‘Golden Bachelorette’ Winner Chock Chapple, 62, Says Elevated PSA & Further Testing Led To Prostate Removal & Advises ‘Early Is Everything’

He wrote alongside a video of himself and Vassos sitting outside, “Joan’s here in Wichita taking care of me, so here’s a life update. Elevated PSA. Biopsy, MRI, another biopsy. Turned aggressive.

“Last Wednesday I had my prostate removed.”

Chapple said he was diagnosed with prostate cancer at age 60.

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It’s important to note that while Chapple has not publicly shared the stage of his prostate cancer, some men with prostate cancer may choose active surveillance, while others may opt for treatment when PSA levels rise or other test results suggest the cancer may be more aggressive.

Chapple continued, “Lost my mother to cancer. I know what’s at stake. My son asked how much time I wanted with my grandkids, and that made the decision easy. Get it removed. Be around. For them. For Joan, for the rest of her life.

“Guys, get tested. Have your PSA checked. Early is everything”

The father of two shared that he remains set to travel to Europe at the end of August after receiving medical clearance, while thanking everyone who has supported him along the way.

Dr. Jonathan Lischalk, radiation oncologist at Perlmutter Cancer Center, previously explained to SurvivorNet, “So for a patient that’s found to have an elevated PSA, oftentimes it’s the urologist that meets that patient first, typically referred from a primary care physician.”

A urologist will perform a detailed history and physical examination (including a digital rectal exam) and consider this information in combination with the patient’s current and previous PSA tests results to make decisions about further testing.

It’s important to understand that a team may recommend repeat PSA testing to help rule out any benign (non-cancerous) diseases such as infection or inflammation of the prostate. They may also recommend additional imaging scans such as an MRI (magnetic resonance imaging)—which Chapple had done.

Chapple explained in the footage he posted on Instagram that he had a blood test done after his time on “The Golden Bachelorette,” which showed he had an elevated PSA, which he and his doctors “decided to “monitor for a while.”

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“My PSA kept increasing and long story short, a biopsy, MRI, and then another biopsy, and it turned aggressive,” he added.

He then admitted his recovery journey as “been a little rough.”

RELATED: Coping With Side Effects From Prostate Cancer Surgery: What To Expect

Vassos then chimed in, praising how “brave” Chapple has been, adding, “he’s actually been a really good patient.”

She concluded, “I’m glad he made the decision that he made. I want to keep him around for the rest of my life … so I think we made the right decision.”

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Understanding An Elevated PSA

Since an elevated PSA does not guarantee you have prostate cancer, doctors will usually perform a biopsy to make an official diagnosis. If your doctor suspects prostate cancer you will likely undergo a biopsy. This is a procedure that involves removing a small bit of tissue to test for the presence of disease.

If the biopsy is negative (there is no cancer detected) next steps can include:

• Repeating the PSA and digital rectal exam every year or two
• Ordering another biopsy
• Obtaining an MRI if you did not have one already

If the biopsy comes back positive for cancer, take a deep breath.

A diagnosis of prostate cancer is not always an emergency. You usually have time to decide on next steps. This will likely include further discussion with your urologist and referral to radiation oncologists and medical oncologists.

“I think one really important aspect to prostate cancer care is that there’s a lot of different options and oftentimes those options can be really challenging and maybe even the most challenging decision that a patient makes,” Dr. Lischalk said.

Depending on what the biopsy shows, you might need additional imaging with MRI or CT (if not already done), bone scan, or a PET [positron emission tomography] scan.

“We have a lot of more advanced ways to review the biopsy as well, including kind of a genomic analysis, which really digs into the DNA and the genetics of the cancer cell, which has changed the way that we approach a lot of cases,” Dr. Lischalk says.

Once your care team reviews all of the information, your prostate cancer will be grouped into localized disease, regional disease (involving a lymph node), or metastatic disease, which means it has spread to distant sites in the body. Localized disease that is only in the prostate will be assigned a risk group ranging from very low risk to very high risk.

A Patient Guide To Prostate Cancer Testing

Based on your prostate cancer category, overall health, and treatment goals, your care team will discuss the available treatment options and what is right for you.

“It’s a very complex process that involves a lot of coordination with the different specialties,” Dr. Lischalk says. “But the goal is to provide the most personalized treatment that takes into account your specific disease and health, as well as your wants and wishes.”

Understanding The PSA Test & What’s Considered Abnormal

A prostate-specific antigen (PSA) test is one of the most commonly used screening tools for prostate cancer. It is also used for tracking the disease following diagnosis and during treatment. To perform the test, your doctor will take a blood sample just like any other routine blood test.

The test checks for the level of PSA circulating in the blood. While the PSA protein is produced by normal prostate cells and usually present at low levels in the blood, it can also be made by cancerous prostate cells.  As the cancer cells grow and become more active than normal prostate cells, they can cause  PSA levels to spike. However, PSA can also be elevated for non-cancerous reasons too.

It’s a routine blood test typically ordered by your primary care physician who may also perform a digital rectal exam to check your prostate health.

If the PSA test comes back normal and you do not have any concerning symptoms such as urinary retention, painful urination, or blood in the urine you will likely continue to have regular checkups and screening to keep an eye on things.

Usually a PSA level of 4.0 ng/mL or higher is considered high and requires further workup. However, many men with a PSA above 4.0 do not have prostate cancer and some men with a PSA below 4.0 ng/mL can have prostate cancer. It’s crucial to review your test results with your care team to understand what they mean and if you need any followup.

For some men, an elevated PSA is normal. Numerous factors can cause a rise in PSA level to including:

• Increasing age
• Enlarged prostate
• Benign prostatic hypertrophy (BPH)
• Infection of the prostate
• Recent biopsy
• Recent ejaculation

It’s worth noting that some medications can actually lower PSA levels. These include drugs used to treat hair loss or urinary problems, such as finasteride and dutasteride.

Prostate Biopsy: Confirming The Diagnosis

The only way to confirm prostate cancer is with a prostate biopsy, where small samples of prostate tissue are taken and examined under a microscope.

Most biopsies are done transrectally (through the rectum) or transperineally (through the skin between the scrotum and anus). It is also done under local anesthesia, and the procedure takes about 20 minutes.

An ultrasound probe helps guide the needle, and often MRI images are fused with the ultrasound for better targeting.

During a biopsy, usually, 12 to 14 cores (small tissue samples) are taken. The pathologist then grades them using the Gleason score (more on what this means below).

If cancer is found, the pathology report will include several factors, including a Gleason score, the location of the cancer, and whether it has spread to nerves. Here’s a breakdown of what it all means:

• Gleason score (now called grade group): This describes how abnormal the cancer cells look. Grade group 1 (Gleason 6) is the least aggressive, grade group 2 and 3 (Gleason 7) are considered intermediate, and grade group 4 and 5 (Gleason 8-10) are the most aggressive.
• Cancer location: This includes how many of the biopsy cores were positive and where in the prostate they were found.
• Perineural invasion: This means the cancer is near or involving nerves, which can have implications for treatment planning.

If the cancer appears to be intermediate- or high-risk, your doctor may order imaging tests to see whether the cancer has spread beyond the prostate.

Common Staging Tests Include:

• Prostate MRI: Assesses whether the tumor is confined or has spread locally
• Bone Scan: Looks for spread to the bones, especially in high PSA or high Gleason score cases
• CT or PET/CT Scans: Looks for lymph node or distant spread

Newer scans like PSMA PET are even more sensitive and increasingly used in high-risk patients.

“The PSMA scan … is a nuclear medicine scan that is actually able to pick up spots of cancer that you may not see on our regular studies such as MRI or CAT scan,” Dr. Leonard Gomella, Chair of the Urology Department at Thomas Jefferson University’s Sidney Kimmel Comprehensive Cancer Center, previously explained to SurvivorNet.

“This is very important to us. This is really redefining how aggressive we need to be in treating a man with prostate cancer, depending on how extensive the spread of the cancer is.”

The scan can help doctors decide between recommending active surveillance and treatment and predict the risk of spread or recurrence. They’re not required for every patient but can provide helpful decision-making information.

Putting It All Together: Risk Stratification

Once all of your test results are in — PSA level, Gleason score (grade group), imaging studies, and possibly genomic testing — your healthcare team will determine the overall risk level of your prostate cancer. This is called risk stratification, and it helps guide decisions about treatment.

Doctors generally group prostate cancer into three main risk categories: low-risk, intermediate-risk, and high-risk.

If your PSA is under 10, your Gleason score is Grade Group 1 (also called Gleason 6), and the cancer is confined to the prostate with no signs of spread, you are likely in the low-risk group. These cancers often grow slowly, and some patients in this group may be candidates for active surveillance instead of immediate treatment.

The intermediate-risk group includes patients with a PSA between 10 and 20, or a Gleason score of Grade Group 2 or 3 (Gleason 7). These cancers may still be confined to the prostate, but they tend to grow faster than low-risk cancers and may require active treatment such as surgery or radiation.

The high-risk group includes patients with a PSA over 20, a Gleason score of grade group 4 or 5 (Gleason 8-10), or evidence that the tumor has grown beyond the prostate. High-risk cancers have a greater chance of spreading and typically need more aggressive treatment, sometimes involving a combination of therapies.

RELATED: Dr. Akshay Bhandari’s Guide To Prostate Cancer Surgery

Your doctor will explain where you fall within these categories and what it means for your treatment plan and long-term outlook.

Preparing For Prostate Cancer Surgery: Before, During & After

Screening Guidelines

For men 55 to 69 years, the decision to be screened for prostate cancer is an individual one, according to The United States Preventive Services Task Force. Men 70 years and older should not be screened for prostate cancer.

Other organizations, including the American Cancer Society, recommend the following prostate cancer screening schedule:

• Age 50 for men with average risk of prostate cancer
• Age 45 for high-risk men, including African American men and men with a father or brother diagnosed with prostate cancer at a young age (younger than 65 years old)
• Age 40 for very high-risk men with a father or brother who died from prostate cancer at an early age

Check Out SurvivorNet’s “Men Beating The Odds”: An inspiring 12-part documentary series highlighting real-life journeys of men challenged and thriving after a diagnosis of advanced prostate cancer

Have a discussion with your doctor to decide the right screening schedule for you. Consider getting screened earlier if you have risk factors such as family history, race, or genetic factors such as BRCA2, a gene associated with a higher risk of prostate cancer.

Contributing: SurvivorNetStaff

Learn more about SurvivorNet's rigorous medical review process.

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