No, this is not a public service announcement. In this case, PSA means prostate-specific antigen; a measure of a specific protein present in blood. Cancer.gov states that the amount of PSA may be higher in men who have prostate cancer, benign prostatic hyperplasia (BPH), or infection or inflammation of the prostate.
Less than a year ago, Alan — my husband of 30 years in October — was accidentally diagnosed with prostate cancer. Little did I know that a seemingly simple conversation and blood test would have the potential to change our lives in what could be the most jarring way possible.
I say his diagnosis was accidental because it stemmed from a conversation between the two of us in which I raised concerns about his rather sudden onset erectile dysfunction. He had no problems achieving erection, but couldn’t maintain one. Since he visits his doctor regularly due to his high blood pressure, high cholesterol, and Type II diabetes — any of which could be a contributing factor to erectile dysfunction — I suggested that he discuss the matter with his doctor. This lead to a request for lab tests to test specifically for PSA levels.
Upon receiving the results of the lab tests, my husband was immediately instructed to report to a urologist for a biopsy. Alarm bells sounded silently in my head, and I know he was worried, but typical of most men, he showed no outward emotion or reaction. However, I knew he was concerned.
It was strange how open the urologist was to having my present. I was literally in the room when they performed the biopsy. The sound was … indescribable as each sample was taken. An odd snipping/snapping/crunching sound. I was also present when the results were delivered less than two weeks later. It’s a good thing, too, because the moment the doctor said cancer, hubby tuned everything else out. I was the one to ask questions and express concern. He listened passively as the urologist reviewed his options: radiation, surgery, or do nothing. Is ‘do nothing’ really an option? When I asked how his previous testicular cancer treatment nearly 22 years ago would impact his treatment, the doctor’s hopefulness at the thought of one and done surgery suddenly faded. Unfortunately, the urologist didn’t have hubby’s full medical history. Again, I was glad I was there, but with this new information, hubby was no longer a candidate because of his previous radiation treatment. Apparently, when one undergoes radiation treatment, the affected area is essentially turned to concrete; it’s ‘melded’ into what amounts to an indecipherable mass making surgery almost impossible.
Well, that wasn’t the news we had expected to hear. Oh, I knew the doctor was going to say cancer, but I had no idea things were going to go so sideways. The only viable treatment option was now radiation, which was a long shot at best.
He ‘graduated’ from radiation therapy in March. Due to unforeseen circumstances (mostly due to a change in medical group and poor communication), he thought that was the end of it, and remained hopeful. However, because his regular doctor decided to leave our medical group, it took nearly more than 6 months to get the insurance caught up so that he could return to him for an office visit. Before he went for his standard quarterly visit, he was required to do labwork.
This time, his PSA was 8, double that considered ‘normal.’ The doctor was concerned because, having completed radiation therapy, this number should have been in the normal range. He inquired as to what the urologist and cancer treatment center had said about the results. Well, they hadn’t said anything because neither office did a follow-up. His doctor was not happy and let him know to immediately contact the cancer treatment center, who passed the buck to the urologist.
At some point in there, more labwork was done. This time his PSA was 40. That’s ten times normal. Uh-oh. Something has gone terribly wrong. This was post-treatment.
Today, he met with the urologist to review his most recent labwork, which was completed two weeks ago. His PSA is now over 100. This is bad. Very bad.
At the moment, we’re waiting for the insurance company to approve a pelvic CT and PET scan to see if the cancer has metastasized into the bone or other area in the pelvis.
So far, 2021 has turned into a reboot of 2020.