by Rodney Maurice, Guest Writer
Diane Newman had always believed in order—lesson plans, morning routines, and the quiet predictability of a life built over decades. As a dedicated schoolteacher, she found comfort in structure. But that sense of control unraveled the afternoon she discovered the letter.
It had slipped between a stack of mail on the kitchen counter, its clinical envelope out of place among grocery ads and utility bills. She almost tossed it aside—until she saw her husband’s name. Charles Newman.
Her hands trembled as she read.
The words felt cold and urgent: elevated PSA level of 19… MRI strongly recommended… the patient has not scheduled… concern for possible malignancy.
Diane sank into a chair.
Charles? Her Charles? The man who woke before dawn to run with his old fraternity brothers, who never missed a day at the gym, who worked long shifts in aviation and still came home laughing? He was the picture of health. Or so she thought.
Why would he ignore this?
Fear crept in, slow and suffocating. Thirty years of marriage, and he hadn’t told her. Not a word.
Her mind jumped immediately to their children. Steven, their 28-year-old son, still finding his footing in life. Cassidy, their brilliant 27-year-old daughter, preparing for her wedding. Diane’s chest tightened at the thought—what if Charles wasn’t there? What if he never walked Cassidy down the aisle?
Tears blurred the page as anger joined the fear.
How could he risk everything?
That evening, when Charles walked through the door, sweaty and smiling from his run, Diane didn’t see the strong, invincible man she had always known. She saw someone fragile. Someone scared.
“Charles,” she said softly, holding up the letter. “We need to talk.”
His smile faded.
And in that moment, Diane realized that love wasn’t just about the life you built together—it was about fighting for it, even when one of you was too afraid to try.
There are many wives like Diane—some are quite outspoken in encouraging their husbands to see a doctor. Others remain more hesitant, often because they fear their husbands’ reactions or are worried about the stigma surrounding prostate issues. Concerns about the word “prostate cancer,” embarrassment over medical examinations, and concerns about judgment can all contribute to their reluctance. However, a high PSA level is a significant indicator that requires careful attention for proper diagnosis and treatment.
Experts weigh in on the consequences of ignoring a high PSA:
If someone like Steve ignores a high PSA—especially a level as elevated as 19—it can lead to serious consequences over time.
A PSA (prostate-specific antigen) that high raises concern for conditions like Prostate Cancer, although it’s not the only possibility (it could also be infection or enlargement). The key issue is that without follow-up, no one knows what’s really causing it.
Here’s what can happen if it’s ignored:
- Delayed diagnosis
If the cause is prostate cancer, ignoring it allows the disease to grow undetected. Early-stage prostate cancer is often very treatable—sometimes even curable—but that window can close. - Cancer progression
Untreated cancer can spread beyond the prostate (metastasis), often to bones or lymph nodes. At that stage, it becomes much harder to treat and is no longer considered curable in most cases. - Fewer treatment options
Early on, options might include monitoring, surgery, or targeted radiation. Later stages may require more aggressive treatments like hormone therapy or chemotherapy, which can have greater side effects. - Symptoms developing later
Prostate issues often don’t cause symptoms early. By the time symptoms appear (pain, urinary problems, bone pain), the disease may already be advanced. - Increased risk of death
Simply put, ignoring a significantly high PSA can allow a potentially life-threatening condition to worsen.
MRI of the Prostate (Multiparametric MRI)
An MRI is non-invasive and painless. It helps doctors see if there are any suspicious areas before doing a biopsy.
What happens:
– You lie on a table that slides into a large tube-shaped scanner.
– The machine uses magnets (not radiation) to create detailed images.
– You’ll need to stay still for about 30–45 minutes.
– It can be noisy (thumping sounds), but you’ll get ear protection.
– Sometimes they inject contrast dye through an IV to improve imaging.
What it shows:
– Whether there are abnormal spots in the prostate
– How suspicious those areas look
– Whether a biopsy is even necessary
Many men don’t need a biopsy if the MRI looks normal.
Prostate Biopsy
If the MRI shows something concerning—or PSA remains very high—the next step is a biopsy to check for Prostate Cancer.
What happens:
– Usually done in a doctor’s office
– You’ll lie on your side or back
– A small ultrasound probe is inserted into the rectum (this helps guide the doctor)
– The area is numbed with local anesthesia
The sampling:
– A spring-loaded needle takes tiny tissue samples (usually 10–15 cores)
– You may feel pressure or quick “snaps,” but not sharp pain for most people
– The procedure takes about 10–20 minutes After the Biopsy
It’s very common to have:
– Mild soreness
– Blood in urine, stool, or semen (can last days to weeks)
– Slight fatigue
Less common but important:
– Infection (you’ll usually get antibiotics to prevent this) Results
– Results typically come back in about 1–2 weeks
– If cancer is found, it’s graded using a Gleason score (which tells how aggressive it is) The Big Picture
An MRI + biopsy sequence is really about getting clarity early. Even if cancer is found, catching it at this stage often means:
– More treatment options
– Better outcomes
– Higher chance of cure
If you want, I can also break down what the different biopsy results mean (from no cancer to aggressive cancer) so you know exactly what each outcome could look like.
In conclusion here is Steve’s diagnosis and what was done:
If Steve’s MRI and biopsy show that 4 lesions contain cancer and he chooses treatment, that doesn’t automatically mean the worst. What matters most is how aggressive the cancer is and whether it has spread. Many men in this situation still do very well with treatment.
Here’s what typically happens next:
- Staging and Grading
Doctors will look at:
– Gleason score / Grade Group (how aggressive the cancer cells look)
– Whether the cancer is contained in the prostate or has spread
Even with multiple lesions, if it’s still localized Prostate Cancer, it is often highly treatable. - Treatment Options
Surgery (Radical Prostatectomy)
– Removal of the prostate gland
– Often recommended for healthy men in their 50s
– Goal: complete cure if cancer is contained
Radiation Therapy
– External beam or internal (brachytherapy)
– Sometimes combined with hormone therapy
– Also has strong cure rates for localized cancer
Hormone Therapy (ADT)
– Lowers testosterone, which fuels prostate cancer
– Often used with radiation if cancer is more extensive
Active Surveillance (less likely here)
– Usually not chosen if multiple cancerous lesions are present - Side Effects to Consider
Treatment can come with trade-offs:
– Urinary leakage (often improves over time)
– Erectile dysfunction
– Fatigue (especially with radiation or hormone therapy)
Doctors try to balance curing cancer with quality of life.
Prognosis
If Steve:
– Is 52 and otherwise healthy
– Gets treatment before spread
Then outcomes are often very good, even with multiple lesions:
– Many men live decades cancer-free
– Survival rates are high for localized disease
Thank you for visiting The Argus St. Louis Newspaper online. Please note that the information shared here is for informational purposes only and not a substitute for professional medical advice. If you or someone you know has a high PSA level, it is important to consult with a healthcare professional. While I’ve done my best to research this topic, I am not a medical doctor. I strongly recommend that men get regular check-ups and follow their medical team’s advice. Remember, prostate cancer is a serious matter—regular testing every six months is essential for early detection and peace of mind.
