When It Comes to Prostate Cancer, Don't Rush, But Don't Stop!

Prostate cancer often becomes a major partner in men's lives. What once was a death sentence, prostate cancer now often takes on the role of a chronic illness for those who find it early. The journey may start with a slight uptick in a routine blood test...the PSA.

The first steps taken can be critical

There is a question about whether the PSA is rising from the aging and enlarging of the prostate or if it is rising because of an early cancer.

Once there is a cancer suspicion, there is seldom any going back. Like any other journey, the first steps taken are critical. You wouldn't start on a long trip or launch a business or plan your educational path without careful study and consideration. The prostate cancer journey is no exception.

Because modern prostate cancer diagnosis and treatment only started to come into its own in the 1990s, and because the options for early and late intervention have exploded over the past decade, the methods and choices for diagnosis and treatment are incredibly many and varied! However, two principles have remained the same throughout these years of advancement.

Don't rush, but don't drop the ball

First....one should never rush to treatment without doing due diligence. If this means one or more extra consults, more research from government or respected institutions, and/or seeking out support from groups or other cancer survivors...do it!

Second....never drop the ball! Once the suspicion that prostate cancer is present is entertained, I think it is critical to carry through and develop a plan for long term re-evaluation and any necessary treatment. In addition, no current treatment plan will guarantee a disease-free future.

So regardless of how rosy your outlook, the journey never ends. You have to always remember you have a relentless partner on this journey that needs to be respected and monitored!

Real-life examples

A couple of examples can serve to illustrate my point.

In our prostate cancer support group, a member relayed what he had experienced. A radiation oncologist advised him not to wait for treatment but to undergo external beam radiation before the cancer spread. Happily, he decided to do more research before proceeding.

When he asked if he should research other avenues of treatment before deciding, the physician acted offended and belittled his reluctance to immediately proceed with treatment. Two years since this awkward experience, he has a stable PSA and is following a careful plan of active surveillance.

Another example with a less happy ending involves a gentleman who for three years post-surgery had undetectable levels of PSA on annual testing and stopped having annual visits with the urologist. He eventually saw a chiropractor for back pain, and when the pain didn't improve his primary provider finally got a repeat PSA. The PSA value was high, and he was found to have widely metastatic prostate cancer.

My PSA started to rise 20 years after surgery

One last example is my own. Twenty years after a prostatectomy at age 49, I experienced my first elevated PSA. Even though my PSA was relatively low and slowly rising, when it reached .4 ng/dl I underwent a PSMA Pet Scan which revealed a dime-sized metastasis in my lower spine.

Three years after after radiating my metastasis and 27 total years after my initial surgery, I continue to monitor my PSA and to have periodic repeat pet scans. I stand ready to continue to monitor and treat as needed because the journey, for, is never-ending.

Prostate cancer is a long journey

These examples all serve to illustrate the same points. Prostate cancer is a journey! There are so many options available today that range from active surveillance to dozens of pharma and radiation treatments.

Prostate cancer has a beginning and, in the best cases, a long successful partnership marked by careful observation and appropriate treatment and many healthy and productive years!