Guest Posts on County 10 are provided by contributors and the opinions, thoughts, and comments within are their own and may not necessarily reflect those of County 10.
For at least ten years, I’ve been seeing a primary care provider (PCP) every year at about the same time each summer, generally in early June. As part of that care, I have my blood drawn and the usual tests for someone my age are done and the results sent to my PCP. For reasons unknown, I skipped my PSA test in 2023, but in 2021 and 2022, those scores landed in the middle of the normal range, with the 2022 score somewhat higher than the 2021 score.
In 2024, my PSA jumped to 4.04, which is just over the upper limit of what is considered normal. I wasn’t worried. I have always figured there’s always a little wiggle room when you find yourself on the margins, but Julian Pousch, my primary care provider said, “I think we should have another test done in about a month just to be sure.”
I’ve learned the hard way in my adult life to trust my doctors’ judgements, so in early July, I headed up to the clinic for another PSA test, sure that this score would behave itself and fall back within the normal range. Instead, it came back a little higher at 4.13.
Again, Julian contacted me. “Let’s put this baby to rest, once and for all.” He suggested that I contact Central Wyoming Urological Associates in Casper to schedule a visit with one of their associates. I still wasn’t concerned, but I decided to go through the motions of making an appointment, fully expecting to waste my time and the time of my doctor.
I called their office a few days later and found out that a urologist travels to Riverton on the second and fourth Tuesday of each month, just for patients like me who dislike taking a damn road trip every time one needs to see a specialist. Just to demonstrate how little concerned I was, during that conversation, I scheduled an appointment in early October, nearly three months later, as my wife and I had made plans to camp a good portion of the rest of the summer and fall, and I was unwilling to change those plans.
Upland game bird seasons start at the beginning of September, and I’m not about to muck up those cherished days of bird hunting with a wasted few hours traveling the 30 miles to Riverton and meeting with a urologist that I would never see again.
So the first available Tuesday in October, I met with Dr. Henry Gottsch, who appeared to me to be a relative of those bearded gentlemen of Duck Dynasty fame. He explained my choices, and when I expressed my wish to get an answer in the most accurate manner possible, he indicated that a biopsy was the way to go.
Traveling and elk hunting during the remainder of October, November, and December, prohibited, at least in my mind, the need to schedule an appointment for Dr. Gottsch to conduct a biopsy. Such was my lack of concern about its outcome. So at that October appointment, I scheduled another for mid-January for that purpose.
Finally, on January 14 of this year, a prostate biopsy was performed, and I can honestly say that I am profoundly grateful that I will never have to experience one again. Twelve samples were removed from my prostate with a tool specifically designed for that necessary purpose in a manner that fully compromises one’s dignity. At least it did mine.
One heals, however, even someone of my age, and in a few days the discomfort and embarrassment seemed a distant memory. I tried my best to focus on the present; but some doubt began to force its way into my consciousness.
What if?
Two weeks later, I met again with Dr. Gottsch. After a short wait, he grimly entered the examination room with a book in his hand entitled 100 Questions and Answers about Prostate Cancer, and I knew this discussion was not going to be as I had hoped.
As you can probably guess, the biopsy was positive. Dr. Gottsch showed me the computer printout of the biopsy results sent to him by the pathology lab and explained the results. Five of the twelve samples taken two weeks before were cancerous.
Particularly important to a prostate cancer patient is the Gleason score, which is a grading system ranging from 6 to 10, with 6 being low grade cancer, or least aggressive, and 10 being high grade, or most aggressive.
With a Gleason score of 7, my cancer was rated at low grade, intermediate. After informing me of all of my treatment options, Dr. Gottsch recommended that I have surgery to remove the prostate.
I then asked him what would happen if I chose to do nothing, to which he replied, “You’ll be dead within 10 years.” Well, that seemed a pretty crappy option, so I did what I always do when I’m having a conversation with a professional: I take the advice I’m given.
Months before this appointment, my wife and I booked a trip to Chile and Argentina to do some hiking and sightseeing for the end of March and the beginning of April. Having surgery before the trip seemed a bad option as the trip required some strenuous hiking and I wasn’t sure if I’d be recovered in time to complete each hike as they were scheduled; so I asked if I could wait until after we returned from South America in April to have the surgery.
“If your Gleason score was higher and you wanted to wait until the end of summer, I’d try to talk you out of it, but you should be fine,” he informed me. Soon after, I scheduled surgery in Casper for April 10 at Banner Health.
For the next two months, I did my best to not think about the surgery and live my life as if I were cancer free, and I was successful…up to a point. The Patagonia trip has been a highlight of my traveling life, and I’m glad we decided not to cancel. But in the Southern Hemisphere nights, while my wife was sleeping in the tent or the bed beside me, I would think about how my life was going to change after the surgery, and the anxiety would return.
The surgery turned out to be a little more intrusive than I envisioned, almost as debilitating as the heart surgery I endured ten years ago. Robot assisted, as most prostate surgeries are now done, I now have an additional six small scars, five of which are located at about the same latitude, just above my navel, all in pretty much a straight horizontal line, and one scar somewhat higher.
If one were to use his imagination, collectively they resemble the Big Dipper, minus one star on the dipper.
Twelve days after my surgery, I met again with Dr. Gottsch in Riverton for a post operation discussion about further treatment and to discuss the pathology report done on my prostate after its removal. Just as he suspected, the cancer was contained in the prostate and hadn’t yet had time to metastasize into the tissue or bone nearby, a result for which I am most grateful.
I will see him again in about five months and probably will continue to do so every six months for a few years. Soon, I’ll have another PSA test done, and I’m hoping for a score of close to zero, which would indicate that the cancer is no longer present.
It’s now been a little over seven weeks since the surgery, and I’m feeling like my usual curmudgeonly self. I go to the gym as often as I can, and yesterday I rode my bike for the first time, post-surgery, which did wonders for my mental well-being.
So, I’ll end this column with a little unsolicited advice to all my male brethren, who for better or worse, have taken the time to read to this point. If you are approaching the half century mark in birthdays or are beyond, do yourself and those who care about you the most a favor and get a PSA test done at least every two years. Although prostate cancer is generally slow growing, it’s still cancer and will kill you if left untreated.