The key to much of this involves early and annual screening which leads (hopefully) to early detection.
Having first heard about PSA testing when I was 40y (in 1995), I started having PSA tests as part of my annual health checkups when I was 45y (in June 2000), and watched my PSA slowly rise each year (1.30, 1.64, 1.79, 1.87, 2.10, 2.60, 2.70, 3.40, 4.00 & 4.20).
So, it wasn’t a big shock to me in April 2012 (at 56y), that my urologist told me that my “blind” biopsy showed low-grade, localized prostate cancer: Gleason 6(3+3); an independent second opinion confirmed this. After 9 years on active surveillance, I had proton radiation treatments during April-May 2021. Today, it’s all just a passing memory…..
To date, I’ve had 63 PSA tests (many including testosterone, CBC, and CMP tests), 4 MRIs, 4 biopsies, 2 CT scans, 2 bone scans, 2 DEXA scans, 2 biomarker tests (OncoTypeDx and Prolaris). Each provides necessary diagnostic information to guide my next steps. So far, so good.
What I found was that decision-making for my prostate cancer has been easier than for some other medical issues I’ve had —> for my two knee surgeries (in 1995 and 2018) and one back surgery (in 2012), I was in such excruciating pain that there was no time to research, ask questions, or get second opinions.
On the other hand, for the cholecystectomy (gall bladder removal) that I had 1-1/2 years ago, my prostate cancer experience actually provided me a great benefit. Even though I didn’t have surgery to treat my prostate cancer (I wound up having proton radiation), I had learned of the need to seek out a surgeon who had done a thousand robotic surgeries - and I did. The gallbladder surgery and recovery went as well as expected.
For my prostate cancer treatment, the SpaceOAR Vue injection went as expected (ouch!); the proton radiation treatments went as planned (uneventful); the ADT experience was just as I had been told — “ramp up your weightlifting and cardio in order to minimize/avoid the side-effects of low testosterone.” I had mild, tolerable (mostly annoying) ADT side-effects - even with a testosterone level that went down to 3.0 ng/dL.
So far, this hasn’t been the worst journey I’ve experienced. (My older brother was diagnosed with pancreatic cancer in early August 2024; he died of the disease in late October 2024.)
The way this has changed me is that I saw the need to study and become a “student of prostate cancer.” So far, I think the decisions I’ve made have been right on track (no differently than for any other illness or injury that I’ve ever had) and my numbers remain nominal.
Take the time to learn all you can and treat the disease appropriately for the diagnosis.