Last August, I was diagnosed with prostate cancer, one of approximately 23,000 Canadian males given similarly bad news in 2020. This week, I began treatment for the disease. I invite you to accompany me on my journey. I hasten to reassure you this column is not a “GoFundMe” endeavour, as important as those campaigns may be for others. (But thank you, Grace, for those delicious muffins.) Nor is my journey designed to elicit pity; most other cancer patients are enduring a far more challenging battle than I am.
Why then am I writing about my illness? It provides me with an easy opportunity to let a wide circle of casual acquaintances know, without requiring a large number of phone calls or emails on my part. More importantly, this small literary effort might serve to “educate” any unaware or unmotivated older men about the need to be regularly screened for prostate cancer. A national charity, Prostate Cancer Canada, describes what it calls “prostate cancer denial.” Their research found that while 75% of men over age 50 knew that this disease was the most common cancer among males, one in four men over 50 were not seeking PSA screening.
What is a PSA test? I am no authority on the subject of cancer. My information comes primarily from the Canadian Cancer Society and other readily-available resources. Prostate-specific-antigen (PSA) is protein made by the prostate gland. It is commonly found in blood and semen. Higher amounts of PSA can be a sign of prostate cancer, but also can serve as an indicator of inflammation or other less scary prostate abnormalities.
My own journey began earlier in 2020 when my ever-vigilant family physician recommended a routine “digital rectal prostate examination.” (“Digital” in this procedure means a diagnostic finger, not some fancy, high-tech digital device.) Given the intimate nature of the procedure and being alert to any potential male patient/female physician awkwardness on my part, she gently inquired if I was OK with her going ahead. Observing that her finger was one half as big as the thick, sausage-like “digits” on my previous male doctor, I felt far more relieved than awkward.
But an unexpected “awkward” moment did soon follow. I obediently jumped on to her examining table, lay on my left side and lowered my head on to the soft and inviting pillow at one end. The only problem with this smooth move was that my rear end was now jammed against the office wall, rendering me literally unapproachable. I had inadvertently gotten on the wrong way. Without missing a beat, my ever-vigilant and also resourceful physician simply lifted the whole bottom end of her heavy table and pulled it out from the wall, with me getting a free ride.
The mildly uncomfortable, but painless and brief, exam discovered a somewhat enlarged prostate. That finding, plus a slightly elevated PSA count, led to a referral for the urology consult. In a phone consultation, the specialist recommended an ultrasound of the prostate to determine its size and texture and biopsies (tissue samples) to determine if cancer is present. These pain-free procedures were done in Owen Sound amid strict Covid-19 protocols.
When cancer was discovered in six of 12 samples, it was then on to CAT and bone scans to determine if the disease had spread beyond its happy home in my prostate. My biggest stress came, not with the procedures, but with the requisite “Johny gown” patients must wear. I have never learned the art of tying those strings behind my back. At least this time, I was also given a dressing gown to hide myself in. Years before, preparing for a colonoscopy, I had only a too-short Johny gown to protect my modesty in a crowded waiting room. I then realized how some women might have felt, sitting down while wearing miniskirts, back in the 1970s. Once settled on my stretcher bed, I proudly displayed my prominent arm veins to reassure the attending nurse it would be a no-brainer to hook me up to the IV. She replied somewhat discouragingly that my veins may be prominent, but they were also “narrow and squiggly.” Three nurses and five jabs later, I was hooked up.
I was relieved to hear that cancer had not escaped the prostate. After another consult, this one with a radiation oncologist in London, the urologist and I agreed that the least invasive strategy might be to adopt a “watchful surveillance” approach. Regular PSA testing and another biopsy in future would keep an eye on this typically slow-growing disease. This concept assumes I “will eventually die with it, but not from it,”
There are at least two times in a man’s life when he dislikes high scores: One is his golf game, the other is his PSA reading. By February of this year, my PSA had jumped from 9 to 16. More assertive treatment was indicated. This week, I began hormone therapy to be followed by radiation. The journey down an unexplored road has begun. Positive thoughts, lots of prayers and supportive family and friends will help light my path. I’ll keep you informed along the way.