Not long after I turned fifty, in the course of a regular physical examination, my internist asked if I was noticing any changes in my pattern of urination. The symptoms I described were typical of benign prostate hyperplasia or BPH. My growth, he said, was a little larger than normal for my age, but nothing to be too concerned about.
About two years later, in 1990, my doctor told me I had scored higher than normal on a new blood test he had given me. It was called a PSA and it seemed to be useful in giving an early warning sign that a man may be developing cancer of the prostate. The normal range was 0-4. My score was 6.4. His digital examination had indicated nothing more than slight continued enlargement, but he felt it would be worthwhile for me to have an ultrasonic examination of my prostate, just to play it safe. The technician and the resident didn’t see anything to indicate the presence of cancerous growth either.
Not quite a year after that exam, I developed prostatitis, a common infection of the prostate that causes frequent and painful urination. My doctor prescribed a six-week regimen of antibiotics and drew blood for another PSA test, just as a precaution. A few days later, he told me my PSA count was up to about 8, approximately 25 percent higher than my previous test. That was not good, but neither was it alarming. Just as enlargement can raise the score, so can prostatitis.
Happily, the prostatitis subsided and disappeared as predicted, but over the next eighteen months, my prostate gradually but perceptibly got a tighter grip on my urethra. Despite intensifying symptoms, I did not see my doctor again until the summer of 1993, when I had my next general physical. I told him my urinary symptoms had worsened and he told me my PSA was up to 8.23. He asked me to come back in two or three weeks. My score on the second PSA test was 8.02. He thought I ought to see a specialist but I didn’t rush to contact the urologist he recommended. Finally, after hearing about a friend’s experience with prostate cancer, I made an appointment for the following Thursday. The urologist did a biopsy on the spot.
When he gave me the results, the doctor was cordial, but businesslike. “Of the six samples we drew,” he said, “one at the base of the gland showed definite evidence of cancer, and two more were pre-cancerous. For a man your age, the thing to do is to take out your prostate. That should give you a 90 percent chance of living a normal life span.”
Not totally surprised, I was nonetheless stunned. “What about radiation?” I asked.
“We can do that,” the doctor explained, “but your chances drop to about 70 percent. I think surgery is the way to go.”
This message is bound to be among the Top Ten pieces of high-impact bad news the average citizen is likely to hear. But with the support of my wife and children, I decided to have the surgery.
I had expected to struggle out of a deep fog after the surgery and had wondered how long it would take me to realize where I was and to start trying to find out the outcome. But the first words I heard were entirely comprehensible and wonderfully welcome: “The lymph nodes were clear and we spared both nerve bundles.” I raised a clenched fist in grateful triumph.
My recovery went smoothly. But the unquestioned high point came when I awoke to an unfamiliar discomfort and woke my wife. At 6:41 A.M. on November 24, 1993, nine days after surgery that might have left me impotent, we had concrete–well, not concrete, but reassuringly firm–evidence that we had been spared traumatic loss. I also experienced a real rush of satisfaction when, one day in a library rest room, I stood shoulder to shoulder with a man about my age, and while he waited and wiggled and grumbled and shook, I whooshed noisily, washed quickly, and whisked out of the room.
Six weeks after the operation, a follow-up exam showed there was no evidence of microscopic cancer cells. Therefore, I do not need further treatment and I should not have to worry about a recurrence.
Given the option, I would never have chosen, and would not choose to repeat this experience. Given the outcome, I regard it as one of the richest episodes of my life. Because of the losses I feared–life, social ease, love–and the losses I felt–assurance of good health and confident self-sufficiency–I am, and for some time will be, more than I was.
Excerpted with permission from My Prostate and Me: Dealing with Prostate Cancer, by William Martin, Cadell & Davies, 1994, $17.95.
