I wasn’t going to ever write about my medical problems, or if I were, I was planning to create a whole new blog dedicated to such, but at this moment I feel that there are many people in my situation and I had the need to vent.
I am about to endure my 3rd Prostate biopsy. I’ve had a cancer diagnosis for a while and I am choosing to live through Watchful Waiting. My GP just told me on my last visit that the statistics of death for those who are Watchful Waiting are the same as those who do nothing. If this is true, I really could just forget the whole thing and go about my life and have the same chances of surviving with – or dying from – Prostate Cancer. Watchful Waiting is exactly like having the Immunity Idol on the TV show Survivor. If you use the Idol too soon, you are seen as a foolish, paranoid wasting a chance to be able to use it when you really need it most. If you are voted off the Island while still holding on to the Idol, you are seen as foolish by not recognizing the obvious signs.
10 years ago I was strong-armed into having a prostate biopsy by my urologist. At that time my PSA was about 2.5 well under the 4.0 cutoff for the Prostate antigen. The biopsy showed pre-cancerous cells. I was about 42. I held out on another biopsy until about 5 years ago, my PSA was hovering about 3.5. In one of the 12 samples the results showed a few of the super slow growing cancer cells that most men die having (but not dying of) well into their 80’s.
Allowing that first biopsy was probably the worst mistake I ever made. My doctor, whom I respect and like, gave me this argument at the time: Don’t you want to see? You probably don’t have cancer and then we don’t have to worry. This was ten years ago mind you, the consensus and dogma of the time was to test up the (literal) wazzoo, destroy as many prostates as possible, save lives. I am now living with the diagnosis of cancer. Upon receiving the results of each of the first two biopsies, my Doctor suggested to me that, “patients usually choose to destroy their prostate at this point with this diagnosis.”
With this cancer diagnosis, I can’t go back to ignorance. Long before the US Preventative Task Force came out with their recommendations to stop all PSAs for any healthy men, studies had been coming out furiously over the years about the men who needlessly destroyed their prostates and that a large percentage of men died with prostate cancer but not from it. But I, with the diagnosis of Cancer, am now tethered to the prostate roller coaster with PSAs every 4 months.
I promised my Urologist that if my PSA didn’t go up I could wait 5 years before my next biopsy, next week is 5 years. Plus my PSA did go up a bit. It’s hovering around 5. Probably nothing to worry about… Stay tuned.
Why Not to worry about PSAs: PSAs can fluctuate wildly due to a lot of different factors, and I’m sure everyone who has had a PSA has experienced the insane PSA anxiety when it’s high. My PSAs go up and down. I have pretty chronic Prostatitis. This can raise my PSA about 2 to 3 points. You can imagine how it freaks me out when I see high numbers, but usually with a course of antibiotics these numbers come down. What I have to look for and truly worry about is PSA numbers rising quickly over a short period of time. Other things that can screw up a PSA is having sex or masturbating to close to a PSA, this can raise the numbers a point or two. A tough tennis game, swimming, hard exercise and such right before a PSA blood test can screw with the numbers too.
UPDATE (as of March 2012): Believe it or not the test was clear, whew! 4 more years.
Alan Brown Art 
Hi Alan, Sometimes I think we just have TMI when it comes to medical issues. Granted, advances in treatment for many diseases have saved lives, but so often, exactly what you describe happens: you hear “cancer” or even “pre-cancer” (as I recently did, which led to what turned out to be an unnecessary surgery) and it makes you crazy. On the subject of watchful waiting, my husband’s urologist did that; my husband did not have cancer cells but did have a high psa and the usual symptoms. So – by the time he had the prostate removed, it was the size of a grapefruit(!) and required major surgery and led to lots of problems. Ridiculous. I guess that’s why medicine is as much an art as a science. Best of luck. Jackie
Hi Alan,
My father followed his PSA numbers obsessively for over twenty years watching them go up a percentage point, down two up one and in the end died of something else at the age of 85. Also I just read your parents eulogies and loved them!