By Ralph Alterowitz
Prostate cancer means change. I certainly did not think about major changes in my life before treatment. Even after treatment, I did not think about permanent changes, probably because I did not expect to be around for long. I dwelled on my life coming to an end in about six months. My two priorities were getting my affairs in order and trying to decide which treatment to choose. But I thought it was kind of stupid to be particular about what treatment to sign up for if I was not going to be around for long afterward.
Now, some years later, I am still around, albeit with many changes in my life. Each one reminds me that I have cancer. From periodic PSA tests and DREs to eating low-fat foods, using soy, and making sure I am never too far from a bathroom. . . well, you get the picture. And each time I remember I was treated for prostate cancer, I am also reminded that it may come back. Before each PSA test, the anxious question is, will I find out that it has recurred?
Having prostate cancer means that it must be dealt with forever. It also means that there are everyday reminders of the cancer. I sometimes imagine that as the cancer surgeon removed my prostate, he implanted a cancer memory chip to make sure that I think about cancer every day for the rest of my life. At least he didn’t charge me.
Of course, there is nothing like a cancer memory chip, and yet, cancer is in my everyday language, my daily thoughts, and part of the work I do every day. It can certainly drag one down. Somehow, however, I think it has made my life better.
This “cancer think” stuff started when I read e-mails deriding Senator (first name) Kerry and his doctor for the positive spin put on the news of Kerry’s prostate cancer; the writers saw it as a disservice to present and future patients. Survivors decried Kerry’s statement, saying he made light of it, the doctor didn’t tell him the truth, and so on.
A general view was that there is no way the senator could get back to work as quickly as he intended. But this was rationalized by others who said politicians have to give the impression that they will be up to the job and that they will be around to do it.
When dealing with a difficult medical condition, it is well-known that a positive outlook increases the chances of a positive outcome. Whether Kerry truly appreciates the changes he will have to make, we do not know. We can be sure that he has talked with people like Rudy Giuliani, New York City’s former mayor. Except for giving up the Senate race, Giuliani seems to be as active as he was before prostate cancer. A study done with HIV patients showed that those who had a positive outlook lived longer.
The Positive Aging newsletter notes, “The meaning we assign to biological events may have significant implications for the course they take. To illustrate, some victims of a heart attack draw meaning from the event…to have a deeper appreciation of life.” One study found that “men who were able to find some positive meaning in their heart attacks were less likely to have a subsequent one than those who did not.”
Prostate cancer survivors have reminders that cancer is part of their lives. These reminders are in the periodic PSA tests and for some in incontinence pads or sporadic leaks. A constant reminder for almost every prostate cancer survivor is the bedroom. Erections are usually hard to get naturally if they are gotten at all.
We cannot prevent prostate cancer from becoming a life-changing event. At one support group meeting, a man asked me, “Is there anything else after prostate cancer?” Looking for what comes next begins with the option to accept the life event negatively or positively. When men choose to accept it as another life event, then they open themselves up to possibilities that make life meaningful – perhaps more so than before.
One man went back to playing tennis and golf despite his incontinence. For him, doing what he wanted meant living as he chose. Sure, some things had to change. But it was either accepting change or forgetting part of the life he wanted to have.
Our own Jim Lewis is an exemplary model. Jim’s bout with prostate cancer made him realize the problems that beset many patients. Beginning with his first book, How I Survived Prostate Cancer and So Can You, he went on to write four more books to help patients manage their disease, and he became recognized as the point man in the war against prostate cancer.
Bob Samuels had retired from his bank position and was living in Florida. After being confronted with prostate cancer, he spearheaded the movement that led to the National Prostate Cancer Coalition.
Quality living has always been an art of balance. Some people master it better than others. Many men without prostate disease live satisfying and happy lives. Similarly, many men live bright, fruitful, and productive lives after prostate cancer treatment. Some get heavily involved in helping other men and couples struggling with the disease. Others plunge themselves into their work, families, or new careers. For many men, the disease begins a rethinking: Why am I here, and what should I really do with my life?
Prostate cancer patients live longer today thanks to early diagnosis, and every day there is more information to help them. Even those who are diagnosed late live longer today than they did a decade ago. Many support networks provide information and counseling so that patients can modify and reorient the management of their disease as new information becomes available.
Just as life is on a continuum, so, too is change. That no two days are the same is obvious to some and rejected by others. People complain about the boredom of one day following the boredom of the previous one. Further, they expect that the next day will be the same. Characteristic of depressed patients, both undiagnosed and clinically, they fail to see that not only is every day different, but that they can make each day unlike the previous one. Each person has the control and the responsibility to make each day one they will enjoy.
There are options for awakening the spirit of living. Have you ever noticed that circuses rarely have one ring? They usually have three rings, and that’s because of the human attention span. You get tired of watching one, you go to the next one. Because they don’t want you to wake up and ask, “Is that all there is to the circus?” In life most people have at least five or six rings: work, family, sports and recreation, social, education, and religion.
Each of us has to choose our own rings. What will make up my life so that I don’t wind up asking, “Is this all there is?” In choosing the rings, I think of a song in the show Barnum. It begins, “The colors of my life are bountiful and bold.” What are your colors?