(updated 10/7/2022, spelling fixes needed)
In March of 2022 a routine exam showed evidence of cancer. A few weeks later I was diagnosed with “stage 4A Prostate cancer”. The “4” means it has spread outside the prostate gland and “A” means the spread is to a “region”: in my case lymph nodes and seminal vessicles and other places in my abdominal cavity. (4B would be spreading outside the region close to the prostate.) The long term prognosis is poor. The cancer is a relatively rare, aggressive type, and because of this most data in the literature documents the much slower growing type.
In 2013 when I got an echocardiogram and my heart ejection fraction (the fraction of blood expelled as related to that taken in with a single beat) had turned to shit, I thought “this is it, I’m close to the end”, was emotionally devastated and cried my eyes out in front of the nurse and doctor. But it was severe atrial fibrillation that had dragged me down and one each epicardial and endocardial ablation later my EF climbed back toward normal as I exercised.
This cancer diagnosis is much trickier. Oncologist #1 was in visible pain going over my situation and could not bear to get close to real candor. Oncologist #2 was much more comfortable with candor and outlined the most likely way things would play out: gradual resistance to treatments making it imposible to prevent further metastisis to other parts of the body. Treatment is purely palliative: Chemicals to slow growth of cancer cells and radiation to kill cells in the region. It is currently not possible to kill the cells outside the region except as a reaction to severe symptoms in cases. Repeated radiation treatments may give me other types of cancer. I know one other guy in a support group and he’s 4B with cancer cells all over his body. Very sobering as I consider a direct conversation with him.
I have two role models to help me deal with this. The first was Joe Sumakaris, a materials scientist who died quite young of prostate cancer and the second was Lois Cavenaugh Daley, a minister and teacher who died closer to my age of complications from a different kind of cancer. Both Joe and Lois were brave and positive to the end. If I can handle this cancer half as well as Joe and Lois I’ll be totally OK to the end. I’m trying hard to keep sight of the fact that it’s up to me to chose how I’m going to respond at the most basic level. If I can keep asking myself “what would Joe do?” and “what would Lois do?” I’m confident I can keep a positive outlook.