rkw

1 out of every 9 men are diagnosed with prostate cancer in the USA. On December 17, 2018, I learned that I had joined that group of about 3 million men in the US. For those like me, whose cancer is considered aggressive, there are multiple treatment options, each with similar outcomes but different side effects. That meant I had to spend a solid month evaluating treatment options, something for which the internet is a big help – but also, in Manhattan, one has access to many great experts as well.

I went with robotic-assisted laparoscopic surgery, performed at Memorial Sloan Kettering on January 2019. I only had to stay over for one night, and my wife was able to spend that night with me. Recovery is generally considered to take 6-8 weeks, but the first week is the toughest – which was the case for me as well.

Prostate cancer will be the cause of death for less than 3% of us guys in the US. For the rest, it's a reminder that we are all going to die for some reason or another, so we should all seek to live each day to the fullest.

My older brother and I have had different kinds of luck regarding prostate cancer. His bad fortune was to have it in his 50s, before laparoscopic prostatectomy was available. His good fortune, though, was negative PSA tests ever since his surgery.

My good luck was to have it much later in my life – my early 70s – and with the much more tolerable laparoscopic prostatectomy. The sad fact, though, is that ¼ to 1/3 of us still have to deal with some level of recurrence after our initial treatment. That is why we all get a PSA test every six months.

One's PSA number should be undetectable after about a month, which was true for me. However, it is known that some of us will have a very low non-rising PSA after surgery, which can sometimes be caused by normal prostate tissue left behind. This is uncommon, and referred to as benign regeneration.

However, the most widely accepted definition of a cancer recurrence is a PSA >0.2 ng/mL that has risen on at least two separate occasions, at least two weeks apart, measured by the same lab.

So, my latest test was 0.15, which is below the 0.2 level — but still a positive test.

What this means is that I'll have to have a followup test in a month. If it's negative, it might mean the test was erroneous (not likely, though). If the level remains positive but not rising, I'll just continue to be monitored. If it starts rising, the experts will want to know the rate of increase- because that is key to recommending what follow-up diagnostic tests or treatments might be recommended.

For the past two days, the main thing I was wondering about was whether to even share this with you at this time. Though I'm not pleased with this, I'm not really very anxious about it either.

To me, it's just another confirmation of the fact that I am getting older and now encountering more of the many potential aspects of aging that we'd all rather avoid, if possible.

As of now, however, I still consider Covid19 as the more significant risk for folks of my age.

#100daystooffload Day 4 (written with StackEdit)