Last Thursday I revealed in a blog post I was diagnosed with prostate cancer. It was a deeply personal revelation, the most honest writing I’ve ever done. I’m following my journey from my diagnosis with this illness through recovery. My hope is it might help those with a similar diagnosis or those who are concerned they might have this illness.
Let’s begin at the beginning.
1. November 9th, The Prostate Infection
On Saturday night of November 9th I was playing board games with friends in Tacoma. We ducked down to the Orange Door on PacAve for Vietnamese food and beer. By the time I left for home at about 11:00 I wasn’t feeling well. I had pain in my back and maybe a little feverish. I hoped it wasn’t something I ate and went off to bed.
By Sunday morning I was feeling pretty crummy. I told Lorri the symptoms, and we both concluded kidney infection or kidney stones. I have an unhappy relationship with my kidneys. We usually get along fine, but every few years they seem to get ornery and knock me on my ass. So I headed off to a Multi-Care Clinic and the doctor agreed, after a urine sample, that I likely had a kidney infection.
He gave me a prescription for antibiotics and packed me off to my doctor. I checked in with Dr. Baliga on Tuesday. She ordered blood and urine tests for me. She also referred me to Dr. Lee, a urologist in Puyallup.
2. December 23rd: The battle with PSA is joined
When Dr. Lee heard my symptoms and saw my test results he was immediately doubtful about kidney issues, despite my history. His thought it was prostatitis, an inflammation of the prostate. He ordered more blood work and imaging of my kidney just in case. He also prescribed four weeks of additional anti-biotics. His view was the prostate infection might still be unresolved. With a sheaf of orders and prescriptions in my hand I trooped out to do battle and scheduled a follow-up for December 23rd.
On the 23rd Dr. Lee shared his concern. My Prostate Specific Antigen (PSA) levels were too high. Normal for my age is 0-2.4 and mine were quite elevated at over 6. After a tactile exam of my prostate, revealing a “mushy” state, Lee concluded the levels could be because of the effects of the infection. But he began to use words like biopsy and cancer in the same sentence with you and that was unsettling. We set a follow up appointment for March 25th with the hope my PSA levels would decline .
3. April 15th: Biopsy
On March 25th, we reviewed an updated blood test. It revealed my PSA level at 4.2. Dr. Lee shared some options with me. He was concerned the prostate infection might not be fully resolved, and that could account for the elevated readings. He also explained the levels were borderline. 4.0 was usually the cutoff for requesting a biopsy, but in my case their were some risks due to the fear of an ongoing infection. We could put this off for another 90 days and review the readings again. I chose to go ahead with the biopsy as soon as possible and scheduled the procedure for April 15th.
I won’t go through the whole business of the biopsy. I will simply share that it was unpleasant. What you should know is that it extracted a sample from each of the 16 regions of my prostate for testing. We scheduled a follow up to review the results for April 22nd.
4. Fear Factor
I’d love to tell you that preparing for the biopsy was easy, but it wasn’t for me. Yes the physical preparations for the test were easy, easier than a colonoscopy. But when my doctor and I agreed to do the test on March 25th, I entered a “cancer coma.” When cancer increasingly became potential diagnosis, it was hard to think of much else. I became much less productive, very unfocused, and I began visualizing him saying the words, “Mr. Smyth, you have prostate cancer.” Despite the knowledge there was only a 16% chance I had it, I pretty much remained in that state until after I got the news. One of my journalism friends summed it up best: there is nothing routine about cancer; it is horrid and frightening. I watched my grandfather waste away to nothing from cancer. That is my association with the disease. Coping with cancer is so emotional, so psychological, it is critical to find strength to fight the revulsion and the fear.
5. April 22nd: I have cancer
On April 22nd my wife and I met with Dr. Lee to hear the test results. He sat down and spoke the words nobody wants to hear. I have cancer. He revealed that my cancer was semi-aggressive and showed me the diagram of the prostate and the three regions of the sixteen tested that showed signs of cancer. Dr. Lee indicated the two best options open to me were radiation and surgery. Due to my relative youth and general good health he recommended surgery. His view was that surgical removal of the prostate gave the clearest road to being cancer free, and if follow up was needed radiation was something we could keep in our back pocket. If radiation was chosen over surgery, surgery would not be available to me. Dr. Lee went on to spend an hour with us, walking through the diagnosis, some treatment options, and referred us to a radiation oncologist to get the pro-radiation side of the argument. He also made a referral to Dr. Porter at Swedish Hospital in Seattle to perform the robotic surgery that will remove my cancerous prostate gland before it kills me.
6. What it means
The number one meaning is I was lucky. The prostate infection that sent me to Multi-Care was a gigantic pain in the tookus , but it set in motion the chain of events that led to discovery of my tumor. I was lucky because Dr. Lee didn’t accept the kidney infection explanation without further exploration. I’m lucky because I made the right choice to not delay the biopsy. All this means I had early detection of the my cancer, which improves my chances of becoming cancer free.
A second meaning I’ve discovered is learning one has cancer is the loneliest experience there is. Don’t let it be. Talk to your spouse and your loved ones, tell your friends and your colleagues. None of them want you to go through this alone and unsupported. Though your affliction is not as mortal as other forms of cancer, recovery be arduous, and when times are hard, you’ll need encouragement, or the stories of others and how they coped with it. Don’t try to tough it out alone, rejoice in the best wishes sent your way.