The Question

The Question comes up periodically, whenever it's time. The Question haunts my dreams, occupies my waking hours, and adds a tinge of uncertainty to everything.

What's my PSA?

If it remains less than 0.1, all will be well,and the Question will quickly recede in my mind, at least until the next test date approaches.

If my PSA is anything else, life will change radically, assuming it's not a lab error. It would mean my cancer was systemic, and incurable with today's medicine. There might be a second PSA test to confirm, with an interim waiting period of a few weeks to 3 months, or I might head straight to the medical oncologist--a prostate specialist. With a rising PSA after surgery and salvage radiation, there would be only one realistic option. Castration.

How's that for drama?

Now, I almost certainly would not choose surgical castration, but rather medical castration. Most people are squeamish about the word "castration" and so we say hormone therapy, or androgen deprivation--but the effect is the same. I would become a eunuch, lose all interest in sex, and hopefully the cancer would be stalled for years. And while it was stalled, I would probably stay on the therapy. If all went well, perhaps it would stave off metastasis for a decade or more. More likely, it would last a few years. There is intermittent therapy, where you get to take holidays from androgen deprivation, but it doesn't sound all that great to me either way.

In the next few days, I'll find out the answer to the Question.