Matt Fish, a 47-year-old Veteran, has an important message for younger men. Know your history and risk factors for prostate cancer: if you’re over age 50, if you’re Black, or have a family history of cancer. Matt adds to that: if you’ve served in the military. And if you’re concerned, talk to your doctor about getting a PSA test. Don’t wait until you’re 50. Be your own advocate.
Matt should know. He was diagnosed with Stage 4 prostate cancer at age 45…..and he’d been getting his PSA checked since age 35. He’s convinced that if he hadn’t had those early tests, he wouldn’t be here today.
A Decade to Diagnosis
As a young man, Matt served in the Marines at Camp Lejeune, NC. Veterans who served at Camp Lejeune from 1953 through 1987 were potentially exposed to water contaminated with dangerous chemicals. Although Matt was there in 1995, outside this window, the VA has been covering his prostate cancer care. Starting at age 35, his VA doctor started checking his PSA annually. Matt didn’t know why, but he figured it was just part of the process. His PSA was high, and “a roller coaster,” bouncing between 5 and 8. (Most men under age 50 have a PSA less than 1.) His digital rectal exam results, and even an ultrasound, were normal. It was chalked up to prostatitis. Matt didn’t want a biopsy, but he made a deal with himself: if his PSA went over 10, he’d do it. A PSA test later came back as 12.
The biopsy showed cancer, Gleason score 7. Looking back, Matt recalls that he had very few symptoms: occasional severe back pain, and, just before the biopsy, problems with ejaculation. That’s why prostate cancer is sometimes called the “silent killer” – men have no symptoms until the disease is advanced.
On Treatment, Life As Normal as Possible
He had surgery to remove his prostate. Further testing of the tissue revealed that the cancer was more aggressive, with a Gleason score of 9. His lymph nodes appeared cancer-free. However, at Matt’s first PSA check after surgery, instead of being undetectable, it was 16. A scan showed one small spot of cancer in his hip: Stage 4. He started medications to lower his testosterone. The treatment is working: his PSA is checked monthly, and it remains virtually zero. The plan is for him to stay on these medicines for a year and have another PET scan. If the spot of cancer on his hip is still there, radiation to that area is a treatment option.
Today, Matt is doing well. His lives with his wife, Penny, and their two children. He stays busy with a full-time job, playing golf, and doing outdoor activities with his family. He prefers to keep his life as normal as possible. He’s got a few side effects from the hormone therapy: brain fog, fatigue, muscle aches – all manageable. The hot flashes are the worst; he keeps a fan nearby.
Stay Busy, Stay Positive
How did Matt cope with all of this? By staying busy. “Working has really helped me,” he says. Just being at home would have destroyed me. I need sense of purpose.” He stays positive, and has a strong support system with family and friends. His wife helps out by reading articles and dealing with paperwork. Matt doesn’t think of it so much as denial, but “I just don’t want it in my face.”
Cancer Is a Family Issue
Matt didn’t have prostate cancer in his family, but there were other cancers on his father’s side, as well as an aunt on his mother’s side who died of breast cancer. Genes (the “instruction manual” of cells) for cancer can run in families. We now know that men may also be at increased risk of prostate cancer if they have a strong family history of other cancers, such as breast, ovarian, colon or pancreatic cancer. And a diagnosis of aggressive prostate cancer at a young age may signal increased risk of other cancers in both male and female family members. Matt has talked with family members about getting genetic testing for inherited cancer risk. (Information from this type of testing can help create a family health plan for prevention and earlier detection.)
Matt’s doctors are also planning to perform biomarker testing on his tumor tissue. These tests of the tumor’s genetic material and proteins may provide information about Matt’s specific type of prostate cancer and guide treatment in the future.
In the meantime, Matt is working to get the message out and raise awareness among men—especially younger men—to get their PSA checked. We’ll be following his story in the coming months.