the "C" word

Last month I received the disheartening news that I had been diagnosed with prostate cancer. Due to my regular visits to the doctor, thankfully, I am in the very early stages. Statistically this bodes well. Based on a biopsy, my doctor estimates the cancer resides in less than 5% of my prostate, confined presently to one side. It is presumed to be a very slow growing malignancy based upon the degree of cell differentiation (usually a fairly good indicator) identified in my biopsy sample. There is approximately a 20% chance (depending upon the books you read) that the cancer is more pervasive and/or has migrated outside of the prostate, which could be bad. Typically prostate cancer spreads first to the lymph nodes, then to the bones. This is of course the worst case scenario. I'm still in denial so I'm feeling relatively calm about the whole thing, but the full realization is slowly taking hold and thus this post which is allowing me to process all of this information. Thus far my research has pointed to one of two possible options (I've pretty much ruled out any radiation therapy): surgery to remove my prostate (which offers two options of its own) or a strategy called watchful waiting.

The surgical option is fairly straightforward. I can have the doctor cut me open and remove the prostate or he can perform this operation via a robotic arm known as the DaVinci method (a nice sounding name undoubtedly chosen for the implication that it is a combination of science and art). Or instead, I can opt to wait. This option entails monitoring the growth (or lack thereof since it is typically a slow growing cancer) every 3 months via a blood test, augmented by a biopsy at the year mark. The reason to employ the watchful waiting strategy is to forestall surgery until the cancer "needs" to be addressed. Why wait? Well, the possible side-effects of surgery are incontinence and/or impotence, both quality of life issues, BIG quality of life issues for most, if not ALL men, I daresay. HOWEVER, quality of life issues don't count for much if you're dead (really, a minimal prospect at this point).

A number of factors need to be considered in making the decision over which course of action to pursue. Age (and this is a big one for me), the presumed aggressiveness of the cancer, the present (again presumed) extent of the cancer and other mitigating circumstances such as physical health, previous surgical history, etc. If the diagnosed patient is older, say in his 70s or 80s, odds are that other factors will intervene to kill the patient before the prostate cancer does. Plus, at this age, surgery becomes less viable due to the body's diminished ability to recover, etc.

However, if the cancer is diagnosed in a younger man such as myself (well, it's all relative - at my age, I'm on the "younger" side of the spectrum) the prospect of surgery becomes much more viable. It's important to remove the cancer before it has the chance to spread in this instance. Also, a younger man has a better prospect of recovery (especially as it pertains to the potential incontinence complication, and a somewhat positive hopeful outcome with that "other" issue).

At this point, I'm heavily leaning towards the surgical option most likely employing the DaVinci method. I continue to read all of the literature available to me, primarily to educate myself about all of the pros and cons and to equip myself with the knowledge to ask the right questions as I seek the right surgeon for the job. In the meantime, I'm eating better, exercising regularly and working at losing some of my excess weight. All of the books I've read thus far have recommended these steps as an overall strategy to prevent and minimize the risks of cancer. Perhaps with this as a motivation versus the old one of just plain vanity, I can maintain a healthier lifestyle. After all, I do plan on sticking around for a long time.