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Your Mind, Prostate Cancer, and the hobby from hell
Let’s raise a glass — not to survival, but to the brain: that twitchy bundle of neurons that insists on interpreting every prostate cancer side effect like it's the end of a Greek tragedy. The disease itself is already absurd — slow-moving but relentless, inconvenient yet existential, like being mugged in slow motion by your own endocrine system. But the real sadist? Your mind.
Chapter One: Psychological Torture, Now in Glandular Format
Prostate cancer doesn’t just attack the body. It recruits your psyche as an accomplice. You’re forced to navigate biopsies, hormone swings, and urinary sabotage while your brain mutters, “But what does it mean?”
The literature (of course there's literature) tells us that a “positive mindset” helps — less fatigue, fewer mood disorders, even better immune response. Apparently, delusion is medicine now. According to a 2015 Psycho-Oncology review, optimists enjoy lower distress and inflammation, possibly because they believe their cytokines can be reasoned with.
Pessimists — those realists with PhDs in worst-case scenarios — suffer more. Likely due to something called “somatic hypervigilance,” which basically means you feel everything and assume it’s cancer. Again.
Chapter Two: Married to a Psychiatrist — AKA Emotional Exposure Therapy
Being married to a shrink during cancer treatment is a special kind of masochism. You get empathy, sure — but also constant analysis. “Tell me how that made you feel,” they say, while you're crying in a hospital gown that’s all draft and no dignity. It's like being comforted by Freud with a scented candle.
Chapter Three: Control Is an Illusion, but It’s a Nice One
People who think they have control fare better. Diet, meditation, even placebo-riddled supplements — it doesn’t matter. The illusion of agency soothes the limbic system. Think of it as psychological Botox: fake, temporary, but weirdly effective.
Even mindfulness helps. CBT, journaling, groups — basically anything short of screaming into traffic. Why? Because the brain responds better to structure than chaos, even if that structure involves writing odes to your withered libido.
Chapter Four: The Carnival of Cognitive Distortions
A cancer diagnosis turns your brain into a rogue theme park of cognitive distortions:
Catastrophizing: “This back pain? Terminal. Obviously.”
All-or-nothing thinking: “If I don’t beat this, I’m just a PSA statistic with a Netflix password.”
Personalization: “This is karma for that bacon-wrapped hot dog in ‘97.”
The brain doesn’t just process trauma — it editorializes it, adds backstory, then casts you as the villain and the victim.
Chapter Five: Learned Helplessness — Now with Free Wi-Fi
Martin Seligman’s bleak little theory comes to life in every waiting room. You start strong, asking questions, demanding second opinions. Then one day you’re just... compliant. Bent over, gown open, whispering “just tell me when to breathe.”
This isn’t weakness. It’s classical conditioning. The psyche numbs itself to survive. Beige walls, endless scans, the scent of antiseptic despair — it wears you down until you’re just another flesh sack on a schedule.
Chapter Six: Coping — Choose Your Poison
There are three main styles of cancer coping:
Approach-oriented: Meditation, research, over-sharing. Admirable. Also exhausting.
Avoidant: Denial, distractions, weird hobbies involving wood glue. Effective until your next PSA test.
Humor-based: My people. Gallows humor, sarcasm, irreverence. Not everyone’s cup of tea, but oddly therapeutic. Studies show it lowers cortisol. So yes — that penis joke is technically medicinal.
Chapter Seven: Optimism vs. Realism — Who Dies Better?
Toxic positivity is spiritual gaslighting. But functional optimism? That’s different. It’s not “everything happens for a reason” — it’s “this sucks, but I’ll make it funny.” Shelley Taylor’s “positive illusions” theory suggests believing you're in control (even when you're not) actually boosts survival. Apparently, lying to yourself — just a little — keeps the immune system from curling up and quitting.
Pessimists may be accurate, but they don’t age gracefully. They just die right and bitter.
Chapter Eight: Meaning-Making — The Final Mind Trick
Eventually, your brain tries to assign meaning. Not because cancer is deep — but because we are. The psyche can’t accept random horror. It needs a story: “I’ve grown.” “I see life differently now.” “I cry less during pharmaceutical commercials.”
Sure, maybe cancer teaches gratitude. Or maybe it just teaches you that adult diapers are a racket. Either way, meaning-making improves mental health. Even if your story is just a sarcastic monologue about hot flashes and waiting-room chairs made by sadists.
Epilogue: Your Brain, The Frenemy
So here you are: a bag of symptoms, hopes, side effects, and bad metaphors. Your body is navigating treatment. Your mind is narrating the whole damn thing with unreliable commentary.
But as much as the mind sabotages, it also saves. It reframes. It rebels. It laughs in the face of hormone therapy and finds metaphors in rectal thermometers. It reminds you — sometimes — that you're still in here somewhere, snark and all.
And if that’s not resilience, I don’t know what is.
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the great cosmic mystery—wrapped in a riddle, buried in a compost heap of dandelions. What better proof of life's transcendent meaning than a weed with better survival instincts than half the people on a reality show? Truly, nothing screams “divine purpose” quite like a yellow flower thriving in dog urine and municipal pesticide.
And of course, every living thing wants to survive. That’s not meaning—it’s biology’s default setting. Amoebas do it. Tapeworms do it. Jeff from accounting does it, mostly out of habit. If clinging to life was evidence of a grand design, then so is your uncle who’s been “writing a novel” for twenty years and still refuses to die of boredom.
As for other planes of existence, I assume if there is one, it's mostly paperwork and the same waiting room music as here, only louder. But sure, let’s call it a mystery. That’s way more comforting than “chaotic meat accident temporarily animated by electricity
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3 ReactionsWhat does Biology's default setting actually mean in real scientific terms?
Your mind is like a garden, and your thoughts are the seeds. You can grow flowers, or you can grow weeds. You can't embrace the future if you cling to negative experiences. The aging process can play some cruel jokes on our bodies. Things change and things go wrong, but always remember, life goes on.
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2 ReactionsI think having this garden gives us both, whether you want them or not.
Being a gardener has taught me that no matter what I want, nature ALWAYS takes what IT wants.
The voles and squirrels take my bulbs, a fungus took my perennials and now marauding wild turkeys are taking everything - But never the weeds!
So I’ve adapted - since I always try to have a Plan B and C. I’ve learned to embrace this tumult, to accept that MY plans are gonna be at odds with nature’s plans.
I no longer fight it, trying to plant a species that’s like candy for a rodent or an ugly giant bird. Instead, I now plant flowering herbs - incredibly beautiful scents, pollinator magnets, and totally distasteful to anything wishing to devour it.
So I guess it’s making lemonade when life gives you lemons - and life will ALWAYS do that!🍋🍋🍋
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4 ReactionsHand Casteels, I do like your posts. However I do have to read them a couple of times. Lol I was wondering if you worry about a recurrence & do you deal with anxiety from this whole process. If so what has helped you. I know you mentioned your wife was a psychologist. Has that helped? My wife has tuned me out. I guess I have worn her down. lol your response is appreciated. Bob
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1 ReactionBob. A man after my own darkly roasted, over-caffeinated heart.
Yes, I worry about recurrence. In fact, I worry professionally. I’ve made it a hobby, possibly even a side hustle. If prostate cancer had frequent flyer miles, I’d have enough points to redeem a free PET scan and a lukewarm hospital sandwich.
As for anxiety; absolutely. This whole process is like being trapped in a Kafka novel with a co-pay. But I’ve developed a few coping mechanisms: gallows humor, writing cynical essays about the absurdity of it all, and glaring at brochures titled “Living Well with Prostate Cancer” as if they personally insulted my intelligence. (Which they did.)
Now, regarding the psychiatrist wife. Living with a trained mental health professional is like living with an emotional TSA agent. She sees every psychological twitch and says things like, “Do you think this is really about the PSA, or is this more about your father’s disapproval in 1973?” Meanwhile, I just want to know if I’ll still be able to pee standing up next year.
Her help is… nuanced. She's supportive in that quiet, clinical way, but after hearing me obsess about recurrence for the 200th time, she now responds with phrases like, “I hear you,” which is married-therapist-speak for “please shut up.” (Actually shut the f up)
So yes, Bob. I worry. I write. I laugh at inappropriate times. And when that doesn’t work, I eat toast and watch reruns of Columbo. It’s not a cure, but it beats spiraling alone in a waiting room with a man in Crocs who wants to talk about his bowel habits.
Welcome to the club. We’ve got matching hospital gowns and an unhealthy fixation on our next PSA test.
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2 ReactionsFull disclosure: I am an experienced mental health professional and a fully trained and vetted (evangelical) pastor. And I'm not particularly suffering from my PC today. It turns out what I worried might be bone metastasis seems apparently to be overworked nerves dealing with osteoarthrosis, a newer name for arthritis (and the aftermath of RP.) I can also disclose I went through a phase watching Columbo reruns 😉 before Comcast yanked the free subscription and I refused to pay for it. Maybe next year.
So I'm mainly back to focusing more on other challenges, reading this forum less, and contemplating life from my preferred distance.
It seems to me that this thread is more about grief than treatment, and I know that grief is real for me and for most of us with PC as well as most of those alongside us with PC. And I only said "most of" to be nice.
While going through grief, I personally try to fully experience the stage and emotion I'm currently experiencing while also reminding myself that another stage is coming. The stages I use to describe grief are denial, anger turned outward, anger turned inward (and toward God, for folks like me), deep pain, and integration. I also see the cycle of grief as starting like a tightly twisting helix rapid-cycling through these phases that eventually may broaden out and become more focused on each stage individually, although all the stages can both be present to a greater or lesser degree as well as come around again in yet another cycle. I woke up this morning with one of those recycling times related to traumatic experience from long ago, and perhaps I'm distracting myself from that by posting here!
All the best given whatever stage and combo you and those close to you are dealing with at the moment and here's to more life for the days yet to come. And if this doesn't resonate with you, that's fine too. Have you ever noticed there's only room for three reactions to a post on this forum and they're all positive?! So here's a like, a helpful, and a hug to you all.
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4 ReactionsReverend, I too agree that we need a 👎🏻 button, but the more I thought about it, the more it would cause the forum to degenerate into a Yahoo chatroom.
So best not to push any buttons if you disagree with the post.
So all this grief you speak about…am I incorrect in thinking that the forum, in your view, is one big pity party? I sometimes feel that it could be, although there is much more in the way of actual prostate discussion and information.
But because men are reared to be strong, stoic and resilient, it’s good to have an outlet with like-minded individuals; it does help to work through some of the challenges and frustrations. Thank you for that insightful post,
Phil
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2 ReactionsActually I don't want a down button either. I'm sorry if I implied that.
I have found the forum very helpful, both for knowledge and for emotion, and I hope my contributions are generally constructive, though I'm quite confident they're not without fault.
I think grief is a normal part of an unexpected and disappointing twist in the journey, and I think we all find our own ways to grieve. People who think strong, stoic, and resilient men aren't expressing grief probably either don't know us very well or aren't listening very closely. Or maybe they're just telling us that so we can maintain our strong, stoic, and resilient posture?!
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4 ReactionsStories, our, advanced prostate cancer guys (aPCguys) stories are vital to ourselves and other fellow aPCguys. At every level they help us cope, learn, and understand our cancer. Help, I need it. For the longest time I denied it. Cope, every minute of every day my cancer is with me, the diagnosis, treatments, and misery has redefined me. Learning about how others cope with cancer is epically helpful. Understanding. I live on the left coast of the USA in-between California and Washington, my timezone drops into the Pacific Ocean. My sunlight rises above the Cascade Mountains and sets in the Pacific Ocean I take time everyday to learn more about my cancer. Why? Because it helps me cope and understand my PC Journey.
Hey, Hans, I really like your writing, it helps me cope, learn, and deal with my aPC life.
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3 Reactions