NEWNAN, Ga. (FOX 5 Atlanta) - Donald Williamson knew he had 3 key risk factors for developing prostate cancer.
He had a strong family history of the disease, was African American, and is over 50.
His father, a preacher, lived with prostate cancer for 15 to 20 years, before he died in February of 2018.
"Even as he was passing away, he was kind of worried about me, because I wasn't feeling well," Williamson says.
After 25 years in the US Army, retiring as a Sergeant Major, Williamson was on 100% disability from the Veterans Administration because of service-related medical issues.
He'd been seeing a doctor regularly, but focusing mainly on his heart health.
But, he'd been feeling unusually rundown.
"Most of my life, I've been pretty healthy, and then, all of the sudden, I was sick," Williamson says.
His doctors had been tracking his PSA, or prostate-specific antigen, blood levels, a marker for prostate gland problems.
African American men are more likely to develop prostate cancer, and more likely to die from it, than any other ethnic group in the country.
So, experts have recommended African American men start getting screened at 40.
Dr. Sean Cavanaugh, Chief of Radiation Oncology at Cancer Treatment Centers of America in Newnan, says there is another challenge.
"As a group African American men do have higher PSA values without cancer, with or without cancer," Dr. Cavanaugh says.
Williamson's PSA had been going up and down, then suddenly doubled.
In March of 2018, a month after he lost his father, he was diagnosed with prostate cancer, and told it was aggressive and likely to spread quickly.
Now, Williamson faced tough treatment choices.
Unlike most cancers, where there are 1 or 2 treatment options, Dr. Cavanaugh says, men with prostate cancer have to choose between surgery, radiation, hormone therapy, chemotherapy and other options.
Many of the treatments can come with negative side effects, like erectile dysfunction, and incontinence.
"So, you have a lot of people talking to you about the side effects," Williamson says. "What you will be able to do, what you won't be able to do. I would tell anyone that your life is more important than all the rest of that stuff."
Dr. Cavanaugh believes surgery and radiation offer a similar quality of life, but different side effects.
"So, it's now a matter of, which is better," Cavanaugh asks. "Which pathway is right for me? Which side effects concern me? And again, it's a careful discussion with doctors you feel are being balanced in their presentation."
Donald Williamson's father chose chemo and radiation.
He chose surgery to remove his prostate, which he believes will give him a better chance of living longer.
He's now nearly a year out.
"I'm okay with that decision," Williamson says. "Still dealing with some of the side effects, but I'm alive."