S2:Episode 22 Generational Family History of Prostate Cancer

Dr. Jordan Smith, host of the "Teach Lead and Expire" podcast, shares a deeply personal and candid account of his decades-long battle with prostate cancer, using his experience to highlight the critical importance of proactive screening and lifestyle changes, especially for men with a family history of the disease.

Main Topic: Dr. Smith's journey through prostate cancer, from early abnormal PSA levels to diagnosis, treatment, and recovery, serves as a powerful call to action for men to prioritize their prostate health and get screened regularly.

Key Arguments and Events:

• Generational Risk: Dr. Smith was diagnosed with prostate cancer in 2023 at age 68 (nearly 69). He realized his father, brother, and maternal grandfather all had prostate cancer, with his father and grandfather dying from it, indicating a strong family predisposition he initially ignored.

• Early PSA and Biopsy Experiences:

  • Began PSA testing at age 50, with consistently elevated (above 3.2, often 6-10) but "normal" PSA for 15 years, often dismissed or attributed to other factors like sexual activity.

  • Underwent his first prostate biopsy early in his teaching career (around age 50/51). He described the procedure as extremely painful and embarrassing, involving 12 tissue samples.

  • Suffered significant post-biopsy bleeding (urine, semen) for 4-5 weeks, which created psychological stress and logistical challenges in a shared public high school bathroom.

  • The initial biopsy results were "abnormal" but not cancerous, leading to a false sense of security and a lack of proactive discussion with doctors about prevention.

• Prioritizing Work Over Health: Due to financial needs (supporting extended family, master's degree for teaching qualification under "No Child Left Behind") and professional commitment, Dr. Smith repeatedly delayed addressing his health issues. He scheduled subsequent biopsies (six total over 15 years) during school breaks to avoid missing work, enduring pain and embarrassment.

• Compounding Health Issues & Caregiving:

  • Stress from work, family responsibilities, and financial pressures led to increased alcohol consumption, weight gain, high blood pressure, high cholesterol, and unexplained numbness in his legs and hands.

  • He also became a full-time caregiver for his wife, who was diagnosed with stage four lung cancer (2017-2019), leading to extreme sleep deprivation and witnessing the devastating effects of metastasized cancer.

• Cancer Diagnosis and Treatment Decision:

  • His persistent leg numbness prompted him to demand an MRI, which finally revealed a lesion on his prostate. An ultrasound-guided biopsy confirmed Stage 1 prostate cancer with a Gleason score of six.

  • Presented with options (prostatectomy, radiation beads, external radiation), he initially chose "watchful waiting" again, driven by his dedication to his students.

  • A turning point occurred when a community friend was diagnosed with metastasized prostate cancer, triggering memories of his wife's illness. This spurred him to choose external radiation therapy.

  • Radiation involved a painful procedure to implant markers for targeted treatment and was conducted secretly during the summer.

• Post-Treatment Complications and Additional Surgery:

  • Radiation successfully lowered his PSA, but he later developed severe urinary issues, including splitting urine streams and passing hundreds of uric acid "pebbles" from his bladder.

  • Emergency consultation with a new urologist led to a CT scan and eventually a cystoscopy, which revealed his bladder was filled with uric acid stones, requiring surgery.

  • He underwent a laser procedure to break up the stones and a TURP (transurethral resection of the prostate) procedure to relieve pressure on his urethra due to an enlarged prostate.

  • Recovery from this surgery was also painful, involving a catheter and prolonged bleeding, forcing him to take emergency leave.

• Transformative Lifestyle Changes and Current Health:

  • Inspired by his experiences, Dr. Smith retired from teaching and committed to radical lifestyle changes: daily cardio and strength training, increased water intake (72 oz/day), improved diet, and a regimen of nutritional supplements (Melaleuca Peak Performance Pack, Prostavan for prostate, Vigor for testosterone).

  • These changes have led to remarkable health improvements: PSA down to 0.1, blood pressure 115/64, resting heart rate 55. He also prioritizes skin care and general well-being.

• Urgent Call to Action: Dr. Smith passionately urges all men, especially those with a family history of prostate cancer, to get annual PSA tests, starting before age 40 if there's a history. He emphasizes that testing can be affordable ($50-60) even without full insurance, and can prevent years of pain, suffering, and potential loss of life. He specifically addresses his sons and grandsons, urging them to get tested.

• Future Discussions: He hints at upcoming episodes focusing on his journey with PTSD and strategies for achieving better sleep, and mentions his song "Student Loan Trap."