My Journey with Prostate Cancer—and Why Every Man Over 50 Should Get Tested

I rarely share personal health updates on social media or in public, whether good or bad. But this time is different. I feel strongly about using my experience to spread awareness about prostate cancer—the second leading cause of cancer death in men in the U.S. (behind lung cancer) and the fifth deadliest cancer overall.

The good news? Prostate cancer is one of the most treatable cancers when caught early. The bad news is that it often shows no symptoms in its early stages, which makes regular screening absolutely critical. Once symptoms begin to show up, it usually means the cancer has metastasized to other parts of the body - lymph nodes, bones, lung, liver, and even the brain. This is why staging typically includes bone scans, CT scans, or PET scans to check these areas.

My Diagnosis

I’ve been getting screened for prostate cancer since my early 50s with the PSA (prostate-specific antigen) test, a simple blood test that can detect signs of cancer long before symptoms appear. A PSA under 4 is generally considered normal, but what matters most is whether the number is rising over time.

In the fall of 2023, my PSA unexpectedly jumped to 9.33. I felt perfectly healthy and had no symptoms—a situation that’s very common. Even the DRE (digital rectal exam) showed nothing unusual. My doctor ordered an MRI (I hate MRIs because I get claustrophobic in that tube). The MRI technician had me lie down to go headfirst into the tube. I mentioned that they were scanning the wrong end of my body, believing that I would go in feet first up to my chest or so. Unfortunately, she told me they do headfirst for prostate images. The images, which I saw on Patient Gateway even before my urologist did, revealed two lesions highly suspicious for cancer. When I met with my urologist a week later, I had already researched the heck out of it, and told him I had cancer before he could tell me. Fortunately, follow-up Bone and CT scans showed that the cancer hadn’t spread beyond the prostate.

Next came a needle biopsy. I had a previous biopsy in 2019 because my PSA was slightly elevated. That biopsy took place right in the urologist's office and was performed via the rectum with just local anesthesia (loads of fun). It showed nothing, but resulted in me getting a stubborn urinary tract infection that took 2 months to get rid of. 

This time, with a different urologist, 12 core samples were taken via the perineum and was done on an outpatient basis under a light general anesthesia (like when you get a colonoscopy). It was painless, except for the tearing off the bandage a few days later. I should have shaved beforehand😏. The results weren’t what I’d hoped for: Gleason scores of 4+3 and 4+4, indicating an aggressive cancer, with a cribriform pattern. Cribriform pattern 4 (CP4) in prostate cancer is an aggressive variant associated with poorer clinical outcomes, such as biochemical recurrence, metastases, and prostate cancer-specific mortality.

I met with a team of oncologists (multidisciplinary consultation) at Mass General Cancer Center in Danvers to review my options: surgery, traditional radiation, or some newer treatments. Surgery, though common, carries tough side effects. Conventional radiation is effective but requires 28–48 sessions over 7–9 weeks—something I simply couldn’t fit into my schedule.

While doing my own extensive research (which I recommend everyone do for ANY type of illness), I found a clinical trial at Mass General using a newer radiation therapy requiring only five treatments over about a week and a half - Stereotactic Body Radiation Therapy, or SBRT. Although the clinical trial was over, my radiation oncologist agreed to go that route.  Because my cancer was aggressive, I also agreed to the medical oncologist’s recommendation of 18 to 24 months of androgen deprivation therapy (ADT or hormone therapy), which became my path forward.

My Treatment

In January 2024, I started the ADT. ADT (Lupron, in my case) stops your body from producing testosterone, which the cancer uses as fuel for growth. By the way, the other option to control testosterone from being produced is to remove the testicles (make me a eunuch), which I outright rejected. ADT is also known as chemical castration, a term that apparently doctors don’t like (“We don’t use that term here”). Because your testosterone is reduced to almost zero, it has an effect on your body. The oncologist said that I would feel like a woman going through menopause. Linda was with me, and I saw her give a little smile. The doctor said that most wives smile after he tells the patient that. Side effects include hot flashes (started a month after starting ADT), emotional changes, loss of body hair (and oddly enough, increased growth on my head), bone loss (I took calcium & magnesium supplements), weakness & fatigue, loss of libido, joint pain (from muscle loss). Fun times ahead. I experienced all of it.

Before the radiation could begin, I had to get gold markers inserted into my prostate. This allows them to precisely target the cancer during treatments. At the same time, I had a gel inserted between my prostate and my bowel. This helps protect the bowel from receiving any spillover radiation that could possibly cause damage and bowel issues later on. This was done outpatient under twilight anesthesia. 

The ADT is started before the radiation to weaken the cancer, making the radiation more effective. In March 2024, I started the radiation treatments (call fractions). I had to go to the Mass General Cancer Center for my first visit to set up the machine. They make a mold for you to lie in, which positions your body exactly where they need it to be for each treatment. I went in every morning at 8AM for treatment, which took all of 15 minutes. An hour before I went, I had to drink 25-30 ounces of water so that I had a full bladder by the time I got there. Fortunately, they are very prompt and take you in very quickly, because I was about to burst (apparently, some men cannot hold it). I’m guessing by design, they have a bathroom right outside the treatment room that you can run to after the radiation is done. The staff at Mass General were the best, and everything went smoothly. I was done by 8:45 and working by 9AM.

Epilogue

Throughout this journey, I was never worried or scared. I was more interested in the research and processes and really didn’t give much thought to any “what ifs”. Not quite an out-of-body experience, but just trying to understand how everything worked kept my mind off of what I was actually going through. I sometimes think I now know more about prostate cancer than some doctors do. I find that doctors don’t tell you everything they should, or give you all the facts. Originally, I was supposed to have 24 months of ADT. You can get Lupron injections every month, 3 months, or 6 months. I started with the 3-month injections, but in September 2024, I decided to get a 6-month injection so I wouldn’t have to come back until March 2025. The side effects from the Lupron were getting bad. The hot flashes (10-20 times a day) I could put up with. The crying at the drop of a hat was tolerable. But the weakness and joint pain got so bad that I couldn’t carry one bag of groceries up a flight of stairs. In March, I told my oncologist that I was not going to continue the ADT treatment. I had done my own research and found that 24 months of ADT was overkill, and studies had shown that 18 months were just as effective in preventing recurrence. My PSA had been undetectable for 9 months, which gives evidence that there is no more cancer. Although he would have liked to see me continue treatment, the oncologist agreed with my decision.

It is 6 months later, September 2025, and my PSA is still undetectable, and my testosterone is starting to return (although very low). I still have hot flashes, which can last for months even after stopping ADT. I still have some fatigue and weakness, but I can carry multiple bags of groceries up stairs. There is still a chance that the cancer could return, somewhere around a 10-25% chance in the next 10 years, depending on the study. Even though the imaging didn’t show any other cancer, it doesn’t pick up small single or small clusters of cancer cells. If it comes back, I’ll just deal with it at that time. - Jim Armstrong

Why Every Man Over 50 Needs to Get Tested

Prostate cancer is alarmingly common:

• 1 in 8 men will be diagnosed during their lifetime.
  
  
• Risk increases sharply with age, especially after 50.
  
  
• African American men and those with a family history face an even higher risk.
  

Despite its prevalence, early detection is crucial in saving lives. When prostate cancer is caught early—while still confined to the prostate—the 5-year survival rate is nearly 100%. Once it spreads beyond the prostate, that rate drops dramatically, to about 32% for advanced-stage disease.

Here’s the problem: early prostate cancer usually causes no symptoms. By the time urinary issues or pain appear, the disease may already be advanced. That’s why proactive screening is essential.

Screening Options

Men should talk with their doctors about starting screening by age 50, or age 40–45 if they have a higher risk (family history or African American ancestry). Screening typically involves:

• PSA Test: A quick blood test to measure prostate-specific antigen levels.
  
  
• Digital Rectal Exam (DRE): A brief physical exam to check for abnormalities.
  

Both tests are simple, low-risk, and can literally save your life.

My Message to Men (and the People Who Love Them)

If you’re over 50—or younger with risk factors—don’t wait. Get tested. Talk to your doctor about PSA screening. Early detection turned what could have been a silent killer into a treatable challenge for me, and it can do the same for you.

Your life, your family, and your future are worth the 10 minutes it takes to have that conversation.

Jim Armstrong