Eight years ago, my PSA (prostate-specific antigen) level nearly doubled from 3.9 to 7.2. Fear makes us accept or deny, to act or do nothing, and months passed until I scheduled an office visit at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

After getting bloodwork done upstairs, a nurse named Kelley Hamill Lemay asked if she could do a digital rectal exam. “Do you mind a woman doing this?” she asked.

No, I mumbled, and she slipped on the rubber glove. The prostate gland is tucked between the butt and the bladder but reachable nonetheless. Recent digital exams had been negative, but Ms. Lemay was in the business of finding a killer. Finally, she eased back and said, “I feel a small lesion on the right side.”

She looked at her iPad, checked the blood test and said, “Your PSA is 8.52. We should do a biopsy after lunch.”

Like an anxious kid at the dentist office I said, “There’s no rush, is there?”

She smiled and scheduled the biopsy for Feb. 6, the morning after the Patriots beat the Falcons in Super Bowl LI. Dr. John Seigne used an ultrasound probe, snipped off a dozen tissue samples and said the results would be back in a week.

Five days later I was crossing the bridge into Brattleboro when he called and said, “We did find some cancer. It’s mostly low risk but some intermediate. It’s extremely slow growing so we’ll schedule an appointment.”

Radiation and surgery are the two gold standards for treating prostate cancer. Neither choice is a cakewalk, and every man’s decision is his own.

Seeking opinions, making choices

Dr. Alan Hartford is a Harvard educated radiation oncologist who interned at Beth Israel and did his residency at Mass. General. He opened the door, looked me in the eye and shook my hand. “Mr. Ainsworth. It’s a pleasure.”

He opened a folder, slid it between us and said, “The universal cure for prostate cancer would be for every man to have his prostate removed at age 40.”

He drew a walnut-sized diagram, divided it into sections and shaded the areas that were cancerous. “You’re pretty close to low risk but the pattern is inexorable — trundling up not down.”

Citing a 10-year randomized trial from England — “Where the Brits are still quite fond of their doctors” — Dr. Hartford said radiation and surgery were both 97% effective.

Some men, he said, prefer waiting until symptoms manifest. “They say, ‘I’m not going to do anything till it bothers me and when it does they go on hormones. Eventually our Darwinian process takes over, the hormones stop working and they go on chemo.”

The surgeon’s pitch was shorter and less convincing. Dr. Elias Hyams had done over 500 robo surgeries using an eight-millimeter camera and making five incisions to excise the prostate. “I can do this,” he insisted.

Both doctors got in their respective digs, Dr. Hartford spoke of “walking around with a catheter and doing kegel exercises for three months” and Dr. Hyams spoke disdainfully of those “who stood at the altar of Dr. Hartford.”

The Big C is upgraded

Dr. Hartford compared radiation treatment to eating a pie. “Eat the whole pie and you’ll get sick, eat it a slice at a time and the body has time to recover.”

Alas, some pies are bigger than others. My MRI revealed a large unidentified mass, but thankfully with no sign of metastasis.

The doctor proposed a one-two punch of radiation and hormones. “You’ll be in menopause,” he added. “Women have it for two years and you’ll have it for four months, so that’s not really too bad.”

Each hot flash began as a ripple across my forehead and intensified into a forest fire. “Welcome to the club!” said my longtime Hadley friend Digger Bemben. “See what it’s like trying to hold it together?”

When I complained, Dr. Hartford shrugged and said, “We have some patients that don’t get a single hot flash. I also have patients crawling the floor from abdominal cramps and diarrhea.”

I got my first slice of radioactive pie in June. All told there’d be 7,920 centigray of radiation delivered in 44 zaps Mondays through Fridays, except the 4th of July.

“Enjoy your holiday,” said Dr. Hartford, who recommended listening to P.G. Wodehouse short stories on my trips north. The doctor self-published his own novel under the pen name Alan Fronig, titled “The First Days of August,” about Dr. Steve August, who blows the lid on a phony cure for cancer. I bought his book; I’d have read the complete works of Fyodor Dostoevsky if he’d told me to.

The treatments begin

The reception area was quiet and spacious, with couches, cushioned chairs, up-to-date periodicals, and a research library with similarly themed titles: “Cancer Therapy,” “The Answer to Cancer,” “Last Rites: Rescuing the End of Life from the Medical System.”

Two women stood over a 1,000-piece jigsaw puzzle. “This has been a bugger,” one of them said. “Lots of colors.”

A radiation tech named JB called for me and I followed her to a changing area, then waited outside a radiation room called Trilogy until an older gent came out, looked at me and said, “I left some for ya.”

Trilogy is a linear particle accelerator (LINAC) that delivers radiation with pinpoint accuracy and has multiple fail safe mechanisms to shut it down if I happen to sneeze or twitch.

Tiny gold coils had been inserted on both sides of my prostate and tattoos were inked on my hips and over my pelvic bone for the radiation therapists to target the cancerous spots in my prostate.

“Lie still and let us move you” said JB, who ducked into the fallout shelter and emerged 15 minutes later. That was it, one down, 43 to go. “Does anyone leave and never come back?” I asked.

“Yes,” she said.

During my waits I met patients like Connie, who wore a Patriots hat and was receiving head and neck treatments. She lived in Springfield, Vermont, and was chauffeured by her grandson. They were going camping that weekend.

Ken lived in Newfane, Vermont, and was nearly finished with his prostate treatments. “It’s like the Army,” he said. “I just want this to end.”

George was a cabinet maker who lived near Mt. Ascutney, Vermont, and wore his gray shoulder length hair in a ponytail. A cerebral sort, he said, “Whatever you’re thinking you’re always going to have a counter point, so try not to think about it at all.”

End of the journey

They gave me a diploma after my last treatment. “Congrats for completing the prescribed therapy treatments with honors in courage, cooperation and good spirits. The entire Radiation Oncology Staff at Dartmouth-Hitchcock Medical Center Norris Cotton Cancer Center extends our best wishes to you. Dated the 23rd day of August, 2017.”

“There’s no reason you won’t do well,” said Dr. Hartford. I handed him his book and asked him to sign it. He wrote: “With good wishes for decades of health, joy and happiness! Alan.”

The radiation’s side effects made me lethargic and unmotivated. A branch that needed snipping went unsnipped; the car remained unwashed, stairways became mountains. I got flu-like symptoms and went to the doctor. No wonder, he said, “You’ve had radiation poisoning!”

Gradually, I became stronger. Today my PSA levels are negligible, my energy is good, and I walk seven miles a day.

This short essay doesn’t come close to telling the whole story, but one word describes my feelings for the people at Dartmouth-Hitchcock who helped make me healthy again. That word, of course, is gratitude.