Prostate Cancer at 46?
Mark Was Expecting a Midlife Crisis, Not This!
I am grateful to share a conversation that I had with Mark Stevenson, who was diagnosed with advanced prostate cancer in his mid-forties. He is a writer on Substack and shares his journey called Prostate Cancer, the Bits They Leave Out…
I think Mark would be happy if I talked about the rates of prostate cancer by age and the signs of prostate cancer — even before our interview.
Rates of Prostate Cancer by Age
Most men are diagnosed with prostate cancer when they are older. From the Prostate Cancer Foundation website, I found these rates for prostate cancer diagnosis: 1 in 11 for men 70 and older, 1 in 19 for men between 60-69, 1 in 54 for men between 50-59, and 1 in 456 for under age 50. https://www.pcf.org/about-prostate-cancer/what-is-prostate-cancer/prostate-cancer-survival-rates/
Signs of Prostate Cancer
Early Signs*: frequent urination (especially at night), difficulty starting or stopping urination, weak/interrupted urine flow, pain or burning during urination.
Later Signs*: groin pain, bone pain (back, hips, pelvis), nerve pain in legs or feet, erectile dysfunction, blood in the urine or semen, weight loss, and painful ejaculation.
*Note that other conditions can cause these symptoms too, so it is best to get it checked out by a doctor.
Interview
[Kristina] Welcome to After He Said Cancer. I'm Kristina Adams Waldorf, a physician scientist. Today, I'm speaking with Mark Stevenson, who was diagnosed with prostate cancer in his mid-forties.
[Mark] I was 46 when diagnosed in 2021. It wasn't something I expected. I was relatively fit and healthy, with no family history of prostate cancer that I was aware of. My diagnosis came after a conversation with a work colleague who was having prostate cancer surgery.
I started noticing I needed to use the toilet more urgently. A PSA test showed my levels were high at 18.1. Subsequent tests confirmed Stage 3 prostate cancer. It was a complete shock as I had virtually no symptoms.
[Kristina] That seems incredibly young.
[Mark] Exactly. Prostate cancer always seemed like an older man's issue. In hindsight, I realized I'd been experiencing some warning signs, like a persistent pull in my right groin during running, which I'd ignored.
The UK healthcare system was supportive. I went through multiple tests, including an uncomfortable biopsy. Eventually, Dr. Akhtar recommended a robotic radical prostatectomy. I was emotionally overwhelmed but trusted the medical team.
The pre-operation process prepared me for potential side effects like erectile dysfunction and bladder control issues. I was also fortunate to have access to a therapist to help process my feelings. The operation went well – they removed the prostate, did a biopsy, and took some lymph nodes. Everything came back clear, but recovery has been an ongoing process.
My wife, Louise, has been incredibly supportive during this time. It was initially during COVID, so I attended appointments alone. Her first reaction was one of strength – "Mark, it's fine. You're always fine." She did find her way to support me by researching extensively, cutting through the medical noise, and gently presenting information about diet, exercise, and managing side effects.
[Kristina] Were you considering genetic factors? Prostate cancer can often be part of broader cancer clusters.
[Mark] Unfortunately, genetic testing isn't a priority in the UK healthcare system. My family history only included my father's bowel cancer. We're considering private genetic testing for our children, especially given the potential inherited risks.
[Kristina] What have you learned through this experience?
[Mark] Two crucial things. First, don't take time for granted. We often assume we'll do things in retirement, but life can change quickly. We've learned to live more in the present, doing things now rather than waiting.
Second, take ownership of your health. I was previously flippant, assuming medicine would fix everything. Now, I understand the importance of personal health choices. It's about making small, consistent lifestyle changes.
[Kristina] What are the warning signs that men and their partners watch for?
[Mark] Going to the toilet (urinating) more urgently is a key sign. Other indicators include blood in urine or semen, and unexplained aches. I recommend PSA tests from your forties, especially if there's potential genetic risk.
For partners, the approach is subtle. My wife doesn't lecture—she presents evidence gently, like recommending a nutritious broccoli soup or sharing research, but ultimately leaving the choice to me. It's about education, not dictation.
The most important message is awareness. Talk about health. Don't wait for a crisis to make changes. Small adjustments in diet, exercise, and lifestyle can make a significant difference.
[Kristina] What would you tell others in a similar situation?
[Mark] Don't wait. Allow yourself to learn from others' experiences. You may not prevent every health issue, but you can take steps to support your body. For partners, the key is gentle guidance – present information and step back.
This journey has taught me that health is a collaborative effort. It's about listening to your body, being proactive, and supporting each other through challenges.
[Kristina] Thank you, Mark, for sharing your story so openly.
[Mark] Thank you for the opportunity to spread awareness.
Other Writers in the Cancer and Caregiving Space
Victoria, the Carer Mentor. You can learn about her journey here: Who Started Carer Mentor and Why? Victoria is inspirational and posted an Anthology of Cancer Experiences this week to highlight the important role of everyone in this journey. She also compiled a recommendation list of organizations and books on the cancer journey. She highlighted the writers below in greater detail in her anthology this week. I repost a mention of them here.
Emma Vivian writes Am I Cured Yet? by Emma Vivian. She writes about surviving the experience of breast cancer beyond that of her friend.
Jeannie Moloo writes A Full Plate with Jeannie Moloo about gaps in cancer care, her late husband’s experience of nonHodgkin’s lymphoma, and her own experience of Breast cancer.
Mel Erwin writes My Lovely Lungs about living with stage 4 lung cancer.
Jennifer Garam writes Rebuilding With Jennifer Garam about her recovery from ovarian cancer.
And, of course, our featured guest today, Mark Stevenson, who writes Prostate Cancer: The Bits They Leave Out.
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I had to stop reading this temporarily as it prompted a thought for an essay on, Living in the Present. I needed to jot some ideas down before they were lost in the ethers. So, thank you for that Mark. And thank you Kristina for interviewing Mark and sharing his story with us.
(BTW, I did come back and finish reading this essay/interview.)
Thank you Kristina and Mark! My two sons are in their 40s and this gives me pause - somehow to get this info to them/their spouses without being the nosey MIL.I especially appreciated the symptoms summary - both of my sons are exceedingly active and I have not heard of the aches/pulling phenom. It’s important that we all be educated and aware. Thank you again!