JOINT BASE SAN ANTONIO, Texas - This past spring marked a milestone of sorts for Master Sgt. Charles Ramirez, a nondestructive inspection technician with the Texas Air National Guard. Ramirez is assigned to the 149th Maintenance Squadron, a sub-unit of the 149th Fighter Wing, headquartered at Joint Base San Antonio, Texas.
At age 42, Ramirez realized he was overdue for his 40-year health physical. He noticed his body had been getting weaker but he just attributed that to his getting older. After making an appointment and getting his levels checked, the results came back. His PSA was high. Ramirez learned that PSA is a protein called "prostate-specific antigen," and can be an indicator of prostate cancer when ample amounts are found in your blood.
His doctor, however, didn't act uneasy. "Don't worry," Ramirez remembered his doctor saying, "It's probably an infection. We'll put you on some antibiotics for a couple of weeks and go from there."
A few weeks later, the same results came back. He then saw a urologist, who once again put him on antibiotics. Again, his PSA came back high.
"Normal is between zero and one," Ramirez said. "My PSA was a 3.8."
At that point, he was told he'd need a biopsy done. Ramirez shook his head at the memory.
"The biopsy was the worst experience I've had with this whole thing," he said. "I'll never forget it."
Ramirez didn't want to go into too much detail, but indicated that where they had to retrieve the 12 samples from was far from pleasant. "It was really painful," he said. "Not only did it hurt, it was just uncomfortable all the way around."
But worse for Ramirez even than the biopsy was the news he received afterward.
The doctor confirmed what the biopsy revealed. He did in fact have cancer, but according to his doctor, the good news was it was in the early stages.
Ramirez was in disbelief.
"At that time, I didn't really believe I had it because both my father and brother had never had it." Ramirez said. "Nobody in my family that I know of had had it. I'm the first one."
His disbelief turned to fear.
"At the word cancer I thought I was going to die," he said.
Ramirez said the doctor reassured him it was not in an aggressive stage and there was still much that could be done, but Ramirez was not satisfied. He wanted to know how it had happened. Since it is unclear what causes prostate cancer, Ramirez said the doctor advised him not to waste time on unanswerable questions.
"He was right," Ramirez said. "It wasn't worth breaking your head about."
Ramirez found solace in one of his coworkers who he had learned was battling a more aggressive stage of prostate cancer.
"Any questions I had, I'd go to him and he'd prepare me with what to expect," Ramirez said.
At the recommendation of his coworker, Ramirez went to a top-ranked cancer hospital in Houston for care.
Ramirez remembered being brought before a panel of two teams, comprised of radiologists and surgeons to discuss his options and choose the best course of treatment.
"They basically recommended three possibilities: radiation, surgery or monitoring it for five years with biopsies," Ramirez said. "I did not like the thought of any more biopsies, so I said, no, I want to do the surgery, and that was their recommendation too."
His doctors performed the surgery March 14, 2014.
Ramirez said he is grateful that for more than two years he's been free of cancer. But for Ramirez, accepting the diagnosis was a more difficult process than the recovery.
"I remember my doctor told me, you're lucky you caught it early," he said. "And I am thankful to be free of cancer, but I didn't really feel lucky. It was hard not to question why I had to get it in the first place. It's hard to explain how your mind works when you deal with that kind of news, and I've talked to other people who've gone through much worse. But everyone has got their own obstacles, and this one is mine."
Ramirez said rather than feeling "lucky," he feels a deeper sense of perspective on life.
"I know it could come back again," he said. "I try not to focus on petty things. I try not to take life for granted. If I see a car wreck in bad weather, it reminds me to make the best of every moment because you can go at any time."
A coworker of Ramirez, Senior Airman Carly Colletti, recalled just being assigned to the NDI section when she learned about his diagnosis.
"You could see he was concerned about it, but he didn't put too much attention on it," Colletti said. "He's really open, so we talked about it. I asked him about the process. I let him talk and I just listened. That's the best thing you can do for someone is let them talk about their worries or fears."
Another coworker, Tech. Sgt. Eric Garza, said that Ramirez kept a sense of humor throughout the ordeal.
"A lot of it is his personality," Garza said. "He is just really humble. He didn't let it get to him. When I could tell his mind was on it, I would just try not to overload him with questions."
But for Ramirez talking about it is cathartic.
"I'm not going to push it on you, but if you want to know, I'll talk to you about it all you want," he said. "Some people shut down. I'll tell you everything - the down and dirty. Some people might be embarrassed about it, but for me it's human and I don't want to hide who I am. I just want to educate people."
Part of that openness is a sense of paying it forward he feels to his coworker who, even though dealing with his own cancer struggle, never shied away from being there for Ramirez.
"He told me straight up what to expect," Ramirez said. "Just having that information and the experience he provided helped me anticipate what to expect when it was my turn. I felt that if he could do it, then I could too. He was my support system. I don't know what I would have done without his help."
Ramirez is also concerned about educating people on the importance of getting yourself checked.
"I had a friend who didn't check it - he felt too macho or something and he passed away from it," Ramirez said. "I'll tell everyone, go check yourself because it happened to me. Early detection is better."
While Ramirez said he doesn't like to overthink the "why" questions in regards to his cancer, he does concede that perhaps it has served a purpose.
"If someone is going through this - even one person and I help them - that's worth it to me. [My coworker] was that person for me.