It’s Movember:

… and Prostate Cancer* is the Subject of the Month
(c) 2015, Davd

The CBC News website recently reminded us (as part of its biographical sketch of his son Justin, the new Prime Minister), that Pierre Trudeau died of prostate cancer in 2000. A Cancer Society volunteer filled out the story for me: The elder Trudeau had Parkinson’s disease, he said, and was facing a future of severe disability leading to eventual death, when prostate cancer was diagnosed. Aggressive treatment was offered to him, which the doctors believed was nearly certain to save him from the cancer—but not from Parkinson’s. Pierre Trudeau decided, the volunteer said, to accept an earlier natural death from cancer rather than a slower one from Parkinson’s.

Prostate cancer is the main subject of “Movember”*. Last Movember, i was going through the diagnostic process, and did not know if i did or did not have it; i wrote one blog about a new aspect of prevention. Early the next year, i learned that i not only had a prostate tumor, but that its “Gleason sum score” was just high enough to count it as cancer. as this Movember begins, i’m about halfway through a series of radiation treatments designed to destroy that cancer, which tests made months ago indicated has not spread yet1.

Over a year ago now, as the diagnostic process was beginning, a good physician told me, “More people die with cancer than from cancer.” That can be read as [1] “some people with cancer die of something else first,” or as {2} “more people with cancer die of something else first, than die of their cancer.” {2}, the more optimistic reading, seems to be true of prostate cancer: It is much less aggressive, much slower growing, than several other kinds—and it is easier to treat than lung, liver, pancreatic, esophageal, or several other cancers.

A neighbour and friend near where i used to live was diagnosed with lung cancer weeks, maybe two months after i was diagnosed with prostate cancer. He died late in September; i started radiation treatment not long after he died. (I had been on androgen suppression treatment since well before he was diagnosed… and my cancer was probably diagnosed at an earlier stage. Prostate cancer detection is much better than it was a generation ago.)

This Movember, i plan to summarize the usual treatments, not as an expert but as one of the victims. Then i plan to go into some detail about what it’s like, for me and a few men i have interviewed, to go through radiation treatment specifically; and what it will do to the part of your life when you’re not being treated. I haven’t yet talked to enough men who are six months or longer post-treatment, but if i do, i might write about that late in the month.

Other subjects that may be included are cancer prevention, hormone treatments, and some suggestions for the treatment system to consider, to make it easier for men to adjust to the demands treatment makes.

The volunteer’s story about Pierre Trudeau, reminds us of one fact people—men and women—tend to ignore or minimize: We are all mortal. Medicine gives our bodies longer life spans, at least usually. It does not give us endless spans. As best i can guess from what people have told me as physicians and nurses, as fellow patients in waiting rooms, and also “out and about”, prostate cancer treatment is usually successful—which means, it keeps you alive long enough to die of something else. Pierre Trudeau decided that his “something else”, Parkinson’s, was a worse way to leave this life.

One thing a diagnosis of cancer—or even the possibility of a diagnosis of cancer—can remind us if we let it; is that our time will eventually come to an end. While going through the waits and the adjustments that prostate cancer treatment requires of us, we might spend some time planning how to make the best of the life span we have left. We can’t know exactly how long it will be, though we might get a good estimate under the Latin name prognosis. By the time most men get prostate cancer, they are already over half way through a normal span.

If you have some dissatisfactions with the story you’ve lived in the years before you were diagnosed (or learned you don’t have cancer, at least not yet)—the disturbance that your life is having, can be occasion for you to make the next few years more worthwhile. Maybe you have started writing a novel you want to finish “sometime”, and then neglected it; or there’s some family history you lived through and your children didn’t, to write down. Maybe your grandchildren are ready to build a boat with you, or travel with you to places their parents don’t know as well as you do. Maybe you’ve thought of buying a few acres and planting an orchard and some gardens, building a summer-house or even a big enough house for ten or more people, for your family to have, or you’ve been talking with some other men at your church about setting up a household where fatherless boys can learn their way to manhood.

Being reminded that you are mortal—that we all are—can motivate you to get back doing those good works that somehow got sidelined. Acknowledging your mortality can help you see your life as a story and cancer treatment, even the process of deciding if you have cancer, as a pause, a chance to choose a new perspective, with which to design and then live the rest of it.

Live a good story.

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*. The Wikipedia Movember page, last modified on 21 September 2015 [as retrieved 27 October] indicates that prostate cancer was the principal focus of early Movember awareness and fund raising. Depression, exercise, and testicular cancer have been added, but the article indicates that prostate cancer is still the largest focus.

1. When those “has not spread” results came in, an “androgen suppression program” was begun which, not to be too nice about it, made me a pharmacological eunuch. My testosterone levels fell like a foot-diameter hailstone; and as consequences, my metabolism slowed down, my red blood cells became fewer, and thus, down went my energy and stamina. (Since i’m old, many people just attributed that slowdown to old age.) Prostate cancers, Dr. V told me, need testosterone to grow, and blood and other tests indicate it soon stopped growing … allowing me to wait fairly safely for treatment.

There could be more subtle aspects to the “androgen suppression program”. I can call myself an ecoforester without lying, but i’m not medically trained. These blogs are for non-medical readers, especially men who have or might have prostate cancer; and the “pharmacological eunuch” experience is something that might be easier to take if you are forewarned… more about that, perhaps, later in Movember.

 

About Davd

Davd (PhD, 1966) has been a professor, a single father keeping a small commercial herb garden so as to have flexible time for his sons, and editor of _Ecoforestry_. He is a practicing Christian, and in particular an advocate of ecoforestry, self-sufficiency horticulture, and men of all faiths living together "in peace and brotherhood" for the fellowship, the efficiency, and the goodwill that sharing work so often brings.
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