When I look back at my prostate cancer journey, it’s clear that nothing about it was simple, straightforward, or predictable. Like a lot of men, I started with a rising PSA and ended up on androgen deprivation therapy — the very thing I tried to avoid at all costs. This is the story of how I got there.
The First Red Flag — May 2023
My PSA had always been stable, so when it started creeping up in May of 2023, I knew something wasn’t right. My doctor recommended a biopsy, and in July 2023 I had a standard 12‑core biopsy. Three of those cores came back positive for prostate cancer.
Hearing the word “cancer” hits you in a way nothing else does. Suddenly every decision feels like it carries the weight of the rest of your life.
Imaging, Opinions, and the First Two Options
In September 2023, I had both an MRI and a PET‑CT. That’s when things got complicated. A spot showed up on one of my lymph nodes — but depending on who you asked, it either was cancer or wasn’t.
- The Mayo Clinic believed the lymph node spot was cancerous.
- The doctor who performed TULSA believed it was inconclusive.
Two experts. Two completely different interpretations. And two very different treatment paths.
At that point, I was given the standard two options:
- Radical prostatectomy
- Radiation + ADT
Both were effective, but both came with significant risks — especially for a 52‑year‑old who wanted to preserve the “trifecta”:
cancer control, urinary function, and sexual function.
Discovering a Third Option — TULSA-PRO
While researching surgery and radiation, I stumbled across something I had never heard of: the TULSA procedure — a minimally invasive, MRI‑guided ultrasound ablation designed to destroy prostate cancer with far less collateral damage.
The more I researched, the more it aligned with my goals:
- Less risk to urinary function
- Better chance of preserving sexual function
- No radiation
- No hormone therapy
And most importantly: it offered a chance to avoid ADT, which I already knew could devastate quality of life.
Even though Mayo didn’t think TULSA was the right choice for me, I trusted the doctor who believed the lymph node finding was inconclusive. I trusted the data. And I trusted my instincts.
Choosing TULSA — November 2023
In November 2023, I traveled to Atlanta, Georgia, and had the TULSA procedure. Everything went smoothly. My recovery was good. My PSA dropped. For a while, it felt like I had made the perfect decision.
I thought I was done with cancer.
The PSA Rise — August 2024
Then, in August 2024, my PSA started creeping up again. Not dramatically, but enough to raise concern. A PET scan in October confirmed what I didn’t want to hear:
- A spot on the prostate
- A spot on the lymph node
The same lymph node that had been debated from the beginning.
I went back to Atlanta for my one‑year follow‑up, hoping for another TULSA. But this time, the answer was clear: a second TULSA wasn’t in my best interest.
Back to Square One — And the Option I Feared Most
With TULSA off the table, I was right back where I started:
- Surgery
- Radiation + ADT
Except now the recommendation was radiation plus two full years of ADT.
I still didn’t want ADT. I had read enough stories to know how hard it could be. But I also knew I needed to treat the cancer aggressively. In the end, I chose radiation with ADT.
January 2025 — The Start of ADT
In January 2025, I began hormone therapy to prepare for radiation. I also had a rectal spacer placed to protect healthy tissue from radiation damage.
And just like that, I was officially on ADT — the very thing I had worked so hard to avoid.
The Cost — June 2025
By June 2025, my PSA had dropped beautifully. ADT was doing exactly what it was supposed to do.
But my quality of life?
It was gone.
- Extreme fatigue
- Weight gain
- No libido
- Impotence
- Brain fog
- Emotional flatness
- Joint stiffness
I didn’t feel like myself anymore. I didn’t feel like a man. I didn’t feel like anyone I recognized.
And that’s how I ended up here — building the ADT Survival Project, telling the truth about what this therapy does, and helping other men navigate the same road I had to walk.
Because if I had to go through this, I’m damn sure going to make sure no one else goes through it alone.