We All Need A Coping Mechanism

Posted by hans_casteels @hanscasteels, Apr 12 11:48am

The Absurdity of Writing as Emotional Release. An Essay for the Emotionally Constipated (well, me, actually)

Let’s skip the pretense: I write because the alternative is worse. Not for healing, not for insight—just to keep the madness on a leash. When life caves in, I don’t pray or meditate. I open a Word doc, glare at the cursor like it just insulted my mother, and bleed onto the page in Times New Roman.

They say writing helps. It doesn’t. It’s not catharsis—it’s containment. A ritual of futility where grief is spell-checked and despair double-spaced. I write not to understand but to make the chaos look intentional. My wife, the shrink, calls this “processing.” I call it bargaining—with syntax.

I sit here, latte in hand, composing trauma haikus, pretending nouns can hold back the void. They can’t. But they’re all I’ve got. Words don’t heal. They organize the wreckage just enough to walk through it without tripping.

So yes, I write. In rage, in terror, in absurdity. Because if I must suffer, I might as well give it a title.

Chapter 1: The Shrinking Universe of Male Relevance
Upon hearing the words “prostate cancer,” I naturally did what any self-respecting man would do: I Googled it at 3 a.m. in my underwear, flanked by snacks and panic. What I discovered, apart from horrifying life expectancy charts and smiling men holding salad, was this: apparently, one’s entire masculine identity is now tethered to a gland the size of a walnut. A walnut. An evolutionary afterthought that, when inflamed, can take down the whole circus tent. This realization has unhinged me. If my walnut is faulty, what else is next? Will my spleen stage a rebellion? Will my pancreas join a union?

But don’t worry, there’s a brochure for that. Right on the cover: two beaming, wrinkle-free people in pastel polos, riding a tandem bike with perfect posture, straight spines, and not a diaper in sight—proof that denial comes with a glossy finish.

Chapter 2: Death by Side Effect, or: “The ADT Tango”
And then there’s Androgen Deprivation Therapy, which sounds like a Victorian punishment for lustful thoughts, but is actually far worse: a chemical lobotomy that robs you of testosterone, ambition, thigh muscle, and occasionally, the will to live. I am now an emotional soup. I cry during dog food commercials. I mourn my libido like a dead uncle. My nipples itch ominously. My wife, formerly married to a stoic man of few words, now shares a house with a sniffling, bloated philosopher prone to muttering things like “Is this real or am I just a hormone hallucination?” while staring at a toaster.

But don’t worry, there’s a brochure for that. Right on the cover: two beaming, wrinkle-free people in pastel polos, riding a tandem bike with perfect posture, straight spines, and not a diaper in sight—proof that denial comes with a glossy finish.

Chapter 3: The Existential Weight of PSA Scores
The PSA test, as you may know, is a numerical representation of one’s worth as a man. Some men use stock tickers. I use my PSA log. One decimal point up, and I’m planning my funeral playlist. One decimal point down, and I consider buying pants with zippers again. My wife tried to take away the PSA app on my phone. I bit her. (Figuratively.) Now she simply nods sympathetically while quietly Googling “how long does ADT last” and “legal options for psychiatric emancipation from spouse.”

But don’t worry, there’s a brochure for that. Right on the cover: two beaming, wrinkle-free people in pastel polos, riding a tandem bike with perfect posture, straight spines, and not a diaper in sight—proof that denial comes with a glossy finish.

Chapter 4: The Psychological Toll of Radiological Fashion
There is nothing more undignified than lying pantsless in a radiation machine while being told to keep your bladder "comfortably full and your bowels completely empty." What is that even supposed to mean? Comfortably full is a myth. So is completely empty. You're either brimming like Niagara or parched like a camel. There is no golden middle ground. My wife, ever the pragmatist, says things like “just drink when you’re told and pee when you’re told.” And I, being the dramatic prostate pilgrim that I am, reply: “I am not a man. I am a vessel. A urinal with eyebrows.”

But don’t worry, there’s a brochure for that. Right on the cover: two beaming, wrinkle-free people in pastel polos, riding a tandem bike with perfect posture, straight spines, and not a diaper in sight—proof that denial comes with a glossy finish.

Chapter 5: On Mortality, Mood Swings, and Marital Diplomacy
Cancer is supposed to make you appreciate life. In theory. In reality, I now obsess over:
• Whether my radiation is secretly microwaving my dignity.
• If the oncologist was subtly mocking my underwear.
• Whether “sexual function may return” is code for “you might twitch slightly during a rerun of Murder, She Wrote.”
My wife, the one sane character in this opera, vacillates between gentle reassurance and the thousand-yard stare of someone who’s watched their husband argue with a bidet. She married a man. She now lives with a sentient therapy pamphlet.\

But don’t worry, there’s a brochure for that. Right on the cover: two beaming, wrinkle-free people in pastel polos, riding a tandem bike with perfect posture, straight spines, and not a diaper in sight—proof that denial comes with a glossy finish.

The Absurd is Real, and It Has Side Effects
This whole affair is absurd. Not tragically absurd. Just weirdly, hilariously, cosmically absurd. A Kafkaesque farce wherein I, the main character, worry less about death and more about groin sweat, bloodwork fonts, and why the radiation tech calls me “chief” every morning.

And so, dear reader—fellow warrior, long-suffering spouse, or random internet user—you now know the truth: The worst part of prostate cancer isn’t always the cancer. It’s the fact that you’re still alive enough to worry about things so magnificently stupid.

But don’t worry, there’s a brochure for that. Right on the cover: two beaming, wrinkle-free people in pastel polos, riding a tandem bike with perfect posture, straight spines, and not a diaper in sight—proof that denial comes with a glossy finish.

And that, truly, is the triumph.
Appendix A:
My Wife’s Coping Mechanisms (A Brief List):
1. Eye-rolling at Olympic level.
2. Secret online shopping.
3. Whispering “for better or worse” through gritted teeth.
4. Occasional vodka.

But don’t worry, there’s a brochure for that. Right on the cover: two beaming, wrinkle-free people in pastel polos, riding a tandem bike with perfect posture, straight spines, and not a diaper in sight—proof that denial comes with a glossy finish.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Whew! I read the whole thing.

When you assemble all these writings into a book, I'll buy one.

I mean, a real book, made of paper, not some online link.

REPLY

This is simply brilliant. Thank you!

I'd suggest collecting and editing your posts in a book format, and I imagine you'd outsell Walsh's "Surviving Prostate Cancer" by at least 2:1.

REPLY
@bluegill

Whew! I read the whole thing.

When you assemble all these writings into a book, I'll buy one.

I mean, a real book, made of paper, not some online link.

Jump to this post

We were writing the same thought at the same time, it seems!--you beat me by seconds...

REPLY

By the way, my major (I have several) coping mechanism is lifting weights. That is, using the weight machines in the gym. When I'm doing the chest press, I tell myself I'm young and getting stronger. With each labored thrust, I'm shirtless on a sunny beach with hundreds of young lovely women admiring my bulging muscles, much like an Arnold Schwarzenegger circa 1975.

REPLY
@bluegill

By the way, my major (I have several) coping mechanism is lifting weights. That is, using the weight machines in the gym. When I'm doing the chest press, I tell myself I'm young and getting stronger. With each labored thrust, I'm shirtless on a sunny beach with hundreds of young lovely women admiring my bulging muscles, much like an Arnold Schwarzenegger circa 1975.

Jump to this post

I am still trying to remember what it felt like to have working cartilage.

REPLY

“ I write because the alternative is worse. Not for healing, not for insight—just to keep the madness on a leash.”

Not sure how much time has transpired since you started ADT…and I’m sorry to be so “on point”….but IMHO, in your case… it’s time to get the hell off it…that is not a medical opinion it’s a sanity suggestion from just another grunt diagnosed with PCa.

I never liked the phrase “prostate cancer warrior”…what a bunch of BS!

Those “in the know” and those who have been convinced by those “in know” folks tell us the way to “combat the enemy” is to slash, burn and chemically castrate ourselves in hopes that our rogue “walnut sized gland” doesn’t take us out prematurely….ridding ourselves of body parts they now deem as “the enemy”….no matter what the consequence to the most important body part….our minds….

I have no idea….but have you felt (and written) this way prior to starting ADT….just my two cent thought….which you are absolutely welcome to dismiss as ridiculous…if I have totally missed the mark…

All the best!

REPLY

Hans

I didn’t think that you could write anything more enjoyable,informative and at the same time, entertaining then ‘Welcome to Prostate Cancer. A Playbook for the un-initiated. Well, this post today is right up there as best seller for all of us going through this ordeal. I highly recommend it to anyone new to this process. I like many wonder what the future holds for me. My highest PSA before my diagnosis was 2.51. 10 months earlier it was 1.33 so I insisted on the next diagnostic test- An MRI with and w/o contrast. My urologist had suggested a wait and monitor since I was not at or above 4. I said no. I was told if the MRI suggested cancer I would have to have a biopsy and was I sure I wanted to go that route after all my PSA was not out of this world. I said I am not taking any chances, especially since my father had prostate cancer. The MRI showed I had a Pi-Rad 5. 2 weeks later I had the biopsy of my prostate and to my horror it revealed a Gleason 8.

I then started the journey to decide what treatment protocol I would follow. I met with surgery and RO and each said there were risks and benefits of each and it was my choice, like I was selecting between chicken or steak from the menu. 1 week later I had my PSMA Pet Scan that showed no evidence of avid met disease, so I opted for surgery. 5 weeks later I had my NSRP and now have a Gleason 9 Grade Group 5 with extra prostatic extension so I started wondering whether I made the right decision, still in disbelief given my low PSA and my PSMA results.
I am now 8 weeks post NSRP and my PSA is CURRENTLY < .1 and thus by definition undetectable.
In addition to my conitued battle with incontinency and the inability to live life as I knew it before, I also have to decide what I will do if and/or when the PSA become detectable and what my quality of life will be like for me, my wife, children and grandchildren. I will soon turn 70 and feel good other than the obvious dependence on my depends, but worry about my future, my morbidity and my mortality, all of which I never let consume me.

I write this for myself and also for the newly diagnosed and un-initiated as I have learned so much from so many others this platform that I realize now more than ever we are all in this together whether we like it or not. My God gives us all the courage and strength to kick this disease’s butt.

REPLY
@hmishkind

Hans

I didn’t think that you could write anything more enjoyable,informative and at the same time, entertaining then ‘Welcome to Prostate Cancer. A Playbook for the un-initiated. Well, this post today is right up there as best seller for all of us going through this ordeal. I highly recommend it to anyone new to this process. I like many wonder what the future holds for me. My highest PSA before my diagnosis was 2.51. 10 months earlier it was 1.33 so I insisted on the next diagnostic test- An MRI with and w/o contrast. My urologist had suggested a wait and monitor since I was not at or above 4. I said no. I was told if the MRI suggested cancer I would have to have a biopsy and was I sure I wanted to go that route after all my PSA was not out of this world. I said I am not taking any chances, especially since my father had prostate cancer. The MRI showed I had a Pi-Rad 5. 2 weeks later I had the biopsy of my prostate and to my horror it revealed a Gleason 8.

I then started the journey to decide what treatment protocol I would follow. I met with surgery and RO and each said there were risks and benefits of each and it was my choice, like I was selecting between chicken or steak from the menu. 1 week later I had my PSMA Pet Scan that showed no evidence of avid met disease, so I opted for surgery. 5 weeks later I had my NSRP and now have a Gleason 9 Grade Group 5 with extra prostatic extension so I started wondering whether I made the right decision, still in disbelief given my low PSA and my PSMA results.
I am now 8 weeks post NSRP and my PSA is CURRENTLY < .1 and thus by definition undetectable.
In addition to my conitued battle with incontinency and the inability to live life as I knew it before, I also have to decide what I will do if and/or when the PSA become detectable and what my quality of life will be like for me, my wife, children and grandchildren. I will soon turn 70 and feel good other than the obvious dependence on my depends, but worry about my future, my morbidity and my mortality, all of which I never let consume me.

I write this for myself and also for the newly diagnosed and un-initiated as I have learned so much from so many others this platform that I realize now more than ever we are all in this together whether we like it or not. My God gives us all the courage and strength to kick this disease’s butt.

Jump to this post

Thank you for your eloquent chronicle of prostate cancer. You navigated the diagnostic labyrinth with admirable stubbornness, told the urologist “thanks but no thanks” to the waiting game, and somehow turned a PSA of 2.51 into a Gleason 9 plot twist. That takes talent. Or at least very determined genetics.

The image of surgeons offering cancer treatment options like entrées—“Would you prefer your trauma grilled or pan-seared?”—resonates deeply. It’s the gourmet buffet of existential dread.

As for the Depends dependency. Yes, nothing like a daily reminder that your body now leaks on its own schedule. At least your PSA is behaving, which in this world counts as a ticker-tape parade.

Your comment is a sobering reminder that low numbers don’t always mean low stakes, and that courage often looks a lot like confused perseverance sprinkled with sarcasm. Here's hoping your next scan is boring, your continence improves, and your next major decision is which grandkid gets to mow the lawn, not whether to radiate your pelvis.

We are, indeed, all in this together. Unfortunately, no one asked us first.

REPLY
@handera

“ I write because the alternative is worse. Not for healing, not for insight—just to keep the madness on a leash.”

Not sure how much time has transpired since you started ADT…and I’m sorry to be so “on point”….but IMHO, in your case… it’s time to get the hell off it…that is not a medical opinion it’s a sanity suggestion from just another grunt diagnosed with PCa.

I never liked the phrase “prostate cancer warrior”…what a bunch of BS!

Those “in the know” and those who have been convinced by those “in know” folks tell us the way to “combat the enemy” is to slash, burn and chemically castrate ourselves in hopes that our rogue “walnut sized gland” doesn’t take us out prematurely….ridding ourselves of body parts they now deem as “the enemy”….no matter what the consequence to the most important body part….our minds….

I have no idea….but have you felt (and written) this way prior to starting ADT….just my two cent thought….which you are absolutely welcome to dismiss as ridiculous…if I have totally missed the mark…

All the best!

Jump to this post

He actually DID write like this before ADT and it’s only gotten better!🤣

REPLY
@hmishkind

Hans

I didn’t think that you could write anything more enjoyable,informative and at the same time, entertaining then ‘Welcome to Prostate Cancer. A Playbook for the un-initiated. Well, this post today is right up there as best seller for all of us going through this ordeal. I highly recommend it to anyone new to this process. I like many wonder what the future holds for me. My highest PSA before my diagnosis was 2.51. 10 months earlier it was 1.33 so I insisted on the next diagnostic test- An MRI with and w/o contrast. My urologist had suggested a wait and monitor since I was not at or above 4. I said no. I was told if the MRI suggested cancer I would have to have a biopsy and was I sure I wanted to go that route after all my PSA was not out of this world. I said I am not taking any chances, especially since my father had prostate cancer. The MRI showed I had a Pi-Rad 5. 2 weeks later I had the biopsy of my prostate and to my horror it revealed a Gleason 8.

I then started the journey to decide what treatment protocol I would follow. I met with surgery and RO and each said there were risks and benefits of each and it was my choice, like I was selecting between chicken or steak from the menu. 1 week later I had my PSMA Pet Scan that showed no evidence of avid met disease, so I opted for surgery. 5 weeks later I had my NSRP and now have a Gleason 9 Grade Group 5 with extra prostatic extension so I started wondering whether I made the right decision, still in disbelief given my low PSA and my PSMA results.
I am now 8 weeks post NSRP and my PSA is CURRENTLY < .1 and thus by definition undetectable.
In addition to my conitued battle with incontinency and the inability to live life as I knew it before, I also have to decide what I will do if and/or when the PSA become detectable and what my quality of life will be like for me, my wife, children and grandchildren. I will soon turn 70 and feel good other than the obvious dependence on my depends, but worry about my future, my morbidity and my mortality, all of which I never let consume me.

I write this for myself and also for the newly diagnosed and un-initiated as I have learned so much from so many others this platform that I realize now more than ever we are all in this together whether we like it or not. My God gives us all the courage and strength to kick this disease’s butt.

Jump to this post

Hey bud, if I can be so bold, I’d say you not only made the right decision, but the best one as well. Your surgical pathology revealed the true aggressive nature of your disease and taking out that central node of cancer was the first step, bar none.
If your cancer recurs you still have the option of radiation and ADT. Yeah, yeah we hear all the ranting, kvetching and moaning against it but it just might save your life.
I just finished both, and although I wished I could have avoided them, nature had other plans for me.
But the whole process wasn’t SO bad - it was an intrusion into an otherwise happy retirement and it did present challenges and discomforts…but here I am, bent but not broken.
I am 6 yrs post surgery so I commiserate on the drips, leakage and all that; I still have a shelf of diapers, pads and mattress covers left over from those early days….see, you CAN get better with time. And you will. Best,
Phil

REPLY
Please sign in or register to post a reply.