PSA and Me. Part One 

When I first started writing this thing I call Fishrocks, I made a pledge to myself that I would only write about the things I was interested in. My intention was to write about my journey through this whole cancer thing, but I didn’t want that to be my main focus. As I look back at the blogs that I have written, most of them have a connection to my diagnosis, treatment, and the effects of both have had on my life. It has occurred to me, however, I have never really told my whole story as a blog. Holly and I went to dinner with another couple who are faithful readers of my blog, and as they were asking me a bunch of questions about my current cancer situation, it occurred to me that I probably need to take the time to write exactly what has happened to me throughout the last 6 1/2 years of dealing with the ins and outs, ups and downs, and the flipped over sideways thing known as my prostate cancer journey. 

Wait…what?!!

Back in September of 2010, I received a call from my doctor. Directly. Which is one of those things that happen in your life which makes you go, hmmmm.   I actually missed the call because I was outside working in the yard, and the call went to voicemail. The voicemail went something like this. 

Doc- Yeah, Dan, Dr. Koebiela here, could you call me back as soon as you get this message?  Thanks. 

The first thing I thought was, shit, that was the doc himself, not a nurse, not a receptionist.   So I called him back right away, but it was lunchtime so I had to wait about an hour. Oh boy. He called me back, once again, himself, to tell me that my numbers for my physical looked great except for one. My PSA was high. My response?  What’s a PSA?  

Doc- It’s a test that measures the amount of prostate specific antigens in the blood. A high number can be an indication of prostate cancer. The normal number for men is usually from 0-4. 

Me-  Ok, doc, what is my number?

Doc- Yours is pretty high. 18. 

Me- Wait, what?!!  18?!!  And the high normal is 4? What the hell?  That can’t be good!!

And that, friends, was my first introduction to the vagaries of the PSA test. After consulting my urologist, who also is one of my best friends, I was assured that the test wasn’t always accurate, that there were quite a few things that could lead to a high number. Dr. Curry was actually a little skeptical of the test because the number was so high, and I was young, 48, and in good shape. I was a runner, non smoker who ate right and was always very active. He figured it was some sort of infection, gave me an antibiotic, and told me to get another test in a couple of weeks. 

(A quick veer off here.  If you figure that the average good PSA score is 0-4, that means an 18 is 4.5 times higher than the highest of the average. Can you imagine if that was your blood pressure?  If 120/80 is an average blood pressure, 4.5 times higher would be 540/360!  Needless to say, if that was your actual blood pressure, you would be in a lot of trouble. Actually, your heart would explode and you’d be dead. I have diabetes in my family, so I have to watch my sugar numbers. A high acceptable number is around 100. If my sugar numbers were 450, I would be diabetic shock or dead. That’s one of the reasons why PSA numbers are confusing.  They don’t make sense compared to other health numbers.)

So, after two weeks, I went back to the lab and gave another blood test for my PSA. I was pretty confident there was nothing wrong, the digital (finger up the ass) test showed nothing, it had to be a mistake. So my friend, Dr. Curry, gives me a call with the results of the latest test. 

22. 

Wait…What the hell??  It went up?

He told me to come into the office the next day to get a prostate biopsy to see if I have prostate cancer. He still thought it could be 50/50 that I didn’t have cancer. 50/50??  A coin flip?  Good God, this is frickin serious, I thought to myself. 

I consider this to be the “wait…what?” part of my cancer experience. It seemed like everything that I heard during the initial diagnosis stage seemed to have me uttering that phrase. 

PSA 18. Wait…what?!

PSA 22. Wait…what?!

And then the prostate biopsy procedure was described to me. Basically, a tube is inserted in your rectum, and then a gun is put in the tube that shoots a needle into your prostate so they can get a sample to see if there is cancer. They repeat this procedure ten times. 

WAIT…WHAT??!!!! NO F**KING WAY!!

Yes way man. Totally. After that lovely procedure, I had to wait for the results. Another thing I was just starting to learn. After every test, there is the waiting. And the waiting sucks. It makes for a lot of sleepless nights. I was fortunate that my doctor was also a friend, so it only took two days to get the results. 

The results? Cancer. In three of the ten cores. All on one side. Gleason scores of two sevens and an eight. Aggressive. 

Shit. 

Of course, I had to ask what a Gleason score was.  I know now that it is a scale that goes from 2-10 that tells you how aggressive the cancer is. At the time I was clueless. If you are keeping track that would be yet another question on the “I am completely ignorant about all of this” scale. 

Oh, and, by the way, after that wonderful bit of news, I was told I needed to go get a CT scan and a bone scan to see if the cancer had spread. 

Spread? (In a whisper) wait…what?

And then comes the fear, the crushing, mind numbing, soul shattering anxiety that only a cancer diagnosis can give you. And I had really only had one question spinning through my mind on that beautiful September day. It’s a question I think every cancer survivor asks themselves when they are first diagnosed. 

Am I going to die?

Part 2 of PSA and Me will be up in the next few days. Until then. 

Thanks for reading. 

Peace.