There’s nothing straightforward about diagnosing and treating prostate cancer. There are numerous boulevards, streets, intersections, and the occasional blind alley when it comes to dealing with this disease.
When a man finds out he has prostate cancer he is confronted with a range of choices and usually not a lot of help about what to do next. Even getting to the diagnosis is complicated. So far, scientists have identified 27 subspecies of “prostate cancer.” Each version will affect each man differently and he winds up with a customized version of cancer that may respond to the same treatment quite differently than the guy standing next to him.
PSA—prostate specific antigen—is the only semi-reliable way to tell what’s going on in a man’s prostate gland. Cancer causes PSA to rise—but not always, as I can personally attest. Sex or even recently riding a bike also raises PSA. There’s not even agreement on what “normal” PSA is because “normal” for one man may be elevated for another.
The only way to diagnose whether there’s cancer or not is via the threatening-sounding “needle biopsy.” And if the biopsy shows cancer, 80% of the time it’s so slow growing that you’re almost guaranteed to die of something else first. But just knowing there’s a cancer growing inside is does not induce comfort, and most men are eager to be rid of it no matter what. But sometimes the cure is worse than the disease. Most often it’s at least erectile dysfunction (ED) if not outright impotence.
The other 20% of the time it’s aggressive cancer and it needs to be treated forthwith.
But how? There are few other cancers that have so many ways of being treated. Surgery? Radiotherapy? Brachytherapy? Hormone therapy? High frequency ultrasound? Cryotherapy? (These latter two are not yet approved by the FDA). Combinations of these?
So what’s the answer? It all depends.
And what about the whole other side of cancer that the medical community tends to ignore? Things like its emotional impact. Its effect on relationships. What cancer does to some people’s spiritual state.
If you’ve been diagnosed with prostate cancer, it’s a long journey. You’ll want some maps.