July 6th is also the day in 2012 when I was diagnosed with stage 4 prostate cancer. My unit had already left for a month-long training exercise in Louisiana, but I had remained at our base. I was waiting to visit a urologist to review the results of recent testing, after my Prostate Specific Antigen (PSA) levels had quickly increased to over 80 (a normal result is between 0 and 4). So, I waited until after the holiday to see a specialist – I knew very little about prostate cancer and assumed that there would be a quick fix. I figured I would return to my normal world of military training and preparing for deployment to Afghanistan in the fall of 2012.
I eventually did join my unit for training, but quickly came to realize that a Stage 4 diagnosis carried heavy consequences. I would not be able to deploy with my unit, and instead, embarked on an aggressive treatment program at MD Anderson Cancer Center.
At the time of diagnosis, a urologist told me that the average life expectancy for advanced cases like mine, where the cancer had already spread into distant lymph nodes, was approximately two years.
Almost twenty years in the military had conditioned me to quickly evaluate a problem, identify possible courses of action, assess risk, and make quick decisions. So, together with my incredible oncologist (who I found after seeking a second opinion, to find a provider that was a better fit for my desire for aggressive treatment), we developed an unconventional plan to treat my cancer. My treatment plan included hormone therapy, early use of chemotherapy (since validated thru the CHAARTED study), early use of Abiraterone Acetate/Zytiga (since validated thru the LATITUDE study), and surgery to debulk the original prostate tumor.
This course of treatment removed all observable evidence of cancer from my body and maintained my PSA at a normal level. Eventually my PSA reached a low point of 1.1 before I suffered a relapse in the Fall of 2013, with my PSA rising again to 3.6. After recalibrating my treatment, replacing Zytiga with enzalutamide/Xtandi, and executing a new immunologic treatment called Provenge, my PSA went down to undetectable levels, and has remained there for almost three years.
As I reflect on my five year “anniversary” with cancer, I’m excited about the future.
ZERO – The End of Prostate Cancer recently chalked major advocacy successes, increasing the amount of funding for the Prostate Cancer Research Program (PCRP) by $10 million per year, and pressing the United States Preventative Services Task Force (USPSTF) to change its PSA screening recommendations so that men won’t have to wait until they are symptomatic to get checked for prostate cancer. Research is moving along, too – advances in genetic testing, new immunotherapies, and new combinations of existing therapies – lots of exciting news!
So, today, I’m focused on both anniversaries, but most importantly, to future ones – hopefully, to many more years with my family, and a time when a diagnosis of advanced prostate cancer doesn’t involve an estimate of life expectancy. I look forward to a future when the medical tools in our arsenal can make prostate cancer a chronic disease instead of a terminal one.