Connect
No. Prostate Cancer is not the “good one”
The narrative is tidy. The reality is not.
People say all kinds of things when they find out you have prostate cancer.
“Oh, that’s the good one.”
“If you’re going to get cancer, that’s the kind to get.”
“Uncle Bob had it. He’s fine. Lost a little down there, but hey—still golfing!”
These comments are delivered with the confident tone of someone who once read an article in a waiting room and now believes themselves an authority on urological fate. It’s meant to reassure. But it lands somewhere between tone-deaf and absurd. Let me offer a correction: if this is the “good” cancer, I’d hate to see the bad ones.
I’ve been diagnosed with high-risk prostate cancer. And no, that’s not the warm-and-fuzzy version. It comes with a steep PSA, aggressive cell patterns, and words like “perineural invasion” that make even seasoned oncologists frown into their coffee. There is no “watchful waiting” here. There is no “small bump in the road.” There is a full-court press of hormone suppression, radiation, injections, scans, and silent calculations no one wants to say out loud.
I am not devastated. I’m not shaking my fist at the heavens. I’m on Firmagon, a hormone-suppressing drug that’s left me with the emotional depth of a cold yam. But I am grieving—just not what people expect.
It’s not my mortality I mourn. It’s the system. The ritual depersonalization. The slow and seamless replacement of medicine with manufacturing.
Somewhere along the line, healthcare stopped being about care. It became process. Diagnosis, categorize, apply template, discharge. Repeat. It’s not medicine—it’s operational logistics. And I? I’m not a patient. I’m a barcode. A chart. A line item in someone’s quarterly review.
When I received my diagnosis, it didn’t lead to a thoughtful conversation. It triggered a workflow. PSA? Gleason? Protocol 7A. We’ll beam you, drug you, and file you. Please don’t ask too many questions. You’ll jam the system.
And I don’t resist. I comply. I sit. I nod. I attend my appointments like a citizen of the bureaucracy. But I’m fully aware that if I died mid-consultation, someone would update my file before closing my eyes.
What’s missing isn’t care—it’s thought. The professional curiosity. The raised eyebrow that once said, “This doesn’t quite add up.” That moment is gone. There’s no billing code for nuance. No reimbursement for uncertainty. We’ve replaced judgment with guidelines, and humanity with templates.
If you dare ask for something different—something tailored—you’re marked as “complex.” “Noncompliant.” A threat to throughput. Heaven forbid you need medicine that isn’t pre-approved by flowchart.
I don’t rage. Rage would require more hormonal capacity than I’m currently authorized to possess. What I do is observe. Document. Witness the quiet dismemberment of individuality in the name of efficiency.
They say cancer robs you of power. But let’s be honest: the system got there first. It took my individuality, stapled it to a protocol, and called it care. I’m not angry. Just quietly aware that I am being processed like all the rest.
So no, prostate cancer isn’t “the good one.” It’s just the one we’ve learned to market well. We’ve turned it into a manageable narrative. Not by making it easier, but by making the process more sterile.
Let’s not confuse predictability with compassion. Behind the spreadsheets, the survival curves, and the cheerful pamphlets, some of us are still watching. Still thinking.
So the next time someone tells you they have prostate cancer, maybe skip the clichés. Don’t offer them borrowed optimism.
Just ask how they’re really doing.
And please—don’t tell them it’s the good one.
Like
Helpful
HugInterested in more discussions like this? Go to the Prostate Cancer Support Group.
Connect
The saddest reply to the question? 'Have you had your PSA checked? " When telling someone about your "good cancer" RP, HT. RT on and on. 'PSA test? What's that? STILL!! The publics' awareness of PC is still in the dark ages. Treatment? You WILL leak and "sporting wood" is all over. All your "junk" will shrink to a very small button mushroom and a pair of raisins. So many younger men are very often dumped because they can no longer perform... Sad,yes but that is the grim reality. The good cancer HA!!
SW
-
Like -
Helpful -
Hug
1 ReactionThe noble PSA test — that quaint little bloodwork most men don’t get unless the stars align, the moon is in retrograde, and their doctor is feeling unusually proactive between golf games.
At first, you're told PSA testing isn’t “standard protocol,” because, you know, men’s health must always remain a delightful game of Russian roulette. “It’s not reliable,” they say. “It causes unnecessary worry.” Translation: “We’d rather not know, and neither should you.”
Then — surprise! — your PSA shows up looking like a bar chart from a horror movie. But suddenly now it matters. Now it's gospel. Now you’re having your PSA read to you like it's your credit score before a mortgage application. Weekly. Monthly. Quarterly. Is it trending? Is it stable? Is it climbing? Is it… you?
Before diagnosis: “PSA is unreliable.”
After diagnosis: “Your entire existence will now be judged by these unreliable numbers.”
It’s a bit like being told your brakes don’t matter until you’ve driven off a cliff.
WTF indeed.
PC diagnosis is full of bad info and outright lies. "you have no family history of PC" you are not old enough to have PC. "side effects of Lupron are rare" On and on....
WTF!!!
-
Like -
Helpful -
Hug
2 ReactionsYour comment is right on. The same goes for those who tell you, “That’s the type of cancer they can heal; people don’t die from that anymore!” Ignorance is bliss.
-
Like -
Helpful -
Hug
1 ReactionIf a favorite baseball team loses ten games, does anyone say the fifth loss was the good one? Hardly. There is no such thing as a good loss in sports just as there is no such thing as a good type of cancer in medicine. The fifth baseball loss may have been by only one run, but the team still lost. Not one person who receives the bad news from their doctor saying "you have cancer" jumps for joy and says, "Wonderful! I got the good one!" Prostate cancer may not initially present any symptoms, but the treatments certainly remind a victim that it's in there somewhere - and it's not "good." Back to the baseball analogy, games go nine innings unless there is a tie. Then you get to play extra innings. No matter what type of cancer you have, including prostate cancer, you're suddenly playing extra innings and no one knows how many there will be as you try to beat your opponent. That opponent is never the "good one" and trying to beat it is never "easy." It sucks.
-
Like -
Helpful -
Hug
1 ReactionHey deku, where are you at with your treatment at this point? I remember your biopsy results being not so great.
Are you on ADT? Thanks,
Phil
The good one, yeah right. I’m going on two years being treated and it’s amazing how many people think oh, your cured, carry on. No, I had and have cancer, it can come back you idiot. Now it’s watching numbers and trying to keep appointments separate. The only ones who know are all out fellow warriors, both boys and girls who have walked the walk. And to try and console those who are joining the membership behind us.
-
Like -
Helpful -
Hug
3 ReactionsThank you, Hans, for this journaling. You are good at articulating what most of us are feeling. I hope doctors, caregivers, family, friends, etc., are also reading them. I wish more education were out in the mainstream about PC, but unfortunately, men generally don't like talking about it. I wish guys would leave their pride at the door and speak openly on PC, similar to what women have done around breast cancer. I wish there were advertisements and a lot of blue during PC awareness month, like there is during breast cancer awareness. Everyone is wearing pink, and almost every athlete gets pink spikes. Thank you again for your commentary.
ADT since Dec 2024; oncologist says I'll need to stay on it for years. I hate it. Completed 28 sessions of radiation (IMRT) last week, side effects continue to linger and extended lack of restful sleep is taking a toll. No idea yet whether radiation was effective and/or whether it caused significant long-term collateral damage. Three weeks ago, developed either an allergic reaction to one of my many medications or else late-onset eczema due to compromised immune system. Overall in a pretty sucky phase of treatment; wondering if it will ever get better or if I will always have some version of a side effect or complication to deal with.
Yeah, the ADT gave me insomnia as well; napping became a must because I just ran out of juice in the PM.
Was the reason for IMRT based on confirmed spread outside the gland or was surgery not an option? I am curious because of your age (51, I believe).
Phil