My name is Brad Goverman. I'm recently retired after a long professional career in the consulting world, and part of my retirement includes taking care of my first grandson who's just turned a year old. So I do that for three days a week. I also author a weekly blog and do a lot of gardening and other things to keep myself busy, so that's a little bit about myself. I was born in Massachusetts, raised in Massachusetts, went to schools here and expect to continue to live out the rest of my life here in the Massachusetts area, enjoy the seasons, and the Red Sox, and the Celtics, and the Bruins, and all of that. So very well-rooted here and a true Bostonian, I guess I could say.

When I was first diagnosed with prostate cancer, I was already a little bit concerned given that my family history, my father was diagnosed with prostate cancer when he was about the same age that when I was diagnosed. And so I had been charting and following my PSA levels pretty diligently. I started to note an upward tick in those, in the PSA scores. And so I was already somewhat alerted to the fact that there was something going on there and I was genetically predisposed to probably having some issue related to that. So when I got the official word on the biopsy that I was already showing signs of cancer, I think I was initially diagnosed with a Gleason 3+3. So I wasn't surprised, I guess, to answer the question directly. I was not shocked at the diagnosis and I was mentally prepared for it, given my family history and following my PSA levels.

Nonetheless, it's still hits you hard. It does. Even though you're expecting it, it's not a surprise or a shock. The news always sort of is concerning because there's this thing, something happening to your body that you don't have any control over. And you understand that it does have some potential effects that could either end your life earlier or cause other kinds of dysfunction. That's sort of how it began for me.

So the day that I got the news about being confirmed from the biopsy that I had prostate cancer, the first thing you do is sort of start getting worried that this is something that first you're going to have to deal with. It's going to cause all kinds of health challenges and other challenges. And then I shared it with my wife, obviously, of course, and we discussed sharing it with my family as well because my brother is probably going to follow in the same footsteps as I am given his genetic dispositions in this area. So there was this moment or time period of disseminating and sharing the information with the immediate family and getting all of their feedback and there was all kinds of obviously support.

One interesting thing to note was that my sister was very quick to challenge, or not challenge, but to offer her advice on therapy. When my father got prostate cancer, she was very much against his decision on therapy. He decided to go down to the radiation therapy path instead of doing a prostatectomy and having it surgically removed. And my sister was against that. And so her first reaction when I told her the news was that, "Of course, you're going to have a prostatectomy and have it removed. You don't want to happen to you what happened to Dad."

I was a little bit taken aback by that, by her immediate reaction that way, because I hadn't even started the process of looking at what my options were and understanding the differences between the different options, therapy options. So she had a very visceral and emotional reaction to it, which was interesting to me. But I told her, I said, "Look, that's probably the path I'm going to go down, but I need to go through a process and I need to look at all the options and understand them better." That's a little bit about what happened to me with the initial reaction and sharing it with my family.

I was originally diagnosed by my urologist, Dr. Haleblian, and he, after seeing my initial biopsy when I was Gleason 3+3, he recommended that I speak to a specialist here in the Boston area. The good news for us here in New England is that we are surrounded by some world-class hospitals, and we have access to some of the great facilities and doctors in the world. So I was able to put together pretty quickly a dream team of doctors that included Dr. D'Amico, who's, I think, he's a radiation oncologist and very well-known and respected. Haleblian first referred me to Dr. Kibel, who specializes more in surgery.

So right away, I had decided that I had two options, either doing radiation therapy or doing surgery. I was fortunate to have two really excellent, really well-respected and world-renowned doctors in both of those areas that were able to guide me and to provide me information and advice that led to my decision for therapy. But it started with Haleblian here, my urologist here in the Mass General Hospital partners organization. And then I was referred out to the specialists from the dream team.

Sure. I started with a decision tree of doing nothing. First of all, I immediately started doing a lot of research and Googling, just getting as much data and reports and studies that I possibly could, just getting smarter about the whole area of prostate cancer and the different treatment options. It was a little bit like drinking from the fire hose and a lot of it just going over my head initially, because I just wasn't grounded in a lot of the science at that point in time. So after I got smarter about the different therapy options, one of them of course is becoming a little bit more prevalent and discussed a lot more in some of the sciences and the journals is active surveillance, which is a fancy way of saying to do nothing and just watch and monitor for any changes or signs of changes or progression in the disease.

And so when I first went to Kibel, who's the first specialist that I was referred to, he actually recommended that I go on active surveillance for a year. I agreed with that diagnosis based on my initial feelings about where things were for me, the grade that I had, and that it just made sense not to jump into something right away, but try that with this active surveillance and maybe it would just plateau and not advance any further. That was kind of hopeful thinking. That was what I did for a year.

And then after a year of active surveillance and watching PSA closely and doing another biopsy or two, my cancer progressed to a Gleason 7, 3+4. I was then told by Kibel that it was time to do something, given my family history and the fact that my PSA levels were climbing and that the biopsy had revealed a progression. He was recommending that I take some action. He was saying to me that, "It's your choice, whether you want to do surgery or go down the radiation path, but I think it's time for you to do something." So I asked him if I was going to go down the radiation path and I hadn't decided yet, I just wanted to get more information, dive deeper into my research and validate some of the things that I had learned, said, "Who would you refer me to?" And he referred me to Dr. D'Amico, who was also a world-renowned expert in radiation oncology.

And so in my first session with Dr. D'Amico, I also challenged him. I said, "What about continuing active surveillance as an option?" And he basically reiterated what Dr Kibel had said and that it's, "Given your family history, the progression, the PSA levels, I would recommend you do something and not continue active surveillance." That was the first hurdle for me was to get over going from active surveillance into dealing with some kind of a more aggressive therapy. Then from there, it was digging deep in both of those options and understanding them more than I did.

So what I learned and what I would recommend or advise myself if I had to go through this whole process again is that I would follow the same path and get educated. My knowledge is power here, for sure. Do as much as your own educating as you can, but then you need to validate that information against the experts as well. And by the way, one of the most important resources for me was YouTube. When I was looking at Dr. Kibel and Dr. D'Amico, both of them are really well-known experts and have given lectures at conferences. And Dr. Kibel even, he's considered one of the foremost experts in the use of robotics or da Vinci robotics for performing surgery. I actually watched one of his surgeries on YouTube. That was extremely helpful for me to understand, what does it entail? What does it actually do?

And then on the other side, on the radiation side, I was also watching YouTube videos and there was particularly a Dr. Scholz who really was very, very helpful to me in understanding the differences between surgery and radiation, the pros and cons of each one. He really was enlightening in terms of how far radiation therapy had advanced over the last 15 years and changed my thinking, because I had originally had gone into this based on my sister's reaction and my own feelings that I was young enough where surgery probably made sense, just take it out and not worry about it anymore and deal with the side effects. But Dr. Scholz's videos on YouTube really changed my perception. And what I learned from that is that the outcomes for both surgery and radiation were pretty much the same in that the side effects were probably a little bit better, less severe, I should say, in the radiation world than it is in the surgery world.

And so that, I hadn't made a final decision, but watching those videos really turned my thinking around away from being just thinking I'm going to do surgery and get it over with versus, well, let's think harder about this. Let's consider the advances, let's consider the pros and cons of the side effects from each of these therapies. And when I combined all that together, I really changed my mind and I decided to go down the radiation therapy path.

In hindsight and retrospect, now it's only been a year out or close to a year out, so proof's still in the pudding for me and outcomes are still years away, right, to look at this thing in more of a long-term picture. But in hindsight, I think I made a good decision for me personally and we'll see how that works out. But another thing that helped turn me around on therapy was when I met with Dr. D'Amico, I asked him about his specific track record when it came to outcomes and he gave me a very interesting statistic. He said to me, "I've had 26,000 patients that have gone through radiation therapy, and out of 26,000 patients, I have had only seven that have had severe recurrence of cancer." To me, that was a pretty amazing statistic and really helped also convince my thinking at that point to go down the radiation path for me.

As of today, I'm about a year, close to a year since my radiation therapy and my PSA levels are close to zero. I have basically fully recovered. I went through... One thing I didn't know when I was doing the research on radiation therapy is that it's common for radiation therapy to do it jointly with a hormonal treatment, hormonal therapy. That was something that I in hindsight, looking back, that I would've probably wished I had a better understanding of why the hormone therapy is needed jointly with the radiation therapy. But my point of bringing this up is that, so after, took me about from October to February, maybe about four or five months before my testosterone really, levels came back to normal and that basically helped return my libido to more of a normal interest in sex again and so forth. That was something that I did wish I knew a little bit more about, kind of understanding how the hormonal therapy worked jointly with the radiation therapy and what some of those side effects were that went along with it.

One thing that I did learn and I'd like to share with other men that may be going down a similar journey is that understanding more of the side effects of both of the options. Even though I had done a lot of research and there was a lot of information out on the web and from your doctors and professionals that can give you all this advice, it's a little overwhelming to take it all in. So you might even think about charting it out and making sure you really understand it.

One of the things that I didn't realize was going to be as challenging was the hormones were interesting side effects to me and knowing what hot flashes are. I certainly have a lot more sympathy for pregnant women and women that are going through menopause of learning what that is like. And the other thing I learned about the hormonal therapies was the impact radiation that was going to have on my sex life. I'm a normal red-blooded male and there was definitely a decrease in interest in libido as a result of the therapies. While it did take four to six months, it has returned to somewhat of a normal state, but those are factors that I didn't really, might not have sunk in as much and had as big an impact when I was going through the process. So those are a couple of items that I wish to share with people that are going to go down the radiation joint hormonal therapy path. The hot flashes were interesting and the impact that it has on your sex life, although that it is temporary.

One other thing that occurred that I went through, which hopefully other men won't have to go through is doing this through a pandemic. It limited the ability for my wife to be part of a lot of the appointments. The good news was that for some of the more important appointments, the doctors were good about doing Zoom or just FaceTiming my wife into those meetings and those appointments. So there was some technology that was helpful, but I do find that even though there's a technology, I find that it's somewhat limiting in terms of being face-to-face. And it's always, I think, especially in matters like this, it's more important, I think, to be part of that process.

So I would recommend to other men to make sure your significant other is part of the process. It was helpful to me and I think it would be helpful to anybody that's going through the process to be able to have that additional support and somebody else who's there listening to what the doctors are saying. Because oftentimes I know this when I take my mother to doctor's appointments, she doesn't hear half the things that are being said just because she's internalizing things while all this information is being shared and it doesn't always sink in. So it's always great to have that extra bit of support. And if you've got a significant other, I'd strongly recommend or a close relative, your family or friend, bring them along with you to some of these key appointments and help you go through the journey. It's always better to go through the journey with someone you love than without someone you love, so that would be my other recommendation.