Talk to Your Doctor About Prostate Cancer and Make Your Own Decision
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In the fall of 2019, Lorenzo scheduled several health tests and exams because he was applying for benefits from the Veterans Health Administration. A routine blood test showed his prostate-specific antigen (PSA) was 7.9—higher than the normal range of 2.0 to 4.0. PSA is a protein made by the prostate gland. His PSA level had been normal until that time. A PSA can be high for many reasons, including having prostate cancer.
“I was a bit surprised, but not shocked,” Lorenzo said. He was aware that normal PSA values can be higher as men get older. “I have many associates, friends, and family members who have had the same experience.”
A second test confirmed he had abnormal PSA levels, which could mean he had prostate cancer or another problem with his prostate. “I knew I had to act swiftly,” Lorenzo said after getting the result of his second test. He was referred to a urologist.
Considering the Options
The urologist took 12 biopsies (a small piece of tissue removed from the prostate and looked at under a microscope to see if there are cancer cells). Under the microscope, cancer cells were found. The cancer had a Gleason score of 7. A Gleason score is a way of describing prostate cancer based on how abnormal the cancer cells in a biopsy sample look under a microscope. It also predicts how quickly the cancer cells are likely to grow and spread. His urologist and oncologist gave him the following options:
- Active surveillance (meaning take no immediate action, but get checked on a regular schedule).
- Surgery to remove his prostate.
- Brachytherapy followed by low-dose radiation.
“I asked many questions,” Lorenzo said. “For example, I asked what were the chances of reoccurrence. I also asked about aftereffects and recovery time. My main concern was survival, of course. I also asked about the effects on my quality of life following whichever option I chose.”
Talking to Doctors, Friends, and Family
He chose to have brachytherapy, a kind of internal radiation therapy where seeds, ribbons, or capsules that contain a radiation source are placed in or near the tumor. He decided on this treatment after doing extensive research and talking to his urologist, oncologist, wife, and several relatives and close friends who had gone through similar journeys, as well as thinking about what is important to him. “Listening to your doctor is paramount,” Lorenzo said.
Lorenzo learned that removing his prostate would be a 3- to 5-hour surgery followed by a few days in the hospital. The recovery time would have been a few weeks to a month. Prostate removal was not his only viable option since his condition was caught early. He didn’t want the possible side effects of prostate removal, which can include impotence, loss of bladder control, and bowel problems. Also, he was not comfortable having an invasive surgery during the pandemic.
Planning for Follow-Up Checks
Lorenzo’s brachytherapy procedure took 45 minutes, and he was able to go home immediately. His recovery was set for 4 weeks, but he was back at work in a week and a half. His PSA level dropped to 0.4 after his procedure. Although it was well within the safe range, it didn’t meet the goal of 0.2 set by his urologist and oncologist. So his medical team recommended that he get PSA tests every 6 months instead of every year.
When asked if he was worried about prostate cancer now, since his PSA level didn’t drop as far as he wanted, Lorenzo responded, “I am not worried at all. Even though my PSA scores did not hit the desired benchmark or goal of 0.2, the drastic drop indicated the surgery and radiation were highly successful, if not perfect. I compare it to the doctor telling me to lose 25 pounds and I only lose 22—not perfect, but not failure either.”
What’s Lorenzo biggest advice for men who may be faced with similar circumstances? “Listen to your doctors, concerned relatives, and associates. Keep a positive attitude and continue to enjoy life to the fullest.”
20 comments on “Talk to Your Doctor About Prostate Cancer and Make Your Own Decision”
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Great information, will pass it on.
This is the most comprehensive article on this subject that I have read! Great piece of informative writing I will share with others.
Thanks for sharing your experience Lorenzo! Well thought out choice and I’m sure others will find it helpful!
I was diagnosed with Prostate Cancer Jan 2020. Talking with Lorenzo about my condition was very instrumental in the decisions I made for course of treatments. Thank You Lorenzo, really appreciated your help.
This is a very informative article. Many men may be helped by this information.
Excellent
Thank you for this article and Testimony Lorenzo Hill. You did what every man needs to do, the first step, schedule a physical and lab tests. Prostate cancer is very treatable and often has a positive outcome when caught early. Screenings saves lives
The information in the article was very informative. It was a great reminder of how important yearly checkups are and how critical early detection can be.
Facts!! Great Article.
I feel that this is a well-written article and it will encourage others to seek a professional opinion about their own health. Thank you for getting the information out there. I know someone will be helped by it.
Very good information.
Now I fill like I know exactly what to do if I find myself being diagnosed.
Very informative. As a relative of a newly diagnosed 75 year old man, I now have questions to ask when I go with him to get the biopsy report.
Thank you for sharing this insightful testimony. After reading this I feel more confident in having conversations with my family members and health care professionals about screenings.
That is a positive story. My PSA was 8. My Gleason score 4+3 but my cancer had metastisised to my bones. After 3 years and most available treatments, now on chemo, my PSA is 65 but am happy to be alive. Cancer sucks.
Thank you Lorenzo for your story. My PSA came back as 9.8 and I needed to wait a month for another test. That test was a week ago and I am waiting for the numbers. I have so many questions. I guess the biggest is, “how do you decide what treatment you should try?” I guess it depends upon how aggressive the cancer is, how large it is, and where it is. Perhaps my doctors will guide me in the right direction.
AJL, I am saddened to read your comment. I hope you are still alive and not in pain.
A dear friend was recently diagnosed and I hope they caught it early. I really hope and pray everyone on this list has a safe recovery with minimal side effects.
Yep, Cancer does suck. I was diagnosed recently with Gleason Score of 7 (4 + 3) and some (3 + 4). 58% of my prostate is cancerous. I decided to have my prostate removed and I’ll live by the consequences of that choice. I’m a young at 66 and I’m hoping for many more years above ground.
My husband’s psa is 17. He is waiting for a biopsy. I am very optimistic. He’s going to be ok.
I’ve been having PSA tests since my early 40’s because my dad was diagnosed at 53 years old. He had his prostate removed and has been cancer-free for 29 years.
My PSA jumped from 3.4 to 5.6 over the past year after watching it slowly rise over several, so I was off to the urologist for further testing. After a concerning 4KScore test result, an MRI, and a fusion biopsy I have been diagnosed with prostate cancer. Gleason 3+3, T1c, both encouraging, but some of the samples taken from outside of the “area of interest” also show cancer. I meet with the urologist in a few days and the surgeon in a few weeks, but since I’m 56 years old it is an easy decision to have my prostate removed – I’d rather wear a pad and use a pill if necessary to overcome any potential side effects than to kick the can down the road and have to deal with this again in the future (frankly, I’d almost rather do the surgery than another biopsy anyway…). I have a 15-year old daughter that I want to walk down the aisle, hold my grandkids, and be able to enjoy traveling the country with my wife after retirement. If I can make it 29 years cancer-free like my dad I’ll be more than happy.
Get screened regularly, and even though some of the diagnostic process is less than pleasant it’s MUCH better than the alternative!
Prayers for all those fighting the cancer battle!
My PSA jumped from 4 to 9 and I was referred to a urologist who did a second PSA test and called me two weeks later to arrange for biopsy. I wish my urologist was wiling to discuss treatment options for Gleason 6 with cancer on both sides. He turned his back to me and read the biopsy results to me. I have asked for a second opinion for treatment options from my family doctor.