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Dan Sexton is in great physical shape. He's fit, lean, doesn't smoke, doesn't drink and eats all of his fruits and veggies. So when he was diagnosed with cancer in November of 2006, he was left thinking, "Why did this happen to me?"

At age 59, nine years later than recommended, Sexton had his first prostate-specific antigen blood test. PSA is produced by cells in the prostate gland. Most healthy men have a PSA level under four nanograms per milliliter of blood, according to the American Cancer Society. If a man has a PSA between 4 and 10, he has a 25 percent chance of having cancer. The chance of prostate cancer increases to more than 50 percent if the PSA is over 10.

With a PSA of 2.3, Sexton became complacent. He skipped what should be an annual PSA test twice in five years. What Sexton didn't know was that his PSA was rising, fast.

"I had no idea what it was all about until I had cancer," he said.

After seeing his PSA increase, Sexton's urologist told him that he was a candidate for a prostate biopsy. Before having the biopsy, Sexton had his percent-free PSA tested.

There are two forms of PSA, one that attaches to proteins in the blood and another form that circulates unattached, or freely. The percent-free PSA is a ratio of how much PSA circulates freely, compared to the total PSA level.

Percent-free PSA tests can be used to determine if a person should have a prostate biopsy. The lower the percent-free PSA, the more likely the man has prostate cancer. Scores between four and 10 usually indicate good candidates for biopsies, according the ACS.

Sexton's percent-free PSA was seven. His next step was to have a biopsy to determine whether or not he had cancer. PSA tests are not used to diagnose prostate cancer.

In a biopsy, a needle is inserted through the rectum into the prostate gland. A sample of tissue is removed and examined to see if cancer is present. In Sexton's case, it was.

On Nov. 8, 2006, Sexton was officially diagnosed with prostate cancer. He then had to choose which, if any, treatment method he wanted to pursue.

There are several forms of treatment for prostate cancer. In a radical prostatectomy, the entire prostate gland is removed as well as some surrounding tissue. Robotic surgery, dubbed the "Da Vinci System," also exists. In this approach, robotic arms, controlled by the surgeon, perform the operation through small incisions in the patients abdomen.

The major side effects of surgery are impotence and incontinence.

Another popular form of prostate cancer treatment is Brachytherapy. The surgeon implants several radioactive "seeds" directly into the patients' prostate gland. Impotence and incontinence are also side effects of Brachytherapy.

Like other forms of cancer, radiation therapy and chemotherapy are also used to treat prostate cancer.

Though there are several prostate cancer treatments to choose from, Sexton wasn't satisfied with any. Then he discovered a treatment he'd previously not heard about, proton beam therapy. Created at Loma Linda University Medical Center in Loma Linda, Calif., proton beam therapy uses protons instead of X-rays, like radiation therapy does, to eradicate the cancerous cells. Because protons give off the majority of their energy after traveling a certain distance, less damage is done to healthy tissue surrounding the cancer.

After doing more research, Sexton knew he found the treatment for him.

Sexton and his wife, Juli, headed to California for their "radiation vacation."

Over the span of nine weeks, Sexton received 44 proton treatments. Each session took only two minuets to deliver the beam into his cancer. Each session, Sexton spent about an hour total at the medical center.

Sexton's recovery from his biopsy was worse than recovering from cancer treatment, he said. Fatigue was the only side effect Sexton felt.

"I got as good a treatment as surgery without going through surgery," Sexton said.

"I got more than just physical treatment," he said. "I was uplifted emotionally, spiritually. My outlook and appreciation of life has been increased."

Today, at 66 years old, Sexton is getting the word out about prostate cancer. "Awareness and knowledge is what my goal is," he said.

"Prostate cancer is a silent killer," Sexton said. "The best treatment is early detection. I was ignorant. I don't want other men to be ignorant."

According to the ACS, one in six men will be diagnosed with prostate cancer during their lifetime. One in 35 will die from the disease. In 2008, more than 186,000 new cases of prostate cancer will be diagnosed in America and more than 28,000 men will die from it.

In part of his effort to bring prostate cancer awareness to men on the peninsula, Sexton attends a monthly prostate cancer support group, held ever third Thursday in the redoubt room at Central Peninsula Hospital in Soldotna. The group is part of the Anchorage chapter of national prostate cancer support group, Us TOO.

During the month of September, prostate cancer awareness month, Us TOO will have a table set up inside CPH. Information will be available to anyone interested. Donations can also be made.

In addition to Us TOO, Sexton and his wife have also opened their home for anyone seeking more information about prostate cancer. Sexton can be reached at 262-9244.

"My main goal is to bring community awareness to men, to (have them) faithfully get an annual PSA test," Sexton said. "Early detection of prostate cancer can save your life."

Mike Nesper can be reached at mike.nesper@peninsulaclarion.com.