Thursday, November 08, 2018

This is your PSA (public service announcement) about your PSA (prostate-specific antigen) test.

Four years ago, during the summer of 2014, I was forced to ponder the possibility of life without Tom when he was diagnosed with prostate cancer. (I blogged about it previously here and here and here.)
Prostate cancer awareness
Long story short, our Independence Day celebration in 2014 was cut short when Tom ended up at the ER with what we thought was a bladder infection. Pain meds and antibiotics didn’t touch it, so within a few days we were at a urologist’s office, where a PSA blood test revealed an abnormally high score of 49. Knowing that a score higher than 4 can signify prostate cancer, I began to panic – and research. (Tom did neither of those things which, in retrospect, was wise. Dr. Google can be terrifying!)
Three weeks after his PSA test, Tom underwent a biopsy, which revealed stage one prostate cancer. Stage ONE! Not stage four, as I had feared and researched myself into believing. I cried happy tears when the urologist told us the news – which absolutely baffled Tom who, having no idea what I had encountered in my researched, questioned why I seemed relieved. It was only then that I revealed my fears to him. So he had to get used to the idea of having cancer at all, and I could breathe a sigh of relief that he’d be around for a while, after all!
The urologist suggested removing the prostate surgically. But we decided to take some time to breathe and to get a second opinion at the University of Washington/Seattle Cancer Care Alliance, one of the top cancer centers in the country. Since the biopsy had shown that Tom’s cancer was stage one and slow-growing, he opted to take part in an “active surveillance” study through the university. Participants in this study have a PSA test once every three months and a biopsy once every 18 months to two years. Many men stay in the study for years, with little to no change in their cancer. Unfortunately, Tom won’t be among that group, as his cancer is now early stage two – still not a panic situation but, according to his current doctor, time to “look into options.” We are still confident that the cancer is well contained within the prostate, but we know that this is NOT a cancer you want to deal with once it has “escaped the capsule,” as they say. In those cases, it can be a killer.
So we are currently looking into treatment options. None of them are great, and all of them come with some degree of risk of both incontinence and impotence – though an excellent surgeon (which we have) can often spare nerves so both can be restored. (We’re too young for this!)
We feel confident that we caught this cancer early – thanks to a terrible infection four years ago. But we are still amazed that prostate cancer, the second biggest killer of men, doesn’t have the spotlight that breast cancer has for women. Men, it seems, are not routinely encouraged to have PSA tests the way women are encouraged to have regular mammograms.
Granted, the PSA is not a perfect predictor of prostate cancer, as it’s prone to false positives, but it is something!  I have begged our sons (29 and 31) to get baseline PSA tests (even asked for it for Christmas this year!) because both their grandfathers and their father had/have prostate cancer. But in my opinion, EVERY man should include a prostate screening in their regular check-ups, beginning sometime around 35-45. This means a DRE (digital rectal exam) and a PSA (blood test). I asked our PCP why this isn’t done on a routine basis and he said that most practitioners will do both tests when requested (and seriously, would the average man ask for a DRE?!), but that it just isn’t the “gold standard” at this point.
Tom and I began to mention this to our family and friends and were amazed at the number of men in their 50s, 60s and older who have never had a PSA test!
So this is our PSA regarding your PSA:
MEN: PLEASE, please, please… GET ONE!
PARTNERS: PLEASE, please, please… make sure he GETS ONE!
Rant over. Smile

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Renate said...

Hubby had prostrate cancer some 10 years ago and our choice was to have the prostrate removed. He did have some incontinence for a while, but recovered his bladder control fairly quickly. As for the impotence, there always is Viagra. We figured, that by having it removed, it could never cause any more problems.

Good luck with whatever you choose to do. Also, Seattle Cancer Care is the best. We found that out when he was diagnosed with Melanoma almost four years ago. So far, so good. No recurrence!

Margaret said...

I'm glad that you are exploring those options we discussed last time we met. They've made such strides in treatments and surgery, but as you said, there are potential risks/downsides to each one. Hope that Tom can find one he (and you) feel comfortable with. I don't understand why prostate cancer doesn't get more attention either. Or lung cancer which is the #1 killer of men and women. Let's do lunch soon! xoxo

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