The Insidious Silence of the Disease

I'm not going to write about prostate cancer all the time--not even often.  But it is, of course, on my mind, so, now and then, I will have something to say.  Like today ...

No one talked about prostate cancer when I was growing up.  I'm not sure why.  In our house it was probably due to some Puritanical proscriptions against conversations having anything to do with the human body.  My "sex education" comprised very little: (1) my parents left lying around a book called Facts of Life and Love for Teenagers, 1950, by Evelyn Millis Duvall, which told me virtually nothing about what I wanted to know; (2) my equally clueless coevals shared "intelligence" gathered mostly from their imaginations and fantasies.

So ... a conversation about prostate problems in my boyhood home?  Not possible.

I'm not even sure when I first learned about the disease, but it was much, much later--when I was well into adulthood.  And then the things I heard made the disease sound not so serious.  It was "slow-growing"; it rarely killed; it was treatable; most men, if they live long enough, eventually get it--all of which are only partially true and very often false.

Physicians diagnosed my father with the disease in 1999, but by then poor Dad was already near death because of some strokes, congestive heart failure, various other issues.  So the doctors did not even treat him for the disease.  It would not be what killed him--and it wasn't.

Because of my pervasive ignorance about prostate cancer, I recall with great shame how I behaved about ten years ago when I learned that a colleague had cancer.  I spoke with him briefly in the faculty room, asking him what type of cancer he had.  And when he said, "Prostate," I virtually snorted with derision.  "Oh, you're going to be fine!" I declared with all the confidence of the ignorant.  "My dad had that ... no big deal."  And I strode out of the faculty room, confident that I'd just cheered up a friend.

Only two words for me: dumb ass.

For much of the course of the disease, the suffering is principally psychological.  As my oncologist has told me over and over, if it weren't for the PSA blood test, we wouldn't even know there was anything wrong with me.  (One of the truths about prostate cancer is this: If you wait till you're symptomatic, it's pretty much too late.)  Yes, I had some bad pain after the surgery (it went away); I've had other changes in the nether regions that have been an ... adjustment.  (Are you uncomfortable yet?)  But--overall--I have not suffered physically from the disease.  Just with corrosive worry that assails me whenever my mind drifts that way.  So I try to keep my mind distracted with reading and writing and memorizing poems and anything that will prevent the red word cancer from appearing on its screen.

When I was taking my daily radiation treatments in 2009, I was deeply humbled in the waiting room.  There, I saw folks of all ages--from toddlers to old, old men and women--suffering physically in ways I cannot even imagine.  I was able to get up out of my seat, walk briskly back to my machine, lie down on it, allow it to zap me.  Then I could get up and walk to the parking lot, drive home, and pretend nothing was really wrong with me.  Because, you see, I didn't feel sick.

But so many others in that waiting room were lying on gurneys, or slumping over in wheelchairs.  Patently, desperately ill.  Helpless.  Hanging on.  Dying.  I felt like an interloper.  A sightseer.  I told my radiation oncologist I felt incredibly fortunate; he said he felt the same way every time he walked through that waiting room.  So, I know: I have been lucky, so far.  I've been able to keep doing the things I love--from reading to exercising to going to the movies to writing to whatever.

I know, too, that other people--many other people--have lived for a long, long time with prostate cancer.  (Though it did kill Robert Frost and Langston Hughes and countless others.)

But hearing stories about other people's success with the disease means absolutely nothing to someone dealing with it.  It's like this: A guy being crucified looks down from his cross when he hears a friend's voice: "Don't worry," says his friend.  "I heard one guy came back alive afterwards."

In my own case, my initial biopsy late in 2004 yielded a "Gleason score" (the rating, 1-10, for the severity of the cancer) of 5--a "low-grade" cancer.  Thus, no rush to operate.  (I waited till mid-June.)  But the post-op biopsy revealed something far different--a 9: "hi-grade cancer."  Not the sort of high grades I'd ever wanted ...

Yes, I've met men who had the surgery years ago.  No problems.  And men who had radiation.  No problems.  Even men who've taken hormones.  No problems.  But I am not those men.  All cases are different because, of course, all bodies are different.  My own surgery failed; my radiation treatments failed.  They were my best shots at a cure.  What's left are basically stalling tactics.  Smoke and mirrors.

And, of course, hope.