Can I survive prostate cancer? That is usually the first question men have when diagnosed. There are many more questions we all have when dealing with prostate cancer.
What are my odds? Will I need surgery? Can prostate cancer be cured? How long will I live?
Being told you have prostate cancer is not a death sentence.
Prostate cancer is however, the second leading cause of death for men. Lung cancer holds down first place.
According to the American Cancer Society, About 1 man in 7 will be diagnosed with prostate cancer during his lifetime.
They also said this in 2016:
The relative 5-year survival rate for regional stage prostate cancer is nearly 100%. Distant stage includes the rest of the stage IV cancers – cancers that have spread to distant lymph nodes, bones, or other organs. The relative 5-year survival rate for distant stage prostate cancer is about 28%.
What to do when you first hear the words, “You have cancer.”
The answer is actually quite simple. Ask your doctor every question you can think of. If you feel dazed and can’t think of what to ask, that’s okay. Go home and begin to create a list. On your next appointment, bring your list and go over it with the doctor.
While I am no expert on the subject, I do have experience. Three years ago I heard the three words, “You have cancer.”
Here’s a chronology of my experience along with my thoughts on the disease.
For years I had had passing concerns about prostate cancer. It runs in my family. My father, my brother and my uncle have all had the disease, This fact alone put me at greater risk. If your family has a history, then you too may be at greater risk.
Knowing my risk I was still complacent.
Some years I would be tested by having a PSA blood test completed. PSA stands for Prostate Specific Antigen. It is scored numerically. The lower the score, the better off you are.
The lowest score is .01. After that, the sky’s the limit. By testing often, like once a year, you know if your number is trending upwards. If it is, further examination may be in order. I have been told that numbers from six (6.00) and higher are in the alert range. Mine was only four when my primary doctor referred me.
Over approximately 20 years, my periodic tests were irregular and not really trackable. I think I pretended to follow it, but I was never truly concerned.
My primary medicare doctor reviewed my new PSA and suggested I have additional examinations. It involved seeing a urologist. Oh boy, just what I wanted to do on my day off.
The urologist didn’t like what he found and thought a biopsy would be appropriate. Another not so pleasant thought. I was still working out of town and it took some time to get it scheduled.
After the biopsy, I wasn’t going to be home again for thirty days. We agreed he would call me with the results. I heard the words, “You have cancer,” over the phone.
I remember sitting down and saying to no one, “Well, I guess that’s it.” I went back to work.
When I next saw my urologist, he explained that my cancer was advanced. He did not know for certain but believed it was confined to the prostate. The twelve biopsies he collected had all scored a ‘Gleason 9’. In this scoring system, nine is very high.
Since then, I have read about the disease and have learned that a Gleason 10 is possible.
I had a bone scan to see if there was evidence that the cancer had spread. It had not.
I asked about surgery. Something my younger brother underwent some twenty years ago. My doctor told me I was not a candidate for surgery do the advanced stage of the cancer.
For the most part, I was under the impression that my only real option was radiation. That’s what I got.
Not So Fast
Radiation didn’t happen for a year. I first needed to stop the growth. My urologist recommended a medication known as Lupron.
This is important
Prostate cancer is fueled by testosterone. If you can eliminate it, or radically reduce it, prostate cancer will subside. In essence, it starves to death. It can come back to life if testosterone becomes present again.
In years past, the only way to stop the production of testosterone, was physical castration. In the last dozen years or so, science has found a way to trick the brain into not producing testosterone. Lupron is one of the drugs that makes that happen.
It is not without side effects. I’ll talk about that later.
Once the cancer is arrested, radiation therapy can begin. The master plan has radiation killing whatever cancer cells remain in the prostate after a year of Lupron injections.
Radiation is quick and painless. I had forty-five treatments. Once daily except on weekends and holidays. The session takes less than ten minutes. Prep is simple but important. They wanted a full bladder and empty rectum. The purpose was to reduce the chances of collateral damage to the bladder and other organs.
There are several types of radiation therapy. I’m a patient, not a doctor. I learned recently from my doctor of a therapy that uses high doses of radiation over a much shorter time period. A few days rather than the forty five treatments I had. The risks of lasting side effects is greater and more serious.
I was always worried about incontinence. It was not a risk in my form of treatment. The new, high dose radiation can not make that claim.
I have read of other radiation therapies but have not been apart of it. The National Cancer Institute has some easy reading on the subject.
The truth about prostate cancer is that it can kill you if you do nothing. If you are proactive, you will most likely survive. According to the American Cancer Society, there are 2.9 million men in the United States, living today who had been diagnosed with prostate cancer at one time.
I remember hearing a comment not long after my diagnoses. Everything was new to me and I was seriously concerned about my survival.
I heard that prostate cancer was little more than an ‘inconvenience’. I think the word ‘pesky’ was a part of the comment.
It bothered me that I had cancer and someone was calling it a pesky inconvenience. The fact is, that is pretty close to being true.
The exceptions to the pesky inconvenience
One of my favorite fiction writers was a man named Vince Flynn. He wrote spy type thrillers. My late mother was still reading his books until she passed away at age ninety-two.
Vince Flynn died of prostate cancer while still in his forties. The disease is significant.
Lupron has side effects.
I received four injections. One every ninety days, for a year. I am a ‘go with the flow’ sort of guy and asked few questions about the drug. As I began to experience the side effects I did not immediately connect them to the drug.
At least not all of them.
My urologist told me I would have reduced levels of testosterone. That was after all, the purpose for the shots.
With that, would come a reduced sex drive. I would likely have the urge to urinate more often and that I might experience hot flashes.
I found a new appreciation for what menopausal women must endure.
The work I did at the time was physical. Heavy lifting coupled with long days and nights on the job. Hot flashes in 100 degree summer heat was not pleasant. The thought of decreased sexual urges was of little concern.
I found I had an increased appetite for food. I ate portions I had never considered. Over the course of that year, I gained fifty pounds.
While that was happening, my physical strength was decreasing. With loss of strength also came a loss of agility and balance. None of it was good for the work I was doing. Eventually I went home to stay.
My urologist wanted me to take the shots for two years. When the time came to begin the second year and receive the fifth shot, I turned it down. I had found that I could not lift a coffee pot for more that a few seconds. I was tired and napped often. I could set my watch by the severe hot flashes occurring every two hours.
I don’t want to dwell on the side effects of Lupron, but it is hard to exaggerate them. I was told that it would take several months after the last injection, for things to get back to normal. In my case, several months meant 18.
It has been over two years now and I still see minor effects of the drug that probably allowed me to survive prostate cancer.
If that sounds like a contradiction, it is not. Without Lupron to stop the expansion of the disease, I would have undergone castration. It used to be a very real treatment. My father was one who needed the procedure.
Dad’s cancer migrated beyond the prostate before being diagnosed. The American Cancer Society calls that ‘distant stage’. He lived for nearly ten years, but the cancer did kill him at age 76.
I am monitored via the PSA twice a year. If my number begins to increase, a therapy like Lupron will be required. My doctors are confident I will not need further treatment.
The final point needs to be, “Prostate cancer is not a death sentence.” At least for most. Only those who have the cancer already outside the prostate are at serious risk of other organs, lymph nodes and their blood containing cancer cells.
The answer to our first question, “Can I survive prostate cancer?” Is a resounding yes. Remember the number from the ACS. One hundred percent of those who are diagnosed before the cancer spreads, will likely survive. You will have some challenges like I did, but you’ll be fine.
As always, if you have questions or comments, leave me a note in the comments section below. I would welcome a conversation with you. — Robert