{"id":150,"date":"2026-07-19T19:50:08","date_gmt":"2026-07-19T19:50:08","guid":{"rendered":"https:\/\/jonesingforthejourney.com\/journal\/?p=150"},"modified":"2026-08-12T21:20:47","modified_gmt":"2026-08-12T21:20:47","slug":"the-diagnosis","status":"publish","type":"post","link":"https:\/\/jonesingforthejourney.com\/journal\/the-diagnosis\/","title":{"rendered":"THE DIAGNOSIS"},"content":{"rendered":"
\n\n

The Words That Changed Everything<\/h2>\n\n

\n There are certain sentences you remember differently than everything around them.\n <\/p>\n\n

\n You may not remember every detail of the room.\n <\/p>\n\n

\n You may not remember exactly what happened five minutes before or five minutes after.\n <\/p>\n\n

\n But you remember the words.\n <\/p>\n\n

\n

\n \u201cYou have prostate cancer.\u201d<\/strong>\n <\/p>\n <\/blockquote>\n\n

\n I was 59 years old.\n <\/p>\n\n

\n And before this journey began, I knew almost nothing about prostate cancer.\n <\/p>\n\n

\n I knew men got it.\n <\/p>\n\n

\n I knew PSA had something to do with it.\n <\/p>\n\n

\n And that was about the extent of my education.\n <\/p>\n\n

\n Suddenly, Sue and I were being asked to understand a disease we had never expected\n to become part of our lives.\n <\/p>\n\n

\n The learning curve was immediate.\n <\/p>\n\n

\n PSA.\n <\/p>\n\n

\n Biopsy cores.\n <\/p>\n\n

\n Gleason scores.\n <\/p>\n\n

\n Grade Groups.\n <\/p>\n\n

\n Cribriform morphology.\n <\/p>\n\n

\n Perineural invasion.\n <\/p>\n\n

\n Imaging.\n <\/p>\n\n

\n Surgery.\n <\/p>\n\n

\n Radiation.\n <\/p>\n\n

\n Words that had meant almost nothing to me suddenly had the power to change\n our future.\n <\/p>\n\n\n

The Story Didn’t Begin With the Biopsy<\/h2>\n\n

\n Looking back, the diagnosis itself was not really the beginning.\n <\/p>\n\n

\n There had already been another important piece of the story:\n my PSA.\n <\/p>\n\n

\n Years earlier, I had undergone HoLEP surgery for an enlarged prostate.\n The procedure helped with the problem it was intended to address, but it did\n not eliminate the need to continue paying attention to my prostate health.\n <\/p>\n\n

\n Eventually, what caught my attention was not simply whether a PSA result\n fell above or below a particular number.\n <\/p>\n\n

\n It was the direction it was moving.\n <\/p>\n\n

\n One of my results was still below the commonly referenced number of 4.0.\n <\/p>\n\n

\n On paper, that might have sounded reassuring.\n <\/p>\n\n

\n But compared with where my PSA had been, the trend bothered me.\n <\/p>\n\n

\n I was told the next test could wait.\n <\/p>\n\n

\n I asked for another one sooner.\n <\/p>\n\n

\n That decision became one of the early lessons of this entire journey:\n <\/p>\n\n

\n \n A number can be within a reference range and still deserve a question\n when it behaves differently than it has before.\n <\/strong>\n <\/p>\n\n\n

Then Came the Biopsy<\/h2>\n\n

\n Eventually, the questions led to a biopsy.\n <\/p>\n\n

\n And the biopsy changed everything.\n <\/p>\n\n

\n Cancer was found in more than one area.\n <\/p>\n\n

\n One sample showed a Gleason score of 4+3=7<\/strong>.\n <\/p>\n\n

\n Another showed 4+5=9<\/strong>.\n <\/p>\n\n

\n That second number became the one that stopped me.\n <\/p>\n\n

\n Gleason 9.\n <\/p>\n\n

\n Grade Group 5.\n <\/p>\n\n

\n The highest Grade Group.\n <\/p>\n\n

\n This was not the version of prostate cancer I had vaguely imagined before\n I was diagnosed.\n <\/p>\n\n

\n I was quickly learning that the words prostate cancer<\/em> can describe\n very different situations.\n <\/p>\n\n

\n Some prostate cancers may behave slowly.\n <\/p>\n\n

\n Mine was showing features that told my doctors we needed to take it seriously.\n <\/p>\n\n\n

Then I Learned Another Word: Cribriform<\/h2>\n\n

\n The pathology report contained another word I had never heard before:\n cribriform<\/strong>.\n <\/p>\n\n

\n It appeared alongside the cancer found in my biopsy.\n <\/p>\n\n

\n At first, it was simply another unfamiliar medical term on a page filled\n with unfamiliar medical terms.\n <\/p>\n\n

\n But I was beginning to understand that I could not afford to skip over words\n simply because I didn’t know what they meant.\n <\/p>\n\n

\n So I started asking.\n <\/p>\n\n

\n What is cribriform?\n <\/p>\n\n

\n Why does it matter?\n <\/p>\n\n

\n Does it change how we think about the cancer?\n <\/p>\n\n

\n What else does this pathology report tell us?\n <\/p>\n\n

\n The report also mentioned perineural invasion<\/strong>.\n <\/p>\n\n

\n Another unfamiliar phrase.\n <\/p>\n\n

\n Another question.\n <\/p>\n\n

\n Another reminder that reading a pathology report and understanding a\n pathology report are two very different things.\n <\/p>\n\n\n

\n\n

\n One of My First Lessons\n <\/h3>\n\n

\n \n If there is a word on your report that you don’t understand,\n don’t simply move past it. Ask what it means and why it matters\n in your specific situation.\n <\/strong>\n <\/p>\n\n <\/div>\n\n\n

The Difference Between Hearing and Understanding<\/h2>\n\n

\n One of the hardest things about receiving a cancer diagnosis is how much\n information arrives at the exact moment you are least prepared to absorb it.\n <\/p>\n\n

\n Someone can explain something perfectly clearly.\n <\/p>\n\n

\n You can nod your head.\n <\/p>\n\n

\n You can believe you understand.\n <\/p>\n\n

\n And then you can get home and realize you remember only pieces of the conversation.\n <\/p>\n\n

\n That happened to me.\n <\/p>\n\n

\n The emotional part of your brain is processing:\n <\/p>\n\n

\n

\n I have cancer.<\/strong>\n <\/p>\n <\/blockquote>\n\n

\n At the same time, the practical part of your brain is somehow supposed to process:\n <\/p>\n\n