typical digital exam that men experience annually after middle age except that there was one added feature. It felt like I got snapped with a rubber band 10 or 12 times. I got the results a couple of days later: Prostate Cancer with a 3/4 - a Gleason 7.

At this point I should tell you that I had experienced very little emotion up to that point. I was taking it all in stride ... carry on ... stiff upper lip. But then ... can we talk? When I heard the C-word, it took only about 20 minutes for me to turn to jelly. There are things you can't possibly anticipate. This was a good example. I had no idea I would – didn't believe I could – be so devastated. I thought of the Woody Allen line: "I don't mind dying. I just don't want to be there when it happens." I had three brothers-in-law pass away last year. One dozed off in an easy chair watching TV. The other two spent a few weeks in the hospital waiting for their prostate cancer that had become “something else” to get them. I really, really didn't want to share in their experience.

So after starting on Prozac plus Xanax (managing to reduce my acute panic to little more than chronic terror) I began collecting a dozen or so second opinions. I was very fortunate to have such expertise available as the choice wasn't easy. I originally leaned toward radiation but the problem is that, if it doesn't work, your pelvic area will likely be damaged to such an extent that surgery will no longer be possible. Then with the operation, do you want a surgeon to make one cut and remove your prostate or do you want him to make half dozen cuts and bring in a robot to assist? I eventually went with the da Vinci computerized procedure. It was I good thing I did.

I'll tell you why it was a good thing but first I should mention the recovery period. It's a lot more demanding than you might think. The prostate has to be separated from around the tube that goes to the bladder. In the process, that tube has to be cut and then stitched back together. You're also going to have assorted nodes removed while, hopefully, all your nerves are left intact. It's not like sniping out a gall bladder. So when you wake up you have a catheter and an abdominal drainage tube and a level of pain proportional to a whole lot of inside stuff being cut, scraped and torn outside. They get you out of bed the first day and send you home the second day but it's nothing like business as usual. How any man would manage that period without the aid of a supportive mate, I've no idea. In summing up, I'll repeat what a friend told me: "You get through it." And you do. Mainly because you have no choice.

I said it was a good thing I went with the surgery option but there was no way of knowing before the operation that an especially aggressive lesion was tucked up under my bladder. So one might indeed say my decision was lucky.

Then, eight weeks post-op, I was back in the hospital with a pelvic abscess and a drainage tube poking out of my belly for the second time. This is not an uncommon complication and something to keep in mind. Twelve weeks post-op and 25 pounds lighter (despite never being overweight) I appear to be sneaking up on normal. The need for adult diapers 24/7 never materialized but Erectile Dysfunction is an unfortunate fact. You win some and you lose some.

I sincerely hope that sharing my experience will be a help to one or more of you. I know that I had lots and lots of help and that I needed every bit of it.

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