Back story…
I’ve been riding for years. I was riding outside for probably a decade, road and MTB. Occasional fit bikes. I started really riding a lot after I retired. Like 90+ minutes a day almost everyday. Started on a Peloton, and progressing to a hysterically loud H2. But that aside, during the pandemic I rode A LOT. I developed saddle sores, I was riding so much. I joked to people that I was a lab rat, furiously riding to get my food pellets. I once rode over 5 hours. To ride over 2 wasn’t a fluke. I rode literally every day.
Then my PSA started creeping up.
I would stop for a week, and it would go back down. (The PSA measures a ‘pissed off prostate’, so mine was pissed off my riding)
I posted several time to the local bike club urging people that had spikes in their PSA to take a week off and get tested again. Yeah, the PSA went down for most of them. I thought I had ‘the secret’ to handling that part of my health.
I would change saddles, apparently not often enough, but donated a box of ‘seats’ that I had acquired over the years. Some only used for weeks. (You all probably know that song)
Then, over the past 2 years, my PSA spiked. It ended up just over 7. I took the week off, and it dropped to 6.9. Um, what happened?!?! I took another week and a half off and got a more advanced PSA test, and it dropped to 5.7. Not a big drop, but a drop none the less. But then it spiked again after a followup test. Something is wrong here, the dodge isn’t working anymore.
I was scheduled for an MRI, and the results were nothing short of stunning.
The urologist was shocked, and told me that I have one of the largest prostates he’s ever seen! He showed me their plastic models and said that mine was easily double their biggest one. (Go big or go home) He scheduled more advanced PSA testing, and came back with the idea that I had active prostate cancer. There are a few measurements of the degree of a mans prostate trying to kill them, and I was originally ruled a PIRAD 4 to 5. I was immediately scheduled for a biopsy, and the results were that out of 13 samples, three of them were positive for cancer, and at least one of them had the earmarks of creeping cancer on a nerve. (A ‘Gleason 8’, on a 1 to 10 scale: a potentially contained wild fire that wants out) The prostate doesn’t have a ‘capsule’ around it like many organs, so if anything wants out, there really is no ‘bag’ that keeps stuff in.
So here I sit with an enormous prostate with creeping cancer, and waiting for the bean counters to approve a PSMA PET scan, looking to see if any of that stuff is setting up house somewhere else in my body.
Years ago, I had been told there are 2 kinds of prostate cancer, and felt a great deal of comfort in it. There was the first kind: If you have it, you are likely dead before you know you have it. It’s like a 5 alarm fire and it spreads like crazy. People that have that have it everywhere quickly. (Oh, so that’s not a big deal because I’d already be dead, or gravely ill) The second kind quietly cooks in the darkness, usually popping up in ‘really old men’. Men usually over 70 to 80. I’m not even 65 yet!!
I read the book about steve jobs and his pancreatic cancer, and how he ignored it for years, and then tried holistic cures, until it was inescapable that he had it, and he was well on the way to dying of it. Now I’m waiting for STAT PET scans and STAT robotic prostatectomy surgery, and realizing how stupid and self deluded I was.
I hope I survive this. I hope I’m not forced to wear diapers for the rest of my life. I hope that creeping crud hasn’t crept to a place I won’t survive. The PET scan is head to mid calf. I won’t glow in the dark (I’m kinda of disappointed at that) but it should identify any wayward bits, and I’ll have to go through repeat PSA and PET scans every 6 months or so for the next 5 to 6 years.
All because I thought I had the tiger by the tail.
Thoughts, so far: Not doing anything. Yeah, my prostate wants to kill me, let it. The idea of wearing a diaper for the rest of my life is humiliating, but not everyone that gets the surgery ends up that way. I hate gambling because ‘gamblers always lose’, but the alternative is not really great.
So I wish I could go back and not be so sure I had ‘The Answer’. Two years ago, it likely wouldn’t be this bad. Three years ago it might be a 'Well, there are unusual bits in your samples, we should get it out, and then I would have a few more options. Who knows when it got gigantic.
I never thought riding a bike could piss my prostate off enough to make it want to kill me, but apparently it does.
Don’t ignore high PSA values. Get an MRI (instead of the rubber glove). It is a longish study, but it cuts the prostate into thin slices and shows every little thing. (The ‘rubber glove’ can’t touch the entire prostate, missing potentially all kinds of nastiness lurking just out of reach)
I hope I can survive this. I was stupid, and wow, this is not how I imagined I’d be spending the spring of 2024.
And all this time, I never knew my prostate was enlarged. Certainly not two to four times the usual large prostate. I missed an opportunity to address it earlier, for sure.
Here is an article relating BPH (benign prostate hypertrophy (your prostate is big)) and biking. Take it (more) seriously (then I did)…
EDIT: I mean, who didn’t know that biking a lot could cause ED (Erectile Dysfunction). I knew that many decades ago, but this? I feel strange feeling like I should have known more about this. Who failed? Me? The industry? Medicine? Lance Armstrong? Everyone, and no one?
Sorry if this is the wrong category, and hope it passes muster.