My attempt for writing this column was to provide a very basic but very honest “firehouse talk” article about cancer. Some people are afraid of even the word cancer. I completely understand. That said, this column has some words to intentionally draw your attention—with the hope of saving your life—as the circumstance came very, very close to being a very different outcome for me. How close? Google “Gleason Score 9” when you have a second.
A brief background
I’ve been a firefighter since 1973, and I still love it. In 2022, I continue as a very active deputy chief who regularly responds to fires and participates in training—doing and learning.
I am telling you my cancer experience, so you can learn. For example, someone asked me, “Did you find out you have prostate cancer from a colonoscopy?” Colonoscopies check your butt neighborhood. My butt currently is fine. This is about the “boy” region and its relatives in a nearby neighborhood—but segregated. You learn something new every day.
The prostate is part of the male reproductive system. It’s a gland that’s located between the bladder and the penis. The urethra runs through the center of the prostate.
Although you probably never did it, you should thank your prostate for being part of your personal pipeline of pleasure, reproduction and relief. I profusely thanked mine before it’s recent departure. Do I miss Mr. Prostate? Read on.
Prostate cancer?!
How did I know? Did it hurt? Any symptoms? No symptoms. None.
No issues with the “gloved hand” test. Nothing unusual found. My issues started with an elevated PSA.
The PSA test is a simple blood test that screens for prostate cancer. The test measures the amount of prostate-specific antigen (PSA) that’s in your blood. PSA is a protein that’s produced by both cancerous and noncancerous tissue that’s in the prostate. Prior to what I describe below, my PSA level rose only slightly over three years, but with the added risk of firefighter-related cancers, exposures and an unknown family history (I was adopted), I realized that I was at risk.
In July 2021, the PSA was rising again (but still under 10). I went to The Urology Group, which has some three dozen urologists in locations in Cincinnati, elsewhere in Ohio, and Indiana and Kentucky. I underwent numerous tests, including a prostate biopsy (I was asleep; there was no pain); a CT scan (listened to music; no pain); an MRI (listened to music; no pain); and a bone scan (listened to music; no pain).
A few days later, my urologist told me, “You have prostate cancer.” Although my cancer was stage 1, my cancer cells were very aggressive, resulting in a Gleason score of 9. The worst is 10; anything less than 6 isn’t overly concerning. So, not great news, but still no pain, no discomfort physically.
The urologist added that, even though we caught the cancer early, he was concerned about the cancer cells escaping my prostate—and the Gleason score (aggressiveness) indicated that those cancer cells wanted to escape, very badly.
To be honest, I wasn’t scared nor worried about me. I was (and remain) concerned about my family. My wife, Teri, and I have five children and six grandchildren, and my disabled sister counts on me each day. That was my 100 percent worry and focus.
Otherwise, I saw this cancer issue as a fire: We’re on scene, we sized it up, we determined what we are going to do, and we do it hard, fast, and with the best-trained and well-staffed folks anywhere.
A critical note
It’s my opinion that it isn’t a good idea to share that you have cancer until after you decide on a course of action. This prevents you from getting advice from all of the “firehouse physicians” who know about all of the exotic and nonexotic treatments and the resulting horror stories.
On the other hand, don’t decide on a treatment until you reach out to the Firefighter Cancer Support Network (FCSN). The people there will connect you with other firefighters who survived, to hear about their experiences first-hand.
After you weigh it all out (make a list of all of the pros and cons), you likely will reach the conclusion of what’s best for you very naturally.
I kept this cancer issue very close to my wife and me. I spoke with my chief, Otto Huber, and a few close friends, but no one else. I spoke with our kids two weeks prior to the surgery. I didn’t want them to worry or have to engage in decision-making.
If you know anything about me, you know that my kids, grandkids and family are my life. I wanted to make this as least disruptive to their lives as possible. This way, I told them what was going on, what we researched, who we spoke with, what we were doing about it and when we were doing it. They did appreciate it.
My urologist explained to my wife and me that two options existed for treatment of my specific cancer: There was radiation, and there was surgery. Of course, there are pros and cons to both of the options.
Interestingly, I initially wanted radiation because of experiences of friends—even though I had very little knowledge of the two options. But surgery? That sounded like, well, surgery, and I didn’t like that sound. Silly me.
Teri and I weighed the options and spoke with friends at the FCSN. I also spoke with some longtime fire service friends who survived prostate cancer.
I have remained very close to many of my brother and sister firefighters over these many years. One of those firefighters (Dr. Jonathan B. Orens, MD) is a highly respected physician internationally. He and his peers (who are experts in urology) were my second opinion. You must get a second opinion.
After sizing it up, Teri and I agreed on surgery (robotic) as the best option to achieve the best results, which is to come out of it cancer-free.
My surgery was robotic radical prostatectomy, which is a laparoscopic surgery that’s carried out via a robotic system. My surgeon sat at a control panel in the operating room and moved robotic arms to operate through five small incisions that were made in my abdomen.
The robotic system provides the surgeon more maneuverability and more precision when moving the instruments than is possible nonrobotically. My surgeon did very well. His history as a world-class video gamer obviously played a critical role in his surgical experience and skill.
Surgery time, and a tube
My surgery (three-and-a-half hours and another four hours to wake up) was on
Oct. 8, 2021. I was in the hospital one night. What was really cool is that they “traded” my cancer-filled prostate for a catheter.
OK. Go ahead now and squint your eyes. Say, “Nope. No way. Uh-uh. No one sticking no tube up into my ‘pal’ down there!”
Again, there was no pain.
Was it awkward for the seven days that I had to use the catheter? Of course. I normally don’t have anything attached to my “pal,” but, really, no big deal. Come on, think back to what you and your little buddy have been through in your life together. A little catheter? Piece of cake.
When the tube is in, you don’t know when you are peeing (you sleep through the night), because the urine automatically goes/flows into a small bag (taped to the leg), and you (or the best wife ever) dump it a few times a day.
It isn’t what you are used to, and it’s a little different, but keep things in perspective. This all happened because I had cancer.
Plus, remember, I had no symptoms and only two options. If I ignored the PSA test (or never got the test), my outcome was predictably horrible.
Waiting for results
After surgery, I was home for a total of 30 days. No lifting, light schedule, etc., which meant no bunker gear, which meant no work or runs.
A week after surgery, they removed my catheter. It stung for about a second as it was removed, but I was fine after that. Not a big deal.
When my prostate was removed via the radical prostatectomy, some tissues around it, including the seminal vesicles and lymph nodes, also were removed and were tested for cancer, to see whether any “micro stuff” escaped from the artist formerly known as my prostate.
At my 30-day appointment, the surgeon took blood and tested to see what my PSA was. Fingers crossed. Prayers. Hope. Etc. He called me two days later and stated enthusiastically, “Your PSA is perfect at 0.01, and I will see you in three months.” Outstanding!
Out of the woods?
Sort of. I am far better off than if I didn’t have my PSA checked in the past several years and didn’t have the surgery. Not the slightest doubt in my mind. The alternative: My fire department would have a spare chief’s car.
However, because my cancer was confirmed (by the post-surgery pathology report) to be highly aggressive (a confirmed Gleason score of 9), despite being considered cancer-free at the time of this writing, a high risk of metastasis (cancer spreading to other organs) exists. I will get blood tests every three months to ensure that there is no rekindle. (Do you see what I did there?)
What’s different in my life?
I wrote this column seven weeks after surgery, so keep that timeline in mind. Changes for everyone post-surgery are different based on the individual. The changes that I encountered include:
Urination. The prostate used to control that, so some of that bodily function is relearned. In my case, I have had very little incontinence issues, but if you tell me a joke and I laugh really hard, I might have a little dribble problem. Same if I cough. Talk to any woman who had kids. It happens. I am wearing a pad and will be for a few months. To me, not uncomfortable and not a big deal.
Another difference: In the past, when I had to pee, I had 15–20 minutes to ignore it, wait, hold it in, etc. Nope. No more. When the pee tones go off, I can’t be delayed. If I’m not delayed, I’m fine.
Energy. Some say that my lower energy level isn’t a result of the surgery but of my age (66). To that, I offer a fond, “Shut up.”
Before surgery, when 11 p.m. came around, I was ready for bed. Now, some days, 6 p.m. is my new 11. I am reminded that this was major surgery, and it takes time for the body to recover from that—and the anesthesia.
Sexual function. Oh, the good part. The real answers that you want. “Pee, schmee. What about sex and erectile abilities?” It takes time. I will tell you that it seems to be getting better, so I am hoping that will continue. I am not yet where I was (aka sexual dynamo), but I am seeing some improvement.
All of this sound like a big deal? Compared with time with my grandkids, family and friends? No comparison.
Get checked
I feel great. If I am tired, I rest. The remainder of it is all coming along well.
This was the closest call that I ever had. I was in several crashes responding. I was in two fire collapses. I was lost and disoriented once. I was assaulted at a fire in a bad neighborhood and got my bell rung. I was transported twice for smoke inhalation, and I wasn’t transported despite smoke inhalation many times more than that and puked. I faced whatever else a typical suburban firefighter would over 49 years. But cancer was the biggie—and that’s why I wrote this column to you.
You, as a male firefighter, have the greatest chance of losing your life at the hands of cancer.
Soon, you will see a campaign—40PlusFIRE—that will focus on active firefighters who are 40 years of age or older and will push them to get a PSA check annually. No excuses. No B.S.
If you are 40 and you go to fires, you must get checked. Ask for it. Make sure that it happens. No excuses. If you know members who are 40 or older and go to fires, push them to get checked.
If you ignore getting a simple PSA test and have cancer, it won’t go away. It will get worse and can kill you. Too many firefighters have ignored the slight rising of a PSA, or didn’t get a PSA test, or got one and were told to see a urologist and ignored it or put it off. After all: No symptoms; how bad can it be?
I had no symptoms!
Don’t be a dope. Look at the photos of your family in your phone, in your wallet, in your helmet and in your locker. Get your PSA test now.
The odds are that you are fine, but if not, you will be way ahead of it and can knock down your “room and contents fire” versus a fully involved, out-of-control personal conflagration.
Make your appointment. Just do it.
