Prostate Cancer

I remember the first time I ever heard the word “prostate” I was watching Who Framed Roger Rabbit, and Roger had confused the word “prostate” with “probate” (it was also the first time I’d heard of probate — I had to have both terms explained to me before I got the joke).

Since then, sadly, I’ve had to experience what a “probate” is, but only recently have I had to contemplate the fact that I have a “prostate.” Even now I still occasionally get it mixed up with the word “prostrate.”

As I get older, my doctor has been keeping an eye on my “PSA” levels (which I’d always joked was in relation to how loud I talk — the louder my voice, the more I’m like a “Public Service Announcement”).

Once it passed a certain level (or volume, as I continued to joke) my doctor started talking about a “biopsy.” Learning what that entailed, I wanted to avoid that at all costs, so I grabbed and held onto the fact that PSA levels often rose “in volume” as a man grows older. Also, after consulting Dr. Google, I learned there are certain foods known to help bring PSA levels down. Tomatoes, for one. And that is not a problem, because I love tomatoes.

Several months of tomatoes being part of all three daily meals did the trick. On my next blood test my PSA “volume” had gone down.

Huzzah! No horrid prostate biopsy for me. Back to life as normal.

The next year, however, it did not go down. It didn’t stay even, either.

It jumped.

My doctor referred me to a urologist. Fingers went up my butt. Yes, the prostate was enlarged, but the trained professional medical fingers did not feel signs of suspicious lumps or bumps.

Once again, a reprieve. No biopsy for me.

Yet.

But they were going to “keep an eye on it.” Now instead of checking my PSA levels once a year, it was going to be twice a year. And so they did, and my levels continued to rise. While the levels were not in the danger zone, nor even in the alarming zone, they unfortunately did land directly in the highly suspicious zone.

It was time for a biopsy.

I balked. I bargained. They’d described what this biopsy entailed and — forgive me, but — I wanted no part of it. So, they reluctantly agreed.

Okay, they said, we’ll check it again in three months.

Three months later, the PSA levels went up again. Reluctantly I agreed to the biopsy, convinced it was a waste of time. I’m a big guy. I have a big prostate. It goes to reason I’d have a big PSA level.

I’ll skip the details of the biopsy. Suffice to say it sounds like something that purportedly happens during a UFO abduction. It involves needles in places needles should never go.

The follow-up meeting with the urologist was set for two weeks later. I went into it fully confident that he’d tell me that the results were negative. That I was fine, it’s just an enlarged prostate, that at least we’d ruled out cancer as the culprit of the rising PSA levels.

Unfortunately, that is not the news I received. What I learned instead is that I have “favorable intermediate risk prostate cancer.”

So this biopsy was not a waste of time and money, and I probably should have gotten it done much sooner. Years sooner.

I was given three options for treatment:

1. Active surveillance, where we just continue watching it. (He does not recommend this at all.)

2. External beam radiation therapy. The advantages of this choice is that it avoids surgery, but the problem is that it damages a lot of internal organs, and will ultimately lead to complications and problems years later.

3. Surgery. Remove the entire prostate. It would be done by a robot, and would take care of the problem all at once. No prostate, no prostate cancer. There are downsides to this, too, not the least of which is that its surgery, but the picture he painted made it sound much better than radiation.

I’ve been given some time to think about it and to do my own research before I make a decision. And believe me, I’ve been thinking about it. And doing research.

Since then I’ve learned of some other options. There’s hormone therapy, and a drug called Provenge, and super targeted radiation.

Provenge is the option I immediately glommed onto. No radiation and no surgery? Sign me up! I had the feeling, though, it would be something my insurance wouldn’t cover. But in further research I learned the company that makes it has gone bankrupt. Supposedly you might still be able to get it, so I’ll be asking about it regardless.

Another treatment has to do with freezing the cancer, but that sounds so complicated that I might as well get surgery. I’ll ask him about that too.

I need to give my urologist an answer soon, and at this point I’m leaning toward surgery. It sounds like the most straightforward path that’s also the most proven. But then again, I have loved ones telling me to get a second opinion.

Stay tuned. I’ll keep you updated.