Why I chose active surveillance instead of treatment for prostate cancer

This is an opinion column.

Sometimes I get mixed up. That’s not unusual. Not at this age. You’d think, though, that I’d be crystal clear about my prostate cancer treatment. About the active surveillance treatment path that I chose to pursue after being diagnosed with the disease this summer.

Except sometimes I call it active waiting, and it’s not the medically correct term.

Active surveillance is getting a PSA test every six months or so to measure the level of prostate-specific antigen in my blood. If it rises significantly, surgery and/or radiation are more aggressive treatment options.

Read more of Roy’s ‘Cancer Chronicles.’

My PSA score in July was 4-almost-5, a spike from prior annual tests, which prompted my primary care physician to send me to a urologist. Weeks later, a biopsy confirmed prostate cancer.

Damn.

Yet I was not wholly surprised. One in eight men in America will be diagnosed with the disease this year, and one in six Black men. If a direct relative — a father or brother, for instance — had or has prostate cancer, you’re a near-lock to get it.

My father died of prostate cancer when I was 11 years old.

Again, not wholly surprised.

That doesn’t mean I wasn’t scared more than at any time in my life (and I love roller-coasters). Scared to death when I heard the C-word referring to me. Scared of death.

Weeks later, back in September when I first told you that I’ve been diagnosed with prostate cancer, I shared, too, that my faith gives me confidence that I’ll beat it. I’ve long held onto Isaiah 40:31 as one of my go-to scriptures, knowing that those who wait upon the Lord shall renew their strength. It became my mantra as my wife and I navigated the waves of treatment options, including surgery and/or radiation.

My cancer was deemed stage 2, a slow-moving cancer confirmed by a genetic test. And because I caught it early, thanks to regular PSA testing at annual checkups, active surveillance was a viable option.

And it’s the one we chose.

I am not alone, surprisingly. In September, The New York Times published an overview of prostate cancer treatments and I learned that “today nearly 60 percent of patients with low-risk cancers choose active monitoring instead of treatment — up from 26 percent in 2014. Some experts believe that number should be higher.”

I am far from alone.

So, yes, I am waiting because I know His power is made perfect in our weakness. And cancer is a profound weakness that, even as treatments of almost all forms of the disease have drastically improved in my near-70 years of life, kills far too many. Far too many.

My treatment, however, isn’t called waiting. It’s surveillance — and my cancer was caught soon enough for me to pursue this path. Thank God.

It’s been almost two months now since I revealed my diagnosis. Sixty days or thereabouts.

I don’t recall how long I endured the expected waves of emotions — fear, sadness, grief and some feelings I don’t even remember — before peace won. Peace in the waiting. In the stillness of waiting.

Surviving in the waiting.

Which is why I sometimes get mixed up and describe my treatment as … waiting.

I endured the emotional gauntlet, in part, thanks to the unmitigated support of my wife, children, family, my faith fam at Rock City Church, co-workers, and many, many people whom I did not know before sharing my diagnosis. People who are sharing their own personal cancer journeys with me. I find myself praying for as many as are praying for me.

That’s why I consider myself a cancer survivor. I know the term. It’s generally meant for those who’ve rung the bell. For those who’ve undergone a bombardment of treatments — surgery and/or chemo or radiation or some treatment I never heard about before — and ultimately became cancer-free.

Many such survivors reached out to me in the days following my initial Cancer Chronicle. I told each of them: I pray that I’ll be able to join you there.

I already have. To be clear: I may still have cancer in my body. My next PSA test isn’t scheduled for a long while, but I am fully confident in this — I am a survivor.

I survived anxiety. I survived fear. I survived grief. I survived the sadness. I now wake up each day with peace, joy, confidence, and expectation. And I live every moment with urgency.

I’ve got stuff to do. For me. For the people I love. For others.

I recently joined a couple of organizations that are committed to elevating awareness about the need for prostate cancer testing, particularly among Black men. I joined the board of directors of the Mike Slive Foundation for Cancer Research, which provides early-stage grants for potentially groundbreaking efforts to cure for prostate cancer, and host free PSA testing at various events across Alabama and beyond.

I am also an ambassador for NowIncluded, an online community where people in underrepresented communities are heard and supported throughout their health journey.

Both entities are committed to saving lives. Our lives.

Because our families need us. Our community needs us. We are needed, gentlemen, to stand up to the challenges of today and tomorrow.

To stand up for those who still look to us for guidance.

Recently, I shared with one of the NowIncluded leaders that I’m already a prostate survivor. She smiled. “We call that thriving,” she said, “thriving with cancer.”

It’s been long proven that a positive attitude can impact health outcomes. So, I’m going to be the healthiest person in every room I walk into. At least I’ll make you think so.

My pastor often says we can’t always control our circumstances, but we can always control how we view our circumstances. So each day while I actively survey and wait, I count it all joy.

In truth, I rarely think about my diagnosis. I almost forget I have (or may not) cancer – until someone asks, “How are you?!” Ask with that puppy-dog expression of someone who actually wants to know.

“Great,” is my response. And my truth. Save for stiff knees and a back that’s been annoyingly aggravating lately, I really feel great.

I step aside and let His power be made perfect in me, whether I still have cancer or not. Whether or not my PSA rises or falls. Whether I live all of my days with prostate cancer or ring the bell someday.

In all ways, I am a survivor, thriving amid the battle.