Primed for a Fight

The only way to know for sure if you have prostrate cancer is to have a biopsy of the prostate. If you need it, get it right away.

“You have prostate cancer.” The punch in the stomach.

“What? What did you say?” The doctor asked if I had any questions and those were the only two I could come up with at that moment.

For years at my annual physical, I’ve been screened for prostate specific antigen, the test that tells the doctor if you have a problem with your prostate such as cancer or benign prostatic hyperplasia. My PSA has been 2.5 for years, and my doctor always said that was a fine number for a man in his 50s. That’s not to say I didn’t have some problems with my prostate. Heck, most men do as they get older, but I was told it was just a slight enlargement problem. Nothing to really worry about.

Once again it was time for my annual physical. I turned 61 this year, but I was sure I wasn’t going to hear any bad news. When the doctor called, he said all my numbers looked good. I thought the call was over, short and sweet, but then he said I might have a problem with my prostate—that after being 2.5 for years my PSA was now 4.8. He added that 4.8 for a 61-year-old man isn’t too high, but the jump from 2.5 to 4.8 in one year was cause for concern. He suggested I see a urologist just to be safe.

I wasn’t too worried. I’ve had my share of health scares but they always turned out to be nothing. I was sure this would be, too. So, I found a local urology office and made an appointment. I was told the male doctors were booked out a couple of months but that a female physician could see me right away. Because I knew a bit about what the test was going to involve, I thought a female doctor—which typically means smaller hands—was a fine way to go.

A few days later, I was in the doctor’s office. She agreed that a 4.8 PSA wasn’t very high but she also agreed that jumping from 2.5 to 4.8 in one year was indeed cause for concern. She asked if she could do a digital exam. Of course, I knew what that meant and it had nothing to do with digital technology, but referred to the digit she was going to use. I said yes, and she proceeded, narrating as she went: The left side of your prostate is soft as it should be but the right side is firm and, on the top, I feel a nodule the size of a frozen pea. After the exam, she told me that firmness is not what you want in a prostate and the nodule—she didn’t say tumor—was a cause for concern. She wanted to do a biopsy. She said, I’m not saying you have cancer but this test will tell us for sure. Cancer? Why did she even use the word? I was sure it was going to be fine.

When the day for the next test arrived, I went into the office with more than a little hesitation. The doctor told me that I would be laying on my side facing a TV screen where I could see the entire procedure. The doctor told me I would feel two slight stings as a numbing shot of Lidocaine was injected into each side of my prostate. She then pointed out a white, circle-looking thing in the upper right corner of my prostate and said that this was the tumor. That was the first time she used that word.

She then said that a needle would shoot out from the probe into my prostate and remove a small piece of material. This was done 12 times and though I could hear and see the needle fire into the prostate, I didn’t feel a thing. The whole procedure only lasted about 15 minutes. Before I left, I was told the results would be ready in a couple of weeks and we set an appointment for me to return to hear the news. I still wasn’t worried.

The two weeks went by quickly and I returned to the doctor for the results. My wife went with me and while we sat in the doctor’s office, we joked around about where we would go to celebrate the good news we were about to get. We were talking about whether we should go out for pie or ice cream when the doctor came in. She saw we were all smiles and laughing and for some reason decided she would just cut to the chase. You have cancer, she said.

My wife and I were sitting in chairs in the office. To our left was one of those little beds with the white paper on it. The doctor sat on a chair, rolled toward the bed, and starting drawing on the white paper. We pulled our chairs closer so we could see. She drew a picture of the prostate. She made circles where they’d taken biopsies. She drew a larger circle on the top right of the prostate and labeled it “tumor.” She drew a darker circle on the upper right and lower right and said that’s where they’d found the cancer.

Then she began reciting some numbers. She said since you have a tumor I could feel we have a T, and because the cancer is on one side and at the top and the bottom you have a T2b, and based on how the cells looked you have a Gleason score of 6. She went on to say a Gleason score of 7–10 is bad and a score of 1–5 is not bad, but I’m a 6. So, there you have it. I have stage 2 prostate cancer, T2b with a Gleason score of 6. Now what?

The urologist told me I have three options. One is watchful waiting. Two is radiation. Number three is surgery. She stated that option one isn’t really an option;  at that point, she didn’t think the cancer had spread, but if it does, I would likely die fairly soon. Now we’re getting serious. So that leaves radiation or surgery. She said radiation certainly isn’t guaranteed and it is usually reserved for people who can’t tolerate surgery, leaving me with option three, a radical prostatectomy. She said she would refer me to a radiation oncologist and a surgeon. They’ll tell me what they advise, and based on that, I’ll have a decision to make.

I still feel like I was punched in the stomach. I’ll let you know what I decide to do and will continue to write about this new challenge in my life. But no matter what happens, as the title of my book says, I will Get Back Up.

George A. Santino helps people who want to break down barriers, including self-imposed barriers, to success. Check out his book, Get Back Up: From the Streets to Microsoft Suites, which was an Amazon bestseller.

My Advice

  1. Exercise and eat plenty of cruciferous vegetables, like broccoli and cauliflower.
  2. Get a physical every year and have both a digital rectal exam and your PSA levels tested.
  3. If your doctor finds anything out of the ordinary with these tests, go to a urologist right away.
  4. The only way to know for sure if it’s cancer is with a biopsy of the prostate. If you need it, get it.
  5. If you hear the dreaded C word, get educated. There are plenty of good books and reliable sources like the American Cancer Society (cancer.org) and the National Cancer Institute (cancer.gov) on the internet.
  6. Get support. Don’t be afraid to tell family and friends.

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