My First Cancer

My quarterly PSA tests have always exerted a gravitational pull on me well beyond their intrinsic strength. That’s because they tell me how well I’m doing in fending off my Stage 4 prostate cancer. Call them my report cards. And yesterday’s test had no more, no less gravity than any of the 22 other PSA tests I’ve had since surgery.

But the results, so patently unexpected, took me with such surprise that my reaction sounded, even to me at the time, more like a shrill complaint than an outburst of innocent incredulity. “What?” I said. “Can that be right?”

Indeed it was. My PSA was “undetectable.” And that’s good.

PSA is a biochemical indicator of prostate cancer, so whatever PSA there might be in me, it’s an amount so scant, so negligible that it just doesn’t show up in the test (my lab can detect only 0.03 ng/ml or more of PSA). And this “undetectable” was down from July’s reading of 0.03, which was itself down from April’s 0.04. And the lower the number, the better.

So what to make of it?

As we say in the cancer community, I am — at least for now — NED, no evidence of disease. You can poke me, you can scan me, and you’ll find not a farthing of evidence of prostate cancer.

We hurriedly improvised at dinner: cheap champagne that was on hand in the fridge.

True enough, I’ve been down this “undetectable” path before, only to see my PSA return and signify cancer’s recurrence. So while we toasted this one test result, I’m taking no victory lap, flying no checkered flag; the race is not yet run. At surgery in 2007, remember, pathology found cancer in two of my pelvic lymph nodes; my cancer metastasized long ago, and it’s virtually certain that some cancer still remains somewhere within me.

Or as my oncologist once told me: “We’re not trying to cure your cancer; we’re trying to manage it.”

“Undetectable,” though, is as good as “managing it” can get, and I’ll take it — gladly — even though I can’t say how, exactly, it might speak to the longer term. The only thing certain is that we’ll test again in January.

And as any cancerian can tell you, the most important test is always your next one.