Evan Saugstad: My prostate, my journey – the journey continues (part 5 of 8)

Although September is known as Prostate Cancer Awareness Month, I have chosen to tell my prostate journey for Movember, Men’s Health Month. I have also chosen to discuss subjects that are not normally found in our local newspaper; one’s personal health, one’s sexual health and one’s cancer.

Movember is the month where the largest percentage of donations are made in support of curing men’s cancers and improving our health.  Please support Movember.  

If the discussion of a man’s body parts, or medical procedures or men’s sexual health offends you, then skip the rest of this.  Just be assured I am still alive, still kicking and still adjusting to life with cancer and cancer treatment.

I left off in 2019 with my first post surgery PSA (prostate-specific antigen) test coming in at 0.09, considered about normal after prostate removal.

Two years later, that was the highlight.  Since then, my PSA slowly began its upward creep.  Not by allot, just a steady increase. 

Since one’s post prostate PSA is normally less than 0.1, it wasn’t long before the Dr concluded my cancer had not been vanquished; it still existed somewhere in my body.  Surgery likely never got all that had escaped the confines of my prostate. Most likely, but never for sure, hiding somewhere near the now vacated prostate. 

No certainty in the long-term outlook either.  May stay as background noise with no change, may eventually disappear or may continue to grow and eventually begin to impair bodily function.  The later meant it is something we must watch and address with time. 

With that, another referral back to BC Cancer Agency (BCCA) in Vancouver.

As before, advised we could still do hormone (androgen deprivation) therapy to eliminate testosterone from the body to slow cancer growth, side effects being loss of muscle mass and body hair, bone thinning, increased in body fat, fatigue and that erections are a history.  Hormones will eliminate the cancer but can stop or slow it from growing and spreading, at least for a while. Maybe be good for a couple years, maybe ten, no way to know with certainty.

Or we could use targeted or external beam radiation with side effects being the possibility of bladder or colon impairment/destruction. Takes six and a half weeks of treatments (five days a week) in either Vancouver or Prince George. 

Not being certain where this cancer is hiding is the issue.  About a 60-70% chance beam radiation would hit the correct spot and zap the offending cells.  Stats – was only a 30% chance I would still have cancer after surgery.

With no immediate rush, book an appointment for a PET (positron emission tomography) scan, technology still in its trail stage in BC.  A 6 – 10 month wait as BCCA is the only place capable of doing this.

A PET scan is like a CT scan.  The difference being a PET scan uses a radioactive drug (tracer) that binds to cancerous spots, making them more visible and easier to find.  

Took longer than expected as at first, the machine was broken, then COVID, but finally, another trip south in Jan 2021. 

Good news was that nothing showed.  Bad news, nothing showed, but with PSA still climbing, cancer still hiding somewhere.   

PSA 0.32 in Sept and 0.38 in Dec 2020.  Up to 0.58 in April 21 and Dr suggests we begin looking at radiation as I haven’t been a fan of hormone therapy.  After PSA goes beyond 1.00, targeted radiation is less likely to be successful.  Begin contemplating when this would be the best fit.

Wait for June’s PSA and surprise, surprise, it drops to 0.50.

My hopes go up, but Dr not sure why it dropped, could be accurate, could be false.  Either way, hold off on the radiation to see what happens with Sept’s PSA.

Crap ….. Sept PSA jumps to 0.83.  Not good, big jumps never a good sign.  OK, time to look to radiation, but first, a CT scan to see if it can locate any cancer at, or outside of the prostate area.  At least this one can be done here in Fort St John on Nov 4^th.  

Kind of feels like the bully has got you pinned and is asking which eye he should blacken.

The good news would be if nothing shows, I still go for the six and a half weeks of radiation.  Best news maybe cancer shows up at the former prostate site and is still eligible for targeted radiation.  Bad news is cancer is found somewhere else in the body, maybe radiation, maybe not, maybe move on to hormone therapy and give up another part of who I am.

Call schedule with the Dr. on Nov 9^th. Not much left to the imagination that hasn’t already been discussed.  Like flipping a coin with “heads you win, tails I lose”, just hoping the wager not to large.

Out for my morning deer hunt, when Dr calls, a couple hours early.  Image shows shadows on the pelvic bone, suspects they may be an anomaly, but to be sure, will order a bone scan for a closer look. That, and another PSA test and we can talk again in early Dec.  Then the usual conversation; are bowel and bladder functions normal, anything else abnormal (yes, yes, and yes, getting older and more things hurt).

And so, my journey continues, more waiting, more tests, more decisions.

Good news – will be able to finish deer hunting season before I must leave town.

Please support Movember as Men’s Health Month, give generously, and help fund cancer research. If you are over 40 and have not had a PSA test, ask your doctor to prescribe one. If you wish to skip that part, book your own appointment, pay $35, and get your own.  It could save your life. 

Evan, and always willing to talk about my journey and answer any questions you may have.