A call to rally my brothers in arms in this battle.
By John McCaa,
Contributing Columnist
The Dallas Morning News
A year ago, at age 71, I joined the army.
Well, “joined” is not the right word. I was drafted. Notification of my enlistment didn’t arrive via letter from the Department of Defense.
It came during a face-to-face visit in a small office sitting across from a man wearing the white coat we typically associate with the medical profession. The “army” into which I had been conscripted was not the United States Army, but the 3.5-million-member platoon of American men diagnosed with prostate cancer.
I would not be wielding a weapon in defense of our country. Instead, my body would provide the battlefield on which doctors would be taking up arms to defeat the trespasser that had clandestinely raided my body. Welcome to the war, Private McCaa.
Cancer’s invasion had been a secret one. There had been no pain, no discomfort. So, its discovery came as a shock. My new enlistment threw me and my wife, Nora, into a whole new world with its own phrases, its own jargon.
Prostate cancer, we would learn, is a “family disease.” As family members of every cancer patient know, the diagnosis brings with it emotional stress, shifts in relationship roles requiring at times more caregiving and more communication.
How did it happen?
During regular checkups to monitor my cholesterol levels, my primary care physician noted that my levels of something called my Prostate Specific Antigen, or PSA, was rising. Specifically, my Gleason Score was up. A blood test revealed my number to be 8.
That suggested an aggressive cancer that should not be ignored. A urologist recommended a prostate biopsy. It confirmed the diagnosis.
I had retired in 2019. Nora and I had dreams of travel and slow, easy days reading, writing and visiting nearby family. All that promptly evaporated.
It brought to mind a warning from Proverbs, “A man’s heart plans his way, but the Lord directs his steps.”
Truth is, none of this should have come as a revelation. My family has a history with the disease. Lung cancer took my mother 20 years ago, ovarian cancer my sister a decade after that. Now, looking for an easy victory, the enemy had planted its flag on my doorstep.
When first confronted with a cancer verification, I hoped it might be a mistake. After all, who has not heard at least one story about a complex medical machine that malfunctioned or a lab result that was misread?
Then came the CT scan, after that an MRI, and finally a PET Scan — all of which pointed to the same conclusion: prostate cancer. This was no fantasy.
The urologist mentioned treatment options. Among them, hormonal therapy, radiation treatments and surgery. The very idea of surgery seemed terrifying. It meant removing my entire prostate and some surrounding lymph nodes during a procedure called a prostatectomy.
Doing nothing briefly crossed my mind, but only briefly. Just as quickly came the realization that it was not just my life that would be impacted, so would Nora’s. And every moment spent contemplating next steps, the enemy within was gaining ground, its mission of taking my life unimpeded.
Like other cancers, prostate cancer disrupts the body’s normal process of renewing cells. It focuses on the tiny prostate gland below the bladder. The generation of new cells there spirals out of control, invading healthy tissue. Left unchallenged, it can be deadly.
This invader has taken the lives of such notable figures as musician Frank Zappa, the celebrated poet Langton Hughes and actors Jerry Orbach and Gary Cooper.
Scouring the latest literature, we learned it is not uncommon. In fact, 1 in 8 men will get prostate cancer at some point in their lives.
Among Black men, that figure is 1 in 4.
In some men, it can grow so slowly that they live their entire lives without it being discovered.
Nationwide in 2025, the American Cancer Society estimated my “recruiting class” of new prostate cancer victims at 315,000 men, with another 330,000 expected to join us in 2026.
In Texas this year, cancer treatment specialists at Texas Oncology report 24,090 new cases of prostate cancer will be identified. About 2,500 Texas men will succumb to the disease.
While sharing the somber developments with a small number of our friends, many of them stunned us with the news they were already in the fight, quietly clashing with the same ailment, some of them for years and looking healthy as ever.
Few things can convince an old man set on a lazy retirement in a small South Texas town to get off his duff quicker than a cancer diagnosis — and a wife making sure he misses no appointments and takes seriously every piece of medical advice.
I had a telehealth meeting with a top doctor at the University of California San Francisco, flew to Dallas to confer with a highly accomplished urologist at Methodist Medical Center, then made a second trip to Dallas to consult with a renowned specialist at UT Southwestern.
All their recommendations pointed to surgery. Specifically, a surgical procedure called a robot-assisted laparoscopic radical prostatectomy or RALP. A specially trained doctor manipulates a large multi-armed device resembling a giant metal spider to remove the prostate and some surrounding tissue. It would include an overnight hospital stay.
That successful operation took place last August in South Texas by my urologist who trained at UT Southwestern. My Gleason score in the months after was undetectable.
Victory!!!
But a fight against prostate cancer is not a battle; it is a war.
Six months after the surgery, that Gleason number started climbing. When it reached 2, doctors made clear that, as in any war, while there may be brief interludes of R-and-R, rarely is it permanent. Cancer was attempting a comeback.
In the last few months, it has meant another PET Scan, visits with a radiation oncologist and multiple radiation treatments. Five days a week for the next several weeks, “combat operations” will continue in my “lower regions.”
The treatments are short and painless. I think of them as “surgical strikes” that, with each sortie, devastate pockets of the enemy beneath the surface.
Nora is part of this fight too, and she carries just as much of the emotional toll. According to one WebMD article, more than half of spouses of prostate cancer patients report feeling helpless, anxious or depressed, although some also report that fighting alongside their husbands has brought them closer together.
What happens next, we shall see.
As much as we may want to believe life goes on, in truth we are all born with a stopwatch ticking inside, the time remaining, unknown to us.
September is Prostate Cancer Awareness Month.
As any good doctor will tell you, there is no better time to be tested than now. Early detection makes all the difference in the world.
In the months ahead, other men and their families, some of whom are reading these words, will face a medical professional who will officially welcome them to our band of warriors in the fight against prostate cancer. If you are one of them, take heart, there are more of us than you imagine.
That’s why I’m sharing my experience here — to rally my fellow “draftees” and encourage them in this fight. To remind them that, in this battle, like the U.S. Marine Corps, we cancer warriors are always looking for a few good men.
