Since my prostate cancer diagnosis, I have become more aware of my body, especially whenever I have a new ache or pain. I no longer put off seeing the doctor in hopes things will get better on their own. In my younger days, I would ignore any pain or symptoms, thinking it was a sign of weakness to complain. Growing up in a male environment, you were encouraged to walk it off and push through the pain. But now I realize how critically important it is to see a doctor for regular checkups, particularly as we age.
I want to share three recent health issues: my right breast, groin, and PSA.
I. My Right Breast;
One morning, I woke up with redness, swelling, and pain in my right breast and worried it might be male breast cancer. If you were not aware, men have breasts too. I immediately called my doctor, who examined the area. She didn’t feel any lumps, but she ordered an ultrasound to be sure. However, the medical imaging department recommended that I have a mammogram first and then an ultrasound. I had no problem and agreed to both tests. However, I was a little embarrassed at the thought of these tests on my breast.
To my surprise, I was in the hospital having a mammogram within two days. My doctor said that the medical imaging department likes to keep on top of screening and offer a quick turnaround. And she was right as the results were available within an hour after having the test. I was relieved to learn that the mammogram was clear.
And within a few more days, I was back in the hospital having an ultrasound. Once again, I was relieved as the ultrasound results were also clear. However, the redness, swelling and pain continued. Therefore, my doctor prescribed 7-days of antibiotics. And after a good 6-8 weeks, the area finally cleared up. I’m thankful it turned out to be an infection and not male breast cancer.
On a different morning, I woke up with a lump in my groin area that I thought might be a hernia. The day before, I was playing the video game Mario golf quite aggressively competing with my son. Therefore it sounded reasonable that playing the game may have caused the hernia.
Once again, I visited my doctor, who thoroughly examined the area. She suspected that the lump was a pulled groin muscle. But ordered an ultrasound to be sure. The results were inconclusive and indicated there was no hernia or strained muscle. However, the lump continued to grow and became painful. I visited the hospital, and the ER doctor believes it’s a hernia even though the ultrasound ruled it out. She referred me to a surgeon.
I’m now waiting for an appointment with the surgeon, who will confirm if it’s a hernia or not. I’m hoping it’s a hernia as that’s entirely fixable.
It’s been four and a half years since my prostatectomy. And for the first two years, I had a follow-up PSA test every three months. And every reading has been a constant <0.008. This value is the lowest the lab in my area can detect, and the less than sign indicates no PSA detected. Or in other words, my PSA is undetectable. Meaning that if there is any PSA in my bloodstream, the levels are below 0.008. And most doctors agree that prostate cancer recurrence is 0.2 or above. Therefore, my PSA levels since surgery have been excellent.
The following two years, my follow-up PSA testing schedule changed from every three months to every six months. And again, my reading has been a consistent <0.008. A number that I got used to and provided me with a great deal of comfort. Therefore, for the first four years after prostate cancer surgery, my results have been a rock-solid <0.008. But that all changed after the four-year mark.
My first reading after year four was 0.008, and it was missing the less-than sign. Once again, the less than sign indicates undetectable, and my PSA is now detectable. I panicked. Where is the less than sign? I phoned my doctor, my surgeon, the lab and even talked with a clinical biochemist. After serious discussions and research, I discovered three possible explanations for the missing less than sign.
1. The lab equipment is ultra-sensitive, and since it detects PSA at extremely low levels, there is an acceptable error rate of 30%. Therefore, results could vary by +/- 0.002, meaning numbers between 0.006 and 0.01 are, in fact, most likely the same result.
2. There are still healthy prostate cells that survived treatment and are producing PSA. If this is true, the levels will not increase or will increase at such a slow rate that the results will likely never reach the recurrence level of 0.2.
3. There are still cancerous prostate cells that survived treatment and are producing PSA. If this is true, the levels will increase faster than healthy prostate cells and most likely will reach the recurrence level of 0.2 and higher. But it may take several years to reach that point.
Since my reading of 0.008, my levels have increased to 0.01, 0.012, and 0.015. A little outside the acceptable 30% error rate. Therefore, I’m no longer comfortable having the follow-up PSA test every six months and have moved back every three months.
The waiting continues
That concludes updates on my three recent health issues. All I can do now is monitor my PSA and wait for the surgeon to examine the lump in my groin. And since waiting can be incredibly stressful, I’m always looking for distractions in life to get my mind on other things.
I’m grateful for the opportunity to share my prostate cancer diagnosis and lessons learned. You can listen to all my medical posts under Gogs’ Medical Testing.
If you’re newly diagnosed with prostate cancer and live in Canada 🇨🇦 please request a free Reef Knot Kit from Prostate Cancer Foundation BC. Each kit contains a copy of my book, Prostate Cancer Strikes: Navigating the Storm. For more details, please read the Announcement in my local paper.