So here it is. The manual I never wrote. The words I never said

Posted by hans_casteels @hanscasteels, 4 days ago

The Things I Should’ve Said: A Treatise for the Next Unlucky Bastards (and Those Who Love Them)

I’m never going to die. Obviously, immortality suits me — I have far too many sarcastic remarks left unspoken and bureaucracies left to dismantle. But just in case the universe has other plans (or the cancer, cardiac history, or sheer cosmic boredom intervene), here are a few things I wish I’d said. I meant to. I really did. But I was busy fending off medical side effects, explaining to people why “positive margins” is not a good thing, and trying to remember which specialist I was supposed to lie to this week about how much wine I drink. So consider this the fine print of my non-obituary: I lived, I griped, I laughed at death. And if I'm wrong , well, I’ll haunt you with passive-aggressive post-its and unsolicited medical advice.

I should’ve said something.

I should’ve opened my mouth—back when it still spoke with testosterone and not the soft, estrogen-laced whispers of a man chemically castrated by the wonders of modern science. But I didn’t. Not because I didn’t want to. Not because I didn’t care. But because, frankly, I was busy peeing for the fifth time that hour, trying to remember the name of my dog, and quietly contemplating if I could weaponize my hot flashes against raccoons in the yard.

So now, dear reader and future inductee into the Brotherhood of the Burnt and Brachy'd, let me rectify my silence. Here are fifteen things I should’ve said but didn’t—likely because I was trying not to fart during a consult.

First, don’t let the cheery pamphlets fool you. “Localized,” they say, as if your prostate set up a charming Airbnb and hasn’t already tried to invade the lymph nodes next door. Cancer is never “just there.” It’s a squatter with a lawyer, and it’s already redecorating.

Second, androgen deprivation therapy will turn you into a moody Victorian governess. You'll find yourself weeping at dog food commercials and fantasizing about punching squirrels. You will become acquainted with the term “emotional lability.” You will redefine it.

Third, those nutritionists telling you to eat kale? They mean well. But you’re not a goat. And kale will not save you. Neither will turmeric, flaxseed, or that smug guy on YouTube who bathes in celery juice and believes prostate cancer is caused by negative thoughts about your father.

Fourth, get a second opinion. Always. Especially if the first opinion comes with a suspiciously glossy brochure and a “treatment package.” You're not buying a cruise.

Fifth, remember this: the moment someone says “this type of cancer grows slowly,” they are laying the groundwork for medical inertia. Insist. Demand. Be the patient they warn interns about.

Sixth, track your PSA like it’s a stock ticker in a recession. If it spikes, don’t be reassured with “Let’s wait a few months and see.” That’s how it ends up on your spine.

Seventh, radiation is the gift that keeps on giving. Not immediately. At first you’ll think, “This isn’t bad at all.” And then one day, you're squinting at a bathroom wall, wondering if what just exited your body was in fact a metaphor for your soul leaving.

Eighth, no one talks about the loneliness. Not the emotional kind—though yes, there's that—but the clinical solitude. You’ll be alone in a room with a machine that makes the Death Star look warm and fuzzy. Your team? Behind ten feet of lead.

Ninth, your libido will vanish. You won’t miss it—at first. You’ll say “I’m focused on survival.” But one day, you’ll watch a documentary on how pandas mate, and weep. For both of you.

Tenth, trust your instincts. If something feels off, it probably is. You’ll learn more from the exhausted radiology tech’s eye twitch than from three urologists and a PowerPoint.

Eleventh, your body becomes a science project. Everyone’s got a theory, a protocol, an algorithm. You’ll be treated like a spreadsheet, unless you claw back your humanity with dark humor and very pointed sarcasm.

Twelfth, ask the hard question: What’s the endgame? Not “cure.” Not “maintenance.” But what will this look like when I’m 75 and leaking into a pad the size of a small pillow?

Thirteenth, dignity is a myth sold to the healthy. Let go of it. Laugh when you can't pee in the cup. Laugh harder when you forget why you're at the clinic and someone gently reminds you it's Thursday.

Fourteenth, you’ll get advice. From strangers. From cab drivers. From men who swear apricot pits cured them. Smile, nod, then go scream into a towel.

Fifteenth—and here’s the kicker—I should’ve told you: you’re allowed to be angry. Furious. At the randomness, at the treatments, at your own failing gland. But you are not allowed to give up. Not because of hope or optimism or some stupid inspirational quote. But because quitting is for insurance companies and HMOs. You, my friend, are now in the underground. We fight smart. We fight dirty. And we write angry essays about it all.

And now, for the civilians. The partners, friends, and well-meaning loved ones who bring green tea and quietly cry in the kitchen when you’re too tired to climb stairs.

Here are five things I wish I’d told you.

First, stop asking “How are you feeling?” I don’t know. I don’t have the words. Some days I feel like a microwaved sock. Some days I feel fine until my body reminds me it’s being chemically neutered. Try “What’s today like?” or just sit next to me in silence. That’s enough.

Second, don’t be the hope police. Let me be cynical. It’s how I cope. It’s not negativity. It’s realism with flair.

Third, never say “at least it’s treatable.” That’s like saying “at least the house fire didn’t reach the bedrooms.” I still have smoke inhalation and a charred dog.

Fourth, forgive me. For snapping, for forgetting, for zoning out mid-sentence. My brain is running on fumes, testosterone-free and dopamine-deficient. I still love you. I just have the affect of a mollusk.

Fifth, laugh with me. Please. Cancer is absurd. The rituals, the jargon, the waiting rooms that smell of fear and disinfectant. If we can’t laugh at this mess, then the cancer wins twice.

So here it is. The manual I never wrote. The words I never said. Use them, ignore them, burn them ceremonially. But know this: if you’ve read this far, you’re already fighting back. You’re reclaiming the narrative. Welcome to the underground.

We have snacks. And sarcasm.

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

@bluegill

Yeah, who needs testosterone? I never liked it anyway.

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It kept me hugely distracted during my adolescence.

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Or more simply, do not go gentle into that good night.

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