Beaton: But cancer doesn’t have me
The Aspen Beat
“I have cancer,” was the title of my column last winter. It’s cancer of the prostate gland, an obscure, walnut-size gland in the male anatomy.
Prostate cancer is about as common as breast cancer. It’s a leading cancer killer among American men, second only to lung cancer.
It kills by spreading, typically to the bones, liver and lungs. Bones ache and break, the liver shuts down, and the lungs fill with fluid and blood.
If caught sufficiently early, however, the cancerous gland can be surgically removed in a five-hour operation. The anesthetized patient is strapped into an operating table 45 degrees upside down so that gravity pulls his guts away from the prostate gland deep in his lower abdomen. Half a dozen incisions are made across his middle. With the help of a computerized robot, the surgeon dodges intestines, nerves and blood vessels to access, cut free and extract the scoundrel.
The surgery often results in side effects such as incontinence and sexual dysfunction. An alternative treatment is to kill the gland with a radiation regimen, but that tends to produce the same side effects.
Another approach is to just carefully monitor the cancer. The growth of prostate cancer is usually (but not always) slow. Patients often live for years or even decades.
They call this “watch and wait.” What they’re watching and waiting for is to see if the cancer is spreading quickly enough to kill the man before something else does anyway.
Watch and wait didn’t fit my cancer profile. It was already past the early stage and into the intermediate stage. In the race between death by cancer and death by other causes, cancer had a head start.
On the other hand, there was no evidence that my cancer had spread beyond the prostate gland. And the cancer marker — the concentration of a substance produced by prostate cancer cells called prostate-specific antigen — was well above normal but not particularly high for a man with prostate cancer.
I decided to watch and wait. I figured that I could overcome this thing. I’ll be a cancer survivor, and I’ll do it my way, I swaggered.
While watching and waiting, I learned all about cancer. I renewed my exercise program. I ate less meat and more vegetables and vitamin supplements. I resolved to will my cancer away.
It seemed to work. My prostate-specific antigen level dropped.
But I learned that “watch and wait” is more like “watch, wait and worry.” Every ache and pain, I worried, was the cancer spreading through my body.
And then the downward trend in my prostate-specific antigen level reversed. It rebounded to where it had been at the time of my initial diagnosis. In the meantime, maybe my cancer had spread.
So this summer I surrendered to surgery to remove my cancerous prostate gland. It was no fun. Judging from how my guts felt afterward, the instruments inserted through those six abdominal incisions must have been egg beaters.
“What doesn’t kill me makes me stronger,” Friedrich Nietzsche philosophized. He had a point, but I think he was slightly off.
Cancer did not make me stronger, but it certainly made me better. Cancer had my prostate, you see, but it didn’t have the rest of me. My heart felt love from reliable old friends and generous new ones. My eyes saw the beauty of this world. My soul marveled at the miracle of the next.
As my knees hit the ground, my hands touched the sky.
My post-surgery prostate-specific antigen level of 0.0 will be monitored for the rest of my life. If it goes up again, then we’ll know that the cancer had spread beyond my prostate before the surgeon removed it, and my days may be numbered.
But the docs think it didn’t and that my days are no more numbered than yours. The most likely outcome, I’m told, is that I’m cured.
I’ve now recovered physically, and I’m back to my normal pre-surgery and pre-cancer self. I know, many of you were hoping for a better outcome than that.
As for those surgical side effects that afflict so many men, well, God is great, and so is my surgeon. (Knock on wood.) Which brings up something else. When should I expect a visit from the pretty women at Make-a-Wish?
(Postscript to middle-aged men: Get a prostate-specific antigen test every year. Insurance covers it, and even without insurance it costs only $50 at a retail lab.)
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