A Funny Thing Happened…

Or could have happened, should have happened, or didn’t happen

 

About half of all of us with incurable cancer (incurable means that it likely will kill us someday) also have to deal with depression and anxiety. Actually, it’s not so surprising.

In many cases there is a predictable progression of events and often it doesn’t end well:

·        Doctor: You have cancer.

·        You: OMG, I’m going to die!

·        Doctor: Maybe not, there are treatments and possibly a cure!

·        You: Oh boy, I’m going to be cured!

·        Doctor: Whoops, the treatment didn’t work completely and the cancer came back. This time it’s not curable.

·        You: OMG, I’m going to die!

·        Doctor: Maybe, but there are treatments to slow cancer growth and give you a better quality of life.

·        You: What’s the use? I’ll just wait for the inevitable…, or

·        You: Then it’s time to finish off my bucket list, visit friends, and write that memoir…

When it seems hopeless there is professional help, medications, counseling, and support groups—but you have to make the choice whether or not to get assistance.

How we react to a bad situation varies a lot. Nobody knows how they will do it until it happens to them. We all have good days and bad days—I definitely hope I have more good days. My approach for the past dozen years with incurable prostate cancer has been to spend time with family and friends, laugh a lot, stay very, very busy, write blogs and books (often humorous—hopefully), and draw and publish hundreds of cancer-related cartoons. I have tried not to offend anyone with cancer—but, I maybe take a shot or two at doctors and drug companies—and bring a smile or little laughter into some lives.

Some have thanked me and even asked to borrow the articles and cartoons for use in other publications. A few others have become angry with me and told me how inappropriate humor is when dealing with cancer. One person, with late stage cancer, told me, “Cancer is not funny!” And suggested I not use humor in communicating with others who have cancer, ever. Of course I know cancer is not funny but I believe a sense of humor can help—it has helped me. Being able to laugh at the ironies of growing old, the strange side effects from medications, those body parts that don’t work very well anymore, and becoming more and more dependent on doctors, pills, injections, and even Depends, makes me smile—at least a little! I know that won’t be the case for everybody. 

Nobody knows if the meds will stop working or we’ll get hit by a bus or the big 9.5 earthquake will hit or…. So I’m trying to enjoy every day and maybe help some others enjoy their days a little bit more. What works best is probably different for each person‑‑find what works best for you. There are many sources of information out there. There are numerous cancer organizations, blogs, support groups, and publications. Find those that fit your needs, beliefs, and comfort levels.

axman

How Your Mind Can Play Tricks on You

At least mine does—all the time

For almost nine years I have dutifully gone to see my oncologist every three months to assess my prostate cancer condition. And I always experience a little dread (maybe my PSA has gone hog wild—hasn’t happened so far) but there is also that glimmer of hope that it has gone to zero and I’ll live happily ever after (of course that hasn’t happened either).

The PSA isn’t even all that accurate, but for those of us with ongoing prostate cancer, it’s the best measure we currently have. The week before the oncologist appointment there are blood tests and sometimes other tests as well. No problem. It’s finding out the results that’s brings on the anxiety. In my case, my blood pressure spikes every time.

Worse yet, many of us guys (including me) probably put too much stock in the results of those tests—an increase in PSA is discouraging and a decrease is encouraging. That makes sense except for the times it’s not logical. E.g. if a PSA score goes from 5.1 to 5.5 (not even statistically significant) it feels like bad news. If the PSA goes from 91 to 89 (again, not statistically significant) there is a feeling of new hope. So the numbers don’t seem to be as important as whether they trend ever so slightly up or down.

My PSA scores have had ups and downs like a mini roller coaster over the years. Except for a brief time after surgery and radiation (when it was nearly zero) it has fluctuated from two to four to three to five and back and forth depending on the current treatment and how long I’ve been on it. No treatment has helped for more than a year or two. Some new medications help immediately and some don’t help at all. There are many, many meds yet to try so this situation is likely to go on and on and on...

I don’t think about these things very often and most of the guys I know who are in my condition (just dropped in to see what condition my condition was in) say the same thing. 99% of the time I’m positive or oblivious, and then there’s that 1% of the time when I fall prey to mind tricks, emotional reactions, and the failing logic of ‘what if’. But this won’t be a problem for another three months, so let life go on.

axman

Get 'er Done!

Rule #1 of Retirement: If you can do it yourself - you MUST!

Well, that's more my wife's rule than mine, but there is this mindset that as time gets shorter you hurry faster to get it all (whatever all means) done.

This summer we needed a new roof over the back deck and new siding on the house. You'd think that your average decrepit, sickly, elderly couple could find a younger and smarter and stronger handyman (or handywoman) eager for the job. After a brief (very brief) discussion we decided that we could easily do it by ourselves over the course of the summer. How hard could it be? And we'd save a bundle of money!

But the real reason we choose to do it may have more to do with that dratted work ethic instilled in us by our depression-era parents and grandparents. Hard work is good for the soul! Even though it may not be so good for the rest of the body.

It took two or three weeks to complete most of the work and probably double that to heal. Next comes the painting - yup, we're doing that part, too. At least paint is less dangerous than skill saws, electric drills, and hammers - if you don't inhale too often. And there IS that feeling of satisfaction, impressing the neighbors, and owning the family bragging rights; "Look what WE did during our summer vacation!" Nobody seems all that impressed and a few brave souls even asked why on earth we didn't get somebody else to do it.

I've noticed that quite a few of our geezer friends, some of them in much worse health than we are, still feel the need and obligation to do all their own repairs and building and painting and mechanical work. Maybe we'll make a smarter decision next time - but not likely.

axman

Oh No! It's Back! Not Fair!

My PSA started to increase almost immediately after my prostatectomy in 2003. So other than the immediate shock, anger, and feeling sorry for myself, I have lived with the reality of recurring prostate cancer from the start.

In the past several months two old (with prostate cancer the 'old' part goes without saying) friends who underwent treatment five and eight years ago discovered that their PSA had started rising again. In fact their PSA had doubled every several months for quite a while. Both thought they were cured. For years their PSA had been near zero. They were sure they were cured.

When confronted with 'recurrence' they were understandably devastated. This happens to thousands of men every year - recurrence after five or ten or more years of being cancer free.

Being diagnosed with prostate cancer 'again' can be more emotionally difficult than being diagnosed the first time.

"It can't be happening again!"

"It must be a mistake!"

"I'm going to check with another doctor - one who will get it right!"

"I'm sure it will be OK when I get re-tested next month."

"OMG, I'm gonna die!!"

What can You Do?

First of all, stay calm. In the world of prostate cancer there is usually no reason to hurry up and take action. There are many treatments and the options vary depending on what treatment or treatments you had originally. Surgery or radiation or radioactive seeds might be options if they were not done previously. Hormone therapy may be appropriate. Or maybe your oncologist will recommend watchful waiting - at least for a while. There is bound to be SOMETHING you and your doctor can agree on. Don't panic. Don't rush to do something before you think it through. Keeping a positive attitude (not always easy) may be the best therapy of all.

axman