In May 2022, I was diagnosed with stage 2 malignant breast cancer and metastatic stage four prostate cancer (Gleason Score 9 out of 10). I had a left-breast mastectomy and four lymph nodes removed. My case was complex. UCSF Breast and Prostate Oncology established a coordinated plan. What to treat first, combining both estrogen and hormone-blocking meds at the same time, and scheduling radiation treatments 42 for both breast and prostate, were all part of the equation.
My mother was diagnosed with breast cancer at age 43. My sister was first diagnosed at age 37 and treated three different times for breast lumps, and both had mastectomy surgery. My father was diagnosed with pancreatic cancer at age 63. They all passed away from cancer.
Besides changes to my diet, lifestyle, therapy, meditation, and more, I journaled. My journal is called ‘Cancer, Cancer, Cancer, Can’t We Talk About Something Else’! I have at least 150 journal entries because you can’t keep all of the thoughts, anxieties, and emotions locked up in your mind.
Moving forward to May 2025. One morning, I felt a lump in my right breast, very similar to the lump on the left. This time, I was very anxious, and I had developed gynecomastia, and for some unknown reason, my estrogen level increased 250%.
The reason I’m informing you is that there’s a balance I’m trying to establish between estrogen and testosterone. If my testosterone increases too quickly, the prostate cancer returns. If I don’t reduce my estrogen, my breast cancer can return.
For 21 months, I was on 240 mg daily of Daralutimide (Nubeqa), a very strong testosterone-blocking prescription, 20 mg of Tamoxifen, and Lupron injections. It kicked my butt.
Early after my diagnosis, I spent one week at a seminar with Dr. Gabor Mate, author of When the Body Says No, and I made measurable lifestyle changes.
I now consider myself to be a cancer warrior, not a survivor. I did everything possible to beat this disease.
Today, I play tennis 4-5 days a week. My goal is to be as fit as any tennis player age 70 or older, and faster to the ball than anyone my age nationwide.
“Cancer, Cancer, Cancer, Can’t We Talk About Something Else’ – Mark’s Personal Journal
Breast Surgery
On December 6th, 2022, I was wheeled into the UCSF surgery prep room. My body felt very cold. A nurse placed two warm blankets on me. She was unable to put an IV in my arm because I was too cold and nervous. Up until the prep moment, I was fine. Repeating the same surgery my mom and sister received was suddenly frightening. They both eventually died from the complicated side effects. The IV was inserted above my ankle instead.
I remember Rebecca visiting me in the prep room and holding my cold hand.
On December 6th, 2024, exactly two years later, I sent Rebecca a text to arrange a video chat. During that video, she informed me that our relationship was over. Our 8.5 years together were filled with fantastic experiences, filled with laughter, entertaining banter, frequent travel, and cherished moments with friends and family. We were soulmates who knew what the other was thinking. Many times, we expressed the same thought at the same moment. When Rebecca flew to Europe and I was home, I would magically wake up in the middle of the night, the moment the plane landed. She’d text me ‘just landed’ and I would respond, I know. Every night together, we would hold each other in a spooning position, and many nights we would wake up in the morning still in each other’s arms. You can’t fake that connection because our subconscious minds were expressing love and compassion.
On December 13th, 2022, at Rebecca’s, it was time to remove the large bandage, assess the healing of the surgery, and reapply the wound dressing. They sliced me open from my chest plate all the way to my armpit. This was the first time I saw the brutal surgery results. For at least ten minutes, I blasted out a wounded animal shriek, a sound I’ve never expressed and could not duplicate if I wanted to. Rebecca was a bit freaked out and worried. My thoughts moved on to what Dr. McCoy, the doctor in Star Trek, would comment about surgery, calling it barbaric medicine. When I saw the destruction, it appeared that my breast was placed on a chopping block and cut off with a medieval battle axe.
‘Are you frigging kidding me?’, I thought. Absolutely nothing has changed since my mother’s mastectomy in 1969. I now understand the trauma that both my mother and sister went through. Why haven’t breast cancer patients protested vehemently about how they’ve been savagely treated and scarred for life? Every morning while getting dressed or taking a shower, that brutal scar is a torturous reminder.
After I fully healed, the scar is always there; my totally flat left chest with no nipple is visibly there. I could easily tell it affected Rebecca, and she didn’t want to see it. Every night we were together post-surgery, I always wore a T-shirt or a pajama top. In the past, we used to sleep naked, feeling the sensory connection and attraction of skin on skin. Post surgery, and together for months in Hawaii with absolute privacy, I would always wear a shirt. When I went swimming in the pool, the ocean, or sunbathing on the beach, I always wore a t-shirt.
Before cancer, we would shower together approximately 20% of the time. In the last two years, we have never enjoyed a single shower together. The last two years, Rebecca never initiated intimacy with me. The complication of prostate cancer was also a major factor. One can be intimate and enjoy sexual intimacy many ways without normal intercourse. I also believed that in one more year, when my testosterone levels return, we could enjoy a facsimile of our previous healthy sex life.
I now realize that seeing me naked with a big scar was not attractive to my partner. Maybe I should have requested a 3-D nipple tattoo.
Ringing The Bell
Friday, June 30th, 2023. I received my last radiation treatment! The first set of treatments started this past March with 15 breast radiation sessions, one a day, five days a week. Following a six-week recuperation break, the long, more extensive 28 prostate radiation treatments ensued.
The amount of total radiation I received was well beyond ‘normal’ prostate radiation. I had four cancerous lymph nodes above my stomach, two near my kidney, and two or more outside my prostate, and the oncology team ordered extensive radiation covering my intestines as well. A specialized machine called ‘Toma radiation therapy’ highly targets affected areas and mostly avoids healthy tissue. I have four small dot tattoos on my midsection, so my placement is perfectly aligned.
The incredible UCSF staff carefully performed micro-adjustments, ensuring the treatments are the same every time. Using the CAT scan data, my body is virtually sectioned off horizontally, and they treat one small section at a time. It’s a substantial amount of radiation. My radiation oncologist says it takes a full year to recover fully.
Possibly, there’s no precedent with another patient requiring significant radiation for both breast and advanced prostate cancer (Gleason score of 9 out of 10). The radiation side effects have been mild. I’ve only experienced a handful of days of tiredness requiring a few afternoon naps. I fully believe that exercise helps, a clean diet helps, relaxation helps, a positive attitude helps, and support from friends and family helps. And mostly, Rebecca offers so much love, and she always is my health advocate. Where would I be without her during this difficult full year of diagnosis, treatment, and countless appointments?
Usually, while inside the Toma machine, I focus on my breathing, and I transition into a meditative state. I believe it can’t do any harm when your body and mind are receptive to treatment.
Today, while in the Toma machine, I thought about my mom, who passed away from breast and bone cancer at age 63. I thought about my dad, who died of pancreatic cancer at age 63, passed away in front of me, and for me. I thought about my sister, who battled breast cancer three times, and we lost her at age 48, plus my cousin, aunt, uncle, and best friend all passed away at a young age from cancer. I shed a few tears, knowing that in one year from today, we will fully enjoy our lives.
Today was my last treatment. When I finished, there was a bell by the nurse’s station that I rang, bringing completion to a long, arduous, full year of unknowns, anxiety, and hope. And yes, I shed a few tears for my family. I shed a few tears for all that Reba has done to support and advocate for me. I shed a few tears believing that soon we will fully enjoy our lives again.