PSA Rising: The Speed Could Be Everything
At age 51, Dave Mayber considered himself lucky to be diagnosed with prostate cancer – and not a different cancer.
“As scary as being diagnosed with cancer is, prostate cancer has a pretty good cure rate, and I had been plenty scared before,” Mayber said.
At 39, he was diagnosed with and treated for non-Hodgkin’s Lymphoma.
Mayber was raised by his stepfather and doesn’t know the family history on his father’s side. Still, his early diagnosis and successful treatment of the lymphoma gave him a healthy respect for the annual physical.
“I’ve been tested and poked more than any man would want, but to lifesaving results. I don’t avoid the doctor. Just the opposite. I want anything found early.”
Mayber’s PSA test of 1.1 would seem to be no cause for alarm. But his internist was concerned that Mayber’s PSA rose .5 ng/mL in one year, a PSA velocity that warrants attention.
“I’m so grateful to my internist for keeping on top of the latest information. He knew PSA velocity was as much, if not more, a concern than the PSA value.”
Mayber could have waited for a few months and been retested, but his wife, Amy, insisted he see a urologist as soon as possible. In that visit, the doctor felt a rough spot on the digital rectal exam and recommended a biopsy.
“I wasn’t worried. I’d heard that many biopsies come back negative. Besides, I had a PSA of 1.1. And I was 51 but felt as if I were in a 25 year old body. I played competitive ice hockey once a week and did spin class twice a week. Golf was another passion. I was in terrific shape.”
The day he got the biopsy results, he was shocked. Immediately, though, he and his wife began doing their homework.
“I have to admit I was freaked out when I heard. But I started weighing the options right away. There seemed to be so many, especially it seemed for someone with a Gleason score of 3+3. By the way, at first, I had no idea what a Gleason Score was, much less how to make a choice about treatment.”
Making A Treatment Decision
Even though “watchful waiting” was presented as a possibility, he never considered it.
“Why in the world would anyone want to wait for cancer to grow? And my wife wouldn’t let me consider it either.”
In the end, Mayber made his decision after visiting a radiation oncologist. He explained that while Mayber’s Gleason score from the biopsy was 3+3, the only way to truly stage a tumor is to completely remove it.
After looking at Mayber’s information and his age, the doctor said, “51 – you have a lot of years ahead of you. I’d have the surgery.”
“As soon as I heard that advice from a radiation oncologist, I knew radiation was out,” Mayber said.
He considered both the robotic and the open surgery. Again, the final influence was his wife who said, “This robotic surgery only has a 3 to 5 year track record so far. What about 10-15 years from now?”
“Amy is my voice of reason and from recent reports, it seems she was right about the robotic decision. She’s also my unconditional support. She went with me everywhere – to every doctor’s appointment and all the time in the hospital. I was concerned about what to tell my two college-age daughters but I never held back anything from Amy.
Support, it turned out, was allimportant to him.
“My family was essential, but it was also wonderful to get cards and flowers. Actually, I struggled with not hearing from some people.”
Mayber found out that while opinions about treatment abound, the delicate nature of the operation was unquestionable and the goal of the ‘trifecta’ (cure, continence and potency) was universal.
“I came away from those conversations with one thought: ‘I want a surgeon with the best hands and the most experience.’
“My former boss had prostate surgery with Dr. Catalona and highly recommended him. While I “interviewed” other doctors, I had no question about my choice. Having an idea of what was ahead, with all the accompanying anxiety, made going in with confidence all the more important.”
Mayber is a recent patient – three months from his radical prostatectomy.
He’s open about his progress.
“I went back to work almost as soon as the catheter was out. My bosses (Mayber sells commercial time for the ABC television network.) told me to take as much time as I needed, but I wanted to get back as soon as I could.”
About the “trifecta?”
“I’m feeling good that the cancer was found in time and is gone. I’m back playing hockey, golf and even spinning. I still have a little stress incontinence, but just three months out and with all my physical activities, that’s not unexpected. Still bothersome but much better every week. I’m expecting full recovery.
“For a guy who feels as if he’s 25, the potency issue is difficult. I had nerve-sparing surgery and I follow Dr. Catalona’s instructions to get back to normal, which includes injecting myself. I was amazed that I could do it. I need patience but I’m confident and, needless to say, looking forward.”
Mayber started a journal which describes, in honest detail, a challenging journey. Right now, that story is mostly for him.
He is going to share his views about testing any time the opportunity arises. Especially, he has advice for men who say they are scared to get tested.
“Get your baseline PSA test and continue annual testing. You should be more scared not knowing. You can’t be cured if you don’t know.”