Thoughts, One Year Later

The press and the Internet are peppered with stories about prostate cancer, about how the vast majority of men are over treated. My husband and I read these stories with great interest as he was diagnosed with prostate cancer last year. In our family, the "c" word is frightening, not just because this disease has a horrible reputation, but because we have watched three close relatives die from it. Two other close relatives, both my husband's father and his grandfather had prostate cancer. We have little information about their cases, but we do know that my father-in-law was diagnosed in his 70's and embarked on a regimen of radiation treatments. Based on this genetic link, my husband had his PSA checked at each annual physical. Over the years, there has been some activity in his PSA level, but certainly nothing remarkable. Last year, his number was a bit elevated so his careful primary care physician recommended biopsies. Since we had already booked our anniversary trip, a safari in Botswana, we delayed the biopsy appointment. Similar to the surgeon's reaction, we were stunned to discover that cancerous cells had spread all over my husband's prostate. Thus began a series of consultations with robotic surgeons, traditional surgeons, radiation oncologists and cancer specialists available to guide the patient through the many tough choices. We were lucky to meet with a top specialist at Johns Hopkins who pointed out that although my husband's cancer was the slow growing kind, it had such volume that it could have been festering in him for as many as ten years. He also cautioned that biopsies do not necessarily tell the whole story. It was possible that the cancer had spread. Surgery in the traditional open method was the only way to get clear margins. Aware of the potential side effects, we set a date for surgery. There is longevity in my husband's family. Given his relatively young age, we wanted more than the perhaps fifteen years together that research speculated was a reasonable guess. With the new knowledge after surgery that his cancer was in fact starting to spread, we were relieved that we had made the correct decision. Side effects can be bothersome, although they do disappear with time. One year later this week, I cross my fingers as I look at my tan and fit husband while we hike through the Chilmark hills, swim in Nantucket Sound, and look forward to celebrating another anniversary with our children and our grandchildren.