What? What did you say? The doctor asked me if I had any questions and those were the only two I could find at that moment.
For years I've had an annual physical and for years I've heard almost the same things: Your blood sugar and cholesterol levels are a bit high. At one point my cholesterol seemed to be above 200, so my doctor prescribed a statin that reduced it to 165. It has remained at that level for years.
My blood sugar level was another story; He seemed to like to stay just below or above 100. My doctor started using words like "pre-diabetic." He also said that I could reduce my sugar level with a little more exercise, which I was glad to do. I also heard that cinnamon was good for lowering blood sugar, so I started putting it in my toast and oatmeal.
Another test that the doctor did was for PSA or prostate-specific antigen. This is the test that tells your doctor if you have a problem with the prostate, such as cancer or benign prostatic hyperplasia (BPH). This test has been available for a while, but some doctors have stopped using it due to the amount of false positive results it shows. My doctor is from the old school, so he does the PSA test. My PSA has been 2.5 years and, according to my doctor, it was a good number for a man in his fifties. That does not mean I did not have some problems with my prostate. Hell, most men do it as they get older, but they told me it was just a small problem of enlargement. Nothing to really worry about.
So once again it was time for my annual physical exam. This year I turned 61, but I was sure that I would hear all the same things. Cholesterol: 165, blood sugar level: 99-101, PSA: 2.5. And that's almost what I heard when the doctor called. My cholesterol was 165 but my blood sugar level, he said, was only 91. He asked me what I had done to lower the number. I told him I had intensified the exercise and started using cinnamon. He told me he had a good job and I thought the call was over, but then he told me he might have a problem with the prostate. I asked him what he meant and he told me that after having been in 2.5 for years, including last year, my PSA was now 4.8. He went on to say that 4.8 for a 61-year-old man is not too high, but jumping from 2.5 to 4.8 in a year was cause for concern. He suggested that you see a urologist just to be sure.
I was not too worried. I've had my share of health scares, but they always turned out to be nothing. I was sure this would be too. Then, I found a local urology office and called to make an appointment. They told me that the male doctors had reserved a couple of months, but that a doctor could see me immediately. Since I knew what the first test would involve, I thought that a female doctor, which usually meant smaller hands, was a good way to go.
A few days later I was in the doctor's office. She agreed that a 4.8 PSA was not very high, but she also agreed that jumping from 2.5 to 4.8 in a year was really cause for concern. Then he asked if he could do a digital exam. Of course, I knew what that meant and it had nothing to do with digital technology, but it referred to the digit I was going to use. I said yes, (as if there was no option) and she proceeded, narrating as she went: the left side of the prostate is soft as it should be. Now I am reviewing the right. The right side is firm and at the top, I feel a nodule the size of a frozen pea. After the exam, she told me that firmness is not what you want in a prostate and that the nodule – no tumor said – was a cause for concern. She went on to say that she wanted to do a biopsy. She said: I'm not saying you have cancer, but this test will tell us for sure. Cancer? Why did she even use the word? I was sure it would be fine.
The test was scheduled for the following week and the next day I went to the gym to train as if nothing had changed, because frankly for me it was not like that. While I was in the gym, I was talking to a couple of guys that I usually see there and I told them my latest news and my next biopsy. These guys were older than me and, of course, both had stories about prostate biopsies. One guy said he had had one a few years ago, and that it was very painful and that he was bleeding from his butt and penis for months afterwards. The other guy said he knew someone who had done it and told him they put a pipe on his butt the size of a baseball bat with spikes on the end that stabbed his prostate a dozen times or more, and you're I wake up for everything. Now I thought I had something to worry about.
When the day of the test arrived, I entered the office with more than a little hesitation. I looked for this baseball bat-sized probe with the peaks on the end, but I only saw this little tube on a table. The doctor told me that I would be lying on my side in front of a television screen where I could see the whole procedure. I asked where the probe was and she showed me the device. It did not seem much bigger than his finger and although it was not very comfortable to enter, it was not the terrible experience that had warned me.
I saw how the probe on the video screen reached the prostate. The doctor told me that I would feel two small bites when I injected an anesthetic injection of Lidocaine on each side of the prostate. Then he pointed to a white circle-shaped thing in the upper right corner of my prostate and said it was the tumor. That was the first time he used that word. Then he said that a needle would shoot from the probe into my prostate and remove a small piece of material. This was done twelve times and although I could hear and see the fire of the needle in the prostate, I did not feel anything. The whole procedure only lasted about fifteen minutes and then it was on its way. Before leaving, they told me that the results would be ready in a couple of weeks and we made an appointment to hear the news again. I was not worried yet. He was 61 years old and had two older brothers, none of whom had prostate problems. Why would he be the first?
The two weeks pbaded quickly and I went back to the doctor to get the results. My wife went with me and while we were sitting in the doctor's office we joked about where we were going to celebrate the good news we were about to receive. We were talking about whether we should go eat cake or ice cream when the doctor came in. She saw that we all smiled and laughed, and for some reason we decided that she would go hunting. You have cancer, she said. What? I replied. You have prostate cancer. Really? I felt as if I had just been punched in the stomach.
My wife and I were sitting in chairs in the office. To our left was one of those little beds with white paper. The doctor sat on a rolling chair and rolled towards the bed and began to draw on the white paper. We brought our chairs closer so we could see. She drew an image of the prostate. He made circles where he said they had taken biopsies. He drew a larger circle on the top right side of the prostate and labeled it as "tumor". He drew a darker circle in the upper right and lower right corner and said that this is where we found cancer. Then he started reciting some numbers. She said that since you have a tumor, I can feel that I have a T, and since the cancer is on one side and at the top and bottom you have a T2b, and depending on the appearance of the cells, you have a Gleason score of 6. She went on to say that a Gleason score of 7-10 is bad and a score of 1-5 is not bad, but I am a 6. So, there you have it. I have stage 2 prostate cancer, T2b with a Gleason score of 6. Now what?
The urologist told me that I have three options. One is waiting carefully. Two is radiation. And the third is surgery. She stated that option one is not really an option, since at this point she did not believe that the cancer had spread, but if she did, she would probably die soon after. Now we are getting serious. Then that leaves radiation or surgery. She said that radiation is certainly not guaranteed and was generally reserved for people who could not tolerate surgery, leaving me with option three, a radical prostatectomy. He said he would recommend a radiation oncologist and a surgeon. They will tell me what they advise and, based on that, I will have to make a decision.
I still feel like I got punched in the stomach. I will let you know what I decide to do and continue writing about this new challenge in my life. But as the title of my book says, I Get Get Up Up.
1. Since most men, if they live long enough, will have some problems with their prostates, all they can really do is postpone it and one way is with diet and exercise. Therefore, make sure you get enough exercise and eat lots of cruciferous vegetables like broccoli and take saw palmetto. There is a lot of information available on this topic.
2. Be sure to have a physical exam every year and undergo a digital rectal exam and badyze PSA levels.
3. If your doctor finds out that something out of the ordinary with these tests, go to a urologist immediately.
4. Have the urologist re-run the tests. If they are still positive, perform a prostate biopsy. This is the only sure way to find out if you have cancer. Do not fear this test. It's not nice, but it's not as bad as you might hear.
5. When you're going to get results, it's OK to expect the best, but plan for the worst. I was so sure I did not have cancer that I was not prepared with any questions. When I got home, I had a lot.
6. If you listen to the dreaded word C, learn. There are many great sources on the Internet and excellent books like: The Guide to Surviving Prostate Cancer by Dr. Patrick C. Walsh.
7. Get support Do not be afraid to tell your family and friends. These are shocking news and will create some stress for you. Being surrounded and supported by people who love you will help more than you think.
George A. Santino helps people who want to break down barriers, including self-imposed barriers, to success. Check out his best-selling Amazon book, Get Back Up: From the Streets to Microsoft Suites.