Early Detection Elevates Mike’s Choices to Treat Prostate Cancer

Mike Garrity’s PSA levels were creeping up: 4.2 at one routine physical, 4.7 six months later.

PSA, or prostate-specific antigen, is a protein made by the prostate. Elevated levels, measured through blood tests, can give doctors a starting point to evaluate a man’s risk for prostate cancer, the second-leading cause of cancer death among U.S. men.

In July 2024, Mike’s PSA level rose to 6.7 after moving to Gainesville. His reading was elevated enough that University of Florida Health doctors ordered an MRI. A biopsy confirmed he had prostate cancer. Next, a grading system used to assess biopsy tissue showed the cancer had an intermediate risk of growing and spreading.

“It tested positive in a number of spots all around the prostate,” said Mike, 73.

He soon connected with Li-Ming Su, MD, the chair and Pete and Carolyn Newsome Endowed Chair of Urologic Oncology in the UF Department of Urology, to discuss options.

Because his cancer was caught before it had spread to other parts of his body, Mike had two options: radiation treatment or surgery to remove his entire prostate. Dr. Su explained to Mike that he could choose the best option for him. They thoroughly reviewed the pros and cons of each in a PowerPoint presentation.

“Early detection is absolutely key in catching prostate cancer before it fully develops, allowing patients to have many more options for treatment,” said Dr. Su, a member of the UF Health Cancer Institute.

Today, those selections include active monitoring, robotic prostate surgery, more precise radiation therapies, focal therapy and combination therapy.

The American Urological Association’s guidelines recommend:

• Initial PSA testing for most U.S. men ages 45-50 to establish a baseline and initial risk assessment for harboring prostate cancer

• PSA testing for men ages 40-45 with an increased risk of prostate cancer, including Black men, men with a strong family history or men with mutations like the BRCA mutation

• Follow-up PSA screening every 2-4 years for men ages 50-69

“Early detection gives patients an opportunity to learn and truly take part in their treatment decision based on their specific goals of cancer treatment and balanced by the side effects that may impact their urinary and sexual function,” Dr. Su said.

Mike ultimately opted for radiation treatment.

“Luckily, I didn’t wait too long so I had the option to choose,” he said. “They explained everything perfectly.”

Still, making the decision was difficult.

“It was a tense time, thinking, ‘Am I doing the right thing?’” Mike said. “I knew I was after talking to Dr. Su that this was the way to go. I’m glad that I did it like this. If you catch it early, the percentages are very high that you can get through it.”

In November, Mike began radiation treatment with UF Health’s Elekta Unity MR-Linac. The leading-edge technology is one of fewer than 50 machines in clinical use worldwide and the first in the southeastern United States. The machine can reshape the radiation dose based on daily changes in the shape, size and position of the tumor and surrounding healthy tissues, personalizing treatment for patients.

With MRI guidance, clinicians can also make real-time modifications to daily radiation treatment to account for bladder and bowel filling, movement of the seminal vesicles, nerve bundles and the prostatic urethra.

It’s a dramatic breakthrough in prostate cancer treatment, said Paul Okunieff, MD, a professor in the Alan H. Porter, M.D., & Claudia B. Porter, R.N., Department of Radiation Oncology.

“It’s one of those advances that makes me wonder how I was able to treat prostate cancer without an MR-Linac for the past 35 years,” Dr. Okunieff said.

Mike successfully underwent 20 rounds of radiation over 20 days, completing the treatment right before Christmas. He experienced minimal pain and side effects.

“Once that was completed, it was just kind of wait and see how things go,” Mike said.

The wait paid off: In April, tests revealed his level had dropped to 1.49.

“It was really good news that they hopefully got it,” he said.

Over the next few months, Mike’s PSA levels fluctuated before recently stabilizing. He continues to receive supportive care through the UF Health Adult Cancer Survivorship Program, led by Katie Warren, PA-C. She has helped him manage side effects like urinary incontinence and GI symptoms, possible side effects of prostate cancer treatment.

“I’m still having some issues, but as long as that PSA stays down, that means I can deal with issues. Being alive is great,” Mike said. “I feel great.”

A retired professional fishing captain and licensed Coast Guard captain whose career took him all over the Southeast — to the Bahamas and back — Mike is back to doing the things he loves, with his family by his side. He fishes the lakes around Gainesville in his 18-foot boat and recently went scalloping with his son in Steinhatchee.

Now, Mike encourages other men to prioritize their health and get tested. His elevated PSA levels did not come with warning signs.

“You don’t feel anything different,” he said. “If I never took any blood test with the PSA included in it, it might have metastasized or who knows. I have a few discomforts, but that’s nothing compared to the alternative.”

His message is simple:

“Don’t hesitate, find out what’s wrong and take care of it. Whatever is in you causing a bug is not going to stop just because you’re ignoring it; it’ll only get worse. Get those tests. Prostate cancer is real, and it’s a hidden danger that you don’t know you have until you take a blood test, which is really easy to do and not invasive or anything.”