I am writing about my journey with prostate cancer in the hope that it may help other men and their families ask better questions, notice what can be missed, and face this diagnosis with more knowledge and less fear. In March of 2026, I learned that my PSA score was 33.5ng/ml (nanograms per milliliter). I was 85 years old. Today, I turned 86.
The last time I had a PSA test was in July 2016, and my score then was 1.84ng/ml. Normal PSA scores are 0–4 ng/ml. Why did I have a test ten years after the one I had when I was 75? Frank Marxer, M.D., our primary care physician for 30 years, retired. My new physician, Dr. Victoria Wright, Piedmont Physicians, decided to include a PSA Medicare Screen as part of my initial testing with her. If she hadn’t done this, I would not have known that I had prostate cancer.
Prostate Cancer
Until then, prostate cancer had always seemed like something that happened to other men. At this age I was active, informed, antique buying in the UK, traveling with a 14 foot trailer in toe from Texas to Virginia doing antique shows with Mary-Alice, still writing, painting, still planning future projects. Like many men my age, I assumed that if something serious were wrong, I would feel it.
I didn’t.
That’s one of the first things I would want other men to understand about prostate cancer: you can feel perfectly healthy and still have an aggressive cancer growing quietly inside you. If my experience has value, it is partly in showing how easy it is to mistake feeling well for being well.
PSA Test
The PSA test — Prostate-Specific Antigen — is a simple blood test. Traditionally, doctors considered anything under 4.0 to be within normal range, although age, enlargement of the prostate, inflammation, and infection can also raise PSA levels. A high score does not automatically mean cancer.
But 33.4 is not a number anyone ignores.
What surprised me almost as much as the number itself was learning why I had not been routinely tested anymore. When many men turn 75, regular PSA screening often stops. Medical organizations and government recommendations have long debated whether men older than 75 benefit from continued screening because prostate cancers can sometimes grow slowly and treatments can carry difficult side effects. A very good study exploring this idea is this study “Who’s too old to screen?” published in the National Library of Medicine. Some of their findings include:
- Our findings suggest that the prevalence of clinically significant prostate cancer in the elderly population may be higher than previously thought.
- As the population continues to live longer and healthier lives, it will become more common to confront prostate cancer morbidity in the eldery population.
- Patients with prostate cancer having aggressive clinical features may benefit from treatment of their prostate cancer well into their eighth and ninth decades of life.
- Testing and diagnostic recommendations should reflect the potential benefit of identifying patients with aggressive prostate cancer even after age 75.
- Prostate cancer detection should not be the issue. Prostate cancer treatment is. The decision to treat elderly men with prostate cancer should be made based on a thorough assessment of life expectancy, patient preference and outcome expectations based on pathological criteria.
- We will need to focus on the re-examination of attitudes toward the screening and treatment of elderly men for prostate cancer.
OK. I have a high score. I made an appointment with Dr. Paymon Nourparvar, at Wellstar Urology. We talked about the high score, and he explained that a score that high might lead to the conclusion that I have prostate cancer. Then he explained it in a way I’ll never forget.
“You have a Joe Biden issue,” he said.
I looked at him and said, “What?”
He explained that when President Joe Biden turned 75, routine PSA screening reportedly stopped. After leaving office at age 83, his doctors decided to do a PSA test and discovered his PSA was extremely elevated and he underwent treatment for prostate cancer. My doctor’s point was simple: age alone does not eliminate risk.
That conversation changed how I thought about aging and medicine. Many men over 75 still have years — even decades — of meaningful life ahead of them. If my journey offers any practical lesson, it is that decisions about screening should involve health, family history, life expectancy, and the wishes of the patient, not simply a birthday.
Next Steps
The next step in my journey was an MRI of the pelvic region. The MRI showed suspicious areas in the prostate, which meant a biopsy was necessary.
A prostate biopsy is not something most men look forward to. In my case, the doctors removed about a dozen tissue samples from different parts of the prostate. Waiting for the results was difficult.
The biopsy confirmed cancer.
Not only cancer, but what doctors classified as “Very High-Risk Prostate Cancer,” with a very high Gleason score of 9-10— the grading system used to measure how aggressive prostate cancer cells appear under a microscope.
Then came another scan using radioactive dye, designed to show where cancer cells might be active in the body. By that point, I feared the worst. Like many men, when I heard the word “spread,” I immediately thought of bones, organs, and terminal disease.
But the scan brought mixed news.
The cancer was active in the prostate and had escaped slightly into two small pelvic areas near the prostate. However, there was no evidence of cancer in my bones or major organs.
That distinction mattered enormously.
Specialists
I soon began meeting regularly with three specialists, my urologist Dr. Nourparvar, who is serving as chairperson of my oncology team, Dr. John French, hematologist and oncologist affiliated with Wellstar Health System, and Dr. Olusola Obayomi-Davies, MD, with Wellstar Radiation Oncology. What impressed me most was not only their expertise, but their ability to explain the disease and treatment plan in understandable language.
Fear decreases when understanding increases. That, too, is part of why I am sharing this journey: because one of the greatest gifts a patient can receive is clear explanation, and one of the greatest gifts a survivor can offer is honest description.
By the time we finished discussing my treatment options, I felt educated.
My treatment plan
First came hormone therapy with Firmagon, also known as Degarelix. This injection rapidly lowers testosterone levels. Since testosterone fuels prostate cancer growth, reducing it can slow or even shrink the cancer. After a month I was tested for testosterone level, and PSA. My testosterone level dropped considerably as shown in the chart (Figure 1).
It was evident that the Firmagon injection was working by immediately blocking hormone receptors, which rapidly reduces testosterone levels. In this case my level dropped from 310 mg/dl (nanograms per deciliter) to <12 ng/dl. There are side effects. Doctors and nurses said that it is normal to experience hot flashes (similar to menopause side effects). For the first three weeks after my first injections, I didn’t have any effects. Then the hot flashes appeared.
Figure 1. Chart of testosterone values April 16 – May 26
What happed to my PSA score. As seen in Figure 2, my PSA score now is 4.7 ng/ml, down from 33.7 ng/ml. This is significant.
Message from my doctor
I received a message in MyChart from Dr. French.
It looks like the medications are working. Your PSA is now down to 4.7. In addition, the testosterone level is undetectable. Things appear to be heading in the right direction.
Happy early birthday! (it’s on June 1)
Please let me know if you have any questions or concerns
– Dr. French
A second injection took place on May 26, a month after the first. I met with Emily K Payne, PA, working with Dr. French, prior to meeting with a nurse for the injection. She said that I should start tomorrow by taking Abiraterone tablets, commonly sold under the brand names Zytiga or Yonsa. Abiraterone is another hormone-blocking medication used in advanced or metastatic prostate cancer. It works by preventing the body from producing testosterone, not only in the testicles, but elsewhere in the body as well. She also said I should start taking prednisone, a steroid.
I asked how long these procedures would last. She said two years. So, I’ll be getting an injection once a month. After the summer, I’ll probably be getting a 12-week injection to reduce hospital visits. However, and when she said this she smiled. “You’ll come in every two weeks for testing to check not only PSA, and testosterone, but also organs such as kidneys and liver.
The expectation is that I may remain on these medications for as long as two years. Radiation treatment will begin later in the summer. Dr. Davies explained that before radiation starts, his team will create an extremely detailed “map” of the prostate and surrounding areas to precisely target the cancer while protecting nearby tissue as much as possible.
The radiation schedule itself will last about five weeks — daily M-F, for 15 minute treatments, 28 times.
Like many men my age, I worried about side effects. Fatigue. Urinary problems. Sexual changes. Hormone therapy effects. Loss of strength. Emotional changes.
Those fears are real.
But I have also learned something equally important: modern prostate cancer treatment is far more advanced than many people realize. Doctors today combine imaging, targeted radiation, hormone therapy, and long-term monitoring in ways that did not exist a generation ago.
Most important of all, I learned that hope is not naïve.
Hope can be scientific.
Hope can come from evidence, experience, and skilled physicians who treat this disease every day.
I do not know exactly what the next two years will bring. But I know this: I trust the doctors guiding me through this process, and I believe strongly in the treatment plan they have designed.
If there is one message I would share with other men between 70 and 85, it is this:
- Do not assume age protects you from prostate cancer.
- And do not assume that a diagnosis means the end of your story.
- Ask questions.
- Get informed.
- Talk openly with your doctors.
- Understand your PSA numbers.
- Know your Gleason score.
- Learn where the cancer is — and where it is not.
And remember that treatment today is often about managing cancer successfully over time, preserving quality of life, and continuing to live fully. If my story is useful, I hope it encourages someone else to seek answers sooner, face treatment more confidently, or simply feel less alone.
Cancer may now be part of my life and sharing that reality may be part of my work now too.
But it is not the whole story, and perhaps by telling it, I can help someone else continue writing his own.
Going Further…some research
Hormone Therapy Research
I was informed that I had a high-risk non-metastatic prostate cancer. When I met with Dr. French, he asked me if I was interested the science behind the treatment he was using for my prostate cancer. He knew I was a science educator at Georgia State University some years ago. I of course said yes.
As mentioned above, my hormone treatment is made up of two parts. Hormone therapy with Firmagon, also known as Degarelix. This injection rapidly lowers testosterone levels. It is not chemotherapy. . It is a form of hormone therapy (also called androgen deprivation therapy or ADT) specifically used to treat advanced prostate cancer.
Dr. French introduced to me a study1 presented by Dr. Gerhardt Attard, an Academic Medical Oncology Consultant who specializes in the treatment of advanced prostate cancer and in early drug development. He presented his study at the 2021 Presidential Symposium 2 of the European Society for Medical Oncology (ESMO) Annual Congress focusing on prostate cancer. The study was done using the SPAMPEDE platform (Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy). The drugs that Dr. French has prescribed for me are front and center of study presented by Dr. Attard. It is a multi-arm, multi-stage (MAMS) platform designed to test multiple treatment strategies simultaneously for patients with high-risk, locally advanced, or metastatic prostate cancer. I’m in this category.
There are three medications used to treat my prostate cancer:
- Firmagon: subcutaneous injections of 120 mg, injected into the abdomen, every 28 days. This medicine rapidly drops testosterone levels, which fuel cancer cell growth.
- Abiraterone 4 tablets taken daily. It is an oral medication used alongside a steroid like prednisone to treat advanced prostate cancer. It works by stopping the body from producing testosterone, which helps prevent prostate cancer cells from growing and spreading. [1, 2, 3]
- Prednisone, a steroid, 2 taken daily
Some Data
Figure 3. Graph showing two rates of survival treating prostate cancer. Black line is use with patients using only ADT (Androgen deprivation therapy), while the green line shows the effect using ADT and AAP (combination of Abiraterone and Prednisone).
Figure 3 shows survival rates comparing using only ADT vs ADT and AAP. The addition of abiraterone was associated with improvements in overall survival with an absolute improvement in 6-year survival of 9%, from 77% to 86%. According to this research, the magnitude was larger than expected.
Figure 3. Graph showing two rates of survival treating prostate cancer. Black line is use with patients using only ADT (Androgen deprivation therapy), while the green line shows the effect using ADT and AAP (combination of Abiraterone and Prednisone).
About Prostate Cancer
Prostate cancer is the most common cancer and the second leading cause of cancer death among men in the United States. Prostate cancer usually grows very slowly, and finding and treating it before symptoms occur may not improve men’s health or help them live longer. You can explore links at this site to learn about prostate cancer treatment, prevention, screening, statistics, research, and more.2
The prostate is a gland in the male reproductive system. It lies just below the bladder (the organ that collects and empties urine) and in front of the rectum (the lower part of the intestine). It is about the size of a walnut and surrounds part of the urethra (the tube that empties urine from the bladder). The prostate gland makes fluid that is part of the semen.3
These and other signs and symptoms may be caused by prostate cancer or by other conditions. Check with your doctor if you have:
- Trouble starting the flow of urine.
- Frequent urination (especially at night).
- Trouble emptying the bladder completely.
- Weak or interrupted (“stop-and-go”) flow of urine.
When prostate cancer is detected in an advanced stage, symptoms may include:
- Pain in the back, hips, or pelvis that doesn’t go away.
- Shortness of breath, feeling very tired, fast heartbeat, dizziness, or pale skin caused by anemia.
Wellstar Kennestone Cancer Center4
The Wellstar Kennestone Cancer Center is a leading oncology and research facility in Marietta, Georgia. Through its multidisciplinary STAT Clinics, medical oncologists, radiation oncologists, and cancer surgeons work together to provide personalized treatment plans and same-day second opinions.
Patients can also access clinical trials, biomarker testing, and targeted therapies close to home in Georgia through partnerships with Georgia Cancer Specialists and the Northwest Georgia Oncology Centers.
The center is a high-volume facility equipped with the CyberKnife S7 System, which delivers fast, highly precise stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) to tumors throughout the body.
Beyond treatment and research, the center’s dedicated Cancer Support Center provides a welcoming place of encouragement, information, and community
Notes
- Published in URO Today: Urologic Oncology, 2021 ↩︎
- National Cancer Institute ↩︎
- National Cancer Institute ↩︎
- Wellstar Kennestone Cancer Center ↩︎
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