I’m Marc’s Prostate

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As a kid growing up it always seemed that we had a daily newspaper in the house, as well as a magazine or two. We watched the network evening news, of course, everyone did, but for real information we turned to print. Very old school. My Dad was particularly fond of Reader’s Digest and would often consume the entire contents of the latest edition in one sitting. The articles were mostly short, crisply written and, in matters of politics, almost always had a right-of-center slant.

The Digest also had jokes that could be repeated safely in polite company. I particularly remember pages of jokes called “Humor in Uniform” (for the World War II generation like my parents ) and “Life in These United States,” humorous little stories about everyday life.  Sometime in the 1960’s the Digest also started publishing a series of short articles on various aspects of human health all written from the perspective of the vital organ featured. I distinctly remember Dad pointing out to me that I needed to read and absorb a little feature entitled “I’m Joe’s Heart.”

“I’m certainly no beauty,” Joe’s Heart says writing in the first person (or organ). “I weigh 12 ounces, am red-brown in color, and have an unimpressive shape. I am the dedicated slave of —well, let’s call him Joe. Joe is 45, ruggedly good-looking, has a pretty wife, three children and an excellent job. Joe has made it. Me? I’m Joe’s heart.”

Joe’s heart goes on to report that Joe probably eats too much fat, has gained weight, smokes and doesn’t exercise enough. Sound familiar? It was a good, gentle and authoritatively delivered message that remains as appropriate today as it was to the Don Draper generation in the 1960’s. Reader’s Digest pieces on “Joe’s Liver” and “Joe’s Kidney” followed. I don’t recall that there was a Reader’s Digest piece on Joe’s Prostate this was, after all,  way before WebMD and “men’s health” (and women’s, for that matter) wasn’t much discussed in the polite company where Dad told his jokes.

Things have changed for the better in that regard with the Internet full to overflowing with good, authoritative information on “Joe’s Prostate,” or in the case that I have become most familiar with – my prostate.

Like more than 200,000 American men annually I was diagnosed recently with prostate cancer. Next to skin cancer, prostate cancer in the most commonly occurring cancer among American men. The disease claimed more than 28,000 lives in 2009, the last year for which we have the most complete figures. There is almost truth to the line I’ve heard and now use myself – “if you live long enough, I’ll get prostate cancer.” Prostate cancer is indeed widespread and it takes a particular gruesome toll among African-American men.

My case – special to me, for sure – nonetheless seems fairly typical in many ways. My own concerns about heart health lead me some years ago to regularly monitor blood pressure, cholesterol and other blood markers. Often these simple blood tests will also include the somewhat controversial screen for prostate cancer – the PSA test, or  prostatic specific antigen. Early this year my PSA level took a jump in the wrong direction. A re-test confirmed the increase and signaled cause for concern. A number of good and caring health care professionals advised a biopsy of, what until this spring had been, my somewhat mysterious prostate. The biopsy, conducted in a doctor’s office, confirmed cancer.

Like millions of other Americans I now know what it’s like to have a doctor straightforwardly tell you – “you have cancer.” Wow. Didn’t see that coming. It is a moment of coming face-to-face with your own mortality. One’s attention is immediately fixed.

Like any unwelcome news there was for me, at least, a period of denial. There must be some mistake, right? Cancer doesn’t run in the family. From a health standpoint I haven’t been behaving that badly. Maybe too much red meat and too few veggies, but I get my exercise. What gives? Soon enough denial gave way to questions about what can be done to treat the unwelcome visitor in the nether regions of the male anatomy? Answering that question became a research mission of the kind I have never before undertaken.

I offer only two pieces of advice in this little prostate post with the first being the importance of becoming your own best advocate when confronted with any health challenge. Doctors and other medical professionals are (generally) wonderful people, committed, smart, caring and often overwhelmed. They exist not just to treat your condition, but to be a walking, talking sources of first-rate professional information. In order to take full advantage of their knowledge, however, I’m convinced you must do your own homework and engage in the development of your own treatment strategy. Knowledge really is power and information about your health care options truly is empowering.

Since April I’ve spent hours reading, consulting friends who have dealt with the same issue, and quizzing health care professionals trying to learn about what I now consider my favorite gland. I gave that gland up to surgery a little over a week ago after it became clear to me that what the surgeon’s call a “radical prostatectomy” was my best option given factors like age, overall health and the state of my cancer. The surgery, again from my perspective, was a very big deal. Thousands of men undergo this treatment every year, but facing major surgery, time in hospital and recovery was a brand new experience for me.

Friends and family faced this new challenge with me and 10 days on I’m feeling better and better. There will be months ahead of coping with and overcoming the undesirable side effects of prostate removal, but thanks to early detection, superb medical care and those who have helped – they know who they are – I feel today like a 60 year old guy with a new lease on life.

Second piece of advice: don’t be confused about the controversy and debate over the utility of PSA testing after age 40. Every male needs to have enough information in order to formulate a personal point a view on this central issue of male health. In my case, because a savvy family practice doctor has rather routinely checked my PSA levels, which led to my early diagnosis, I am an advocate of the checks on a regular basis. The rap against the test is that it’s not precise, produces false positives and causes many men to undergo expensive testing that may not be needed.

In short, whatever you decide for yourself, don’t be a victim of a lack of knowledge. Take charge of your own health. Decide what works for you. It just might save your life. In my case I’m convinced regular testing and early diagnosis did save my life.

Finally to all the family and friends who have sent endless good wishes my way for the last couple of months I can only say – thanks a million. In the busy world of the 21st Century it is all too easy to take for granted, or not fully appreciate, the awesome power of people who take the time and trouble to care. Take it from me: it means the world.

Late last week a call from my surgeon confirmed that the pathology work up on my former prostate and the other tissue he removed during surgery was negative. My cancer had not spread beyond the prostate. In the textbooks they call that a good outcome.

My personal brush with the disease that is described as the “most rapidly rising” in most countries around the world was both frightening and enlightening. I am richly blessed to have had access to (and been able to afford) world-class health care and the tools to seek out information upon which to make life changing (and saving) decisions. I come away with a new appreciation for the American public health crisis of obesity, poor nutrition and lack of access to care and I’m convinced that knowledge and awareness of a whole range of health care issues is at the heart of a healthier country.

I’ve always taken good health for granted. I now consider it a gift, indeed a miracle.

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