Prostate Cancer. Male Denial, and the absurdity of it all

Posted by hans_casteels @hanscasteels, Apr 10 10:17am

Men don’t go to doctors. We go to garages, sheds, or pubs—sacred spaces where nothing must be spoken unless it involves timber, oil, or football. A man will discuss the death of a beloved dog with more emotional clarity than the lump in his groin. Medical consultation is, in our private mythology, reserved for catastrophic limb loss or inconvenient decapitation.

Denial, for the average male, is not a moment. It’s a system of belief. A cathedral built brick by stoic brick over decades. Our fathers taught us to tough it out. Their fathers taught them to die quietly. The cycle continues. Illness is weakness. Complaining is unseemly. Preventive care is for Americans and people who own yoga mats.

The body begins to fail, of course. Quietly at first. An ache here. A dribble there. We assume it’s just age—or, if we're particularly committed to the illusion—just the weather. That persistent night-time urination? Must be the evening tea. Or the mattress. Or the fact that one side of the bed is clearly cursed. Anything but the organ slowly strangling itself inside your pelvis.

When a partner urges us to “just get it checked,” we bristle. If she persists, we stall. If she makes the appointment for us, we go—resentfully, like a man being marched into a pottery class. We crack jokes to signal comfort. We quote obscure statistics to display control. And when the doctor dons a glove, we retreat into the last true fortress of the aging male: irony.

Once inside the machine—tests, probes, scans—we begin to perform the Ritual of Masculine Surrender. It starts with a joke about turning your head and coughing, and ends with the quiet realisation that you’ve become the punchline in your own dark comedy.

Some men weep. Others double down on stoicism. Most just sit there, nodding solemnly, trying not to vomit on the doctor’s tasteful shoes.

And still, we resist. The diagnosis arrives like a telegram from the front. The prostate—previously unknown, unsung, and unappreciated—has declared war. It’s built a fortress. It’s bringing in reinforcements. The bladder is collateral damage. Erections are taken hostage. Hope is put on long-term disability.

But even then, we maintain the illusion. We call it “a little cancer.” We say, “It’s treatable.” We compare notes with other men, like generals discussing failed campaigns. “Oh, you went the radiation route? Interesting. I opted for chemical castration and despair.”

Because to admit the full weight of it—the fear, the humiliation, the betrayal by our own biology—would be to strip away the last tattered remnants of the male fantasy: that we are somehow exempt from decay.

We are not. We are meat with delusions of grandeur.

So we bluff. We limp into the clinic, complain about the parking, and read Car and Driver while contemplating mortality. We tell ourselves we’re strong. That we’re brave. That it’s just another phase of life, like puberty, except this time everything is shrinking.

Eventually, we stop pretending. But only after it’s far too late to benefit from honesty. By then, we’ve been poked, scanned, shaved, dosed, and told—very politely—that we will never urinate like a young man again.

But don’t worry. There’s a pamphlet for that too. It’s got a photo of two smiling seniors on bicycles.

Neither one of them is wearing a nappy. You’ll find that comforting.

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

@kujhawk1978

You're not wrong...

Not once have my doctors talked about the side effects of ADT, radiation or chemotherapy.

I have looked those up myself.

I have been "fortunate..." Despite a high risk prostate cancer, GG 4, GS 8, short time to BCR, and rapid PSADT and PSAV, I am here 11+ years after diagnosis

I've had surgery, SRT, triplet and doublet therapy. Total time on treatment, roughly three years...which means eight plus off.

In those 11+ years, I've lived a lot, vacations, birthdays, anniversaries, ski trips with friends, concerts....

If you think statistics, Bell Curve, standard deviations, mean, mode, averages ...I am probably an outlier.

My surgery was nerve soaring and I regained erectile function in 12 months with the help of 5 mg daily Cialis and frequent self stimulation.

SRT did not fry the nerves.

During the 18 months on Lupron and 12 months on Orgovyx I never lost my libido. Genitalia shrinkage, yes, still, I could attain erections.

My recovery of T has been rapid both times, why, I don't know, exercise maybe?

Was there a difference between being on treatment and not in my life, no. The only difference was how I felt living my life. My wife and I did the Ring Road in Iceland, the Bataan Death March Memorial in White Sands, NM with my sister, the Gravel Unbound in the Flint Hills of Kansas, a 55 mile gravel bike ride, with my daughter, skied with friends in Colorado....

I have generally held my medical team to high standards, active listeners, shared decision making, open to other than the standard of care I have also held myself to a high standard, do the homework, know the terns, definitions, take responsibility for my decisions on treatment.

Like I said, I realize I'm an outlier. In part that is because of my approach to managing my cancer and in part, who knows, with my clinical data I should not be on intermittent therapy.

I also realize many on these forums experience the full gauntlet of side effects and less than stellar medical teams.

Kevin

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Kevin, It is truly amazing to have been through so much therapy, invasive procedures and life changing drugs and come through it the way you have.
And maybe you are an outlier, but if you recall, @retireddoc is actually on TRT because his oncologist feels that the truly aggressive clones were destroyed by triplet therapy.
Hopefully, the same is true in your case and you can remain on intermittent therapy for longer periods of time.🤞

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@heavyphil

Kevin, It is truly amazing to have been through so much therapy, invasive procedures and life changing drugs and come through it the way you have.
And maybe you are an outlier, but if you recall, @retireddoc is actually on TRT because his oncologist feels that the truly aggressive clones were destroyed by triplet therapy.
Hopefully, the same is true in your case and you can remain on intermittent therapy for longer periods of time.🤞

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Thanx, like I said, not sure "why me," but I'll take the outcomes!

Interesting point on the triplet therapy, Taxotere kills everything that is rapidly growing, thus the loss of hair, damage to the nails....and perhaps the aggressive clones which were behind my rapid PSADT and PSAV.

Still, when I punched in my labs to MSKCC's nomogram, the PSADT and PSAV hadn't changed in 2022-2023 with the last go round though I understand the debate around USPSA and those values.

Colonoscopy on Wednesday, so, no coffee this morning, ugh, I hate drinking it black and nothing to eat until Wednesday evening, no Manhattan tonight. Going to be a long two days!

Kevin

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@stevieg

I’m having Great Depression over not being able to get an erection !

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It's been 5 years now since my surgery...I'm 70 and my PSA is undetectable as my erection. The Trimix does work...it's not a romantic sex...but it's sex and you still can get off...sometimes, just not the same of course. I too am depressed...it's like we are not men without our dicks working. This forum has been helpful to be able to talk to others or at least express yourself. I have 4 kids, youngest is 35 and 6 grand kids, I was here to walk my youngest daughter down the aisle, so we still have much life to be thankful for. I hope you can come to terms in a good way and be happy you're still alive not only for you but your loved ones.

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@onestepmore I agree: "we still have much life to be thankful for. . . . be happy [we]'re still alive not only for [ourselves] but [our] loved ones."
I am 68, have two kids (41 and 39), two grandchildren (9 and 7 years old). I faced death almost 40 years ago, and miraculously survived. My doctor friend said he knew of only three people who had my illness, one died, the other became a vegetable.
I am thankful every day to have seen my children grow, and my grand kids growing up. Each day above the ground, I consider a bonus now -- a gift that keeps giving. I do hope we see more days, and years! Best,

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