An elevated PSA was the beginning of my journey and after a conclusive biopsy, it was time for me to consider next steps.  A year into living into what I considered a routine life, as a widower and solo ager in my late 60s, financially stable, working part-time, happily residing between two communities and dividing my time between the urban landscape of Atlanta and the Blue Ridge mountains of western North Carolina, I blithely continued moving through the world with the rhythms of a 'hail fellow, well met.'

I have good friends, a strong social network, and an active life that includes satisfying erotic energy with a loving partner (this information will be more relevant later). I take vitamins, exercise, floss and see my primary care physician twice each year. There is no history of cancer in three generations of my family of origin.  So, during a routine physical when my PSA was noted as elevated, I took it as a matter of course. I stay current on relevant reading and recognized the controversies over the PSA test focusing solely on routine screening for potential cancer. 

It was not until later that I learned the utility of the PSA test as a gauge for how effectively a particular prostate cancer treatment is working. I knew the PSA was a standard test included in health-related screening but never paid it much mind.  Because of my elevated score, my physician moved me into the diagnostic class of "watchful waiting." Subsequently, I learned that the prostate-specific antigen, the PSA, is a protein of normal prostate cells that is released in higher amounts by prostate cancer cells.  Click here to learn more.


Treatment Options for Prostate Cancer and What I Chose

I was tasked to weigh options on a course of treatment that I could live with based on many factors; I learned there is no obvious choice.  I have prostate cancer, staged as an "intermediate unfavorable risk" with high Gleason scores. The Gleason score is a number assigned to prostate cancer cells, based on their likeliness to spread.  The score of the two main cell types in a tumor predicts its aggressiveness. Through the diagnostic process, providers continued to tell me what a lucky man I was to have the cancer diagnosed while the tumor was still localized to the prostate's fibrous capsule.

Biopsies revealed the tumor to be aggressive, translated in my colloquial understanding and non-medical mind that the cancer was building enough steam to launch a somatic field trip, using my lymph system as a roadmap and my bones as its interstate freeway. Luck was held in the finding of the tumor's containment to the gland, while it was still at the gate and before it left the station, providing different treatment options.

One thing is certain about prostate cancer: It is complicated. I learned there is no obvious choice when it comes to decisions as I was tasked to weigh options leading a chosen course of treatment that I could live with, based on thinking over multiple factors, including the stage of the cancer, age, lifestyle and risk of side effects, such as urinary incontinence and erectile dysfunction.  Click here to learn more.