Last month, we did what we could to fight breast cancer. Now, we tackle another nemesis.
I’ve known Shell Suber since he was the Richland County chairman for the Republican Party several years back. Some of you may know him, too. Good guy.
Whether you know him or not, those of you of the male persuasion should listen up to what he has learned, the hard way, about prostate cancer. This being Movember, the message is timely. Actually, it’s always timely. This is from his blog:
I have prostate cancer
By Shell Suber
NOTE: This was originally published as a small series of posts on Facebook on November 6, 2013. Published here in its entirety with minimal edits.
I have prostate cancer. I found out a few months ago and I haven’t told many people. I didn’t see the point. After some surgery next week I won’t have it any more so why make a federal case of it? I had my gallbladder out last year. How is this any different?
But it is different. Read on to see what I mean.
First, I need to assure everyone I feel fine. No symptoms at all. In fact, I might have gone years without even knowing I had prostate cancer if not for a lucky break. More on that later.
Second, and this is important, PLEASE DON’T SAY ANYTHING TO MY KIDS. They are 9 and 5 and we decided to just tell them Dad is going to have another thing taken out, like that gallbladder last year. No sense bringing up the “C” word when it’s not going to be an issue after next week. Sadly, Abby and Walt have ample reason to associate hospitals/cancer with funerals and we don’t want them to be scared that this is anything like that, because it isn’t. Thanks.
This is a good place to share a few quick facts about prostate cancer. If you don’t have time to read all this, just read the capitalized part at the beginning of each paragraph.
CANCER IS ALWAYS BAD, BUT SOME IS WORSE. It depends on size, speed, and location. Prostate cancer, if it is caught early like mine, is on the “not as bad” side of the cancer spectrum. To be sure, prostate cancer can be serious, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.5 million men in the US have been diagnosed at some point and are still alive today, like me. This is because it’s usually a slow moving cancer and it’s in an organ that doesn’t have a lot of high-level involvement with your blood (like your liver, lungs, and pancreas do.)
IT’S RATHER COMMON. Only skin cancer is more common. About 1 man in 6 will be diagnosed with prostate cancer. The older you get, the more likely the diagnosis. About 6 in 10 cases are guys 65 and older. It’s rare before 40. At 47, I’m on the “fairly young but not unheard of” side.
ONLY MEN GET IT. If you didn’t know that already, you aren’t quite sure what a prostate is, are you? I wasn’t either, to tell you the truth. Anyway, I won’t go into what role it plays. You can look it up. Just know that any man can get it. And it’s also worth noting that black men get it at a noticeably higher rate for some reason. And, as far as they know, there aren’t really any behaviors that “cause” it (like smoking/lung cancer).
IT’S EASY TO FIND. Prostate Cancer is, as cancer goes, an easy catch. There is a simple blood test called a PSA test that gives the doc a fairly good indication that all is good or, if not, more testing is needed. If you want to read more about the PSA test and your PSA “number,” there are a million articles out there. All you really need to know is that it’s a blood test like all the others you have ever had – one needle in the arm and you are done. The OTHER way to check is… well… do you remember the Moon River scene in “Fletch?” [ Moon River ] Anyway, Dr. Babar was checking to see if Irwin’s prostate was the size and shape it should be. If it’s not, you may be in for more testing. In my case, that meant a biopsy. It’s an outpatient procedure that takes no time at all and they even give you a Valium afterwards if you want. Sort of like getting a really great lolly-pop.
IT’S NOT NECESSARILY HEREDITARY. There are some cancers that are very hereditary. Breast cancer, for instance. But prostate cancer doesn’t work quite that way. So don’t go thinking you are in the clear because nobody in your family has ever had it. You aren’t. I wasn’t. Nobody in my family has ever been diagnosed as far as I know. Some of you may know cancer took my mom five years ago and her father last year. Both of those were unrelated to mine and to each other. Oh, and when I say “nobody in my family has had it,” that’s probably not true. Read on.
IT’S USUALLY TREATED IN ONE OF THREE WAYS. Because it’s such a slow cancer, sometimes when they find it in an older fellow, they just watch it to see if it’s growing so slow it won’t cause a problem. I mean, why bother if it’s not going to kill you before you’re 110, right? Other times they just try to slow it down with radiation. Again, so it won’t get you before something else does. Then there’s me. I’m only 47. They can’t slow it down THAT much. Besides, the risk is always there that it could “get out” of the prostate and that would be, um, bad. So for me, it’s removal of the prostate, a treatment you avoid if you can (because of the side effects) but it’s a virtual cure (as long as the cancer is all in the prostate.)
If you just read all that, you now know a lot more about prostate cancer than I did.
HOW I FOUND OUT I HAVE PROSTATE CANCER. As I said before, I might have never found out – for years maybe – but for a lucky break. Last year my wife and I decided, after much talk and, I feel, a sufficient period of procrastination on my part, that I should have a vasectomy. So I went to see my lifelong friend Tom Edmunds. Tom and I have known each other our whole lives and played a little football back in the day. He’s a urologist now and the man to see if you are going to get snipped. Blood work was done pre and post and my follow up PSA numbers gave him reason to be suspicious. [A note about PSA numbers: High is bad. Low is good. But CHANGE is what gets their attention. If your PSA number is the same this year as last, that’s good. If it’s higher, well, you may be in for more tests.] Anyway, had I not “manned up,” as Tom is fond of saying, who knows? We might not have known until it was too late.
LATE EDIT – After my original post, Tom, my urologist, shared this about PSA numbers…
Get a baseline PSA at age 40. 0.7 is the mean. If your baseline is above 1.5 at age 40, it needs to be watched yearly. Also, a rise of 0.4 in 1 years’ time is a reason to be checked out. Make sure your doc does an EXAM. Many don’t. African American men have twice the incidence. If your insurance company won’t pay for a PSA, get it anyway! What is your life worth? – Dr. Tom Edmunds
If you need more information (or a good urologist), contact Dr. Tom Edmunds at Capitol Urology, vasectomycolumbia.com, (803) 251-6602, info@capitolurologysc.com
SIDE EFFECTS. Next week I am going to have my prostate removed. Simple as that. They take it out and I don’t have cancer any more. Besides, after you are done making babies, you don’t really NEED it any more. So what’s the catch? (You just knew there must be one, right?) Well, there are two rather unpleasant possible side effects. Without getting too graphic, the prostate is right down there near a handful of nerves that we men are VERY fond of – the nerves that make it possible for our buddy down there do all his jobs. Removing the prostate damages these nerves. Most of the time the impact is temporary. But sometimes it’s not and that sucks, which is why they avoid taking it out if they can help it. But being dead is worse, so…
WHY AM I WRITING THIS? At first I was going just keep this quiet. I didn’t want to be “that guy with cancer.” People sort of treat you differently – you know what I mean – and I didn’t want that. Besides, after my surgery next week, it will be gone for good, along with my prostate, so why tell the world? Here’s why. Because this is one of those things that if more guys get tested, there will be more old guys for me beat in golf in 30 years. More PSA Tests = Less Funerals. Simple math. I’m too busy for funerals. So there you are.
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By the way, I was reasonably sure that his kids would not see this — why would they be reading my blog?
But I checked to make sure it was OK with Shell that I post this. His response:
Amen to that, bro.
I have to weigh in on this.
With all due respect to Mr. Suber, men also should be aware of the growing body of evidence suggesting that the PSA tests may sometimes cause more harm than good, especially for older men. I’ve got experience.
I am 60 years old and over the last three years I have had more than a dozen PSA tests, a half dozen digital prostate exams, a full-blown transrectal ultrasound (TRUS) and a 16-point needle biopsy of my prostate.
I had my first PSA test back in my late 40s and it came back, as I recall, around 3 ng/pl. Unusually high, according to my family doctor back then, but not a cause for concern. He, too, spoke of trends being of more concern than absolute numbers. Continued routine annual testing up until I was 57 came in around the same when, in the fall of 2010, it spiked to 6.9. That prompted the TRUS and the needle biopsy. Both came back absolutely negative. My PSA slowly dropped back to around 6 over the next 18 months, only to spike again to nearly 17 at my annual physical last summer!. Another trip to the urologist two weeks later and yet another PSA test. It came in at 6.2. She sent me back home after a long chat.
And after all of that cost, significant worry, and serious physical discomfort, my urologist has finally come to the conclusion that I am cancer-free and one of those statistical outliers in the prostate cancer arena who probably has nothing more than BPH (benign enlargement of the prostate) which, in and of itself, can cause what we’ve seen. My urologist concedes that when one is measuring nanograms of something per picoliter, one is dealing with nearly homeopathic-level indicators and PSA lab results, even repeated ones, are subject to being misleading and occasionally being outright erroneous. N.B.: Results from Lab A generally cannot be compared to those of Lab B, as there are different testing protocols that can give widely different results.
So my urologist and I have decided to go back to annual PSA tests using one lab and watchful monitoring, and not to go into a dither based on any one test.
Yeah, I almost posted a similar thought. It is akin to the whole mammograms/early detection saves lives deal. It turns out that that is not at all clear. Many “cancers” that are detected and treated at great personal and financial cost, including long term side effects, might have resolved themselves, while the small number of early detected cancers that are not “cured” were likely fatal anyway. Breast cancer mortality has not fallen, while detection has risen.
My husband has a story very like yours, Mr. Crockett. He is 50. His PSA goes up and down but has been above normal every time measured over the past 6 years or so. He’s had two biopsies and several rounds of high powered long term antibiotics, on the theory that it’s prostatitis, none of which has had any clear effect on the numbers. His doctors have concluded that it likely is just him but he is cancer free. They continue to monitor it. It has caused significant worry at times.
One brief PS….
During the course of my last round with the urologist, she told me about a new patient who had just moved here from CA. Seems he, too, had PSA ups-and-downs. But his urologist out there had insisted that he have a needle biopsy every six months for several YEARS, despite every one of them coming back completely negative. My urologist observed that some of her colleagues in the field make a great deal of money performing unwarranted procedures…not to mention the physical/psychological/fiscal effects on their patients.
As he doesn’t mention it, I can only hope that Mr. Suber’s diagnosis and his decision on surgery was based on more than PSA testing.
Your urologist is a she?
Sorry. I have often said that all doctors should be women. But this gives me pause…
Both my GP and my urologist are women and both have given me the requisite physical examinations regarding the prostate. I had some momentary pause, but they were the first to point out that there are advantages to the smaller hands of most women in this situation…if you get my drift. 😉
“over the last three years I have had more than a dozen PSA tests, a half dozen digital prostate exams, a full-blown transrectal ultrasound (TRUS) and a 16-point needle biopsy of my prostate.”
Sounds like my last experience with the TSA.
OK, as long as someone is cracking wise.
My favorite urologist story… Years ago, I had an appointment with the urologist — I forget for what — and as I arrived and was about to enter the waiting room, out came a good friend of mine, leaning on his wife. He had just undergone a vasectomy, and was still much under the influence of the sedatives.
I said “hey,” and he looked up, and his face lit up with a delighted smile. “You came to see me!” he cried. He was deeply touched.
I didn’t have the heart to tell him it was a coincidence…