It was fourteen years ago this month when ...

... I underwent prostate cancer surgery (a prostatectomy) at the Cleveland Clinic. My family physician had detected something ... different ... about my prostate gland during a routine physical back on November 30, 2004, and I'd had some small pieces plucked out of me (that was fun!) and subjected to a biopsy. Which had turned out positive (which, of course, means negative).

But the Gleason score (a measure of the cancer's intensity) was apparently only moderate (a 6 on a 10-point scale), so the surgeon said I could wait until school was out to have the surgery. (I was teaching at Western Reserve Academy at the time.)

So ... as I said ... I wasn't really worried. (Too much.)

I wrote some about all of this in my memoir Schoolboy (Kindle Direct, 2012), and below is some of what appears there:

June 2005.

Early on Thursday morning, 9 June I enter the Cleveland Clinic for surgery to remove my prostate gland (a prostatectomy).  I will be home on Saturday afternoon.  During the procedure, I emerge briefly from the anesthesia.  People busy around me.  I say, “I don’t feel any pain—just some pressure.”

Dr. Klein, leaning over my abdomen, his hands buried inside me, some effort thickening his voice, says, “I’m—just—trying—to—move—your—bladder.”

 “Oh,” I say.  And go back to sleep.

When I awake again, I am in recovery.  Joyce is there, her hand in mine.  Dr. Klein tells me he was able to spare the erectile nerves that Dr. Moore said must go.

In the first days at home, I discover that it hurts fiercely to move, to laugh.  (I have to stop playing a DVD of Grosse Point Blank when I laugh so hard at Dan Aykroyd that I scream in pain.)  For about a week I endure a catheter and its attendant indignities, but Joyce and I walk around town, going farther each time, visiting our usual stops and shops.  I feel myself getting stronger every day.

A week and a half after surgery, I get a call from Dr. Klein.  The post-op pathology report on my prostate is not good.  The cancer is more serious than the biopsy predicted.  It is not a Gleason 6; it is a Gleason 9.  There is only one score worse.  He says he wants to see me again and that I will likely have to undergo a daily course of radiation for seven weeks.

I return to Dr. Klein’s office on 15 July.  Joyce, away teaching at a writers’ conference (I’ve urged her not to cancel this commitment), participates via speaker-phone.  Dr. Klein is pleased that my most recent PSA test is zero, indicating that no active cancer cells appear to have escaped the prostate capsule to cause continuing problems.  He wants me to have PSA tests every three months.  As for treatments, I can do nothing, start radiation (his recommendation), or undergo a combination of therapies, including hormones.  The latter can mean enlarged breasts, the loss of all sexual desire.  Other unpleasantness.  I say I will think about it.

In mid-August I am back at the Clinic to discuss treatment options with other specialists.  Joyce and I are both concerned about doing anything more.  My body has endured a lot.  And besides, my PSA remains at zero.  Still, some awfully smart doctors are advising action, so I schedule radiation treatments.

And then I change my mind.  Here’s why:

On 17 August, at a nearby Borders, we find a book called Dr. Peter Scardino’s Prostate Book.  Scardino is chair of the urology department at Memorial Sloan-Kettering Cancer Center.  He is a cautious man.  I like what I am reading.  If the PSA is zero, he says, it’s generally not time to do anything radical.

I exchange email with Dr. Klein on 19 August.  I ask if I will hurt myself if I wait until I get a positive PSA test.  He says probably not.  I promptly cancel all other appointments.  I will wait, and hope.

School begins in just a couple of weeks.  I’ve been reading the complete works of Willa Cather all summer, preparing for our study of My Ántonia.  The first solo car trip I take after surgery is on 5 July—to visit the Cather birthplace in Virginia, then to Pittsburgh to see the school building where she taught, the home where she boarded.

On 28 August, Joyce and I go down to the Great Lakes Science Center to see Body Worlds II, the astonishing display of actual human bodies and body parts preserved by a process called plastination.  I linger for many minutes over the glass case that holds the prostate gland.  Such a small thing.  A squishy walnut.

But--as followers of this site know--things did not go all that well. The PSA rose; the cancer came back; and--despite a number of treatments, it's still lurking in my body and will one day emerge to introduce me to Mr Reaper.

I've had two rounds of radiation, sessions of immunotherapy, and have been on drugs that have dramatically altered my life.

But--as the naive say--I'm still here. Still hanging on. The latest radiation sessions have slowed the growth once again (temporarily, I know), so I am "enjoying" a bit of a respite. I can pretend for the nonce that All Is Well. Though there's always that wee voice deep in my brain that says, Oh, Dan, don't be an idiot!