I was diagnosed in January 2014...

Attached is my clinical history, 10+ years.

Mine is a high risk PCa, GS 8, Grade Group 4, rapid PSADT and PSAV, time to BCR after surgery.

As others have said, this is a "fortunate" time to be living with Advanced PCa given the exponential advances in imaging, treatment and most importantly, how the medical community thinks about managing advanced PCa.

Gone are the day of continuous, sequential and progressive monotherapy with single agents, each destined to fail with death following. Now, we combine treatments, bring them forward in the PCa and while the general school of thought is Advanced PCa is not "curable," it can be managed as a chronic disease for many, sadly, not for all.

This "wealth of choices", when to image, with what, doublet or triplet therapy, which ADT, which ARI, which type of radiation, PARP, Radioisotopes, Genomic tests...requires us to inform ourselves and have discussions with our medical team about treatment choices, what, when, for how long...

In those 10+ years, I've packed a lot of living - birthdays, anniversaries, skiing in Colorado, watching my daughters graduate from high school and college and go on to the next phases of their lives, vacations to Iceland, The Big 5 in Utah, Oregon, Glacier, Waterton and Banff National Parks...you get the idea. Next April we're planning a trip to Sedona, AZ with our daughters.

I will never forget the phone call from my urologist with the results of the biopsy, the shock, the "pity party..." Since then, I've picked myself up off the floor, informed myself, made decisions...

None of us are thrilled about treatment, each time I've started ADT and when I started chemo, I questioned myself, angry at what I was doing, knowing the side effects...for whatever reason, the radiation treatments (all 69) have not evoked the same feelings, perhaps because for me, zero side effects and a very short treatment window. Each of us make decisions from a plethora of choices while deciding on the balance between quantity, quality of life, treating too soon, too late, continuous or intermittent..,

So, there is "hope."

For friends, colleagues and acquaintances who now know better than to say "oh, you are lucky, isn't that a good cancer", a sharp response of, that's an oxymoron, say that to the 30k who die of it each year and if you want to get into the details of the side effects of treatment, how much time do you have to talk...!

I am not downplaying his PCa, 30k or so die each year of it, not with it. I have a friend who will soon join that group.

So, we are living in a world today where living with our Advanced PCa as a manageable "chronic" disease is more possible.

Kevin