So, I have prostate cancer....

 So, I have a prostate. I know most folks haven't thought about that, but would realize it as soon as they did. It's been a long time since any provider wanted to do a manual examination of the prostate (the "finger wave," as one friend used to put it). Instead, each year I've had a blood test for prostate specific antigen (PSA). 

All the adults reading this will, or should, know that men are likely to have prostate cancer. I've heard it said most men will die with it, but not of it. Many friends and family know that my father has prostate cancer, and has had it for years with little consequence. So, I was expecting that, sooner or later, my PSA would be wrong. I just wasn't expecting it at 66.

Last February my PSA was high. I thought little of it. Then in May it was high again. I still thought little of it, but my nurse practitioner had a different opinion. That's when I found myself with an appointment with another nurse practitioner attached to a urology group. There for the first time I had the "finger wave," and she said, "Well, maybe it's a little bit large." I had yet another PSA, and this one, too, was elevated. So, they recommended a prostate biopsy.

Now, a prostate biopsy is done by sticking hollow needles into the prostate to take samples and then check those samples for cancer cells. There are two ways to do that. Without getting too detailed, one is from the back, through the rectal wall. The other is from the bottom, through the skin of the perineum. It won't surprise anyone that I looked into the two procedures, and chose the less common one. Going through the perineum took more samples and reached marginally more of the prostate, and has less of an infection rate (although the infection rate from the other approach is also small, but less small). I just wanted as thorough a biopsy as I could get.

And, of course, I couldn't get that procedure in my local hospital, or in the larger hospital in the next county. So, I found myself going to the University of Tennessee Hospital in Knoxville. (I suppose it's an alumni experience of sorts.) I had the biopsy in August. The result: I have prostate cancer.

Now, it could be a lot worse: prostate cancer is easily treatable, and success rates are very high. Still, as I told a number of people, it's one thing to know the statistics, and another to see where I fit into them. Still, I was both disturbed and not. I really did figure that at some point I would have it. I just hoped that, like my father, "watchful waiting" would be an appropriate approach.

Unfortunately, it wasn't the case. My cancer is, as my doctor says, "moderately aggressive," and so not something to just watch. So, the next question was, how big is it, and where is it? It looked like it was all still within the prostate with no metastasis, but that needed to be confirmed. So, there were studies: a bone scan and an MRI of the pelvis with contrast. (I enjoyed those; but, then, I've been told I have perverse taste.) There were insurance issues and delays, and those were frustrating. I'm sure I'll say more about that, but the bottom line is that we didn't have the results before the end of September. I have cancer, and just learning enough to choose a treatment path seemed to be taking forever!

One thing I did discover in the process is friends who had been through this themselves. That's a real blessing, and I'll write more about that, too; but they offered me the sources of information that had been helpful to them. I read it all, and also Mayo Clinic and Medscape and WebMD and... well, you get the picture.

So, my doctor advised, and Karen and I agreed, the best choice was to remove the prostate. After all, no prostate, no problem. By the time we'd reached that decision, the doctor was scheduling surgeries in late December. I didn't want to spend Christmas season recovering, and I didn't need to worry about my deductible (yes, I will pay one, but it will be manageable, and set us up for 2023 real quick!), so I asked to go into January. And that's how we got here: in three days I'll be in surgery, and then we'll go from there.