Cancer

Some stories are just good to start telling from the meat. Five years ago, when I was first diagnosed with prostate cancer it was the next step in a long journey that has me sitting where I am today. No one except my wife knew that I had been diagnosed, not even my mother, why add more fuel to a huge fire that has friends and family reeling from this miserable pandemic experience, which for me, has been much different than it has for most of you and incredibly more stressful than for most. Let me take that back, one other person got the news late in the game of my positive diagnosis before today, my old friend and doctor in Eagle Ed Dent, who I will forever credit with helping save and prolong my life for hopefully many years. I had surgery on Monday, which is hopefully the culmination of a long and always stressful fifteen year or so journey in a unique state of mind knowing that all of us are mortal, and that each and everyone of us will get the call one day. It’s how you respond that makes you rise above the turmoil, doubt, uncertainty and keeps you questioning any type of purpose for being here. I am writing this note in the hope that maybe a friend or two will read it, and that perhaps one of my guy friends, or one of my female friends who has a husband or a boyfriend who takes all this stuff for granted will be diligent when the time comes and make their own best decisions. Prostate cancer is unique, common, very curable and easily detected if you take the proper precautions and stay on top of it. Years ago, I was fortunate to work with a gentleman named Chuck Fothergill, one of Colorado’s greatest fishing guides and fly fishing authors. His books were a wealth of knowledge and remain some of the best “guide to” books ever written about the western states and their cherished rivers. We worked together at Westland’s Ranch as guides for Henry Kravis on his private property just upriver from Buford, Colorado. The Ranch property was just recently sold to Michael Bloomberg who was one of our clients back in those days along with many New York City political, celebrity and sports stars for two to three weeks every summer season when Henry would host them at his private estate, 4000 acres along the White River and “Stitz Park” which was smack in the middle of his property which the largest herds of elk in Colorado migrated through every fall during hunting season, it was a spectacular property. Chuck Fothergill was always doodling during the day trying to recreate fly patterns we talked about for use in his books when we sat around and waited for our clients at Westlands every day, he was a curious man who always wanted to share knowledge of fly fishing, he had a dry sense of humor and would have made an incredible Santa Claus, he had a kind soul. Chuck was a gifted writer and when he died of prostate cancer after his second battle with the disease, it affected many of us in our little fly fishing world, it was a sad and great loss. I sent Chuck a card for the holidays while he was in the hospital fighting his last battles with cancer, it of course was a smart ass holiday card with Santa and his reindeer splattered on the front of a big jet airliner wishing a good season, I got a note back from him saying it was one of his favorite Christmas cards that season and it made him laugh, mission accomplished. Before Chuck got sick the second time, while we were casting rods on the grass of Westlands one day, Chuck told me I had one of the finest loops he had ever seen thrown by a fly caster, it meant the world to me, and we talked at length about my approach to fly casting and how I had simplified everything for both myself and my clients, it was wonderful and a life moment I’ll always cherish. Chuck was gone too soon in the late 90’s, a true legend and gentleman of the fly fishing world. While I was attending Florida State University somewhere around 1980 I had developed a pretty severe prostate infection which was treated with antibiotics and vanished, I recall my doctor telling me to not worry about anything but to just pay attention to it as I got older….which I really didn’t do until I had routine blood work done while living in Eagle, Colorado as part of my yearly physical work, my doctor at the time was Ed Dent. Ed was also a very good friend in town who I rode mountain bikes with often and I remember we had at least one really good day together on the ski hill while I lived there. When my blood work came back everything looked really good, I was a very fit adult as I approached fifty years old back then. Ed was great to deal with as a doc, most of my session was spent bantering and laughing about stuff, whatever it was, and Ed had a great way of setting things straight. I believe it was somewhere around 2005-6 when my blood work came back with a PSA (Prostate-Specific Antigen) that was just slightly outside of “the normal” range for all men. If you have lost interest in this story at this point, I do not expect it to have you thumbing through definitions of PSA, but I would suggest you at least investigate what it is, how it is measured and what it means, it could save your life someday. I will never forget Ed telling me “does this mean you are going to die from prostate cancer in 10-20 years? No, but it is something you want to stay on top of”. It was a semi alarming statement at the time, but I swore I would pay attention to it in the future. Thanks Ed. Move forward ten years or so after consistent PSA blood test numbers that stayed just a little on the high side which my doctors all said to continue to surveil. Then almost exactly five years ago, my numbers came in just a little bit higher, and my new Urologist ordered a prostate biopsy which is about a one on a scale of ten on the fun meter. The results came back in and I got the classic joke response of I’ve got some good news for you and some bad news for you. I asked for the bad first just so I could be grumpy. The bad news was that cancer had been detected in one of the dozen core samples they took from my prostate. And the good news? It was a very small amount of extremely nonaggressive cancer (less than 5% of one of the dozen cores). Prostate cancer aggressiveness is measured on the Gleason Scale, which I also encourage you to investigate and get a minimal understanding of. My Gleason score was the lowest possible, a particularly good thing, I was thankful and blessed. There is one very big problem with all of this diagnosis, however. You have cancer, and cancer does not just decide to one day take a hike and disappear, it is in your body, waiting for the proper signals and conditions to do something new. It’s terrifying, especially when you see what cancer has caused and done to some of your very best friends, family and acquaintances. I lost some very good friends, one I considered a besty, after I had been diagnosed and told no one, it’s a bizarre place to be emotionally, spiritually and physically. At this point I started reading, and after reading a couple of books on the subject, which is two more books than I read in five years of four-year college I came up with what seemed to be the most common sense decision to move forward, because once you have been diagnosed, the decision is 100% up to the patient on how to proceed forward. It was clear I wanted to continue to pay close attention to my PSA numbers twice a year and make a decision based on any future changes. My doc thought that was a prudent and smart game plan as I was nowhere near a life-threatening situation, yet. Two years later with things staying steady, my second prostate biopsy produced all negative results, which kept me in a happy place moving forward. The cancer had not spread and was still nonaggressive. I was legending. About a year ago, with a now new Urologist due to a teaching job and insurance change for Anna my wife, I had a blood test done to keep both he and me updated on my cancer state. His name was Dr. Brenton B. Winship which I thought was a cool name and a guy I could trust. My PSA numbers had increased enough to be a concern, so my third prostate biopsy was ordered. It was nervous time for sure. Dr. Winship explained a newer and improved way to target problem areas with a prostate MRI. We did that. There were two suspicious areas on that MRI which were much easier to target during the biopsy. Biopsy results came back with an elevated but not life-threatening Gleason Score as one of the spots was benign but the other had grown slightly more angry and aggressive. I received an email from the doc explaining the likelihood of this now more aggressive cancer developing over the next ten years, which was still fairly low, or the possibilities of even eventually killing me. Dr. Winship explained there was really only one good option to avoid potential danger. Remove the prostate gland robotically, which we did on Monday, March 15th. The procedure normally takes 3.5-4 hours, my surgery was over five hours because I had a really big prostate (duh) and a narrow pelvis, so It took some extra wiggle work to remove the prostate from it’s position. Once detached, it is removed through a small incision above your belly button….wallah. I’m so thankful for Anna, my wife, through this adventure. She is incredibly smart, analytic and keeps it all in perspective and celebrates my small gains as I move forward. It’s actually been a good week for me, but there is definitely down time ahead until I heal back up. My surgery pathology results look super positive for an extremely healthy and long future…. It has been a difficult year for all of us, I’ve told a few former friends and acquaintances to go fuck themselves for their attitudes during the pandemic, I have left them for dead because they just didn’t give a shit about any of it. As an adult with Asthma, minor COPD and cancer during the pandemic it has been a pretty infuriating and terrifying experience seeing how many have handled it, or not handled it. If you had been in my shoes the past year you would get it. I’ve stayed clear of so many friends and things to do because of my conditions, but I have charged hard solo and will continue to do so. This story runs all over the board, but I hope it helps one person along the way make good choices. I feel lucky to have been properly guided along this long journey. I’m not sure how else I can help in the future, but if anyone needs to discuss a similar issue, I’m glad to share it all and I encourage people to continue to support cancer research so people like me have the opportunity to stay out in front of their own cancer battles and share their own stories for years to come.