You breathe a little easier when the first test comes back with a number the doc calls “undetectable.”
But, they don't have a bell for you to ring that soon, celebrating the “defeat” of the disease. Way too early for that.
The whole experience – taking months of appointments, tests, waiting for test results, surgery, recovery - tells you this ain't necessarily over, that nothing about this kind of cancer is simple, and the doc will want another test in three months, then another in six months.
If you're lucky. Like I was.
I wrote here last spring that, “Having dodged a bullet, apparently, I'd like to help some other guy do the same,” about my experience with prostate cancer.
I figured if I could shove one guy up out of his recliner to get a simple PSA test, it would be well worth the effort.
I had my prostate removed last April in a three-and-a-half-hour surgery at Poudre Valley Hospital in Fort Collins. Had to spend the night in the hospital, but was on my way home late afternoon the next day.
The post-surgery pathology report couldn't have been better. “Clear margins,” meaning the cancer wasn't close to the edges and probably hadn't spread, and “no lymph node involvement.” That's good news, lying there in a hospital bed with a tube running out of you.
But, there's no temptation to go get a pitcher of beer to celebrate. (I've learned that beer is like dropping a depth charge into your innards, post surgery. So I miss my late afternoon Pabst Blue Ribbon.)
I've done a lot of reading about this disease. So I can tell you in layman's terms that going into this deal, you have three of what I call “check valves” downstream from your bladder. (There's a medical term for these valves, but it creeps me out.) Taking your prostate out takes away two of the three check valves. And until that last one gets up to speed to hold back the tide all by itself, you can spring a leak stepping down out of your pickup, or with a hearty laugh, or a big sneeze. Coughing hard can be a risky proposition.
But, it beats the hell out of cancer.
And it gets better. Seven months later, I'm pretty much over the side effects. And as this recovery goes on, I've learned not to expect sympathy from any woman who's had children, and as a result has a challenged check valve of her own. They've been there, done that. So don't bring it up.
The good news is that my first post-surgery PSA was what they call “undetectable,” just what my surgeon wanted to see. And the test three months after that was the same. I take another PSA in six months.
Nothing happens very quickly on the road to prostate surgery. I had a problematic PSA of 7.8 early in the summer of 2024. We figured it could be high because I exercise on a recumbent bike.
Later that summer, after I quit riding the bike, I had a 6.4, which the literature told us is within the normal range for a 73-year-old white guy.
But both are high, so I had my first appointment with a urology nurse practitioner that fall, and a digital exam, which isn't any guy's idea of fun. But, (wish I could think of a better word to start this sentence), it beats cancer.
Then there was an MRI to get an actual look at the critter. Then about a month later I was told I needed a biopsy, which entails a couple pain-deadening shots in a place you never thought you'd get a shot, but is then painless as they take a dozen tiny samples. It's all over in about five minutes, and I didn't whine. Honest.
Then, a couple weeks later, we met with the urologist again, who told me I had cancer, which wasn't the ton of bricks you'd expect, because I'd read up enough on the disease and knew I just wanted to get rid of my prostate all-together.
But then they have to wait about another month, so the damage they did taking all those samples can heal.
To quote the Beatles, it's “a long and winding road,” and if you worry too much, it just makes it worse.
They've made so much progress in fighting this disease that the essential book I read about it - “Dr. Patrick Walsh's Guide to Surviving Prostate Cancer” - has been significantly updated between it's first edition back in 2001, and the fifth edition in 2023. I read it cover-to-cover, and recommend it highly. (It has summaries at the beginning of each chapter, in case you don't have the patience to read all 424 pages.)
Along the way, I've been fortunate, with a smart general practitioner who told us even though my PSA had declined from 7.8 to 6.4, there was still a 25 percent chance of cancer, which turned out to be the case.
I had family support from my nurse practitioner wife and my physician assistant daughter. I had a gifted young urological surgeon – trained at Duke - who performed robotic surgery that took hours to complete. We have great health care facilities here in Cheyenne, and just down the road at the Medical Center of the Rockies.
And the recovery period went so well I was even able to help an old friend build his mountain cabin last summer.
Blessings at each step in the process.
There will be more tests and waiting for results. But seven months later, I can say so far, so good. And thank you Lord.
Plenty to be thankful for this Thanksgiving.
Let me end this the same way I ended that column last spring:
If you're a guy who hasn't had a PSA test in as long as you can remember, for the love of God, go get tested!
Early detection is crucial in fighting this deadly disease.
Dave Simpson can be contacted at DaveSimpson145@hotmail.com
