Mike Boesen:
My name is Mike. I was diagnosed with cancer, prostate cancer probably in 2017, give or take. And the only reason I say that is because after the diagnosis, we were going to go through this watchful waiting phase and thinking it was going to be a slower progression. And a year later we had another biopsy and it looked like it was growing faster than we had expected. So at that point we kind of evaluated our pros and cons and said, "Let's just do the surgery and take the prostate out." And that was 2018.
My case I think was a little unusual. I'll get into some technicalities of it, but I'm getting instructed here. After I finish, I'll let Lisa probably run the rest of the show.
But the surgery process does an initial scan during the surgery looking for whether the cancer has spread, and that showed that it had not spread on the initial mid-surgery evaluation. And at that point the decision is to go forward with the surgery. I didn't find out until well later that if it had spread, they would stop the surgery and would not take out the prostate. So live and learn after the fact.
But lo and behold, after all the samples were sent to the lab, they came back positive that it had spread to some surrounding lymph nodes. And that point the course of action was to get scheduled with hormone therapy and radiation. So that's kind of where that went a few months later. So this was all mid 2018 with the surgery, and by Thanksgiving I was doing the radiation and the hormone therapy.
That's it for now. I'll resume later with anything more. Let Lisa I take the talking stick.
Lisa Boesen:
I'm his wife. And I always say, "I have enough healthcare to make me dangerous." I've worked in healthcare for 35 years and I know enough about the system to keep my radar up. But I will tell you when, yeah, we thought it was going to be an easy course, you were just going to have it taken out and we were going to be good to go. And that was in July.
Mike Boesen:
That was July.
Lisa Boesen:
It was July. And-
Mike Boesen:
After the surgery, the thought was it's all clear, proceed.
Lisa Boesen:
Yeah, and then-
Mike Boesen:
And then-
Lisa Boesen:
... we had just kind of a follow-up for medical oncology and we were like, "Well, we'll go. We don't know why," because they hadn't told us yet that it had spread. And they actually classified it as stage four. So if you know your stages, you're pretty freaked out. Like you thought you were in the clear, and then we leave and we're stage four, which means it's in the lymph nodes and that we've got to get it out of the body and limit spread.
So we were, that day, I will say UC Health did a great job of we didn't have to do a whole lot of scheduling. They had it all scheduled out of when to start the radiation and all the appointments. We just had to show up, which was a good thing because we were still in shock that it was that severe or that it had spread to that level. And so kind of in a way, you're glad they didn't just, that that mid-surgery scan came out the way it did, I guess. I don't know.
Mike Boesen:
Well, again, in one way I'm glad that it was detected even after the fact, just glad to be detected instead of months or a year down the road and say, "Oh, by the way, we missed it." So at least we got a head start on that.
Lisa Boesen:
So then he came home and he said, "Not only are we going to go through radiation chemo," which we knew we had to do. He told me we were going to go vegan overnight.
Mike Boesen:
Well, it wasn't all that quite instantaneous, but I quickly started doing research, and reading, and finding out. I came across a book called The China Study, which is really a landmark book, and it showed tremendous correlation between eating animal protein and cancer, and vice versa, plant protein and cancer. And it was all in lab rats, but they were literally in the studies manipulating the cancer markers up and down by switching diets between these lab animals.
So I said, "Well, even if there's a little bit to this, what do I have to lose?" So I said, "I'm going to do what I can to go plant-based." And Lisa, to her credit, was kicking and screaming and said, "I'm not going to cook two meals every day." But in retrospect now, it turned into be probably literally a big life changer maybe, physically and socially because it's been what? It's five years now-
Lisa Boesen:
Five years, yeah.
Mike Boesen:
... over five years now that we've been totally plant-based and I'm glad of it. I think we feel better. Hopefully it's doing its work on my cancer diagnosis.
Lisa Boesen:
His PSAs have always been undetectable.
Mike Boesen:
Knock on wood.
Lisa Boesen:
Knock on something. Yeah.
Mike Boesen:
Still knocking. But yeah. So I don't have any trouble with the plant-based diet and we're kind of disciples for it if you couldn't detect that in our talk.
So and it's really, kind of really changed Lisa's life too because she's into cooking, and writing, and blogging. And she's got several cookbooks now, they're plant-based, and we won't get into her side of the story, but-
Lisa Boesen:
It's all about you, remember that.
Mike Boesen:
... but that's what I meant. It was literally life-changing, it changed her life probably more than mine because I really wasn't a big meat eater to begin with, but now I know better.
So anyway, that's my story there. As far as I did have some side effects that I think I didn't anticipate, but by and large, I feel like I did before. Really no side effects physically as far as fatigue or weakness and stuff like that. I was literally playing racquetball and squash during the morning. I'd have radiation at 7:30 and I'd go play squash at 8:30. So it really wasn't slowing me down until I probably pushed it too hard and it triggered some cardiac electrical problems that are really maybe related, maybe not related. But otherwise, I'm doing anything that I was going to do before, so.
Lisa Boesen:
Well, and to that, that was also helpful is you were really good about doing all the pre-bladder training.
Mike Boesen:
Yeah, I was really-
Lisa Boesen:
You were like a dog after a bone on that one.
Mike Boesen:
I was really kind of pleasantly surprised, let's say. The first few days and weeks after I got, after surgery. And I was actually online looking for, okay, what's the best source of diapers for the rest of my life? And I said, "This is not going to be fun."
But I went through the bladder control exercises that the UC Health had recommended. And it's nothing complicated, but I really forced myself to go through it. And it's really just strengthening the muscles in that pelvic girdle down there. And pretty soon I was better than I was before, because men with prostate problems are frequently going to the bathroom, and holding it, and in pain, and always conscious of it, and very slow to urinate. And all of a sudden without that prostate, I'm like teenager again. It's just flowing. So I was going three hours at a time between visits, which is way different than 30 to 60 minutes. And so it was quite a beneficial change in that regard if you look at the silver lining.
So anyway, is that what you want to know?
Lisa Boesen:
Well, I'll share my part. So one of the things that we really were not expecting, and maybe it was in between all the lines and the literature they send you, but no one really ever said, "Oh, and by the way, especially if you're on a hormone reduction therapy, that your libido goes away." And nobody really said, "If you go on hormone reduction therapy or as you go through this process, your sexual life's going to change for a while and it might be forever." It was always kind of like, "You're going to get the nerve-sparing surgery," so I'm thinking everything is spared and it wasn't.
And I think looking back, if I could do things over again, so this is a kind of a little tip, before you go through this, go on a heavy weekend or something, go have some fun, really enjoy each other. Because it didn't really dawn on me that... Because I think when we went into surgery, we thought you were going to do surgery and then that was just going to be it. And I really hadn't anticipated that the diagnosis could actually be worse. It never dawned on us that it could be something worse.
So a helpful tip is going into it, they might say, "We have clear margins." And yes, there's a cat in the background. That, "You have clear margins and we're doing nerve sparing." And it all just sounds wonderful. I think it's good to also be prepared that it may not be. And go have a fun weekend. Go really enjoy each other and have a lot of intimacy because if you go on, one is the surgery of just trying to get your bladder back, and get back in the warm, and he brings a bag home, there's nothing sexy about that, of the whole recovery process. But then if you have to do the hormone reduction therapy for what, two years I think?
Mike Boesen:
Yeah, it was literally two years and-
Lisa Boesen:
Two years. Did not see that on the radar as that could be... I'm trying to think of a good way to put it. I'm not going to say an issue, but one of the side effects is there's just no libido for two years. And then there's none as you're going back, you're getting it out of your system for another six months to a year. It could be three years. And we were young.
Mike Boesen:
We were still young.
Lisa Boesen:
We're still young. We had not anticipated not having fun, and intimate, and good to each other. And so that was kind of a whole other thing to just throw into the mix along with having to learn how to cook plant-based.
But you were just kind of, you take your pills at four o'clock in the morning and we were just doing this for two years. And then you wait another six months for it to get out of your system. So to me, that wasn't really clear like, "Just so you know, y'all, this is, it's a possibility that you may not have sex for a while." It did not exactly come out, and I think that's really important for couples.
The other is afterwards we're questioning it and it's embarrassing because you haven't had that conversation before. And you know it's not the medical oncologist, radiation oncologist, it's not the surgeon. So then you have to go see another urologist that specializes, supposedly, in that kind of thing, but it's not really such a thing, I don't think. But you go and you tell them, "We'd like to have," be blunt again, "we'd like to have sex again." And so they give you all kinds of little interesting, not all kinds, like two, a pill-
Mike Boesen:
Two or three standard solutions.
Lisa Boesen:
Two or three standard solutions.
Mike Boesen:
And they really weren't pills.
Lisa Boesen:
They weren't pills, they were just solutions.
Mike Boesen:
Some of the solutions, it's focused on increasing blood circulation. And I can see some of that post-surgery and maybe some of that comes back in time. Time meaning years, not weeks or months.
Lisa Boesen:
Right, right. Be patient. Yeah.
Mike Boesen:
And we're kind of back, but not like we were before, but we're-
Lisa Boesen:
We're functional.
Mike Boesen:
... functional.
Lisa Boesen:
We're fine and we just have to plan.
Mike Boesen:
Right.
Lisa Boesen:
And so we're maybe not be as spontaneous, unless you're going to be spontaneous but you know you can need a couple hours. But there are things out there that I think you finally figured out wasn't even what he told you to do. I think you just kind of had this aha moment. We got this thing, let's try it.
So what I'm really grateful for too in all this is I had a friend dancing at a dance. And I told her, we were just talking on the side and I'm like, "Mike's going to have..." We just had his surgery. We were back dancing. And I said, "He's having his hormone reduction therapy." And she pulled me aside and was just so incredibly blunt to me, just shared everything. And I'm very thankful because no one was telling me, "Oh, this is going to happen and then that's going to happen. And these are the things that they might tell you will work, but they really don't work. And you're trying to be intimate and they don't work because they just kind of want to get you out of the office. They don't really want to talk to you about how to return to intimacy and the tools that you have, and then other tools."
But so I think I was always very grateful that I had a friend that was just really, and I didn't really know her that well. We got to be really good friends after that conversation. And I thought if I have girlfriends who they tell me their husband has prostate cancer, I'm going to pull them aside and just say, "Would you like to have a very frank conversation about it?" Because we were not... I think just the way ours played out, we just weren't ready. But I think anytime you have your prostate removed, I'm like, "Just have a conversation."
Mike Boesen:
To be fair, I think every case can be different.
Lisa Boesen:
Yeah, yeah.
Mike Boesen:
And the consequences, side effects can be different for every person.
Lisa Boesen:
It could be worse. We could be worse than we are actually.
Mike Boesen:
Could be worse, but could be better. But now it could be... I feel actually pretty fortunate that I didn't have other side effects. Physically other than the intimacy I was not really affected. I was doing physical activities like before. And I didn't have to go through any kind of chemo so that was probably a good thing. The radiation was 40 days of running over to the hospital and in our case, we're super lucky that it's like a mile and a half away and I could be the first one in line 7:30 in the morning. And just scheduled it every day and got it out of the way. And oftentimes before Lisa even got out of bed, I'm back from my radiation.
Lisa Boesen:
True. It's true.
Mike Boesen:
I'd grab something to eat and head off to go play squash or something. So it was kind of a non-event in a lot of ways.
Lisa Boesen:
Yeah, you never got sick, you never got weak.
Mike Boesen:
Right. And I'm thankful for that. And there's a lot of guys who probably on the other side of that curve. And so you get some good and some bad, and hopefully everybody gets some of each.
Lisa Boesen:
Well, I mean fortunately I'm retired, but I still do a lot of writing, so I had a lot of flexibility. But I think it was just the overall, there was so much shock because it was just not what we expected. And it really took a while to kind of get your head out of stage four, stage four, stage four, stage four, and not go down that path. And just keep thinking they caught it stage four so early, it wasn't like in his bones yet, it's in his lymph nodes. So we just need to just make sure it doesn't get into the bone, which I think is the next place that it goes to primarily.
So all you, then you think about is we're going to do whatever it takes for it not to go into the bone. And so some things just kind of got put on... I mean, yeah, he did go play pickleball and all that kind of stuff. And I'm thinking after that, we still went on a trip in May. Right? We did go to Ireland in May.
Mike Boesen:
That was after the-
Lisa Boesen:
We still did things while he was doing the hormone reduction therapy. We had to wait awhile after the radiation because we couldn't miss that at all. We weren't missing that.
So I mean, I'm fortunate that we had a lot of flexibility, we're both early retired. But we were able, we were fortunate that we know that people are working that don't have that luxury of having some flexibility. And so I'm sure even though you're, if you were never ever tired, but if you retired, you go lay down or something. Someone who's trying to work may not be have that luxury. I think it was just mostly mental, like whoa.
Mike Boesen:
Well there's a great unknown. How long until this gets worse?
Lisa Boesen:
Right.
Mike Boesen:
How many years do I have left? You don't think about that until after it really hits you over the head. And with that kind of a sobering smack, I think it was easier to accept going right hard into this plant-based diet, that expecting that's going to help. Because what else? There's a lot of things you can do to help, but it's not something that you want to mess around with.
Lisa Boesen:
Right. Once you go through hormone reduction and you go through the radiation, then you're just kind holding pattern hoping the PSA stay undetectable. And when they rise, then they have to go back and look at the algorithm, and talk about what are going to be next steps, where it could be. Because then if it is anywhere, it's metastasized. So that's kind of like it's not, it's... I mean that's just the only other option is it metastasizes at some point. So that's why we just want to keep it undetectable so we know it's not anywhere.
But then over time you just kind of, after the three years, it's not that we don't think about it, we just don't think about it so much maybe. I don't know. He probably does every day. He probably thinks about it every day.
But that initial, it was scary. There's no doubt about it. You're like, "Holy crap. That's not what I expected." And then it has far-reaching consequences if you don't get it under control and do what you're supposed to do.
Mike Boesen:
I can't really put years on a timeline very well, but I know that years before, several years, during my regular physical exam, the doctor would say, "Oh, you have a very large prostate." And then pretty soon I'm on Flomax to deal with that.
And then finally, I think it was after we retired and moved here that the doctor said, "Oh, I can feel a nodule on your prostate." And, "Okay, then let's do a biopsy." And then so we did the biopsy and it came back positive at that point. But then we said, "Well, it's still real early. Your PSA is really not that high." I will say that on the Flomax, the PSA was like two or two and a half, which is really pretty low. And then when I got off the Flomax, I think we decided to get off of it for a while, it went up to like four or five, which is still not crazy high. But with the biopsy they could see that they had gotten bigger or the Gleason score had gotten a little higher, not crazy high, but like eight or whatever the scoring is.
At that point I said, "Well, if this is just going to keep growing faster and faster, let's just take care of it, and cut it out and move on." And there really wasn't a lot of discussion of anything else like side effects, consequences. It was more just, "Let's get it taken care of."
Lisa Boesen:
I don't even think there were any other real options. It was kind of like the recommendation was just to take it out because it's early-ish.
Mike Boesen:
Or just keep watching and waiting, but it's just going to get worse, so-
Lisa Boesen:
Yeah.
Mike Boesen:
... might as well just... And consequences of the surgery, I'm sure vary from person to person, that some guys will have more continence problems and some guys have less. The whole sexual recovery is probably the same thing. Some fast... I don't think the urologists really know, so it's really kind of hard for them to say, "Okay, this is what's going to happen," because it's kind of an unknown. To the surgeon's credit he, I guess, was able to spare the nerves and stuff, and I guess that's a good thing, but...
Lisa Boesen:
It's a long haul.
Mike Boesen:
It was a long haul. The surgery really wasn't that bad or painful. It was all endoscopic with just two or three holes in my front side and doing it all remotely and...
Lisa Boesen:
You go home with a bag. I mean it's like-
Mike Boesen:
Home with a bag for a couple weeks and...
Lisa Boesen:
I'm like, "Really? We go home with a bag?" We got home with a bag tied to your leg. I'm like, "Okay, it's fine." I mean, I'm old school. We used to keep you in the hospital forever and a day, but it's fine. They send you home with a bag.
Mike Boesen:
Well, you don't run around too much with the bag. So I was kind of hanging out. But it's not like I felt bad, I just had this little anchor with me. More of it was more of a mental strain at that point. And even during those two weeks, we hadn't been told that the lab had come back with finding it in some lymph nodes. We thought we were in the clear for two weeks.
Lisa Boesen:
We're just like, "We got this."
Mike Boesen:
So when I went back to get the bag removed, that's when they said, "Oh, by the way, we found it in some lymph nodes." So that was a big day.
Lisa Boesen:
Well, I know, but I think you were by yourself and when it came back, it didn't trigger. You know?
Mike Boesen:
Well you weren't there.
Lisa Boesen:
And so, I wasn't there, that's why
Mike Boesen:
Because we thought it was a non-event.
Lisa Boesen:
It was a non-event. We still kind of thought it was a non-event. I don't think it stuck in until we went to the medical oncologists and we were all like, "Well, why are you here today?" We're like, "We really don't know why we're here today," because we think we're clear. It was a fog. I'm just going to tell you at some point, things-
Mike Boesen:
There was a lot of fog at that point.
Lisa Boesen:
There was a lot of fog starting to come in when you realized-
Mike Boesen:
Because you're so distracted about worrying about the future and worrying about the present.
Lisa Boesen:
And are you going to be able to go to the bathroom and don't have to have your... I literally asked him, "Which is more important to you, going to the bathroom or having sex?" And he said, "Going to the bathroom." For men, that's important, not having to wear a diaper.
Mike Boesen:
Because it's like six, eight, 10 times a day as opposed to before it's probably 12 or 18 times a day.
Lisa Boesen:
Miserable.
Mike Boesen:
So if you can cut that down to... Now, if we were too old to have 18 times a day-
Lisa Boesen:
Right. But there is this trade off. I mean it does-
Mike Boesen:
Right.
Lisa Boesen:
... taking that prostate out really helped your quality of life so much better.
Mike Boesen:
Oh, it really did.
Lisa Boesen:
Yeah, it was like night and day. We could travel or go to four hours to North Platte and not worry about having to go to a bathroom every hour.
Mike Boesen:
Sit in the car for three hours and no worries.
Lisa Boesen:
So it was kind of foggy, but you're kind of in that you just do what you have to do. We got to take care of what little wounds you have, make sure you're updated.
Mike Boesen:
At that point I'm doing reading, I'm looking at this, what can you do with diet and diet cancer? And I'm getting all kinds of opinions. And I was pretty much in a fog, not quite knowing where to take this. But there was enough evidence that I thought the plant-based route was going to be the way.
Lisa Boesen:
Just stave it off. Just stave it off out the bone.
I guess for me, because it really always bothered me that I just didn't really know what I was getting into. I just-
Mike Boesen:
Well, I didn't either.
Lisa Boesen:
Well, neither one of us really knew we were getting into, but I think just anytime they say "hormone reduction" I think that should be a red flag to say, "What does that mean? What does it do?" Because basically it makes you, not a eunuch, I have another word for, androgynous for two or three years. And again, they should be able to tell you, "You won't have a sex drive, you won't have this, you won't have that. You're going to lose hair. You're going to lose muscle mass." But I think they've more focused more on the muscle mass part than really what happens to you sexually.
And so I think just for any of that, just ask questions because it's all kind of connected. You might be, it's kind of a whole functional area.
Mike Boesen:
I think what Lisa's saying though is you can ask questions, but you shouldn't have to ask questions.
Lisa Boesen:
Right.
Mike Boesen:
Somebody should be telling you this stuff.
Lisa Boesen:
Right, right. Somebody should be telling you, "Yeah, so if we go down this course, this is what you can expect. And then if you're going down this course, these are always some things you can expect."
And I think you should, treating it beyond just a surgery, it's really a social thing. It's a social surgery. You can take your gallbladder, nobody really cares. You can take somebody's prostate out and it affects the spouse, so it affects you too. So it's one of those that I think a little bit more attention could be taken. So just do some research. A lot of times they give you a couple of different options of how to approach it based on your age and so forth.
But I just think it does affect the couple and you need to know how you're going to work through it over two or three years, and then just talk about it. And you got to be patient. And I don't know, be open. I'll just tell you this, be open to trying things you thought you would never do because there are options out there. That's the other part, I'd like to give a sense of hope that there's plenty of options out there and they don't always come from your surgeon or urologist. And just kind of be open and being okay with that. That's just kind of the way it is.
So that's our journey and we're just happy to share it. And everyone's going to be on their own journey and work through it the way they can do it. And we just wish you the best on yours and hope you have success.
Mike Boesen:
And I wish the best to all the other guys who are dealing with this. And I feel like I'm on the lucky end of the curve so far.