Ok Guys Over 40…Here’s What’s Up!
Stephen G. Barr
11

Response on the Specter of Prostate Cancer

Stephen, you just did a most wonderful service to men everywhere. Thank you from the bottom of my female heart. You have lived in this nightmare in your family, so you know…you really know. I have too, and I also know.

I was horrified when doctors, researchers, scientists, whomever that National healthcare group consisted of, decided that men no longer needed to have their PSA’s checked on a regular basis, because “most prostate cancers are slow killers and men who develop them will die of other causes first.” What absolute bullshit!!! I can’t emphasize it enough…what absolute bullshit!!! The key is that not ALL prostate cancers fall into the slow growing group, and if someone is unlucky enough to be an outlier, it is a very quick, horrible, painful way to die. Perhaps more modern methods of treatment will prolong one’s life, but that extended life may not be very pleasant.

I will be specific here in an effort to try to create more awareness of this disease. Both my father-in-law and my husband have had very aggressive prostate cancers. And, yes, it most likely is a genetic weakness.

In 1992, shortly after my mother-in-law had slowly passed after deteriorating for 14 years with Alzheimer’s, my father-in-law was diagnosed with prostate cancer. He was a very active man, who was a farmer and who climbed high into nut trees into his 80's. He had had some lower extemity swelling, so my sister-in-law finally took him to the doctor. The doctor ended up doing a biopsy of his prostate and only found a trace of cancer in one of nearly 100 slides of the biopsy. Correctly, my father-in-law was diagnosed with prostate cancer, but was told he’d outlive the disease and die of something else. Back then, everyone believed that older men who developed prostate cancer had slow growing cancers. Wrong story! He continued to have increasing problems and pain, dying two years after diagnosis. At the end, with all of his six children and their spouses attending him in homebound hospice, with morphine drips, and with all the best care possible, he passed in a very, very painful state. I can’t imagine myself going through the pain this man endured. Near the end, he became uncharacteristically negatively outspoken about things he never normally would have cared about or addressed. He had no personal strength left. He passed at age 84. Some would say it was time for him to go, but I will say that no one should ever have to go that way.

Fast forward to 2007. My husband had taken his father’s illness and passing seriously, and (thank you, God) had continued getting PSA tests on a regular basis, despite the fact that the recommendation had changed. At the end of April, one test was quite high (for a few months they had been rising). When it got to that high level, his urologist did a biopsy of his prostate. By this point, there existed a Gleason Scale rating for the aggressiveness of prostate cancer. It went from 01 to 10, with 10 being the most aggressive. My husband had primary cells that rated 3 and secondary cells that rated 4, for a combined total of 7 on the Gleason Scale. Any reading that was 6 or above was considered aggressive. His urologist wanted to do a regular prostatectomy right there and then in the local hospital.

With his father in mind, my husband and I said we wanted to go to the experts. My husband found MD Anderson Cancer Center in Houston, TX and we went with them. The normal procedure was to contact them, wait to hear from the doctor’s PA, make an introductory appointment, and then return there a month later for surgery. Since we knew how aggressive the cancer was, my husband requested that he have his surgery the day after the introductory meeting. He had decided he didn’t want that aggressive cancer in his body, period. Therefore, he wouldn’t have radiation or any less traumatic treatment…he was going with the prostatectomy, and wanted it done with the (at that time) new DaVinci robot assist. As is the case with all robot assisted surgeries, the doctor needed to be thoroughly and well trained to use the robot. His MD Anderson doctor had been extensively trained in Germany and elsewhere in the U.S. on the use of the robot. The doctor agreed that although it was unusual, they would do their own biopsy analysis and consider my husband’s request. They obtained the biopsy tissue from the urologist and confirmed the initial results of the 7 on the Gleason Scale. They then set up my husband’s meeting and surgery. My husband had gotten his initial biopsy results on 4 May and had his surgery on 12 June. In that period of time, the cancer, which was centralized in his prostate, had grown nearly an inch in size. It was very fast growing. The post surgical analysis of his prostate also showed some tertiary cancer cells that registered 5 on the Gleason Scale. So, in effect, my husband’s prostate cancer would have registered as a 12 on the Gleason Scale, if it had had a register that high. And, the cancer was becoming more aggressive as it enlarged.

My husband and I consider ourselves to be very, very fortunate. All of his cancer was excised, and he needed no additional treatment of any kind. We now are activists to tell people not to listen to recommendations, until you know you can afford to do so. We have three sons, all of whom are adults now. And, two are in that 40ish stage of life, where screenings are necessary. While trying hard not to be overbearing and overboard, I keep reminding them of their family history and to get the screenings done. They appear to truly understand, so I feel good about that.

I know that many men hesitate to get involved in screenings that could result in an ultimate state of erectile dysfunction. And, I am sensitive to the fact that most men are uncomfortable with women “messing” in this area of their lives. However, I will say that this is a problem for everyone, and a war on cancer that everyone needs to fight. In some cases, where prostatectomy has been done, men manage to retain their erectile ability, because such surgery today spares nerves. However, if one isn’t so lucky, there is the option of having a penile implant. Many, many men today have had them and are having them. This is no longer a new frontier.

Like Stephen, I will end by urging all men to have regular screenings for prostate cancer. PLEASE listen!