Having dodged a bullet – apparently – I'd like to help some other guy do the same.
(This is one of those rare times when I can write “guy,” and not have to add “or girl.” This is just about guys. Sorry if that offends.)
Last June a friend from up in the mountains died of prostate cancer. Great guy. Year older than me. He battled it for 2½ years, but it ultimately took his life. He stayed active throughout, traveling all the way to Indiana to see that total eclipse of the sun last year, mere weeks before he died.
Seemed like an opportune time get my PSA checked. I hadn't had one for maybe 10 years. It's not like I hadn't been to doctors. It's just that I was plagued by orthopedic problems – knee, shoulders, back – and other things were top of mind.
It was a busy summer. I was up in the Snowy Range a few days every week, helping a neighbor build the foundation and ground floor for his cabin next to mine. We dug holes. We moved rocks and dug out stumps. We poured footings. We stacked concrete blocks and filled them with concrete. We unloaded trailer loads of lumber. We built “box beams,” and connected them with floor joists. And we put down 24 sheets of three-quarter plywood. Lots of work.
I wrote about it here. Could two 73-year-old guys, with a combined age of 146, build a cabin high in the mountains without heavy equipment? Yes, at least so far. Folks who stopped by were amazed at the size and stoutness of what two old goats were building.
“You're no spring chicken, Dave,” one friend advised me.
Right before the Fourth of July, a letter with my PSA score arrived. “That's high,” my retired nurse practitioner wife said of the 7.6 score. Repeat it in a couple months, we were told. Bike riding can result in an elevated PSA. And maybe digging holes and pouring concrete.
Right about when we finished the cabin work for the summer, the score from my followup PSA arrived – 6.4, a little lower, and we learned that that's not unusual for older guys. Other crises took center stage when I tore the Achilles tendon in my right leg, and spent a couple months on crutches and in physical therapy.
Meanwhile, my family doc recommended that we address that elevated PSA. With a 6.4, he said there was a 25 percent chance of cancer. So, when we discovered that our insurance wouldn't cover a urologist in Cheyenne, we scheduled an appointment at the Medical Center of the Rockies.
A digital exam – not much fun, but no big deal – revealed an enlarged prostate, but nothing that clearly indicated cancer. So they recommended an MRI, which I had in Cheyenne right before Christmas. In January, the urology nurse practitioner first used the term “lesion” - that will get your attention - and we scheduled a prostate biopsy for February.
The biopsy wasn't “something you'd want to do every day,” the urologist said. But it wasn't that bad, either, and it only took 10 minutes. The injections to block the pain were a little uncomfortable, but I couldn't feel anything when they took 12 tiny needle samples, which were sent off to a pathologist.
Everything takes about a month in this process, and in March the doctor had bad news – I had prostate cancer – and good news – it looked very treatable. A “Gleason score” of eight or above is bad. I had a seven, but my 4 plus 3 seven was worse than a 3 plus 4 seven. You might get away with monitoring the situation with a 3 plus 4 seven, but not with a 4 plus 3 seven. (I know it's confusing. But it is what it is.)
While this was all going on, a friend recommended the book “Dr. Patrick Walsh's Guide to Surviving Prostate Cancer.” Walsh was acknowledged as the “world's foremost authority on prostate cancer,” working at Johns Hopkins.
At our library, I found the third edition, but then got the fifth edition (used) on Amazon. I read it cover to cover. It's a tribute to the amazing progress that has been made in research and battling this disease that the fifth edition is much different than the third, and more optimistic about treatment.
The urologist explained that I had two options – surgery to remove the prostate, called a radical prostatectomy, or radiation. I had read enough to know that I would opt for surgery, which is referred to as “the gold standard” in seeking a cure.
Problem was, according to the book, patients my age – 74 – were for years considered too old to handle the surgery. The urologist told us the joke used to be that a guy my age could only get the surgery “if his dad brought him in.”
But, lots of progress has been made since then, and the advent of robot-assisted surgery – a true game changer - has made the surgery more precise, far less bloody, and available to older guys.
That made the decision easy, so on April 8th I had the surgery in Fort Collins. A gifted young surgeon worked on me for three solid hours, robot assisted, and I spent one night in the hospital before going home late the next day.
A more complete examination of the prostate is possible after surgery, and it looks like they got it all, with “clear margins” and no lymph node involvement.
It's a month after surgery this week, and while recovery from major surgery has its challenges, and recovery from prostate surgery has some specific challenges, I'm feeling pretty good, more normal every day, and taking the dog out for long walks mornings and afternoons.
I'll get another PSA test in July, and the expectation is that my number will be “undetectable,” meaning none of the indicators of prostate cancer are roaming around in my blood. Worst case, if that isn't the result, radiation and hormone treatments are options.
Longevity in my family played a part in my decision to go with surgery. My mother lived to be 99. And with granddaughters aged 6 and 4, I want to stick around as long as I possibly can. And I figure those two guys with the combined age of 146 last summer still have a year left, maybe two, to finish that cabin in the Snowy Range.
I've been writing this weekly column since 1983. I've written about everything from murder trials to my kids picking all the marshmallow bits out of a box of Lucky Charms. I've written about putting dogs I've loved to sleep, and about old people on fixed incomes trying to hold onto family homes in the face of rising property taxes.
This column is different, though. Because if just one guy reading this decides it's time to go get that PSA test he's been putting off, and a cancer that is slow moving in its early stages is caught in time, then this column will be a success.
Doctors can work wonders these days, with their advanced treatment strategies and robot-assisted surgeries. But there's no substitute for catching prostate cancer early.
The death of my friend last June motivated me to get my PSA checked.
He probably saved my life.
Two words for guys reading this column:
Get checked.
Dave Simpson can be reached at: DaveSimpson145@hotmail.com
