“Here’s How I Knew I Had Prostate Cancer”: One Patient’s Story of Abruptly Elevated Markers

The prostate is a small gland located in the male reproductive system that’s essential for producing seminal fluid. When it’s healthy, the prostate is shaped similarly to a walnut, but prostate cancer occurs when cells within this gland begin to multiply uncontrollably.

While many prostate cancers progress slowly and may not cause significant harm, sometimes going unnoticed, there are aggressive forms that can spread rapidly. Prostate cancer ranks as the second-most-prevalent cancer among men in the United States, affecting one in eight men during their lifetime. The American Cancer Society estimated that in 2024, around 300,000 new cases would be diagnosed, and more than 35,000 men are expected to die from the disease.

Fortunately, prostate cancer screenings are improving to become less invasive, and less painful.

Symptoms of prostate cancer

Prostate cancer symptoms may be non-existent for most individuals with early-stage (stage I) prostate cancer, explains MD Anderson urologic oncologist Lisly Chéry, MD: “For prostate cancer to cause symptoms, it may be at an advanced stage when it becomes harder to cure,” Dr. Chéry says. “That’s why prostate cancer screening is so important.”

Key prostate cancer symptoms to watch for include:

• Blood in urine

• Difficulty urinating

• Pelvic pain

• Frequent urination

• Weak urine stream

• Bone pain

• Blood in semen

• Painful or burning urination

• Difficulty in controlling urination

Prostate cancer risk factors

Several factors may elevate a man’s risk of developing prostate cancer, such as genetics, race, lifestyle choices, metabolism, and age. Prostate cancer tends to be more aggressive when diagnosed at a younger age. The average age for a prostate cancer diagnosis is 66, and typically, the older a man is at diagnosis, the less aggressive the disease tends to be.

Ryan Bergland, MD, a urologist at the Cleveland Clinic, explains, “Having a first-degree relative, [such as a father, brother, or son], with prostate cancer significantly increases risk.” One relative doubles the risk, while early-onset diagnosis in a relative before age 50 can quadruple the risk. Prostate cancer risk is also higher among those who are overweight, physically inactive, and have a poor diet, which can influence the severity and progression of the disease.

Screening protocols for prostate cancer

Screening for prostate cancer typically includes a prostate-specific antigen (PSA) blood test and a digital rectal exam (DRE).

Here’s who needs prostate cancer screening, and when:

The American Cancer Society advises that men at average risk start screening at age 50. Men at higher risk, including African American men and those with a first-degree relative who was diagnosed with prostate cancer before age 65, should begin screening at age 45. Men with multiple first-degree relatives who were diagnosed at an early age are recommended to start screening at age 40.

If your prostate-specific antigen levels are high, you may be referred for a biopsy to confirm whether it’s cancer, and your doctor will develop a treatment plan accordingly.

Prostate cancer treatment

“We’ve been using hormonal therapy for decades, but now we have second-line therapies and other treatments that can slow the disease down,” Dr. Bergland says. “It’s not farfetched to say that our ability to turn metastatic prostate cancer into more of a chronic disease than an acute disease for our patients is increasing every day.”

Additionally, researchers at the University of Michigan have developed a promising new urine test that can help differentiate between aggressive and non-aggressive prostate cancers, potentially decreasing the number of unnecessary biopsies.

Ahead, we share the story of Anthony T., a 58-year-old prostate cancer survivor from New York who shares the importance of health maintenance and regular screenings for prostate cancer, especially for those with a family history like his.

Here’s How I Knew I Had Prostate Cancer

By Anthony T., as told to Dr. Patricia Varacallo, DO

I consider myself fortunate. I’ve got a great primary care doctor who’s been vigilant about getting me screened for prostate cancer, especially given my family history. My dad died from the disease 24 years ago, and although it’s a tough subject, my doctor kept stressing the importance of early detection.

So I started getting my PSA levels checked in my late forties. All seemed well until my check-up in August 2021, when I turned 56. That’s when my doctor called to say my PSA was slightly elevated—just above four, when national guidelines have historically suggested a level of four or under is considered “normal.” My doctor suggested we should retest in a few months.

With my travel schedule for work, the follow-up bloodwork got away from me a little. By the time I got around to it that December, my PSA had jumped to almost seven.

I was stunned.

My doctor referred me to a local urologist, where I underwent an MRI and a biopsy. After gathering 15 prostate tissue samples—not a fun process for any prostate patient—in my case, every single one came back positive.

The experience during the procedure was far from comfortable, and I didn’t feel quite right about the care I was receiving. I decided to seek a second opinion at Mount Sinai.

My treatment for prostate cancer

To be honest, the thought of treatment scared me. The complications my father experienced from his prostate surgery weighed heavily on my mind, and I feared facing similar issues, but I learned that medical technology has come a long way.

My doctor explained that I had high-grade prostate cancer with a Gleason score of nine, which assesses the aggressiveness of prostate cancer based on microscopic appearance. This indicated that I had a more aggressive but localized cancer.

Given my age and family history, my doctor thoroughly reviewed all treatment options and recommended a robotic-assisted laparoscopic prostatectomy to remove my prostate. By February 2022, six months after that first mildly concerning blood test, I was set for surgery.

Despite my worries, I found comfort in knowing that recent medical advancements were on my side and that I was in capable hands. The surgery was successful, and afterward, my primary concern was the potential side effects, such as incontinence and erectile dysfunction.

My doctor remained optimistic about this and discussed options, like penile rehabilitation, that could manage these issues if they arose. Further, I received a prescription for Cialis to help maintain blood flow to the penis. This is crucial as prolonged lack of blood flow can damage the muscles and tissues, affecting the ability to achieve erections independently.

Recovery after I was diagnosed with prostate cancer

My wife, Sherry, was truly incredible during my recovery, and helped me manage the catheter I required after the surgery. (A catheter is a flexible tube inserted into the bladder to help drain urine when you’re unable to do it on your own.) A week after my operation, the catheter was removed.

Within a month, I had no issues with incontinence and no longer needed protective pads. I was also able to experience arousal, marking another important step in my recovery. My prostate-specific antigen levels were tested again about eight weeks after surgery, and my doctor called me and told me they were undetectable. At that point, I truly broke down in tears.

I am immensely grateful for the positive outcome, an opportunity my father unfortunately never had. I continue to keep a close eye on my health with regular blood tests every three months, and everything continues to look good. The advancements in medical technology have transformed the outlook for many, making treatments far more manageable.

I urge all men to prioritize their health and stay vigilant. Even without symptoms, it’s essential to be proactive with your health, as catching cancer early can make all the difference.

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