Older men need regular PSA screening

Prostate cancer is to men, as breast cancer is to women.

The second-leading cause of cancer deaths in men comes from a small gland located between the bladder and the penis. If not monitored or treated, prostate can be a killer.

Likewise, the No. 2 cause of cancer deaths in women, is breast cancer. So what’s the difference?

Over the years, more awareness has been directed at breast cancer screening, than with the prostate gland. Therefore, with September as Prostate Awareness Month, let’s put the spotlight on this type of cancer.

I’m one of those statistical males where prostate cancer will affect one out of nine men in their 60s. I began screening about every 18 months to two years, when I was in my 50s, then about every year to 18 months, after I entered my 60s.

An abnormal PSA or prostate-specific antigen found in the blood, alerts physicians that prostate cancer may exist. During the past six years, my PSA slowly climbed from a 3.18 in 2014, to 6.36 in 2017. In 2019, the PSA more than doubled to 16.57, causing my general practitioner to refer me to a urologist.

Other warning signs began to develop during the first seven months. I had frequent urges to urinate, but the stream was weak. Occasionally, blood would appear.

Dr. Brian Montgomery, a urologist, saw me in late August 2019, and quickly re-ordered another PSA. It returned with a score shy of 17.

“The higher the PSA, the more likely prostate cancer,” he said, reviewing the latest result with me.

A month later, Dr. Montgomery completed a core biopsy of the prostate, by taking samples from 12 areas. When he presented the results to me two weeks later, I had the presence of cancer in two quadrants, the left base and left lateral apex.

Dr. Montgomery’s attention focused on the left later apex, which measured the adenocarcinoma – cancer forming in mucus- secreting glands – up to 16 mm in its greatest dimension and occupying 95 percent of the surface area.

Furthermore, Dr. Montgomery said the pathologist issued a Gleason grading score of 8, which means I have a high-grade legion that can spread more quickly than scores half that.

The left base showed adenocarcinoma taking up only 5 percent, but the Gleason score came in at 6. Based on my PSA, however, Dr. Montgomery said he expected to see the adenocarcinoma in more than two quadrants.

“It’s all statistics with many different results,” he said.

One test remained before Dr. Montgomery offered his final decision on treatment. A bone scan using criteria based on National Comprehensive Cancer Network (NCCN) guidelines, determined if the cancer had spread.

“If you’re metastatic, that basically means high risk,” he pointed out, “but your imaging shows it has not spread.”

Dr. Montgomery said I was very fortunate not to have the cancer in more than two quadrants. Statistically, he said the prognosis shows I have a good chance to beat this disease and there’s an 80 percent chance I will not have a reoccurrence of prostate cancer.

The treatment: based on all the tests and the Gleason scores, I was deemed a good patient for receiving radiation treatments, instead of having a radical prostatectomy, where the prostate and surrounding tissues are removed.

The next step: Dr. Montgomery implanted three radioactive seeds into my prostate that would accurately guide radiation beams to not only the affected quadrants, but also the entire prostate.

Dr. Gary E. Campbell, a radiation oncologist, with more than 37 years experience, oversaw the next step, with me receiving 43 radiation treatments over three months. The last session June 1, ended the numerous 128-mile roundtrip journeys.

The 43 treatments I received give a higher percentage of killing most cancer cells. Dr. Campbell said statistically, out of hundreds of patients, he can tell how they will do with their treatment plans. With each 20 to 25-minute treatment, technicians shoot external radiation beams to the area that’s being treated.

With the end of radiation treatments almost three months ago, I have encountered some side effects, from swelling in the legs, urination and bowel movement problems, restless nights and some tiredness – they should go away. Coming up soon is my three-month checkup with Dr. Montgomery.

Both doctors, however, have repeatedly said the best indicator of how treatments worked is with another PSA...and with a score of 2 or below.

“I would anticipate your PSA will be extremely low,” Dr. Campbell predicted.

Steve Ranson is editor emeritus of the Lahontan Valley News in Fallon, Nev., and past president of International Society of Weekly Newspaper Editors (ISWNE) and the Nevada Press Association. He can be contacted at fallonsports@yahoo.com.