Stephen shares how delaying a visit to his doctor despite urinary symptoms led to a prostate cancer diagnosis and Stage 3 disease. He reflects on undergoing surgery, hormone therapy, and radiation, becoming his own advocate throughout treatment, and making lifestyle changes to support his health. Today, with an undetectable PSA, Stephen encourages men to get annual PSA tests, advocate for themselves, and help break the stigma surrounding prostate cancer.
Hi, I'm Stephen Skinner. I live here in San Diego. I'm a native of Los Angeles, so a native Californian, and I'm a prostate cancer survivor. Today, four years after my diagnosis, I'm always aware of all things related to prostate cancer. Four years ago, I was not getting tested and I knew something was wrong, and I took it upon myself to find out what was going on, and that led to my diagnosis and treatment.
I had issues, symptoms. I was having trouble urinating. Well, I assume most men have to get up and pee at night. I could feel some restriction when I was trying to urinate. But honestly, I was also afraid to go to the doctor. And I don't think I realized how serious it might be. I knew something was wrong with my prostate, and it took me longer than it should've to go see my primary care physician who was not doing regular PSA screening because we had had the conversation about why that may lead to a false diagnosis or too much treatment when it's not needed.
I went to see my primary care physician about four or a little more than four years ago and said, "Something is wrong. Please, I need a PSA test." And my results came back at 22, which freaked me out because it wasn't four or some nice low number. And she referred me to a urologist and then you have a sequence of tests.
I had an MRI which confirmed that I had a lesion on my prostate and then I had a biopsy and then I had surgery. And in between, there was a lot of anxious waiting. When I was diagnosed with prostate cancer, I felt like it was my fault because A, I had waited. I wasn't getting tested by my primary care physician because she felt it wasn't necessary. And I also hadn't seen... This was kind of during the tail end of COVID. So I wasn't seeing my primary care physician as often as I should.
Even though I knew something was wrong with my prostate, I was afraid to go see my doctor, which is not how I usually operate, but that happened. So by the time I got my first PSA test, it was already kind of too late for early intervention. And I felt terrible about it. I was very hard on myself and it just felt like, "Okay. Now we have to hurry up and do everything we can so I don't die tomorrow." And that was four and a half years ago.
Yeah. I mean, getting a cancer diagnosis is really like that's quite a gut punch because cancer is something that happens to other people, right? I always thought I was... Outwardly, I appeared, I presented to be a very healthy person, but I'm 67 and your body doesn't last forever. So I had already found out a few things. I started seeing a cardiologist when I had a hip replacement in 2017. Prior to that, I found out I have an aneurysm in my aorta. So I had some… Which is totally manageable and isn't the kind of thing that's going to kill you, but still, that's another big, scary word like cancer.
I was depressed. After my surgery, I was depressed because I was in a big... I just wanted my prostate out of my body. Get this thing out of my body. I had robotic surgery with a good surgeon who I trusted through my healthcare network, but I'd never had any surgery like that. And it's invasive. I was not a happy camper after my surgery, just having gone through that.
I was having some personal problems with a long-term relationship in my life, and that compounded how I was feeling about myself. I literally went home to recover from my surgery and thought, "I need to pack up all my stuff because I'm going to die now and I don't want somebody else to have to go through all my things."
And I knew I was not in a great mental state, but surgery was more mentally difficult than physically difficult. And post-surgery, I had a PSA test that showed that I still had PSA of 0.9, which meant that there were still cancer cells in my body. And again, I blamed myself for waiting too long to get tested, thinking, "Well, of course, if I'd gone in earlier, this wouldn't have happened."
And my surgeon basically said, "You need to see an oncologist." And he didn't say, "I'm done," but it felt like, "Well, I've done what I can. Now you need to go get this whatever, get this mess cleaned up." So that's when I connected with Moores Cancer Center where I'm a patient today. And I asked a family member who's a big shot doctor in Beverly Hills, who's the best MD PhD in San Diego, and he referred me to Moores Cancer Center.
And when I started at Moores Cancer Center at UCSD, I didn't know what to expect. I just, again, I wanted to take the most aggressive approach I could to dealing with the residual cancer that I still had. So I've had to learn how to speak the language of someone with cancer. So I had or have a Stage 3 locally metastatic prostate cancer, which means that it has spread outside the prostate, but only in the local area around my reproductive organs and has not spread to my lymph nodes or to other parts of my body.
So I felt like I dodged a bullet, even though nobody wants to see the word metastatic in relation to their own cancer. And so, once at UCSD then, I started, I had physical therapy because I had to work on bladder control a little bit. That was not a big deal for me. It wasn't real hard. I started hormone therapy, androgen deprivation therapy, ADT, and radiation. And as soon as I started the hormone therapy, my PSA went down by an order of magnitude from 0.9 to 0.08.
And then as soon as I completed my radiation, which was every day, five days a week for seven weeks, then my PSA was undetectable. And so, at that point, I felt, "Okay. This is where I want to be." And again, that was three years ago. So I've had undetectable levels of PSA for the last three years and I finished the hormone therapy about a year and a half ago.
I kind of quickly figured out that I was going to have to be my own patient advocate. My mother was a nurse and I watched how she managed her own healthcare. And so being my own patient advocate meant not shying away from learning about what I could do and what treatments I needed and being able to talk to my doctor about what was going on, being active rather than passive in my own treatment. And it also meant being honest with myself about my lifestyle and things I could do overall that would help me.
I'm a recovering alcoholic and I did not come to recovery until after my cancer diagnosis because I realized that I could not fight cancer during the day and be a high functioning Don Draper kind of alcoholic at night and get through this.
And I had to be honest with myself about changing my lifestyle in a way that was going to enable me to be as healthy as I could for as long as I could. And another part of that meant learning as much as I needed to learn about prostate cancer and treatments in order to be able to talk to my doctors.
When you have ADT, androgen deprivation therapy, the idea is to deprive the prostate cancer cells of testosterone, which they tend to feed on. It's candy for them. And so medications that you take change your bodily function in a way that you're not producing testosterone anymore. And so that has a huge effect as a man. You've just gone through an operation, you've let a robot have its way with you, and now you're going to live without testosterone for a few years in order to save your life.
I had what I thought was nerve sparing, robotic surgery. Everybody wants to know... I'm a man. Men want to know, "Well, hey, am I still going to be able to get it up afterwards?" And it's like that is the least important thing in the world because you might die if you don't get treatment, but the answer is, it depends. And so, one of the first things my surgeon said to me was, "We had to cut the nerve the next day." And I was like, "That didn't even register with me what he had said." But then it was like, "Okay, great. So I'm going to have ED now."
That was depressing. It's not depressing today because there's a medicine for everything, right? It's just a question of how it gets into your body. ADT, androgen deprivation therapy, if you read about prostate cancer and you educate yourself, you're going to learn about the different kinds of prostate cancer, and the ones that are resistant to certain treatments and the ones that aren't.
And the ones that are resistant are called castrate resistant because it means if you were castrated, it wouldn't make any difference. Guess what? Taking Lupron and ADT, that's a form of chemical castration and nobody wants to talk about the fact that that's actually what you have to go through. It was a difficult couple of years, not mentally. Mentally, it was a very... I felt like I had turned a corner because my PSA was undetectable, but physically, it was difficult.
Those drugs make you tired. You lose body hair, you lose muscle mass, you may develop osteoporosis, you go through the male equivalent of menopause, and that really messes with your head because at a time when I was trying to save my life, then I have to just embrace the downside of these treatments. The upside is they work, at least they worked in my case, and a year and a half after discontinuing those medications, because I'd done the whole two-year course, my body has recovered, but it's like I've gone through puberty twice and I've gone through reverse puberty once. I mean, it's a journey.
Today, I feel great. I am thriving because of choices I made a couple years ago. I don't think day-to-day about having cancer. And when a doctor tells you you're in remission, then your immediate question is, "Well, for how long?" And there's no way to know that, just like there's no way to know... Nobody knows what's going to happen tomorrow, and that remission is like that too. But I'm three years with undetectable PSA. My testosterone has returned to normal levels. I am healthier as a result of the choices I made to stop drinking and change where I could to change my diet. I am honestly in a much better place physically, emotionally, psychologically than before, and I'm very happy about that.
What I tell my friends who will listen and, is get tested annually. Tell your doctor that you want to have an annual PSA test, and that's what you as a patient want and expect as part of their standard of care. Get tested annually and don't shy away from learning about how important it is for men to know about prostate cancer in the same way that women know about breast cancer.
Prostate cancer is the big secret among men who don't like to talk in general and absolutely don't want to talk about their private parts with other men. But every time I see the news about a man who has died of prostate cancer, I'm reminded that there's such a need for raising awareness in this area. And because I have educated myself, I'm able to talk to my friends or colleagues about the importance of that as well.