The Prostate Papers—Chapter 7: The Wrap II

Gary decided his prostate cancer was not yet in the rearview mirror.

I know. I wrapped up the Prostate Papers project in the last episode. It was planned as the final episode of the series. I didn’t want to write about my prostate cancer any longer, and I’m sure you didn’t want to listen. After all, in my thinking, it was over. My cancer staging was encouraging (favorable intermediate risk), my state-of-the-art treatment was scheduled, and the long-term prognosis was excellent. I was optimistic. A couple of weeks in San Francisco for my radiation sessions, and it would be in my rearview mirror, disappearing into the past.

Reality Sets In

Well, it didn’t quite turn out that way. After returning home to Santa Fe, I debated for several weeks whether to leave the Prostate Papers project closed and on the shelf or record a new “final” episode. I’m not looking for sympathy, but I decided I wanted to be honest with my listeners, especially my new buddies in The Club, who graciously shared their prostate cancer experiences with me. So, one more chapter in the Prostate Papers, and it’s over. I think…who knows?

Anyway, what I discovered, even with all my research, is that prostate cancer lingers. It’s not “one and done” for most patients. My optimism and belief that I was in control masked the reality of most cancers. Even with successful treatment (surgery, radiation, or chemotherapy), a period of recovery can be long. And there are side effects. Boy, are there side effects!

I should have known this intimately. After all, my first wife underwent every treatment in the books for breast cancer. It was treat, recover, deal with the side effects, and then repeat. It was part of her life (our life) for seven years. I was denying reality, assuming my cancer was different.

A Real Surprise

It wasn’t. In my case, I was hit almost immediately after my last treatment with a serious, radiation-caused urinary tract obstruction. I now need to self-catheterize several times a day. It surprised me. Notwithstanding my over-the-top research, this treatment side effect never appeared on my radar. On a positive note, my radiation oncologist says it should diminish over the next few weeks or months. A couple of friends who experienced the same issue after their radiation treatment also reassured me that they recovered from this uncomfortable side effect. I’m guardedly optimistic, but patience is in order.

By the way, we haven’t even touched upon the well-known, long-term outcomes of radiation treatment for prostate cancer. These side effects can take months, even a year or longer, to show up. It’s become painfully clear to me that prostate cancer will always be part of my life.

So why am I reopening the Prostate Papers and sharing my post-treatment status? My primary motivation is an obligation I felt to guys who are dealing with their prostate cancer issues and who listened to, or might tune in to this podcast series. There are enough challenges and decisions in the diagnosis and treatment of prostate cancer that full disclosure of the potential side effects can be overlooked. It happened to me, and I did a ton of research throughout this journey. I thought I was well-informed but discovered I wasn’t. If this can help a few of my prostate cancer buddies avoid unpleasant surprises, it’s worth the effort.

A Bit of Advice

So, my advice is simple. First, accept the fact that prostate cancer is now part of your life. You might be among the few lucky ones who complete their treatment with no short- or long-term side effects and never have a recurrence. That would be great but don’t assume it’s a given. Prostate cancer takes its toll on many of its victims.

Second, avoid nasty surprises by doing your homework. Take the time to do your research. Understand the post-treatment risks. Be well-informed when you go into your urologist’s office. Same with your surgeon or oncologist when it comes time for treatment. Ask your medical team the tough questions. It’s your prostate, your body, your life, and you have a right to know. Forewarned is forearmed.

Finally, this may seem harsh, but don’t let anybody tell you everything will be fine. I know folks who say this are trying to be supportive by using anecdotal evidence to reassure you that your prostate cancer is no big deal. You’ve heard it—"My friend had prostate cancer, and he’s just fine." That may be true, but what they may not know is their friend didn’t want to share the very personal post-treatment challenges of erectile dysfunction, urinary incontinence, or rectal issues with them. These are not easy discussions with folks outside the prostate cancer brotherhood.

Personally, I think it’s better to be prepared for the risk of unpleasant outcomes and side effects than to be surprised when they occur. That said, every guy is different. If you’re a glass-is-half-full kind of guy, go with your optimism.

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