Sutter Cancer Centers
Michael G. - One Man's Journey Through Prostate Cancer
I have cried a lot these last five months. But men aren't supposed to cry, particularly tough old lawyers like me who spent years fighting bad guys like the crooks that ran Enron. However, nothing could hold back my tears, both of fear and joy.
I have also done some praying; something I haven't done for years.
My life seemed so normal, not boring, but routine. And, being organized and following what men over fifty should do, I had an annual physical in February 2013. I dutifully got an extensive blood test a week before, and that included a PSA test to see if there is anything wrong with my prostate, a routine screen for cancer. The prostate is a little walnut sized organ next to the bladder and it produces semen, something I really wasn't too concerned about now that I am in my early sixties and have no desire for more children.
I get my test results on line from my medical clinic, usually a few days before I see my doctor. This is a mixed blessing. The results pop up on a very informative medical records page all about me. I always wondered how I'd feel if I got back a test with a red flag on it that says "way out of whack". Well, I got one-a PSA test of 5.95! A normal PSA should be under 4. This was a big jump over 4, and an even bigger jump over my last PSA of 2.3. "No need to worry. Your prostate may be inflamed. I am going to have you take an antibiotic for a couple weeks, and we'll test again", my family doctor said reassuringly. I must have had a panicked look because he added "No need to panic just yet".
I didn't cry at that point, but a nagging little voice in my head told me to read everything I could find on the Internet about PSA tests and prostate cancer. After 20 articles, all saying the same thing, I fell asleep that night with my I-Pad on my belly.
I took all the antibiotics, hoping it was a benign hyperplasia or something other than cancer and my prostate would shrink or get better to get a normal test result. I read there was controversy over this test for sometimes producing false positives, so doctors usually also do a rather uncomfortable "digital exam" to check for hardness or other abnormalities. My doctor found none. And, I had no prostate cancer symptoms (no trouble urinating, no blood in my urine or semen, no loss of bladder control and no pain in my lower back).
This can't be serious, I kept thinking. No one in my family had prostate cancer as far as I knew. An aunt died of breast cancer in 1965, but she owned a uranium mine in Wyoming, and my mother always blamed her death on radiation poisoning. What is worse is that in my childhood, whenever my mom mentioned so-and-so got cancer, it was like a death sentence; they never got better.
I was starting to work up a pretty good fear of dying from cancer; but I wasn't sick, and I couldn't feel it or see it. What was going on here?
Two months later, a second PSA test came back even higher- a big jump to 6.41! Dr. Padilla, my family doctor again tried to reassure me, but he has always been very thorough and proactive about my health. Then he said "I'm sending you to a urologist who is an expert in these things. He will probably do a biopsy to see what is going on." I called my wife, Jackie, from my car outside the clinic and told her the bad news. She had been reassuring me right along that I was fine, but now my base intuition kicked in, telling me there must be something wrong. I didn't cry just then, but a shroud of anxiety and fear took over my subconscious. At this point, all I wanted was to get this biopsy thing done, and find out I was going to be alright.
The urologist I saw, Dr. David Yee, was also a cancer surgeon, an extremely bright and competent doctor with a very caring personality. It was now late June and he did the biopsy, a very uncomfortable procedure without being sedated. He took sixteen samples from my prostate. I almost fell off the table as I tried to move further away from him each time he took a sample. It would be a week or so before the results would come back. I told him I was on my way to northern Wisconsin for a motorcycle ride with a grade school friend for ten days. He suggested I go and try to have fun, and he would give me the results in person when I got back on July 11.
I rode a rented Harley Softail across northern Wisconsin and along the western shore of Lake Superior like it was the last ride I would ever have. My buddy Gary said I seemed distracted, so I told him about my PSA tests. He was just the first of all my fifty and over friends I have asked to go get a PSA test and repeat it every year.
The ride along Lake Superior was a beautiful distraction. I was nervous getting back to Sacramento, and on the way to see the urologist, I prayed for the first time that I'd be fine. I was sure this would all be a false alarm and my anxiety would go away.
Dr. Yee brought in another doctor with him, not a good sign, I was thinking. He didn't mince words. "There is cancer in your prostate. Nine of the biopsy samples show it. You have some choices here. We can use radiation to destroy the cancer or we can do surgery to remove the prostate. I recommend surgery, robotic surgery that I have done many times; it allows the nerves connecting your brain to your penis to be spared. I do not recommend waiting to see what develops." The young female doctor with him gave me a comforting look. I was floored. But, something inside me told me to be strong and I said "I want this out of me, doctor, as soon as possible". To this day, I can't believe I said that; I am usually a wimp when it comes to medical things. But then again I have never had surgery.
I left his office in a daze, got in my car and called my wife Jackie, who was driving in Oregon with her sister-in-law, going to a quilting festival. I told her to get off the highway if she was driving, and gave her the bad news. She felt bad about being four hundred miles away. She asked me how I was doing and I started to cry.
Scientists have recently done studies on crying, trying to figure out why only humans shed tears. Crying can last for seconds or sometimes an hour, and is certainly a neurological response to stress. I cried out for help, for compassion, for relief from my fears and my vulnerability. I was there alone in my car. I pulled myself together and drove home. I said another prayer. Please God help me through this.
That night I was invited to my buddy Ed's 61st birthday dinner at his favorite restaurant. I had to go; it would divert my now cancer-consumed mind for a few hours. At the dinner, his wife Teresa casually asked me if I had resolved the "medical issue" I told them about a few weeks before. I had to get it all out, and of course, that cast a pall on Ed's birthday dinner. Teresa and I, as non-practicing Catholics, had a long discussion a month before about whether there was a God and a place like Heaven. On a business trip in April, I saw a book in the airport called "Proof of Heaven" by Eben Alexander, a doctor who had been in a coma and wrote about being in another dimension with his deceased relatives, a place of great beauty and peace. I devoured that book. Now I was thinking that an after-life might be in my near future.
Teresa promised to pray for me, and to get her friends to do so as well. I thanked her for that. I hope it works, was all I could think. And, I decided that I would tell all my friends and relatives what was going on with me. Some people hold things like this close and don't say anything until it seems too late. I realized later what great therapy this would be for me, sharing this with the people who meant the most to me. My emotional roller coaster ride was just getting started.
Over the next few days, I wrote to seventy-seven friends and relatives, including my colleagues on the executive management team I am on at the large electric utility I work for in Sacramento, telling them I was facing prostate cancer, but my doctor told me that "If surgery goes well, the odds of this doing you in will be minuscule".
I got back dozens of replies offering up their prayers and good thoughts. It was very comforting and I felt so loved by these words from all of them; it made a difference to me in ways I can't express. These friends and relatives were there for me. Just the suggestion that someone would pray for me made me stronger. No one had every told me in my life they were praying for me. What a powerful thing among human beings. I have no doubt it helped my situation.
Now I had to wait my turn for surgery. It was three weeks away on August 9. I went to work in a fog, hoping to stay so busy I wouldn't dwell on the fact I had cancer in me. I told my friends that the surgery should remove all the cancer, but if it didn't I would have to have follow up radiation for many weeks to kill what is left. Hopefully, there would be no sign of it having metastasized-spread to other parts of my body.
I began to do some things that subconsciously were preparing me for a possible bad ending. I cleaned out everything in my office but my personal stuff, and completed all my required employee training courses for 2013. At home, I made sure my files and lists of stuff were in order. I went to the annual Radio Day auction of the CA Historical Radio Society and bought six antique tube radios and five transistor radios for my collection. I took out my Vespa and my Harley motorcycles for long rides. We went to a John Mayer concert at a big outdoor venue near Stanford. It was like I would never do these things again.
My doctor had told me that robotic surgery would take six hours and I would be out of the hospital less than 24 hours after. But, I would be home four weeks recovering. If all went well, I would recover control of my bladder in a month or so, and maybe in six months, I would get all my sexual functions back. I would need some physical therapy to learn to control my bladder with stronger pelvic muscles. I didn't realize that even laparoscopic surgery can tear you up pretty good.
Jackie and I had several crying episodes together in that three weeks before the surgery. There is nothing more comforting that having your partner in your arms sharing your feelings of helplessness and fear. Was this the beginning of the end for me, or another tough time we'd get through after 41 years together?
I walked into a modern hospital that looked more like a nice luxury hotel and got settled in a couple hours before surgery. For some reason, I wasn't afraid; again I surprised myself. I had passed all the pre-surgery blood tests and took all the medicine. Now it was time to get this over with and move on to the next stage. As to the surgery itself, I remember nothing other than the operating room and the robotic surgical arms above me that looked like the Starship Enterprise. When I woke up, my surgeon came in and said it all went as planned. When he left, I cried some good tears.
During the first couple weeks of recovery, I was getting around very slowly and not thinking about much other than pain pills and taking long naps. Then I saw the doctor and had some catheter tubing removed, which was good; things were getting back to normal. He told me that during surgery, he removed a dozen or more lymph nodes close to the prostate and, thankfully, none of them had cancer cells in them. The doctor also said, "It was good we did this surgery right away and did not wait. The cancer was more aggressive than even the biopsy showed. We will do a PSA test in two months to see if there is any evidence of cancer remaining. If there is, we will do radiation." Good news, followed by another big contingency, another big worry. Now my next PSA test had to be below .10 or there may be a problem.
I asked Dr. Yee "Why did I get this, doc? I never smoked or drank to excess. I have a good diet. Did I have too much sex, or not enough?" He smiled and said "We don't know. Sometimes it's genetic. It could be the American diet. We don't know". And, prostate cancer is usually slow growing, taking years to develop. It appears I had just the opposite.
Two months is a very long time when you are anxiously waiting to have another test for cancer. I spent a week at our house on Camano Island in Washington state taking in the beautiful views of islands and bays in Puget Sound from our deck. Once again, I cried when we got there after an 800 mile drive north on Interstate 5. I was not sure I would ever see those views again.
I went back to work on September 9; I would have a PSA test on September 30. I tried filling up these anxiety filled days with lots of meetings during the day and at night, lots of mindless television. Also, I read about foods that have anti-oxidants in them that are supposed to prevent or control cancer, like the tomato, which has lycopene in it. I read studies that showed lycopene might prevent or control prostate cancer. I also read studies that said it was not conclusive. I decided to load up on lycopene for the next two months; I ate raw tomatoes, pizza with extra sauce and drank tomato juice everyday. Why not load up on pasta marinara? As an Italian, I love it.
On October 1, I was coming home from work and Jackie asked me to pick up some burgers and fries from In & Out Burgers, the famous California chain of cheap, but delicious fast food. Just after I ordered, I got a message from the Clinic saying I had a new test result. I grabbed the burgers and went out to the car, opened up my I-Pad and logged into my Health Profile. My PSA test was .03, way below the .10 threshold! I couldn't believe it. I sat there in my little MiniCooper and cried; this time they were tears of joy.
Jackie and I cried some more tears of joy when I got home; our dog Zoe was very confused, but she got extra cookies that evening just for being there. I called our son and daughter, and then sent Teresa a special thanks for all her prayers. I felt like I got my life back.
Six days later Dr. Yee confirmed that this was great news. A PSA test will be repeated every three months for a year and then repeated every year after that. If it stays under control, I won't need follow up radiation. I sent a very happy e-mail to my seventy-seven friends and family members.
I am back to normal I believe, whatever normal is for me now. I am riding my motorcycles again, and every Thursday night is Pasta Marinara Night, with lots of tomato gravy. My view of life has changed a bit. Life is even more wonderful than I recognized; and, it is so fragile and goes so fast. We never wasted any time in doing the things Jackie and I wanted to do, but now everyday seems very special to me. We are planning a three week trip to Tuscany with three other couples for June next year.
I am on a mission to tell every fifty-and-over male I know that they need to have an annual PSA test; they also get an abbreviated version of my story. My doctor said there are 230,000 new prostate cancer cases every year in America, and one of every six men alive today will get it. That needs to change.
I think that God intervened on my behalf, urged on by all the prayers for me these past few months. I will go with that for now. I am sure there is something going on even in my narrow, modest little slice of life that is much bigger than me alone. I've embraced the idea of a loving caring God; for me, it has to include the goodness of humanity, a collective effort to make things better for the human condition, whether it be for a humble soul like me in a crisis or for an entire society. If for nothing else, I thank God there are doctors like Dr. Padilla and Dr. Yee who took care of me in this bad situation. And, I especially thank God for my family and friends who care so much.
By Michael Gianunzio
Fair Oaks, CA
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