I have always been very healthy and strong; I prided myself in that. In 2015, I was 62 years old, retired seven years from being an elementary school principal and very busy with my family. I was an 18th-century reenactor, president of my local historical society, vice president of a national reenacting group, working with my son several hours each week on our family genealogy, teaching adult education classes at a local retirement home…well, just very busy and happy about it.
A Routine Visit
In December 2015, I had my yearly physical with my family doctor. For the past 10 years, I had received the rectal exam to check my prostate. My doctor always declared it was fine and never said I should get a PSA (prostate-specific antigen) blood test. Now, knowing what I do about PSA, baselines, etc, I should have had my PSA checked several years before. I was ignorant of prostate cancer and was even ignorant of what my prostate did! When I went in for my physical that month, I was having some problems urinating and I was tired at times.
I told my family doctor about these problems and when he did the rectal exam, he told me of an abnormality. He made an appointment for me at UCPA on Erford Road in Camp Hill. In a few weeks, I had an exam there and my first PSA test. My PSA was 4.0. They treated me with antibiotics for prostatitis. In the next two months, things seemed to be a bit better. When I went back to UCPA, another PSA showed that it had risen to 6.0. My urologist recommended a biopsy of my prostate. The result was that 10 of the 12 samples of my prostate were highly cancerous and the PSA taken soon after showed 7.0.
Diagnosis
The urologist told me that with that much cancer detected in my prostate, my PSA should have been in the 100s. So, PSA is not foolproof, but if it had been done regularly starting when I was 55 or even 60, it would have shown a steady increase. This would have alerted us that something was wrong with my prostate. After an MRI, bone scan, and CAT scan, I was diagnosed with Stage IV prostate cancer in May 2016. It was in two ribs and in one of my vertebra. Cancer had broken out of the prostate and was infecting my bones.
I was referred to an oncologist at Hematology and Oncology of Central PA on Erford Road. My oncologist is wonderful, caring, and very expert. On July 14, I began chemotherapy: six sessions which were finished in October. Since I was having some pain in the cancerous vertebra, I had 10 radiation treatments on that vertebra, t-10, at the same time as chemotherapy. I also began stomach injections of Firmagon which, in layman’s terms, depletes the testosterone in my body. Prostate cancer feeds on testosterone which is produced by the prostate. Having little testosterone in the body stops the cancer from growing…for a few years.
Treatment
Stage IV prostate cancer does not really go into remission. It does not disappear once it’s outside the prostate and infects bone. It lurks and waits to find testosterone to feed on. After a few years, on average, the Firmagon no longer works. Then the prostate cancer begins infecting soft tissue. So, the end of life is then closer for the victim. When I first met with my oncologist in June 2016, he gave me five to seven years to live.
In November 2016, I began radiation on the prostate. I could not have it removed as it was Stage IV, but the radiation would kill the cancer. The chemotherapy had worn me down but I was still chugging along. The radiation wore me down even more. I had 33 sessions which lasted until the end of December, every day except weekends. In addition, the monthly Firmagon injections gave me hot flashes every few hours, as if I was going through menopause.
Continued Treatment
From January 2017 until October 2018, my PSA was under control. I had bone and CAT scans every three months and the cancer was not growing; there was still the same amount in the two ribs and the t-10 vertebra which caused me some pain. In October, after so many stomach injections, my belly was hard with scar tissue. It was decided to go to a new drug, Lupron. This would be given every three months as a hip injection.
However, after two of the Lupron injections, my PSA was rising. In March 2018, I went back on Firmagon stomach injections, yet my PSA was still rising. I had a PET scan taken July 2019 and it showed that the cancer had grown a bit in my ribs and my pelvis. After a second opinion from a cancer doctor at Sloan-Kettering in Manhattan, who conferred with m own oncologist, it was decided that I would start immunotherapy followed by a transfusion of Xofigo. Both of these treatments would stop the cancer from growing for, hopefully, a few more years. It does not make the cancer that is already there disappear.
Immunotherapy is a new treatment in the last few years, as is Xofigo. With immunotherapy, all the blood is extracted from my body and recycled back in while a machine takes out about a pint of blood with white blood cells. This blood is sent to California where the t-cells are extracted and mixed with a drug called Provenge. Provenge enriches my own cells to fight any new cancer.
The Fight
Through all of this, I have certainly become a new person. Anyone going through a life-threatening disease goes through stages. When I was diagnosed, I was in denial for a few weeks. Then, I decided to just tell close family. Once I had a treatment plan, I began to tell others and ask men if they had their PSA tested. I became an advocate for early detection, educating others (men and women) on prostate examinations, PSA, and fighting this disease. I became aware of an organization which is a leader in all of these issues: ZERO, the End of Prostate Cancer. I am now a spokesperson for ZERO and collect donations on their behalf.
I cherish every day. My wife Linda is my main support along with my family and friends. I have not curtailed any of my hobbies or volunteer work. If anything, I have become more involved as I make every day count. Sure, I cannot do physical activities like I once did, but I make a difference in many more ways than I ever did. My religious faith is strengthened and I know that my mental attitude is bolstered by faith. I believe God has a plan for me and I am on that path.
Journey Through Exercise
Along with treatments, medications, and being actively involved in several organizations, exercise is also important. My oncologist tells me that cancer does not like exercise; with the treatments my body has undergone and continues to undergo, I have lost muscle which has been replaced with fat!
At times through this journey, I have exercised regularly. But I let myself become lazy and did not have an exercise regimen. The program, LIVESTRONG® at the YMCA, is changing that. The staff of LIVESTRONG® at the YMCA at the Harrisburg Area YMCA are professional, passionate, and caring. They make me want to exercise.
My journey is difficult and I want to fight it to the end. With all that I have going for me: caring doctors, the ZERO organization family, my own family and friends, my faith in God, exercise, and volunteer activities, I will keep chugging along and preaching to others. Get your PSA checked early, educate yourself about prostate cancer, be aggressive in your fight, keep your family and friends close, and actively exercise. Every day is worth the fight!
—Mark Hagenbuch
