A Very Angry Prostate

Cancer. 

No other word evokes so many emotions and consumes so many thoughts of both the one with the diagnosis and those who learn of it. On Tuesday, June 25, at 4:40pm, I learned that I have prostate cancer. 

One of the questions I'm most asked: "How did you know to check?" Naturally, some wondered if I had signs or pains. There were none. Last September, I had my second physical with my new primary physician. With an age of 50, he requested a PSA (prostate-specific antigen) test be added to my blood panel. The next day, the results were in my portal. For my age, my PSA should be no higher than 4. My reading was 4.191. Since this number was out of range, the portal chart visually shouted at me that this was HIGH. Googling sent me into a spiral of thinking I might have prostate cancer which led to many thoughts of mortality. I was at work sitting in my cubicle attempting to calm myself and praying as waves of anxiety, thoughts and emotions washed in.

I contacted my primary via the portal and expressed my concerns. He responded that this number was only slightly elevated but would make a referral to a urologist. 

When I visited him again early this year for a follow-up, I mentioned that I had not contacted a urologist due to life and my mother's passing in December.  He was compassionate but didn't seemed alarmed at the number. He reiterated it was only slightly out of range but he could give me a urologist referral.  

When I finally did schedule a visit with a urologist, on June 6, eight months had passed since the first PSA number. The urologist was a bit concerned at the number and wanted to schedule a prostate biopsy. He requested another PSA test. After blood was drawn, he performed the digital rectal exam.  He gave no feedback on the exam and I was honestly too scared to ask. If the PSA test results came back lower, the biopsy would be canceled.

The next morning, the lab emailed that results were ready. After gaining access to the portal, my PSA reading was 7.3. Google claimed that different labs could produce different results and that men with PSA results between 4 and 10 had a 75% chance of not having cancer. I emailed the urologist's assistant asking if he had notes from my rectal exam. He replied that the exam was normal. At the time, this gave me comfort that I didn't realize how much I needed. 

I reached out to close circles to pray for me and the biopsy - that the procedure would be quick and easy and that the results would be benign. I focused on that belief.  

Meanwhile, the biopsy was a week and half away. More than enough time for my mind to be distracted and wander. I prayed for my thoughts to be captive. Friends offered prayers, support and stories of men they knew who had been treated for prostate cancer and were doing well.

When biopsy day arrived, June 19, I had two pre-procedure tasks: giving myself an enima (which was far easier than expected) and taking an antibiotic. For the procedure, I received a local and had twelve samples taken. The option to be sedated wasn't discussed but apparently is an option. However, I believe that process would've taken longer than the procedure. In a fetal position with my pants at my waist and a paper blanket covering me, I waited longer for my urologist to arrive than the procedure's length of time. Afterwards, I described to my urologist, "That was weird but also not as bad as I thought." He indicated that many have told him they're underwhelming. That's not the word I'd choose.

He asked me if I wanted the results dropped in my portal. "So, that would be available before the follow- up?" He nodded yes. I honestly didn't know if I wanted to see results without context. I agreed to it but also knew that the next few days would be a mixed bag of anxiety, thoughts and emotions.

The procedure was on a Wednesday. The results came the following Tuesday, June 25. Maybe my body knew what the results would be. My heart rate reached 150 before reading the message and results. "Unfortunately we did find prostate cancer. The prostate cancer is high risk and will need to be treated. We will arrange appropriate staging studies and referrals at your follow-up visit." The results were T3b-T4 OR Primary Gleason pattern 5 OR >4 cores with Grade 4 or 5.

I Googled that but limited the search to two sources. I didn't want to go down a rabbit hole and wanted to move my follow-up from the following Tuesday to sooner, but nothing was available. 

That evening and into the next day were a fog for Kim and I. She described it as being gobsmacked. We shared the latest news with our adult daughter whom we've kept updated all along. After chatting a bit, we asked about her thoughts.

"God's got this."

While she could've been repeating back to us what we've already said about the situation, her phrase was spoken truth from her heart. We couldn't help but be pleased to see this young woman of faith and Christ follower speak Godly wisdom.

By Thursday morning, June 27, the fog had lifted. Maybe it was the time needed to process everything. Maybe it was my scheduling visits that morning with an oncologist and surgeon. Maybe it was leaning into God's  peace. That Thursday and every day since, I have had a peace about the situation and the future. It's truly the peace that passes understanding. 

The following Tuesday, July 2, was the day after my 51st birthday. Kim accompanied me to the follow-up with the urologist. My expectations for the visit were to see some sort of imagery of the cancer and discuss treatment options. Half of the samples have some level of cancer and two of those samples are the most concerning. 

My urologist wanted me to get a PSMA scan which is a form of PET scan. It would help confirm the treatment plan he was recommending - hormone therapy and seed implants. The PSMA is only a few years old and will reveal where the cancer is located and if it has spread. The urologist offered encouragement that I shouldn't feel rushed to make a treatment decision. Consider all my options. The cancer is slow-growing and has been there for a while already. He said we would get a plan together and he'll be along for every step. It was the type of encouragement that I didn't know I needed. 

The oncologist was my next visit and was scheduled the following Tuesday, July 9. This consult offered more context into my specific prostate cancer, options available to treat it and the oncologist's recommendations. He described a 3-stage approach of hormone therapy, radiology and seed implants. Surgery was also an option and I had a consult scheduled but Kim and I believed the 3-stage approach described by the oncologist was best for me. Plus, I've always viewed surgery as a last result. In my case, I could have the prostate removed and still need radiation several years later.

Next was the PSMA scan scheduled for July 15. This is a relatively new scan where I am injected with a radioactive substance that targets a protein called PSMA - Protein-Specific Membrane Antigen - which is expressed by prostate cancer. The next day, I had a message from my urologist in the portal. A lot of news seems to happen on Tuesdays.

"PSMA scan was negative for metastatic disease."

What an amazing praise and answer to prayer! It also confirmed what my oncologist believed - that it had not spread.

I've wondered if this could've been caught earlier? Rectal exams have all been normal over the years so only a PSA test could've caught this earlier. PSAs are checked starting at 50 but I'm encouraging any male reading this, when you have a physical exam, request the PSA. Every decade starting at least at 30.

I've wondered why this is happening to me? Why now? If it had been found later, options may have been fewer or grimmer. But why not me? If one person comes to know Christ through this experience, it's worth it. And I've already had several encounters where the person was amazed at my outlook, attitude or calmness. All glory to God!

This past Tuesday, September 10, I began my healing journey with getting my first dose (a double) of the hormone therapy and will receive single doses for the next 6 months to likely a year. I also was prepped for the radiation therapy which will likely begin before the month is out and last for 5 weeks with short daily treatments Monday through Friday. The seeds implants would possibly be in November.

For prayer specifics: it's not beyond Jesus to completely heal me. Yes, there is cancer in my prostate...but He could remove it in a blink. Miracles still happen. But if that's not His Will, pray for wisdom and discernment in the treatment. Pray the path chosen will be the best for completely healing me of any and all of the cancer. Pray that I will have no or minimal side effects. Pray these treatments will be covered by insurance and that the Lord will provide for costs not covered. He has and always will provide! Pray for my wonderful family who have been and continue to be a support through all of this. Pray that God is glorified through this and that everyone can experience Jesus in whatever means they need to experience Him.

God's got this. He has me and He has my family. Isaiah 41:10 “So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand."