A 15 year Wife's Roadmap to Deal With Your PCa Husband
Your Husband's PSA Is Elevated: A Wife’s 15-Year Roadmap to Mild Panic, Medical Jargon, and Unsolicited Advice from Hans at the Golf Club
It starts, as these things do, with a phone call. He emerges from the bedroom holding his cell like it just informed him of its own terminal illness. “The urologist says my PSA is high,” he announces, eyes wide, voice trembling with the kind of dread normally reserved for tax audits or surprise visits from your in-laws. And just like that, your life changes—not in a dramatic movie-of-the-week kind of way, but in the slow, insidious, paperwork-laden crawl of modern medicine. Congratulations. You’ve just become the unpaid project manager of your husband’s prostate.
Year 0: The Phone Call – aka “Honey, Don’t Freak Out But…”
You’re making dinner (read: heating up leftovers) when your husband walks in, pale as skim milk and holding the phone like it bit him.
“The urologist says my PSA is high.”
Welcome to the club. You didn’t ask to join, but the initiation is fast and free of charge. Your husband is about to become obsessed with acronyms, urine flow charts, and the exact radius of his prostate. You, meanwhile, will Google “PSA” 14 times and then regret it immediately.
Pro Tip: Pour yourself a large glass of wine. This will be a theme.
Months 1-6: The Diagnostic Odyssey – Now With More Probes
Brace yourself for a series of tests, all of which involve either needles, scopes, or a deep and personal relationship with imaging equipment.
There will be:
A biopsy (he’ll whimper like a traumatized otter afterward)
A CT scan (“do I have to fast?” he’ll ask 9 times)
A bone scan ("why the hell are they scanning my bones if it's in my prostate?")
Several highly enlightening but emotionally draining conversations about Gleason scores and cribriform patterns, which you'll pretend to understand
You will nod sympathetically while the urologist explains things in a tone normally reserved for flight safety briefings. Then you will go home and Google everything again.
Helpful Tip: Every man becomes a part-time oncologist during this period. Expect unsolicited lectures on hormone pathways.
Year 1: Treatment Choices – Choose Your Own Adventure (But All Paths Include Side Effects)
Will it be surgery? Radiation? Brachytherapy? Hormone therapy? Cryoablation? Prayer? (You’ll meet a Barbara in the waiting room who swears by wheatgrass and Reiki.)
Whatever you choose, he will now begin a slow, reluctant slide into the land of hot flashes, mood swings, and erectile debates.
“It’s not you, it’s the Firmagon.”
“Yes, dear, I know it’s the Firmagon.”
Wife Survival Tip: Keep your sense of humor. And a fan. For both of you.
Years 2–4: The Hormone Haze – Moody, Sweaty, and Marginally Hairless
Your formerly stoic husband now cries at insurance commercials and gets winded tying his shoes. Sex becomes a fond memory, replaced by arguments over which low-fat yogurt brand tastes less like regret.
You’ll start hearing phrases like:
“Do you think my testosterone is low again?”
“I read on a forum that pomegranate juice helps.”
“Maybe I should try goat yoga.”
This is also the phase where he might purchase highly questionable supplements off the internet and insist they’re “natural.”
Marriage Maintenance Tip: Gently remove the laptop after 11 p.m. Nothing good happens in the prostate forums after midnight.
Years 5–7: The Surveillance Years – PSA, PTSD, and WTF
By now, you’ve both learned to dread the “PSA check.” It’s not a blood test, it’s a mood test for the next three months.
Your job during this phase:
Remind him that a small PSA bump does not mean imminent death
Hide the scale (the ADT weight gain is real and he’s VERY touchy about it)
Distract him with crime shows where at least those men have functioning prostates
Your Motto: “Let’s wait for the doctor to call” (and “Jesus, not this again” under your breath).
Years 8–10: Acceptance, Adaptation, and the Hobby Phase
The cancer is likely stable, slow-moving, or sleeping off the hormone nap. Your husband has taken up a hobby. Woodworking, birdwatching, competitive complaining—whatever fills the void once occupied by testosterone.
You’ll still attend semi-annual urology visits, now conducted by someone born after your wedding anniversary. He’ll still ask, “What’s my PSA again?” even though you texted it to him three times and made a spreadsheet.
New Challenge: He now corrects other men about PSA thresholds at dinner parties.
Years 11–15: The Long Haul – Just You, Him, and That Damned Prostate
You’ve now been to more medical appointments than vacations. He has strong opinions about which nurse draws blood best. You suspect he may be in love with one of the radiation techs.
PSA is low, libido is lower, and the dog gets more cuddles than you do. But you’re still here. Still sarcastic. Still slightly stunned that something the size of a walnut could have dictated the last decade of your life.
“We beat it,” he’ll say.
“No, dear,” you’ll reply. “We endured it. Now go take your Metamucil.”
Final Notes for the New Initiate Wife:
Always pack snacks for the waiting room
Don’t argue with a man on hormone suppression—it’s like fighting fog
And remember: this is a marathon, not a sprint
But if you sprint toward the wine fridge once in a while, no one will blame you.
Interested in more discussions like this? Go to the Prostate Cancer Support Group.
Feels just like it used to, orgasm is still strong and satisfying.
And I never have to worry about maintaining an erection, even after orgasm.
It feels great for me and I never worry about losing an erection, even after orgasm. I highly recommmend it over radiation or drugs, which can cause other serious problems sometimes.
He already had radiation and hormone therapy, hoping his libido comes back, and insecurities leave.
You might consider a penile pump. Mine was covered by medical insurance. I wish your husband well; it is not what we signed up for, that's for sure.
I showed "A 15 year Wife's Roadmap to Deal With Your PCa Husband" to my wife. Her response, after laughing out loud, was to immediately check our house for bugs planted by the Mayo Clinic. This is exactly what has happened to us and somehow our daily routine got into the prostate cancer support group chat pages.
In the last three years, I've done more reading and research about PCa stuff than about the subjects of any college courses I can remember. For what? An oncologist once said something like this in a support group meeting, "You guys probably stay up all night reading about PSA numbers and Gleason scores, which only makes you more anxious. Sure, learn about what's going on, and stay alert to new treatments, but rely on medical science and professionals to handle the concerns. There is nothing you can do to change what has happened so enjoy life as much as you can - while you can." He even said the best thing you can do for yourself is have a sense of humor about this very serious thing that has happened to you. Personally, I think he's right.
My take is to try to laugh and be as happy as I can, as long as I can, while knowing in the back of my head that I have cancer. Some of us have it more seriously than others but it helps nothing to present a poor-me, depressed, why did this have to happen attitude to others. That only makes it all worse for everyone.
Thanks for the post, Hans. It made my wife and me laugh. We needed that.
You're welcome. I share your point of view. Others on this forum have complained... so I am done posting. I am now posting my thoughts on Substack, @hanscasteels, or nutmeg_phantasy. Both are mine. All the contents are free, because, after all, what would I do with all that money Substack generates?
Hello Hans,
Thanks for your witty comments!
I have been following and enjoying your dialogs on this Mayo Clinic Connect web site for the past several years. Your creative humor is great and helps me get out of my depression and deal more positively with my prostate cancer journey, now in its 4th year.
Is there a way I can email you directly, or should all my interfaces be through this Mayo Clinic site?
Thanks,
Jay Keyes @jayhiii
sent you a private message. Also, https://nutmegphantasy.substack.com/
That's me
What's to complain about, no one is forced to read any post. I enjoy reading your posts. To be honest, I won't be going to the other sites, kinda stuck here, by choice. Hans, don't let the complainers win, post away, and while posting insight into this nasty business of cancer, give us a chance to laugh our way through it. Best to all.