No. Prostate Cancer is not the “good one”

"Standard of Scare" . Too funny ! I have a good GP now , but it took me 3 years to find him . My long term doctor retired 5 years ago - great guy and 'old school' and so cautious . I went to this one GP , booked a long appointment of 45 minutes to talk about my case and logical next steps , etc . after 5 minutes he was grabbing the door handles saying "thanks for coming in ! " . I said to him "where are you going I paid for 40 more minutes with you ?" . In Canada it is rare for people to call-out their doctors ... but there was no way this guy was booking a long appointment on my profile and getting paid for it , for a 5 minute " Hi and Bye! " session . So I fired him ! HA!!

Hans... this is the most succinct, on-point, insightful piece I have read on the subject. Not just prostate cancer, but cancer in general. I have always been on top of my health. Pretty good diet, no bad habits (social drinker I guess is one), exercise vigoruously and intensively my entire life, get checked regularly (every 6 months lab tests - including PSA). But I get diagnosed at 63 in July 2023. Stuff stuck into every hole in my body. Scanned in multiple machines. "Caught it in time" - "all I needed" was a radical prostatectomy. No "apparent" spread. Incontinence, ED, stomach pain, perineum pain followed - a measure of all still exists 18 months later - all activities in my life have changed. I go every 3 months for bloodwork to see if I'm still "good". No, there is nothing "good" about cancer. And I did completely feel inserted into a "system" with a template - a protocol. No nuance. No time to ruminate on alternative therapies. Heaven forfend I be a "science-denier". Please don't read this wrong. I am extremely grateful for some of the wonderful, kind, caring people I met along the way, and for the support of family and friends, and that we are adaptable as humans, and that I have the opportunity to carry on. This cannot be understated.
Then my brother, at 66 (also fit, never-smoker, exercise enthusiast), gets diagnosed out-of-the-blue, with stage IV esophageal cancer. He was immediately inserted into the "system". The template was invoked. Bombarded with chemotherapy that made him sicker than I'd ever seen him - throwing up, unable to move or eat. This continued for 9 sessions every 2 weeks - he had lost almost 70 pounds by then. An artificial esophagus (stent) was inserted into him. Within 6 months he had gone from a fit 170 pound man to 100 pounds. He passed last weekend. I believe the "template" may have killed him faster than the disease - and the 6 months that he did live, were brutal on him!
Cancer is, ultimately, a lonely journey for the person experiencing it (regardless of the support and love offered). I know that if I experience this again, I will be looking into alternatives, no matter how difficult the "system" makes it on one to do so ("advice", guilt, fear, no financial support or coverage, logistical challenges, etc., etc.). There has to be a better way than our current path.
Very best to you and everyone who takes the time to respond on this forum! The discourse is helpful.

Of course, cure rates are different for all types of cancer and that certainly means it would be better to get a good cure-rate cancer than a bad cure-rate cancer. Can't argue that. I just think there must be a better way to describe prostate cancer than calling it the "good cancer." Maybe refer to prostate cancer as "the one that might let you live longer." The key word being "might." To name drop a bit, I was an acquaintance of the author Vince Flynn, who was writing best-selling novels as fast as he could when he was told he had an aggressive prostate cancer. When he died at the young age of 47, he had the type of cancer that could have been referred to generally as having a good cure rate. But in his case it wasn't that type and it was in no way a good cancer. Maybe I'm only trying to say prostate cancer should be known as a cancer with a possible good cure rate but never as a good cancer?

Exactly. Calling prostate cancer the "good cancer" is like calling a mugging “a teachable moment”—sure, you might walk away smarter, but you're still bleeding and missing a wallet.

Yes, statistically, prostate cancer often progresses slowly. Yes, treatment options can be effective. And yes, if you're lucky, old age or boredom might kill you first. But the key word there is if. If it’s not aggressive. If it’s caught early. If your biology cooperates. If your treatment team isn’t made up of the Three Stooges in lab coats.

The phrase “good cancer” is a lazy linguistic placebo—a pat on the head from people who want to wrap your terror in a warm, condescending blanket of denial. It's the verbal equivalent of saying, “Don’t worry, it’s just a little bit of cancer.”

And as for Vince Flynn—he’s a brutal reminder that the statistics don’t write your ending. Biology does. Random chance does. And sometimes, that “good cancer” doesn’t even bother with dinner and a movie before turning metastatic.

So yes, let’s retire the term “good cancer.” Replace it with something more accurate—say, “conditionally survivable malignancy,” or “a crapshoot with decent odds if you get the slow kind and no one screws up.”

But good? Cancer isn’t good. Even when it’s behaving

Is keeping my PC at bay with RP ADT and radiation considered cured? I think not. For some there is no rise in PSA for years even. Others being so glad with those low PSA numbers for years even UNTIL cancer rears it's ugly head again years later. Yes, it can and does happen. PC is mostly on the mind to us PC patients. Always checking the PSA and enduring the horrible side effects of past treatments that have ruined my well being and quality of life to remind us that "I'm still here" just lurking about for now.
SW

MTB - Very good words ! . You're a great writer yourself - good for you . You hit on one thing , how lonely Prostate Cancer is . So true, after you get the news you have the "good one" , its hard to explain to people how your life changes . How insulated your world is now . I looked after my father 25 years ago when he was dying WITH prostate Cancer . I was his Care Giver . It left me with PTSD the Dr says . 6 months of back and forth to the hospital , dad loosing weight , dad not wanting to go to hospital for pain medication and so on . He was an engineer . smart man , but did not trust doctors . He had a Overseas contract that required him to take a physical . Prior to this he had not seen a Dr in over 10 years ! at 60 , he was told he had prostate Cancer ( quite a high PSA if I remember right ) . They said we 'think' we caught it early , which didnt add up to me give no Dr visit for 10 years and a hyper PSA level around 20-25 ( I think) . He died on a rainy west coast winter night in Vancouver , at the hospital , at 67 . I held his hand all through it . I covered his face with the bed sheets after the "death rattle" for what seemed like hours . He really wanted to live . I was not close to my father , but I owed him the ultimate respect at every point . Hence when I got PC , I got anxiety right away ( never had that before, as im quite a cool collected guy I think , also a commercial pilot - so I trained this way in life ) , and also I felt so isolated . Anyway ...enough about me . God Bless you and your family . James on Vancouver Island .

Very accurate Sir ! A Lady in the Sauna yesterday asked what the marks on my Belly are from ( one being quite large from the Laparoscopic PC surgery infection) . I told her from Prostate Cancer surgery . She paused then said , thats the best type of cancer to get other than skin cancer . I said " really ? , interesting, at what Gleason score does it shift from being the best , to considerable concern and why the mortality rate is so high for The Best type of cancer? " She then asked , what is a Gleason score . I responded by saying , "exactly , just what I thought . You dont know much about Prostate Cancer do you ? Gleason cell types are crucial to long term survival . Prostate Cancer is far from being the Best Type . But I do than you for those encouraging words . " . Was she being dismissive or polite , or both , or ? Perplexing ! James on Vancouver Island .

Yep. From now on, I have CSM. Conditionally survivable malignancy.
And that ain't good.

You're a good person. Care-giving is a monumental task and takes a toll. Best to you as well!

Hans:
Thank you so much, I’ve been a BSN, RN and spent much time in emergency medicine, but I had a calling and became a Case Manager for Hospice. In all, I’ve been in this second career profession for about 24 years now and I ask myself everyday where’s the compassion, having to call for permission to stay over cause a patient is actively dying. I always was the patient advocate and doing what ever possible to bring closure in the circle of life and family. I was always fighting for the best for each and time they need to listen to or just talk with them.
I finally had to accept that some and have to same more than ever,just don’t have compassion, which cannot br taught.
Then diagnosed with prostate cancer and that when I really saw that lack of compassion and sometimes, even most times, “I’m sorry” loses its effectiveness. Just do it progress or procedure the same way for everyone. I’m
on the receiving side of being dependent on another nurse for a period of time and I as a nurse understand I just ok all your clothes, even you undies, all your wallet and anything that looks valuable, and completely at their mercy and compassion, and some either don’t have it and don’t care, just doing the function. We are not a bunch of oranges all with same diagnosis, we are each an individual and a care plan which works best when it’s read and applied, they are individually written for a reason, to provide the best care possible and better understanding my mental, fear and spiritual condition. I just left my role to take care of my own cancer and my expectation is have caregivers that understand compassion and to ALWAYS treat the mind, body, and spirit.