I just had an impromptu get-together at a local coffee shop with my friend R., who was on his way back from somewhere else and was swinging through my town.

He had recently told me that his PSA levels have become elevated again, this after having a Cyberknife therapy a year ago that's supposed to be 98% effective.

Let me back up a bit. R. is someone I've known for about 20 years now. I met him when i was in my late 20s at a singles event. He was the first man I fell deeply in love with. Outgoing, gregarious, great sense of humor, very smart. We eventually moved in together, but there was a lot of friction, much of it having to do with his insistence on still seeing female "friends" while we were living together. No, he didn't want to double-date, no, he didn't want to introduce me to them or have me come along. You can see why I hated the idea. We had many battles about it, and he would tell me i was just insecure and jealous. This was the man I loved, the first man i could see myself spending my life with.

He wasn't being physically unfaithful, but he had such a way with women, I think it was hard for him to give that up. He could get any woman to share her innermost thoughts and feelings with him in record time.

Eventually, we broke up. This was a major cause of the breakup, but it was also becus he was always (being 12 years older than me) very controlling and very argumentative.

Anyway. We remained friends for all these years and kept in touch. Despite his having caused me so much pain, I never revealed in later years just how much pain he caused me.

Fast forward about a decade or so. Those of you old-timers around this forum may recall my stories of how the woman he ended up marrying late in life left him. (She, too, found him very controlling and domineering.) R. became deeply depressed and went on anti-depressants. He pursued her. Shortly after their divorce was finalized, she had second thoughts. Maybe six months after that, they remarried. Unbelievably, a year or two later, she left him a second time. You can imagine the heartache.

In the past year, she's had some serious medical issues, was in the hospital for many months and even now still has a tube and bag attached to her for fecal and urine output. It started with an obstructed bowel. She's had several surgeries, and may have to have another one. She qualified for disability and gave up a good paying career as a nurse.

Last year, my friend R. had elevated PSA levels, which point to prostate cancer. They kept doing biopsies for many months until they finally found cancer. After much research, he opted for a somewhat new prostate cancer treatment called Cyberknife. It avoids the need for conventional surgery which has a high risk of either incontinence of impotence, or both. R. told me it was 98% effective.

That was last year.

More recently, his PSA levels, having dropped to normal levels following the Cyberknife and high radiation doses, have risen again to where they were when he first tested positive for cancer. He's waiting for the latest biopsy results from last week but is prepared now for another treatment called cyro-something, which involves long needles but again avoids incontinence/impotence risks. He can't have any more radiation cus he's already had the maximum limit. He says he doesn't want to wear diapers for the rest of his life, and he recently bought a very sporty muscle car, cherry red, a Camaro which I saw for the first time today.

Back when he opted for the Cyberknife surgery, his insurance company, a well-known one, declined to pay for the treatment becus they considered it experimental. He sued them and they eventually settled with him out of court. In return for paying for the procedure, they made him sign an agreement saying that if the prostate cancer returned and he needed subsequent treatment for it, they would not pay for it.

Talk about a Orwellian choice. Fortunately, R. has dodged that particular insurance coverage bullet because his wife, as a former nurse at a good hospital here, had an excellent policy which pays 100% of everything, regardless of insurance policy. So he's covered.

Another good thing is that through all the medical crises both he and his wife have experienced in the past two years, she has finally come around to wanting him in her life. She bought her own condo a long time ago and they live apart, but on paper they are married, and he had insisted a ways back when, when she depended on him for taking her to the doctor, and to surgery and for just plain being there for her when she needed it, that she keep him on her insurance plan, mainly for all the trauma she put him through when she ditched him...twice. She agreed. (He's 62 now, I think, and dropped out of f/t corporate career life and is now working 3 p/t jobs. So he needed insurance to get him thru age 65, when Medicare would pick him up.

So now, perhaps facing the reality of spending the rest of her life with colostomy bags and scarred all over, she realizes R. has proven himself worthy of her love. She's also come face to face with his mortality. So she's proposed to him that they remain in each others lives, to what capacity, I'm not sure, but that they would continue to live apart, even while she would not date anyone and she hopes that he wouldn't either.

R. seemed undecided about all that. His parents, he explained, remained together in a traditional marriage for all of their lives.

Anyway, I'm feeling rather depressed about my friend's health. He's been through a lot in his personal relationship, and now it could be a worst case scenario with his own serious medical issue. So far, a CAT scan and MRI have not shown any spread of the cancer beyond the prostate.

I don't have a lot of people in my life, but R., for all his faults, was and has been an important person to me. I would be devastated to lose him.