Wes shares how family history, rising PSA levels, and his own research led him to take prostate cancer screening seriously. After MRI, biopsy, and a second opinion at UCSD confirmed an aggressive form of prostate cancer, he chose radiation and androgen deprivation therapy over surgery based on his priorities for quality of life. Wes emphasizes the importance of being your own advocate, bringing support to medical appointments, and focusing on early testing and informed decision-making.

Hi, my name is Wes Danskin, live in San Diego. I knew my father had prostate cancer. I'm a technical type person, a researcher, and I knew almost nothing. Because I hadn't been feeling well from an emotional erection standpoint and so forth, I went in, had testosterone supplements about, now it's been maybe six years ago, maybe seven, on and off, very expensive, no real side effects. But as part of that, you get tested blood work for blood cell content and PSA. And so that then opened the door to PSA testing. So the PSA went up a bit. I started learning what that means.

Then I did more homework and I found out that my dad had been adopted. I didn't know that until I was 40 years old. And his biologic father died of prostate cancer at 83. So now I'm going, "Oh wow, we have three data points, grandfather, father, and me at almost identical age to my father. And my brother's nine years younger. My son is 36.” I decided I would learn this.

As I mentioned, the PSA went up from maybe two to three and a half. Actually pretty modest. The urologist that I was meeting with was mostly related to hormone testosterone replacement therapy and said, "Well, maybe we don't want to do prospecting because MRIs are useful, but they can be misinterpreted. Oh, here's a dark spot. Let's go in and biopsy at their risks for that."

So I understood that, so we postponed that for a year. In retrospect, I might have had the MRI just as data, not necessarily to be actionable. I would, as many people would say, "You need to be your own advocate of your health." So I would have now, in retrospect, appreciated the data. And I would have made the decision based on probabilities and things of what we do with that data. But I didn't until like a year later. And then it went up some more, and now it was like, okay, you probably ought to have an MRI.

And so I postponed that until maybe November of 2024. Now we're barely a year away from now. And then I had an MRI. Sure enough, oh, there's two spots that look like they're... Got to get the jargon going, looked like a spot. Okay, what do we do with this MRI that looks suspicious? Okay, we do a biopsy. That was about Christmas a year ago. And it came back with quite a few. So maybe a total of 14 samples, all but six showed some prostate cancer.

I had been working at Scripps, excuse me, working my medical stuff for 40 years at Scripps. I found out UCSD is better by a lot of people's acclimation. It's also a research facility which aligns with my personal views. And so I went over there. So now I'm talking to those guys. They're interpreting the biopsy that was done at Scripps. They're telling me, "Oh, you've got cribriform and intraductal. These are aggressive forms of cancer. We should probably do something," meaning not just sit and watch at the active surveillance part.

So by that time, I was pretty well up to speed with the jargon and some of the basic concepts, and then my girlfriend's in medicine as well. So she would go with me to the various different meetings. I thought that was really good. I learned that when I was taking care of my mom, for all of you people out there, you need an advocate with you every medical meeting you go to because you'll either be scared or inattentive or thinking about something else. So two people can take that information in far better.

So it really became a method of learning, but because not so much for myself, but for my brother who's nine years younger and for my son who's 36, and as I said, three data points, grandfather, father, and me, I go, "Man, I better learn this well.” How do they get diagnosed at a prudent time and what do they do, albeit the information and technology is moving rapidly and improving rapidly.

First I think they did a very good job of listening to my priorities. I told the people at UCSD, I ended up with three urologists and excluding the testosterone guy. So I actually had four total. But I told the three that were taking care of me, a surgeon, a radiologist, and a medical oncologist, that my priority was not to live longer. Again, my priority is not to live longer, but to live well during the period of time that I can. And based on that, we went through some options.

Those options were first, I have a mesh in my belly area because I had a hernia that was cleaned up, as we would say, when I had gallbladder surgery. And I go... I wasn't asked. They just simply did it. But what that means is it's very hard to go through the belly button for internal surgeries, including prostate surgery. So I go, "Okay, that's off the table." Okay, well, what now? We shouldn't just watch it because of the cribriform and Intraductal.

So then deal with it was you either have radiation short and sweet, or longer and whatever. And so I had 25 sessions of radiation treatment because surgery's off the table, waiting doesn't seem to be prudent. Radiation is far better than it was even three years ago, much less 10 years ago, far more targeted. So I had to let go of ideas. I heard from my dad 30 years ago, had radiation, one tough cowboy type dude. He goes, "I can't tolerate this anymore. I'm stopping." Well, those are in historical footnotes from what I've heard. I've never heard that now. It's targeted very well.

UCSD has some magic tools that they use to make it even better. So those are selectively around the countryside, United States at least, and probably will become more routine. So I wasn't too concerned with the radiation. But in my discussions with the urologists and others, I said, "I'm actually more concerned with the side effects of the treatment than the disease itself."

So I go, "Okay, well, I guess I will go down this path of radiation." And then they said it would be prudent to go on androgen deprivation therapy. So early on they said with cribriform, a lot of times you'd be on androgen deprivation therapy because I learned that testosterone is like sugar to the prostate cancer. There's an equivalent in women's cancers as well for estrogen, but so we dropped the testosterone to zero.

The urologists, all three of them agreed, including my other outside advisors, that going on the radiation for 25 days, doing six months of androgen deprivation therapy was prudent. Maybe not 18, but six seems prudent. It turns out that for other reasons, I ended up with nine.

And everybody was very good, and I want to emphasize this. They were very good at listening to my priorities. And when I relate this story, I always say that other people's priorities might be different. But they listened very well with probabilities to what my preferences were, and so that's the path we're on.

I deal with science stuff. So I found out that the... So I was on pills, ORGOVYX, and they didn't really drop the testosterone quite as fast as people wanted, hence the reason I'm on nine months, not six, because I then went to an injectable Firmagon, which is a quaint name. So I'm on that, and I found that I did have a lot of the side effects that come with prostate cancer. They're not horrible, they're part of getting older in some ways I've realized.

So now that drug has a half life of 53 days. So I get an injection every 30 days. It has a half life of 53 days, which means it'll take five times 53 roughly to be out of my system, so nine months. So I suspect that I will see changes fairly gradually from the standpoint of testosterone returning. I also know because I was on testosterone replacement therapy that my body shut down the production of testosterone. So how all of this plays into my next year, I don't know.

I would say that every male starting at age 40 ought to be tested for PSA. Prostate cancer is a much tougher topic to describe to a whole population. But I think if you had easy public information like this, then I think people can wade through it and get an answer that makes sense to them, I would say with the data. If you don't have the data, you're just hoping.

There are many worse things to have happen in life. I've gained a lot of weight. My sex drive is near zero. I pee every hour, didn't used to, but these are first world problems, and I've traveled internationally enough to know that.