Betting the Hand You’re Dealt

I finally finished reading Prostate and Cancer by Sheldon Marks, M.D. as my physician requested. It's a relatively easy read and answers many of the questions I had about my prostate cancer.

The book begins with some rather scary statistics: More than 189,000 men have been diagnosed with prostate cancer in 2002, and more than 30,200 men previously diagnosed will die as a result of it.

Dr. Mark suggests that if a cancer is large enough to show up in a PSA test or during a routine exam it's significant:

We know that many men have prostate cancer and are never affected during their lifetime. Most don't even know they have prostate cancer. But it is believed by urologists who specialize in prostate cancer that if we detect prostate cancer because of an abnormality on exam or because the PSA level is elevated, there is most likely a significant cancer present.

That strongly suggests to me that it's not a good idea to sit back and observe how fast the cancer's growing unless you're pretty sure you have less than seven years to live.

Naturally, though, the book doesn't really answer the question that has been bothering me the most, which the author readily admits:

How can I know what treatment is right or wrong for me?

I find it interesting that with prostate cancer, everyone expects that we will have all the answers and know for an individual what the "right" course of treatment will be. Yet with every other aspect of health, men and women are accustomed to not knowing these answers.
"
There is no right or wrong. Rather, the question should be "What is best for me at this time."

In many ways prostate cancer has been the most difficult cancer for me to deal with precisely because experts seem to differ on the best possible treatment.

Of course, it's probably not entirely irrelevant that the physician who recommended the book is a surgeon and that the author is also a surgeon. If one were really looking for the "best" answer, it might be wise to also read a book written by a radiologist or a physician who specializes in alternative treatments.

In essence, though, by choosing to have surgery rather than radioactive treatment I'm rolling the dice that I'll live longer than seven years, the time when cancer commonly returns with older radioactive techniques. Naturally, there's no data on newer radioactive techniques, so it seems nearly impossible to accurately compare the two.

By having surgery, I'm also giving myself a second chance, as I did with my throat, you can have radioactive treatment after surgery but they generally don't want to do surgery after radioactive treatment because of its effects on tissue.

It's rather drastic surgery, but I guess you bet the cards you've been dealt, not the ones you wish you'd been dealt.


So many facts
so many statistics --
hope outweighs them all.

4 thoughts on “Betting the Hand You’re Dealt

  1. You’re an amazing person, Loren. You’ve had a raw deal these last few years with your health, but you face the subject straight on, focusing on the positive while being very aware of all the possibilities. You inspire me, and not many people do nowadays.

    If one wasn’t a hiker before, one would want to become a hiker after reading what you write. Well, and a grandpa and a poet, but we don’t all have these options.

    When is your surgery? I thought I read end of the month, but with your cold, is that still on for that time?

  2. “You inspire me, and not many people do nowadays.”

    That goes for me too, Loren. I know that more of us than you imagine are holding you in their thoughts, sending wishes and prayers for your successful surgery and for many more years of being a hiker, a grandpa, a poet, and a lot more besides.

What do you think?