Can I Live with Doing Nothing?
Do you have a friend who sees right through you? I do. His name is Regi Campbell. Here’s what happened.
We were coming out of a board meeting which ended late as usual. Regi was rushed as usual. I walked him to his car to have a little extra time to catch up.
We talked. He got in his car and opened the window. Turning to me, he asked, “What are you going to do about your prostate cancer?”
“I have chosen to do what is called active surveillance,” I answered.
I half expected an encouragement, but that is not what I got. No. He sat there staring at me silently. I stared back until it got uncomfortable.
“What?” I asked.
“You don’t do good doing nothing.
"You will not be at peace living with this disease in you. I know you and you need to do something about this cancer to cure it,” Regi said.
“Like what?” I asked.
“Do a radiation treatment and be done with it.”
“You give me this advice, but you have no idea all the due diligence I’ve done to come to this conclusion,” I said adamantly.
“I don’t need to know. I know you,” he said. He closed his window, backed up his car, and left me standing there in the parking lot.
I was pissed.
I went home and told Kathy. I was expecting her to be as annoyed with Regi as I was. I wanted her to tell me, “You are doing the right thing. Don’t listen to Regi. What does he know about prostate cancer?”
Instead, she said, “He does know you pretty well.”
I talked with three urologists, two of whom were surgeons. I also talked to three radiology oncologists. And I also talked to at least a dozen patients, not to mention the two books and the multitude of articles and videos on prostate cancer.
I’m all over this thing. When I went back to the urologist who originally diagnosed the cancer, he was shocked. “You talked to how many doctors about this? That’s nuts,” he said.
I disagreed with him. This is serious stuff in a critical location. The prostate is Grand Central Station for every man. In my humble opinion, there are major intersections in men’s bodies: heart and lungs. And the other is the prostate.
If either one of those major systems goes bad for me, then the quality of life as I know it is over. Thirteen years ago I almost died of a heart attack. I put off going to the emergency room until the pain in my chest trumped my denial. I caught it just in time. The doctor inserted a stent, and I avoided a heart attack which would have killed me or changed my quality of life.
Now I’m faced with prostate cancer. What I’ve learned is if I do anything invasive to cure it, there is a risk of urinary incontinence or loss of sexual function. How about that for a couple of options. And I have talked to the men who now live with one or both of these consequences. Not good.
I also found the standard of care for men with slow growth, early stage prostate cancer diagnosed after 65 is active surveillance. Without admitting it, the medical community is saying, we have been too aggressive in treating prostate cancer.
I came to this conclusion because all three urologists and all three radiologists told me to do active surveillance. But they always ended with, “There is one downside with active surveillance. You must be able to handle it emotionally.”
But Kathy and Regi know me really well.
I think I am handling this well. But from time to time, I don’t handle it so well. Those times come when I am forced to think about the disease. This may come from an email because I’m subscribed to a prostate cancer bulletin board website. Or it may come because of a conversation with a doctor, patient, or relative/friend of a prostate cancer patient.
I don’t wake up everyday thinking, I have cancer. In fact, I don’t think about it much at all. But Kathy knows me better than I know myself. She knows I am thinking about it. Even if it is at the subconscious level. She knows. She sees my mood and my stress level. And the more I defend myself, the more I come to realize she is right. I am thinking about it.
It is a slow growth Gleason 3+3=6. That’s good. What’s not so good is the cancer was found in six of twelve biopsy samples. But the DNA testing confirmed slow growth regardless of the biopsies. The other really good news is I am not showing any symptoms. The trains are all running on time at Grand Central.
When I think through this data, I say to myself, “You're fine. Continue on active surveillance. It is a slow growth cancer." As long as I follow the standard of care, I’ll be alerted to any change and then I can take action if necessary. This is all true.
But then again, it is cancer.