Patrick's P.S.A. to Men: Get Your PSA Checked

My name is Patrick Boll. I'm an actor, and in the summer of 2016 my doctor told me my PSA was 1.15. "PSA - what is that? Public Service Announcement? What the hell's a PSA?" And so my journey with prostate cancer began. Since the 1.15 was well below the 4.0 threshold for concern, my doctor paid minor attention to it. "You're a big guy (I'm 6'4"); you probably just have a big prostate. No worries." And so life moved on.

A year later, summer of 2017, my PSA had more than doubled - 2.85. Still well below the 4.0 threshold, but the significant jump in such a short time was concerning enough to my doctor that he suggested I see a urologist. But I'm a busy guy (aren't we all! ). I was heading out of town to go on tour so I put it off while I continued with life. Bad idea. 

Six months later my tour ended and, at the urging of my wife, I did see a urologist. He performed the ever joyful digital exam as well as checking my PSA again. While my PSA was steady in the mid 2's (2.65), the digital exam gave him enough concern that he recommended I get an MRI. The joy continued.

A week later I got my MRI during an early evening visit to the NYU Radiology Department. The first sign of REAL concern came when the phone rang the following morning at 8:00 a.m. and my caller ID showed my urologist’s phone number. (I don't know about you,  but I've never gotten an 8:00 a.m. phone call from a doctor who says, "Good news - your test results came back and you're fine!") My early morning phone call was a little different. I was told the MRI showed a significant mass in the prostate consistent with cancer,  but I needed a biopsy to be sure. 

A week later my scheduled biopsy confirmed my worst thoughts ...

Before I tell you that thought - A word about my biopsy. I was told "it's no big deal", "you might feel a little pressure", "it's a quick procedure, it'll be over before you know it" - they lied. I've been through a lot in my life - the prostate biopsy was one of the most physically painful experiences I've ever endured. I'm not gonna sugar coat it. I thought I could be a tough guy. Forget it! Yes there was lubrication, yes there was a topical anesthetic, localized to help ease the pain of the actual tissue pull but none of it helped. I suddenly became FULLY aware of my extremely low threshold for pain. If you're going through this,  please take a moment to assess your threshold for pain and act accordingly. If you don't think you can handle it, tell your doctor that you want a local anesthetic (similar to a colonoscopy). It's not worth being "macho" to endure that kind of pain. You're already going through enough - don't make it worse by trying to be a tough guy.

So, back to my thought ...

My urologist looks me in the eye, and on my 54th birthday (Happy frickin' birthday to me!), tells me I have cancer.

My first reaction was not fear, however, but confusion. "Wait... what? Me? Are you sure you're not confusing me with one of the DOZEN or so 80-year old men sitting out in your lobby? Today's my birthday - I can't have cancer!" (I never said I was a rational thinker.) But I did.

Pictured right: My lovely wife of 27 years - Therese

Now it was time to explore my options. My diagnosis actually began with some confusion. I was told by my urologist and my surgeon at NYU that I had a Gleason score of 3 4 (7), so considering my age and physical condition, surgical removal of my prostate (known as a “radical” prostatectomy) was the best chance for survival. (Is there such a thing as a “conservative” prostatectomy? A “regular” prostatectomy?) However, my second opinion (ALWAYS get a 2nd, and even a 3rd or 4th opinion!) told me something different. After a second analysis of the same tissue by the team at Memorial Sloan-Kettering, my Gleason score was actually designated as a 3 3 (6) and therefore surgery was not recommended, but instead I was told I could go on active surveillance (sounds like a military exercise). My wife and I were stunned, but loved the idea of not having surgery right away.

I spent the summer of 2017 waiting to have another biopsy (O joy of joys), and consider my options - active surveillance or surgery. In late August, after my Oncotype genomic prostate score showed that my cancer was in the Unfavorable Intermediate Risk category, surgery was back on the table (no pun intended). Following a second biopsy that proved to be more painful and troublesome than the first (I wasn't given anesthesia and they only got two samples out of a requested 15),  we decided to go ahead with the surgery.

I will say, the moment we made the decision to have surgery, the relief of knowing that I would probably have this cancer out of my body was much greater than the uncertainty of living with active surveillance and wondering if the cancer would spread any time soon.

Pictured left: One week after surgery

Everyone’s cancer is different, but it was the right decision for me. It was also during this time that I attended the Inaugural Prostate Cancer Summit in New York City and became aware of the great work that ZERO Prostate Cancer does for men at all stages of the disease.

Following a few months of preparation (pre-surgical meetings, physicals, blood tests, lung capacity tests, etc.) surgery day arrived - November 1, 2018. (Yes, the day after Halloween - I was still coming down off my sugar buzz.) I arrived at the Memorial Sloan Kettering Surgical Center at the ungodly hour of 5:45 am. More tests, important rules to follow, papers to sign - then it’s into the robes, footie socks and funny hat, ready to go. I walk into the surgical room, lay down on the table, begin to discuss the --- and that was it. I was out. The next thing I remember, I was waking up in recovery, groggy, uncomfortable, head spinning - the usual post-surgical state. I later found out that my scheduled three-hour surgery ended up taking nearly seven hours, but NOT due to complications. It was due, instead, to my doctor meticulously taking his time and performing as thorough a procedure as he could, connecting nerve endings and giving me the greatest possible chance for recovery and a normal life. 

I was very fortunate that my surgeon took his time. My surgery was an unmitigated success. Not only had the cancer been removed (it was completely contained within the prostate), but I slowly regained full function.

One of the greatest fears of most men going through the process of a radical prostatectomy is the question of sexual function. These concerns are real. The surgery not only includes removal of the prostate, but also the seminal vesicle, a gland located behind the prostate that produces semen. When that gland is taken away, so is your ability to produce one of the most basic components of being male. 

For me, it was a shock. While I understood the need for the gland to be removed, the first time I had an orgasm and nothing came out, I was scared. I felt like a part of my manhood had been removed at the same time. It really messed with my head for a while. But as time has passed, I’ve gotten used to the change. Besides, the choice was clear - removal or cancer.  With regards to the surgery, I was very fortunate that my doctor took his time, reattaching as many nerves as he could. While my sexual function has not returned to what it was, I would say I’m at about 90 percent. And with help from the little blue pill (actually, my pill is white, and it’s called Sildenafil), I can live with the slight decrease in sexual function - considering the alternative. But at this point, my life is about a lot more than sexual function. It’s about spending as many days and years as I can enjoying time with the ones I love.

I’m now a year removed from my surgery. I go in every three months to get my PSA checked and so far, so good. I also talk about my journey in my new cabaret show titled THESE GUYS ARE TROUBLE. It's important for me to be honest about my experience and share my story with others. 

I consider myself one of the lucky ones - early detection gave me a second lease on life. As I told my kids when I was diagnosed with cancer: I’m not dying from it, I’m just learning how to live with it.

To find out more info about PSA tests and where to get screened, click here.