Budd Nielsen - One Mans Journey Through Prostate Cancer

Chapter 1

Prostate Healthbefore the diagnosis

I have to say now that, in reality, years before my doctors horrifying phone call is when my cancer journey actually began. It was during one of my normal physical visits with my main doctormy general practitioner. He suggested it would be a good idea (at my young age, ha-ha!) to visit a good urologist. Strange how things materialize, because I just happened to know a very good urologist. You see, six years earlier, my wife and I went through a lengthy and definitely very difficult journey through infertility. Throughout that difficult time in our lives, one doctor (Cowan) out of the many doctors we visited with was part of a cool group of physicians called Urology Associates.

Later that day, when I returned home from my general practitioner physical, I explained to my wife what he suggested I do (have the urologist visit). She was hot on the trail. She called Urology Associates and set up my first visit. At this visit, I was reintroduced to Dr. Cowan. The visit went well. Dr. Cowan did all of the usual things, including the dreaded glove test. The doctor visited with me and took some notes. Everything turned out good enough, and I was set up for my second appointment six months in the future, and he would like to see me on a continual basis of every six months thereafter (something all men some do). At my second appointment, Dr. Cowan performed his normal exam and looked over his previous notes plus the notes he had from my general physician who sent me to him in the first place. He said, in his opinion, he felt that I had a slightly enlarged prostate gland but nothing out of the normal for my age and no red flags. From what the notes indicated from our first visit to what he was now noticing, there was nothing alarming or out of the ordinary. Just a slightly enlarged prostate and enlarging is a normal occurring performance of the prostate gland. I think it was on my fourth visit to him which would be a timeline of two years of accumulated visits. He said that he thought it would be prudent to have some outside testing done. This was where a few more small pieces of the puzzle first began to come together. One of the outside tests he wanted to do was a prostatic specific antigen test (PSA test). To explain PSA to you, Ill say it like this: our prostate gland produces what is known as a protein (or antigen), and this protein is labeled as PSA and its found in our blood, since its in the blood. When the lab draws a blood sample from you, they can then look for that specific antigen and will measure its level. That definition you just read is extremely simple and is all mine. You should (as with any information in this book) check it out with your doctor or urologist. This is a simple blood test that might perhaps help in detecting the possible presence of prostate cancer, or it may just show the normal effects of getting older. It is important that I explain to you that these PSA test results should not be interpreted as absolute evidence of the presence or absence of this disease regardless of the results. This PSA test number is more like a guideline to use and to help you and your doctor decide which path to take for future health concerns and which steps would be more beneficial for you. They are not a positive note of cancer.

Heres some information for you. Normal PSA levels range from 0.0 to 4.0. The lower the number, obviously the better. However, even a level of a 4.0 may not be a cause for alarmthats still an acceptable range. Once the PSA levels rise above 4.0, you may start to think about it, and yet, it is still not an alarming level. However, you and your doctor should at least sit up and start to take notice and begin to check into the reason why the level is raising above 4.0. There are several reasons for an elevated level, and one of those reasons might beI repeat, might bean indication of prostate cancer, but it would be way out on the side line at best. The level is one reason why it should be investigated, because this is an issue that should be addressed. Please take it from the one who wrote this book: the sooner you find out why these numbers have their continuous but slow and steady raise and what is causing these issues, the less has to be done to correct it exactly like preventive maintenance on anything, plus, the earlier detected, the high percentage of a healthier future outcome, which makes the odds hugely stacked in your favor. Dont roll the dice on this one, brother!

Since my journey began, I have spoken with many prostate cancer survivors because I wanted and needed to speak with different men that had gone through this. I needed multiple opinions (another lesson I learned from my dad) so I could make an intelligent decision for my own course of action, which is something you should also consider. In all the test case scenarios that I have studied, it seems that the guys with the earliest detections have the brightest outcomes with the fewest problems now and later. The longer you wait, the tighter the hold cancer can get, and the more aggressive it may become. This is important, so take note. Aggressive cancer inside your body is never good. Also importantthe longer you wait, the fewer options you might have to combat this enemy. Many of the gentlemen I spoke with are living with everyday problems that they will face for the rest of their lives, including myself. This may affect you for the rest of your life, so its good to talk to others who have been in this situation and walked this journey. They know the reality of what youre going through and can offer insight.

This is my best advice to every man: Get a good doctor on your side. Go to the appointments to have the dreaded glove test and also get PSA tests done, at the very least, once every year. I went to my doctor and did bothglove and PSA testevery six months. Now get this, because I had frequent visits, my doc was on top of the situation and was able to spot anything that he thought was just a wee bit unusual. These doctors are in their respective professions because they care about people and they want to help you; they want you to have a good prosperous life. Detect it early and eradicate it early as possible. In this situation, you dont want a yellow flag thrown for delay of game.

Some more information for you: Every guy needs to be tested by a urologist and tested early in this game. Most of the studies I have read state that, by age fifty, a man should start having regular yearly checkups. I personally think forty years of age is a good starting point for men to be tested once a year. The reason I say forty is that, right around the age of twenty-eight, our male prostate begins its own little growth program unbeknownst by you and will continue this growth most likely til the end of days. Most physicians recommend age fifty, and as with everything, you should always discuss this with your medical provider. But if you are age fifty or older and have never had a urology checkup or PSA testing done, then get off your doctor fearingand man up! This information Im telling you is not only for your benefit, brother, but you have to understand, you also have loved ones who love you and are depending on you. You dont want to let them down when a simple visit to the doctor once a year is a proactive step toward taking care of your health, your future, and taking care of your family too. We do maintenance on our cars, why not on our own bodies?

My first PSA test results were in the normal range at 3.0. At this level, there was no need for worry or concern. I felt normalno pain, no side effects, and there didnt seem to be anything that would set off an alarm or raise a red flag to my doc or myself. However, and this is the kicker, neither one of us knew there may be an ugly monster slipping his dreadful form into that which was not his. I didnt have any of the characteristic early effects which are: an unusually hard-to-start urine flow or the extremely slow and longer lasting flow, bladder infections, urinary tract infections, or kidney problems. Those are signs that are usually associated with an enlarged prostate, so at this time in my journey, I was OK, sort of like running under the radar. Over the next couple of years, each one of my six-month visits to the urologist showed the PSA test results were slightly higher than the one before. It had gone up a split fraction of a point. Just slightly higher, never a huge jump at any one time. This also is why you personally, not just your doctor, but both of you need to study your PSA test results, because this slow and steady uphill trend is a telling factor. A few more pieces of the puzzle were coming together, and I did not like the picture coming into focus. Fortunately, I started my testing early, and that proved to be incredibly important. Because I did start my doctor visits early and I also started my PSAs early, my doctor had my baseline level, which is an excellent benchmark (a great starting point) for any doctor to determine what is normal for their patient, and just as important, you will know what is not normal. So jumping ahead a little, Dr. Cowan had seen me early, he had seen me twice a year over the years, he performed all the normal exams, made many notes, and had a good understanding of my health while in the normal PSA range. So now he was able to see a slow but steady increase in my PSA test scores as each one came back to him. Plus, he was educated on my normal prostate glands size and hardness because he had performed the golden glove test on me each time I visited his office. After adding all this information together from over the years, the signs were not pointing in an encouraging direction; however, they were still in the normal range, so all things considered, it was not a terribly ugly position either.