My name is Gogs Gagnon and I'm currently five years out after my prostate cancer treatment and I'm here to share my experience. I was very healthy and fit and I was very active in the gym and I was in martial arts. I rode my bike every day to work and back home. And I didn't expect to get a cancer diagnosis, I had no symptoms of any kind. I was at my doctor's office having an annual physical, that's something he recommended once I turned 50. That I just have an annual checkup to make sure that I was healthy, nothing to worry about. And at one of my annual physicals, he recommended that I have a PSA test. Now I was getting blood work anyway and I thought getting a PSA test, why not? Let's get that done too. So off to the lab I went and I had my blood work and didn't think much about it.

And next week I was in the office going over the results with my doctor and he was very happy with all my results. Everything was in a healthy range except for my PSA, it was slightly elevated. He wasn't too concerned about it because it was my first reading and he thought, 'Well, why don't we just read it again in a few months?' And I thought, 'Sure', I never really thought about it. A few months later had another reading and the results were a little higher, so he still wasn't too concerned. But he did a digital rectal exam. He didn't feel anything, he said my prostate was enlarged, but that's quite typical as men age. So he sent me off to a urologist just to get a second opinion. And urologist did a digital rectal exam, said the same thing, basically enlarged, but nothing really to be more concerned about. And sent me for another PSA test another three months later and my PSA test was up even higher.

So at that time, the doctor was getting a little concerned and sent me for a biopsy. And this is when you start to get a little concerned and you start to wonder what's going on. And so you do a little bit of research. And so I had my prostate biopsy and the results were negative, no cancer found. And as a patient not knowing very much about that, I assumed that what that meant was I had no cancer. So my doctor wasn't concerned anymore, but he did recommend that I continue with my annual PSA testing anyways, just to keep an eye on it, which I did. And over the years, my PSA continued to rise, still no symptoms and still no real concern.

But it was about four years later, or almost five years later, my wife and I moved and we had to find new doctors and found a new doctor. And she noticed my PSA has been rising for several years and so she was concerned about that. So she did a digital rectal exam and didn't find anything other than a large prostate. She sent me off to a urologist. And this time the urologist said, 'Well, because you had a negative prostate biopsy in the past, let's do an MRI'. And this is something that I didn't know either, my first biopsy it was just a blind biopsy. I didn't realize that it's possible to miss a tumor, but I guess that makes sense. So I went off to the MRI and the results came back that there was a significant anomaly, not just a little anomaly, but significant anomaly in my prostate that was outside the reach of the digital rectal exam.

And that's something else I assume too. I assume that when the doctor, I had several doctors to do a digital rectal exam, I assumed that when they told me my prostate was smooth, I assume that was the entire prostate was smooth. But no, only what they could feel. So after I had the MRI, went off for another biopsy, but this time they targeted that significant anomaly and that's when they found cancer. So here I was in the doctor's office getting results of my prostate biopsy. And when I heard the word cancer, that's when I immediately shut down. I immediately thought the worst. And I can no longer process any of the information that the doctors telling me. And I kind of panicked and I didn't realize I was in shock. And I, first thing I thought of was I wanted to get rid of it.

And I wanted to do surgery, without understanding anything about my cancer. Without understanding what my Gleason score was, not even understanding if the cancer had spread, not realizing that there's more tests to be done, not realizing that there's many options to consider. Not realizing that there's many other doctors that I should talk to, here I am assuming the worst. Even my doctor told me to slow down. He gave me a whole bunch of information. He said there's more tests that we needed to do and he recommended that I speak to a radiation oncologist. He recommended that I go to a cancer clinic and speak with a nurse navigator. So I did those things, but I think because I had this urgent need to get rid of it or I felt I had this urgent need to get rid of it, I think in the back of my mind I already made that decision to have surgery.

So I don't think I had an open mind when I made that decision. After the surgery, I woke up and it was quite real at that point. You see when you're making decisions, especially when you're in shock and you don't have all the facts and it doesn't perhaps seem so real until you wake up and you had the surgery and this is real and there's no going back. And that's what so important to realize this before you make that decision, you're committed. Once you've had whatever treatment you've decided to have, there's really no going back. So another reason why it's so important to take your time with the decision and make sure you understand all the pros and cons and also understand what the side effects may be and if you're willing to live with those side effects as well.

So here I was woken up and it's like, 'well, this is real, all right'. But I've been so lucky though because I have the support of my wife, support of my family, they were there for me. And I recovered, actually not bad. It wasn't that bad. I think I certainly wouldn't have recovered as fast without the support of my family. They were there with me. And there was this one incident where, I was quite fit before my surgery and after surgery I realized that I wasn't able or it was recommended to not do certain things for the first six weeks after surgery. And I believe no matter what treatment is offered, there's some kind of recovery period recommended. And it's very important to follow doctor's advice. And if you're not supposed to lift more than five pounds or not supposed to climb stairs or not supposed to carry groceries or whatever the rules are, it's very important to follow them.

So here I am trying to get back into my fitness level by going out for walks. And I'm glad my son was with me because I had felt, became very dizzy and very weak as I was pushing myself too hard on a walk. And I actually started to collapse and my son was there to grab me before I fell on the pavement. So just very lucky to have the support. But it's important to follow the doctor's advice on recovery. It's whatever treatment you have, there's going to be some kind of recovery period. Just follow the advice of the doctor.

Life's been good. I'm actually at a point now where I don't even feel I've had treatment, although I do want to point out one thing. I was aware of potential physical impacts, but I wasn't really aware of emotional and mental impacts. About a few years after my surgery, that's when I started to develop a fear of recurrence because I had met many men who have had recurrence several years after their treatment. Not just surgery, but other treatments as well. And that's when I started to develop this fear of recurrence. And now when I go for my follow up PSA testing, which I have to do for the rest of my life, there's always this little anxiety or wondering what the number will be. And sometimes this anxiety can get a little out of hand. So it's very important to realize that potentially, there's also emotional side effects as well to whatever treatment or even if you don't get treatment, just having cancer itself is an emotional impacts and that you'll need to find ways to help cope with that.

And for me, I found talking about it helps tremendously. And also just writing journals, writing about it really helps as well. So whatever means helps, whatever means is out there, is important to realize that not only you going to have to deal with physical impacts, but you need to take care of your mind as well. So that's something that I didn't realize. But things are good. Like I said, I don't really feel like I've had the surgery and I'm pretty much back to normal other than the fear, I'm not sure the fear will ever go away. So I'm doing very well actually.

Just because one treatment option works for one person doesn't necessarily mean it's going to work for another. Every case is so different. And that's why it's so important to have a good understanding of your case and understand what the options are that are best suited for you. But I tell you, if my surgery was unsuccessful, I would've not only regretted it, but I probably would've just hated myself for not taking the time, not doing my homework, not doing my diligence to ensure that I made that best decision for me. Because I was thinking if I had done my homework, if I had really spoke to a radiation oncologist and went to the cancer clinic, talked to the nurse navigator, went to support groups, talked to other people who went through it, and really felt that I understood all the options, all the pros and cons, and really understood my specific case. And then if I made that best decision, if that decision had failed or if that treatment had failed, then at least I would be in a position to know that I did everything I could to make that best decision rather than just going in and hoping for the best.

So that's basically what I would do differently, is try to understand that I was in shock, try to understand that I needed time just to recover from that shock. And it's not a good idea to make decisions while you're in shock. So number one is sit back, learn to accept that you have cancer before you make any decisions. Then once you're in that acceptance stage, then you could reach out for information because I wasn't able to process the information while I was in shock. I was just glossing over it, not understanding it. So acceptance, then process the information, then speak with multiple doctors, get multiple opinions and really ensure that you understand what those treatment options are and what the pros and cons are of each one.

And even I would join a support group before I made my decision and listen and speak with other men. Realizing that every case is different, realizing that even if some of the men had successful treatments that worked for them, it was because of a lot of different variables involved. So there's a whole bunch of research that I didn't do that I would do. And one other thing that is quite interesting, my spouse, she was very supportive throughout this whole thing. But one thing I didn't do is I didn't include her as much as I should have. And as I said, I shut down at the beginning and I didn't even want to talk to her about it. But I would've involved her more in the process as well, before making that decision and moving forward.

One thing that I didn't realize is not only are there a lot of options, but there's also a lot of trial, clinical trials as well. I didn't realize that. I assumed, wrongly assumed, that clinical trials are for secondary or treatments or follow treatments, but it's quite possible that clinical trials could be a primary treatment as well. So just to keep a real open mind to what's out there. And also make sure that you speak to more than one doctor and don't feel embarrassed to ask for a second opinion or to get a second opinion. It's something your doctor should encourage and should want you to do. So it's very important not to just go with the first treatment that you're most familiar with. So I think the big one, is understanding there's lots of treatment options and you get multiple opinions. And to join that support group to get a bond base going of knowledge.

I was really hesitant to join that support group because I didn't want people to feel sorry for me. And I had no idea really what a support group was. I really had the kind of a wrong impression of it. And it was tough really to admit that I even needed to go to a support group. So walking through that door was very difficult, to take that first step there. But after I went in there and I realized it's just a great group of guys who are there not just to talk about cancer, but just to meet people and bond and talk about the weather and sports and different things. And it was real helpful just to be there. And that's when I started to learn about all the different options that all the different men went through and all the different difficulties that they had and all the different things that they had done. And to realize that this whole world out there that wow, you really need to try to broaden your horizon by not just simply doing Google searching on your own, but to actually get out there and meet other people and talk with them.

And the great thing about the support group is they're not there to judge and they're not there to give advice. They're there simply to share their experience. And it's just been very bonding. I met many, I've dealt many great friendships as a result of it. And now I'm thinking, 'Wow, if I had to go through this over again, I would join that support group first'. The support that I got from my spouse was, I'll talk a little bit about that. How she supported me was not by, how do I say it? She didn't pressure me one way or the other. She didn't ask me a lot of questions. She didn't even ask me how I was feeling or anything. She basically would sit with me and in silence and just let me be, let me process it. And sometimes she would just put her head on my shoulder and just hold my hand. And that was the kind of support that worked for me and that I was looking for.

And later on I got more and more comfortable with her because we were just sitting together. So I did start to open up a little bit to talk to her and she was very nonjudgmental. And she just basically listened, which was very important to me. And then when I was more comfortable, she recommended that why don't I just write a little journal and I don't have to show it to anybody. It could be just private. And then I could rip it up afterwards if I needed to just to get things off my mind, which was very helpful. I started to write and I didn't realize how, for me anyways, how therapeutic that was just to start writing.

So I wrote these journals and what had happened is I had coworkers and friends that would call me and email me and ask me how I was doing. And so I decided that maybe I trust them, maybe I'll share some of my private journal with them. And so I did and I was really overwhelmed by the response and they encouraged me to keep on writing. And that's when I decided that, well maybe I'll write a book. And I didn't realize how much time and effort is required to write a book, but I was very committed to it. It was a real labor of love. And so I wrote this book and I really didn't expect anyone to read it per se. It was kind of something I'll give to my kids so they can remember their dad.

So I wrote this book, took me two years full time writing. I have a much more appreciation, better appreciation, of authors out there. And how much writing books is very time consuming and the editing processes and all this. But here I wrote this book and I'm quite proud of it. And to my surprise, I didn't even expect anything really, to my surprise a Prostate Cancer Foundation BC here in Canada, they read my book and they now endorsed it and they give it away free all across Canada to newly diagnosed patients. So I still can't believe that happened, but just the writing was enough for me and this is a bonus. It's so important that you need to understand your specific case, understand your test results. And if there's anything in your test results that you don't understand, you need to, ideally you need to understand them to help you make a better decision, to make the best decision for your particular case.

And in some cases, depending on many factors, there is something called active surveillance. And maybe I'll just point out that my dad was diagnosed with prostate cancer two years after my own diagnosis, which is kind of odd. Usually the father gets prostate cancer first. Now he was diagnosed, his cancer is even more aggressive than mine was. But he'll be 90 years old this year. So due to that, well it's his decision, but due to his age and his life expectancy, he's decided not to do anything about it. And so that's an option as well, depending on your age, your health, if there's other health issues. And also depending on the grade of the cancer, maybe there's some lower grade cancers that perhaps you could avoid treatment for a period of time and maybe monitor the situation. So there's just a lot of things to consider in making your decision.