Prostate cancer and PSA tests: perspectives of a young survivor

How has prostate cancer changed my life? 

On Sunday I was working on grading some papers before dinner when up popped a “you’ve got mail” kind of message. The email said that my PSA (the blood test for prostate cancer) test results were ready.

Yay!

I was diagnosed with a serious prostate cancer about 28 months ago at the shockingly young age of 42 (average age of diagnosis is 70) and had surgery for it.

Ever since I’ve been doing fine and my PSA tests  have behaved. In other words, I’m in long-term remission.

However, every time I get my blood drawn for another PSA test (now every 4 months, but at first every month) it is stressful to put it mildly as I await the results. Even when I’m not thinking about it, I’m thinking about it… if you know what I mean. One of my daughters in high school recently took the PSAT test…sometimes just the words PSAT test (so similar to PSA test) hit me.

So on Sunday, like on so many other days when I got the email notice my PSA test results were ready, as I logged into my patient account to retrieve my results, I briefly imagined what my life would be like if the PSA results were bad.

First, it would mean my cancer was back and it is difficult to describe how discouraging that would be.

Second, more immediately what would be facing me is most likely more PSA test results at a short interval and if they continued to increase,  a ~ 5-week course of intensive daily irradiation of the pelvis, possibly preceded by nasty anti-androgen therapy to sensitize any residual cancer to the radiation. Such a treatment has many side effects, some potentially permanent and greatly increases one’s risk of secondary cancers of the bladder and colon and potentially leukemia or lymphoma as the tops of the femurs in the legs get some radiation. The anti-androgen therapy is reportedly very horrible and can also have permanent side effects.

However, on this day, like on so many others, the results came back “undetectable”…more precisely “<0.01ng/ml”.

The ideal result.

My breath came in a little easier when I saw what has become my favorite number. I hope that this trend of results continues for a long time (knock on wood).

I’m chained to these tests for the rest of my life and you can tell they are somewhat like slow torture, but with each one that comes back OK the odds are just that smidgeon better in my favor of staying in long-term remission until I die and having the “joy” of ultimately dying of something other than prostate cancer. It’s ironic because being a cancer survivor means that on some level I’m more at peace with death, but at the same time I really don’t want the prostate cancer to do me in ultimately. Being a young prostate cancer survivor means, for example compared to someone diagnosed in their 70s, that I have a much longer road ahead of me. As hard as it is, I hope that road is really long.