David was diagnosed with prostate cancer the day before his 74th birthday

David Callister had only recently retired when he received a prostate cancer diagnosis in March 2021 – the day before his 74th birthday.

Back in 2017, a regular blood test showed a PSA (prostate-specific antigen) reading of 7, which was at the upper-acceptable level for his age of 70, and he knew that a high PSA level can be an indicator of prostate enlargement and cancer.

‘At the time, my doctor wasn’t overly concerned because I was in good health and didn’t have any significant prostate symptoms,’ said David.   

Then in early 2020, David began experiencing significant prostate symptoms including frequent urination and incontinence.  A blood test showed his PSA reading had increased from 7 up to 13 – which was regarded as high and often indicates prostate problems. 
 

‘Initially an MRI scan didn’t confirm any cancer, but the urologist said I need to focus on getting my PSA level down to 6, so I needed to take action. I believed I could do this; I was up for the challenge and feeling optimistic.’  

To reduce his symptoms and get his PSA level down, David took supplements and focused on a mostly vegetarian diet which included fish, high grain cereals and fruits and cut back on wine. However, in January 2021, a blood test showed his PSA reading was now up from 13 to 15. ‘I was hoping that my dietary changes and supplements would reduce my symptoms and get my PSA level down but didn’t have any luck. I was a bit shocked and disappointed at this result after the effort I had put into my diet. Obviously, the abnormal prostate cells were on a growth path to tumours anyway.’

In February 2021, a biopsy and MRI scan, the pathology test showed a grey area in the prostate, but still couldn’t confirm any cancer. Then a few weeks later a PET scan then a second biopsy confirmed it was cancer (one year after he started to have significant symptoms). It was classed as intermediate growth cancer. ‘I was shocked to some extent and naturally disappointed to be diagnosed with cancer because I believed that I had always had a healthy lifestyle as a non-smoker with a mainly “Mediterranean diet”, and exercise… I had always associated cancer with physical illness, but I realised that if the cancer is early stage and if you don’t need chemotherapy, it may not affect your physical health significantly.’ ‘Lucky for the modern PET scan which then motivated me to take timely action. I wanted to act on it quickly, knowing that early treatment has a great chance of success, but that the process would still take many months.’ ‘I confided in my family and a few friends, but I didn’t want to talk about it all the time and I didn’t want too much sympathy. I just wanted to get the treatment finished and have everyone forget about it.’

After consultation with the urologist and radiation oncologist, David chose ADT (androgen deprivation therapy) followed by 20 sessions of external beam radiation sessions over four weeks. Prior to treatment, David benefited from using Cancer Council Queensland’s booklets about understanding prostate cancer and radiation therapy. To educate himself about his cancer and the process of radiation therapy. ‘I had the 1st ADT injection in May 2021, a year after my significant physical symptoms started. In July, my PSA reading was down from 15 to 8. In August, I had the 2nd injection and by the commencement of the radiation treatment in October, my PSA reading was down to 2 which indicated that the tumours may have shrunk enhancing the effectiveness of radiation. I was pleasantly surprised that the ADT injections worked quickly, greatly reducing testosterone feeding the cancer.’ ‘Two weeks before the radiation treatments, I also had a small operation to insert gold markers onto the prostate in order to accurately target the cancer cells.’ Throughout October 2021, David had 20 radiation sessions, Monday to Friday, each lasting approximately 20 minutes including preparation. ‘The sessions were well organised and not at all painful. I did have some side effects from the treatment such as tiredness, warm flushes, some weight gain, and loss of strength as a result of greatly reduced testosterone. However, I was still able to carry out my usual activities and I kept on exercising which is highly recommended. I had some general anxiety but not mood swings or feelings of depression.’ By the end of December 2021, three months after radiation finished, David’s symptoms had improved, and his PSA reading was down to a very low level of 0.008! His oncologist was pleased with the result.

Since the radiation treatment, I have a blood test and I see the oncologist every 6 months. In June 2022, December 2022 and June 2023 my PSA levels have only increased very slightly and my testosterone levels are back to normal for my age. My cancer is in remission now and hopefully it won’t come back.’

‘I count myself lucky because having significant symptoms combined with increasing PSA levels, I knew that something was definitely wrong and I acted on it quickly, getting the cancer treated while it was early stage. I believe if I hadn’t had the PSA levels checked over the years and just accepted the physical symptoms as part of getting old, I probably would have had advanced cancer by now and spread outside the prostate.’

David says that his general health is great.

‘I still have some excess weight around the middle and my muscles and strength are still not quite as they were. I am walking a lot and going to the gym, so I feel like I am getting back to where I used to be before my diagnosis.’

‘It’s important for men, especially those over 50, to have regular check-ups because you could have prostate symptoms thinking it is normal part of ageing. If cancer is detected at an early stage, it can usually be successfully treated without disrupting your life too much.’

‘Although cancer is still at the back of my mind, I find it best to think positively and assume it’s not going to come back.’

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