Hello, my name is Michael Salvadore Jr., I'm from Narragansett, Rhode Island. I'm 65 now. I'm 14 years in. I am an industrial auctioneer and machinery & equipment valuation analyst. Prior to that, I was in the metal stamping and spin casting industry. My family has a long history in the jewelry industry, going back to the ‘30s. And in 2008, March 28th, I was diagnosed with prostate cancer with a very high PSA. And since then I've been on what I consider to be a great journey.

As every man knows, when you're getting an exam from a doctor, it's probably one of the more uncomfortable experiences. And for me, sitting in the doctor's office in your underwear, it's cold, you're on the patient exam table, you're sitting on that paper that crackles and creaks every time you move. My doctor was giving me the results of my exam and my heart rate was good, all my other analysis of your annual physical was good, there were no issues. And then he said to me, "Your PSA is 66." And I was pretty ignorant then about what PSA meant. And I asked him, "Well, what does that mean?" And he said, "Well, anything over four is likely..." And he drops the word bomb, cancer.

And at that moment, everything in my body and my mind froze. I couldn't hear, my field of vision narrowed just to his face and his lips as he was speaking. I couldn't hear a word he was saying. I couldn't tell you if my heart was beating, if my blood was pumping, or if I was breathing. All I could think of was, I got a two-year-old daughter, my wife is pregnant with the next one on the way, and just recently have been married and now I have cancer. And it was a surreal moment that is etched into the memory banks of my mind.

And I left my appointment with my doctors, my doctor walked out, he said, "Whatever you need, call me. I'm here for you to help you through." Went out, got in my car, thought for a moment what am I going to do? And I just said, "Forget it, I'm not going down." And I got on my phone, called a friend of mine who had just gone through prostate cancer surgery. And he said to me, "Don't worry, it's not the end of the road. Take a deep breath, concentrate on your care." And that was the beginning of my journey.

After my hearing came back to me in my doctor's office, my doctor, I asked him, "What do I do?" He said, "Call your urologist. Go see him." So, that was a Friday afternoon. On Wednesday, I was in my urologist office. We reviewed the results of my PSA and my wife was with me. We had a very long discussion about possible treatments and places to be treated and we got a list of names from him. And I'm very grateful to my urologist for all of the doors that he opened for me. And I went on a roadshow. I went to Boston. I visited Dana-Farber, Brigham and Women's, Beth Israel. I went to Johns Hopkins. I went to Duke. I went to Yale. I went to Sloan Kettering. For the next probably 35, 40-days, it was a mission to seek out the best care that I could get, which was the advice that my PCP had given me, "Go where you get the best care." And I was relentless. It was my life, it was my two daughters, it was my wife, it was my sisters and my family, and I wasn't going to back down.

When I went to these various medical institutions, or for instance, Johns Hopkins, I got into the first multidisciplinary clinic that they ever had. I haunted them and I haunted that poor woman who was the facilitator and the organizer every single day, sometimes twice a day. I wanted in. So I saw all the top doctors at Johns Hopkins. I saw the chief of medical oncology at Sloan. I saw chief urologist at Duke. I saw the doctors at Cleveland. I spoke to the doctors at Beth Israel. One of the most important things of your path and your journey and your fight is to be an advocate, to demand for yourself that you get the attention of the best doctors that you can find and that you go where you find the best doctors. And you have to demand that. You have to be the advocate. You have to be a tireless advocate. Relentless advocate.

My wife has been with me every step of the way. She hasn't been with me on every appointment. She was with me on my initial appointment with my urologist, and I'm a pretty independent person, kind of went on my own. And we had a two-year-old at home, so I couldn't really... Logistically it was a little bit different. And plus my wife was pregnant, so I couldn't be dragging her all over half of Georgia to visit with these doctors. But the support and the encouragement that I got from friends and from family, I couldn't have done it without them. They were my support, but they were my inspiration too, and without them, it just wouldn't have happened.

Looking back, I was just unbelievably naive and ignorant about certain aspects of men's health. And prostate cancer is very pervasive, and it's very important that men be aware of the prevalence. It wasn't prevalent in my family, so it really wasn't a discussion that happened around the holiday dinner table or Sunday dinner table. When you're diagnosed with cancer, the first thing is, what do you do? I mean, it's a stun grenade that goes off in your life and it's just the initial recovery of trying to get your balance back to understand that you got to go figure this out. So I relied on the advice of medical professionals. I relied on the advice of my urologist, who was a young guy, who was well-trained. I relied on the advice of my personal care physician who had been my PCP for, I don't know, almost 30 years at that point, 25 years.

And I relied on the advice of the people and the doctors and the medical professionals that I had encountered along the way of my research and my journey of finding the place to get the best care. And it's a lot of information to decipher and to sift through, but after you go through it, you start to see a common thread and a common theme. Everyone's course of treatment is individual, and now cancer treatment is so individualized that it's almost like a concierge service.

So after going through and visiting all these medical institutions and getting all this information and having a consultation with my PCP and my urologist, two guys that were just tremendously important. And talking with my wife and some other friends who had gone through it, I decided that I would enroll in a trial at Dana-Farber, which was a double chemo. And my first chemo was July 1st, 2008, it was a Wednesday. I drove up from Narragansett with my oldest friend, longest friend that I've known for, I don't know, now, 60 some odd years. And I got my first chemo on that Wednesday and I left Dana-Farber and we went down on Newbury Street in Boston. We had lunch on the street. We were watching people. We went shopping. I drove home. That afternoon I went surfing.

The next day I went to work. Friday was the third, had friends up from New York. We had a party on my deck. I'm like, "Oh, this is going to be a piece of cake. I'm going to go through chemo and then I'm going to sail through this." We watched the fireworks. I had a couple of glasses of wine, and I woke up the next day and the eighth army had rolled over me. And nobody told me it takes a few days for it to hit you. And that was my first experience with chemo. And every three weeks after that, I would get treated. And I went through 36 weeks of chemotherapy, which it turned out was a successful course of treatment for me.

My chemo was radical prostatectomy, Dr. Richie, and surgery was successful. It looked at that point like maybe they had gotten it all. And Dr. Richie was very confident and encouraged that they had gotten everything, tumor had shrunk back through the chemotherapy and my PSA had dropped all the way down into the high teens, which was a huge drop from 77. And initially looked like it was good and then three months later, my PSA started to rise, and six months later it had tripled. So at that point, in consultation with my medical oncologist at Dana-Farber, we embarked on a course of radiation, and that dropped it down a little bit, but it has been persistently present since then and it's been treated with hormone therapy for the past fourteen and a half years.

The thing about going where you get the best care and going to a medical institution that has access and that has relationships and has partners with institutions and business entities that are advancing medical science is that as your survivorship goes on, better drugs and better technology come into play. And at Dana Farber and Brigham and Women, they are at the epicenter. They are at the nexus of medical technology in Boston that has educational institutions, life science companies, medical professionals that are just continually advancing the point of the spear and state of the art. So Brigham and Women ended up with one of two of only in the country of what they call a LINAC. It's a linear accelerator and MRI machine all into one.

And using a radioactive isotope tracer they were able to identify a very small invasion in one of my lymph nodes in my pelvic area. And using this unbelievable machine, they were able to pinpoint in six dimensions this area and blast it with radiation. It's an amazing technology and underscores why when you are diagnosed, you need to go where you get the best care.

Early intervention is key and it's important to understand your family's history and to understand the predilection that your family's genetics may have to a cancer in general. And I think that if I were to go back, I wouldn't change anything. I wouldn't change the doctors that I chose. I wouldn't change where I chose to get treated. I wouldn't change what I chose to do. And I think that that's a result of being your own advocate. And the most important thing that anyone can do is to be their own advocate. If I had to go back and give myself advice, I would say, don't get it.

For any newly diagnosed patient, I would recommend that, take a deep breath, keep your wits about you, approach it as a problem to be solved, and seek out the best care that you can get, regardless of where you have to go to get it. It's your life, it's your future, you need to be at a medical institution that can afford you all of the benefits that you need and that you should demand for yourself.

I would say to relax and take it one step at a time, one day at a time. Stay off the internet. Watch out for voodoo doctors, there's a lot of misinformation on the internet. Focus on your medical professionals. Find the best professional for you, for your particular care that you need. Rely on them and lean on them and engage with them, and they will in turn return back to you the best care that they can give to you.

So many people think that when you're diagnosed with cancer, that you become branded, that you become a damaged person or an inferior person, or there is something wrong with you. And for me, what I have found is that unfortunately, there are so many people that have to deal with cancer, not just prostate cancer, but all different kinds of cancer. And when you hear someone has cancer, you feel for them, you wish that there was something that you could do for them. You always, or I would always, and people always respond, have done this for me, is that the first thing you say is, how are you feeling? How are you? And you learn that there's a lot of compassion in people and that there are hundreds of thousands of people of medical professionals, of scientists, of researchers, of doctors and nurses, and receptionists that are all there for you and are all there for your care and for your health and for your survivorship.

And when you sit in an office with just your doctor, that's the tip of the spear, and behind your doctor is a whole medical institution of people whose life and dedication it is to advance the science, advance the treatment, and advance care to help you either beat it or live with it and live through it. And it's comforting to learn and know that those people are there and it's... You see who your friends are, and you see the people that go out of their way to support you, and you see the people that go out of their way to support your family. And life takes on a different color and a different shape, and it's not all bad.

I guess everyone deals with adversity on their own terms. And if I could give advice, I would say that don't deal with this adversity in isolation. And I've discussed it with my family, we talk about it. It was all we talked about at the beginning. My professional colleagues all know, it's not a secret that I keep. For me, it helped reinforce my defiance that I won't back down. And I think of that Tom Petty song all the time. And it's helped gain the support of other people. Your mental health and the attitude that you take, it's one of the most important medical things that you can do for yourself. I don't know what the right word is, but your positive mental attitude can make a difference. And I believe for me, that having a positive mental attitude is what's kept me going for 14 years. And your positive mental attitude, your faith in your doctors, your faith in general, and just the belief that you got the right people and they're going to do right by you.