The news that Joe Biden, ex-President of the U.S.A., had been diagnosed with an aggressive form of prostate cancer hit close to home for me. There was a lot of doom-and-gloom reporting, which seemed to me to miss the mark.
I received a very similar diagnosis just over three years ago. After my annual physical, my family doctor ordered a number of routine tests, including the standard marker for prostate cancer, Prostate-Specific Antigen (aka PSA). Normal PSA is 6.5 or less, and mine turned out to be over 300. After a couple of scans, my doctor called me to come in and discuss things. It seemed that I almost certainly had prostate cancer, which appeared to have spread to many points on my bones. He referred me to a specialist, who immediately ordered a biopsy, which then confirmed the diagnosis. The biopsy was perhaps the most unpleasant episode in the whole story (don’t ask!)
There are a variety of treatments for this disease. If the cancer is confined to the prostate, surgery is the treatment of choice, perhaps followed by either chemotherapy, radiation, or both. If the cancer has spread to other places such as bones, there are other treatments available, depending on the actual type of the cancer. My variety is of the type that typically responds well to Androgen Deprivation Therapy (ADT), using drugs that suppress the body’s production of male hormones. Testosterone in particular provides fuel for the cancer’s growth.
I had a short course of radiation (5 sessions) to treat two of the larger bone metastases. This was pretty easy to bear, although the radiation oncologist I saw was the gloomiest of all the doctors I saw, giving me 3 years or 5 if I was lucky. (I’ll come back to that).
The actual course of ADT is pretty easy to deal with. I get a shot in my belly every six months, and take a pill once a day. The shot suppresses hormone production, and the pill (as I understand it) enhances resistance to hormones that might still be floating around. I had a bit of a reaction to the pill — an unsightly rash on my scalp, causing me to lose most of whatever hair I had at the top. It passed, and some of the hair has grown back.
What has been the upshot of this treatment? Four months after the initial diagnosis, my PSA had dropped to around 8. Three months later, in September 2022, my test results said <0.1, which means it’s undetectable. It has stayed there ever since. That’s as good as that gets. Adding to it was a follow-up bone scan in November 2023, which found that almost the spots on my bones had disappeared — a “dramatic reversal” was the radiologist’s comment. Last fall, my urologist said that my cancer is “deeply suppressed.” He didn’t say “in remission,” but that seems to me to be close enough for all reasonable purposes.
The doctor who gave me 3 years or so to live was wrong, thanks be to God. It’s now over 3 years since I saw him, and I’m doing fine. I have heard reports from other men on the same treatment regime, many of whom are also doing fine, some after 15 years or more.
The specific treatment I’m on only became generally available about 6 years ago, so I’m benefiting from the continued advancement of medical knowledge. Many types of cancer used to be short-term death sentences, but people are living happy and productive lives much longer than could have been imagined a few decades ago.
Joe Biden’s cancer is more advanced than mine was at diagnosis, but I believe my story and those of many others give reason for hope. It is said that more men die with prostate cancer than die of it. I’m hoping that will be true for me, and also for Mr. Biden.
There are naturally some mildly bothersome effects of my treatment. They’re a bit personal, but suffice it to say that it pushes the male body back to pre-puberty conditions. The most obvious is the loss of body hair, which curiously does not include facial hair. My beard is more or less as it was before, if a bit grayer. (I am almost 77, after all!). It this is what it takes to stay alive, I’m OK with it.
For me, the important thing is to greet each new day as a gift, trying as much as possible to keep active mentally, spiritually, and physically. The last one is a bit of a challenge, due to an arthritic hip which predates the cancer. I’m probably not a candidate for a hip replacement, because the cancer damaged the femur below the affected hip. So it goes!
The other annoying thing is that I can’t travel outside Canada. Because I was diagnosed with metastatic cancer, no insurer will give me travel insurance. The irony is that I traveled many times without giving any thought to such insurance, thinking I didn’t need it. Now that I know I would need it, I can’t get it!
I have no idea what causes cancer, but what I do know is that early detection is hugely important. Regular screening by your doctor is vital in this regard, and it troubles me that many people (about 1 in 5) do not have access to a family physician, and often don’t get the early detection and treatment that they need. My wife and I were fortunate to find an excellent doctor who was taking new patients when we relocated to Edmonton. Others are not so lucky, sad to say.
And now for a political comment, directed mostly to the province of Alberta: our current government has been at war with the health care system, including the medical profession, for as long as it has been in power. This is shameful and dangerous behaviour, leading to the deterioration of care across the board. Our current premier says she is fixing the system by carving it up into subsections. I don’t understand how a major top-down re-organization helps the folks who are not getting the care they need. Fix things at the bottom — starting with support for family doctors, nurses, associated professionals, and all the people on the ground who make our health care system work.
If you’ve read this far, more power to you! Share it with your friends, especially the male ones. As the old radio show theme song said,
“Keep happy! Keep healthy! To heck with being wealthy!”
Cheers,
Robin
Into the blue... 