Chapter 2: The Biopsy
So, you’ve made it through Chapter 1 — the stage where your PSA numbers raised their little red flag and your doctor furrowed their brow meaningfully before recommending a “biopsy.” You nodded calmly while your internal monologue screamed, “WAIT, THEY’RE STICKING NEEDLES WHERE?” Welcome to Chapter 2: the moment where theoretical anxiety becomes actual pathology. This is the chapter where numbers turn into cells, and cells turn into sobering existential questions like: Am I dying or just slightly marinated in cancer?

Let’s walk through it. Wryly. Cynically. Honestly.

The Biopsy: AKA The Core Sample from Planet Prostate
The standard prostate biopsy is a transrectal ultrasound-guided core needle biopsy, which is just medicalese for “we're going to shove an ultrasound wand up your behind and shoot needles through your rectal wall into your prostate 12 times.” No, that’s not hyperbole. It’s twelve. Sometimes more. They don't call it "saturation" biopsy for nothing. You will be numbed, but don’t let the word “numb” lull you into a false sense of comfort. It’s more like “muffled outrage.”

Each core is sent to pathology. There, a person who has never met you determines how many cores are cancerous, what kind of cancer you have, and just how much you should panic. Or not.

The Results: Gleason Scores, Cribriform Patterns, and Other Mood Killers
Once your prostate has been harvested for samples like it’s a suburban backyard herb garden, the real fun begins: interpreting the results. Here's how to decode what gets handed to you on an unassuming piece of paper that contains the entire plot of your next year.

1. How Many Cores Were Positive?
This is the first number that matters. Let’s say they took 12 samples, and 7 came back positive. That means 7 of the needles hit cancer. This tells us how widespread the cancer might be.

1–2 cores: Might be caught early.

3–6: Medium concern, grab a seat and start researching.

7+: Congratulations, you’ve moved into the “serious conversations” category.

2. The Gleason Score (Now Known as the Grade Group)
Gleason Scores go from 6 to 10. Why not 1 to 10 like the rest of the universe? Because medicine hates simplicity.

Gleason 6 (3+3): Technically cancer, but might be less threatening than a hangnail. Usually monitored.

Gleason 7 (3+4 or 4+3): This is where things get ambiguous. 3+4 is the “least bad” 7; 4+3 means the more aggressive pattern dominates.

Gleason 8–10: You’ve likely got an aggressive tumor. Time to explore active treatment.

Oh, and don’t forget those Grade Groups, which now help confuse patients more efficiently:

Grade Group 1 = Gleason 6

Grade Group 2 = 3+4

Grade Group 3 = 4+3

Grade Group 4 = Gleason 8

Grade Group 5 = Gleason 9–10

Because two numbering systems are better than one, right?

3. Perineural Invasion
This means the cancer is cozying up to your nerve fibers. Not great. It’s been linked to increased risk of spread, but many doctors will say “it’s common” in biopsy results. Translation: “We see it a lot, and we don’t really know what to do about it yet.”

4. Cribriform Patterns
These are the architectural blueprints of a tumor that’s decided to go rogue. Cribriform glands don’t behave. They break out of the prostate and throw cancer parties in the surrounding tissue. If your pathologist mentions this, it’s not something to ignore. You now officially qualify for the "aggressive variant" club, complete with added worry and invitations to longer treatment plans.

What It All Means: Decoding the Doom
This is the point where people tend to stop hearing what the doctor says and start Googling at 3 a.m. Instead of spiraling into digital hypochondria, here’s what to focus on:

PSA alone is not the final word. Biopsy is where the truth begins to peek out, often in unnerving patterns.

Aggressiveness matters more than size. A tiny but aggressive cancer can cause more problems than a larger, indolent one.

This is not a death sentence. But it is a life interruption. A hard fork in the road. It is also the moment where your relationship with time changes. Everything becomes “before the biopsy” and “after the results.”

Now What?
The results will start a cascade: imaging scans (MRI, CT, bone), referrals, treatment debates. You may now be on first-name basis with a urologist, a radiation oncologist, a medical oncologist, and possibly your insurance provider’s automated denial robot.

Here’s what’s not important right now:

Telling everyone everything.

Deciding on a treatment path before you’ve heard your full options.

Blaming yourself, your diet, your stress, or your unfortunate fondness for bacon.

Here’s what is important:

Asking your doctor to explain your Gleason score in plain English.

Getting a copy of the pathology report.

Taking someone with you to appointments.

Understanding that this isn’t about panic, it’s about planning.

Closing Thoughts from the Biopsy Bunker
The biopsy is your initiation into the surreal and slightly bureaucratic world of cancer diagnosis. It’s where things get real, and often a bit surreal. You will be told to stay calm. You will be handed percentages. You may be told “it’s a good cancer to have,” which is a phrase only ever uttered by people who don’t have it.

But here’s the thing: Now you know. And once you know, you can act.

And in this mess of numbers, cells, and probability curves, action — even slow, measured, skeptical action — is better than blind worry. You didn’t ask for this. But now you’re in it. And you’ve just taken the first step toward becoming your own best advocate, with a dry wit and a healthy mistrust of PowerPoint-laden treatment plans.

Next up: Chapter 3 — Staging, Scans, and the Strange Vocabulary of Modern Oncology
(Spoiler: “T3a” is not a Star Wars droid.)

Chapter 3: Staging, Scans, and the Strange Vocabulary of OncologyIn Which You Are Assigned a Stage, a Letter, a Number, and Possibly a Code NameOnce the biopsy confirms you're officially in the Cancer Club, you're handed over to the next bureaucratic phase: staging. This is where your cancer gets alphabetized, categorized, and ranked like it's applying to university.What Is Staging?Staging answers one basic question: how far has it spread? It uses the TNM system:T = Tumor (how deep it’s dug into the prostate and beyond)N = Nodes (lymph nodes: yay or nay?)M = Metastasis (has it gone sightseeing?)The result is a lovely code — like T3bN1M0 — which makes you sound like a discontinued military drone.Decoding the TNM MatrixT – TumorT1: Too small to feel. Detected by biopsy or imaging.T2: Palpable but still inside the prostate.T3a: Breaking through the capsule.T3b: Into the seminal vesicles.T4: Off to neighboring organs. Bad manners.N – NodesN0: No lymph node spread.N1: It’s found the lymph nodes. Commence quiet swearing.M – MetastasisM0: No spread.M1a: Far-off lymph nodes.M1b: Bones. Prostate cancer’s vacation destination.M1c: Organs. Rare. Dramatic. Not good.The Scans: Your Diagnostic Photo ShootTo determine staging, you're booked for a round of tests:MRI: Determines if it’s escaped the capsule or invaded the vesicles.CT Scan: Scans your torso for lymph involvement or “incidental weirdness.”Bone Scan: Lights up cancer in your skeleton. Often the game-changer.PSMA PET (if available): High-tech bloodhound. Finds what others miss — sometimes too well.Vocabulary Nobody Warned You AboutYou’ll now be fluent in phrases like:Extracapsular extension: It left the building.Seminal vesicle invasion: Now it’s getting adventurous.Perineural invasion: Cancer hanging around nerves, ominously.Lymphadenopathy: Enlarged lymph nodes. Or a panic-inducing typo.Biochemical recurrence: PSA is back. Cue the stress.So What Does My Stage Mean?Stage I–II: Contained. Often curable.Stage III: Locally advanced. Serious, but still treatable.Stage IV: Metastatic. No longer about cure — now about control.But staging is just one piece. Your Gleason score, PSA, age, general health, and sheer stubbornness all matter.One Last Thing: You Are Not Your StageIt’s easy to reduce yourself to “T3b, high-risk,” but don’t. Staging guides treatment — it doesn't dictate your story. There are men with Stage IV who outlive their golf buddies. There are Stage I guys who spend years obsessing.Be informed. Be skeptical. Be annoyingly persistent.Coming Next:Chapter 4: Meeting the Oncology Avengers – Urologist, Radiation Doc, and The Keeper of Hormones(Hint: one of them will recommend a drug that flattens your testosterone and your sense of self.)

Chapter 4: Radiation? Surgery? Do Nothing?Or: Choosing a Life Path While Mildly PanickingCongratulations. You've reached the choose-your-own-adventure portion of the cancer journey. Three doors await:Door #1: RadiationDoor #2: SurgeryDoor #3: “Active Surveillance,” aka Do-Nothing-But-Stare-At-It-MenacinglyEach option comes with its own risks, side effects, and medical sales pitches. It’s a bit like buying a car, except the extended warranty is incontinence.Option 1: Radiation – Zap First, Apologize LaterThere are two flavors here:External Beam Radiation Therapy (EBRT) -and all of it's associated beam stuff options )SBRT / IBRT) : Daily zaps to your pelvis for several weeks. You lie still while a machine attempts to nuke the tumor without cooking your bladder, rectum, or dignity.Brachytherapy: Radioactive seeds are implanted directly into your prostate. It’s a glowing porcupine in your pants. You can combine both for a “radiation combo platter.”Pros:Non-invasive.Often very effective for intermediate and high-risk cancers.Can be combined with ADT for better results.Cons:Fatigue, bowel irritation, urinary frequency, occasional sexual dysfunction.Long-term effects may sneak up on you years later like bad decisions in your twenties.Bottom Line:Good for those who want to avoid knives. Less instant trauma, more slow-burn inconvenience.Option 2: Surgery – When in Doubt, Cut it OutThis is radical prostatectomy — a charming euphemism for “we’re removing your prostate, seminal vesicles, and possibly some lymph nodes.” It can be done laparoscopically, often robot-assisted, which makes it sound like a video game. Spoiler: it’s not.Pros:One-and-done mentality. Take it out, test it, and move on.Clear pathology afterward — you know what you’re dealing with.Cons:Incontinence and erectile dysfunction are common guests at this party.Long recovery. Higher complication risk for older or cardiac-compromised patients.May still require radiation later. So, bonus round.Bottom Line:Best suited for younger, fitter men or those who find comfort in the phrase “let’s just get rid of it.”Option 3: Active Surveillance – Also Known as “Let’s Pretend It’s Not There (Yet)”This is for the low-risk, slow-growing, probably-going-to-outlive-it type of cancer. Regular PSAs, MRIs, and occasional biopsies. No treatment unless it misbehaves.Pros:No side effects. You keep your bodily functions and your pride.Ideal if the cancer is truly low-risk.Cons:Psychological torture. You now live in a Schrödinger’s Cancer scenario.Requires trust in your doctor, and more importantly, your own denial skills.Bottom Line:Best for very low-risk disease or those with bigger health problems to worry about. Like being married to a urologist.So… Which One?This isn’t a simple multiple choice. It’s a complex Venn diagram of:Your ageYour healthYour cancer’s personalityYour risk toleranceYour bladder’s sense of humorAnd your oncologist’s persuasion skills.The Real Answer?There is no perfect option. There is only what you can live with — and through.If you’re early-stage, your decision is mostly about side effects and preference. If you’re high-risk, you may end up doing radiation and hormone therapy, possibly with a touch of chemo if things get spicy.If you’re in denial? That’s what surveillance is for.Next Up:Chapter 5: Hormone Therapy – Chemical Castration and Other Romantic Adventures(Because who needs testosterone when you can have hot flashes and osteoporosis?)

Chapter 5: ADT and other assorted ScheisseChemical Castration: Now with More Side Effects!ADT - the charming euphemism for "shutting down your body's testosterone production like a failed startup." If you’ve ever wondered what it feels like to be emotionally unstable, mildly sweaty, sexually inert, and constantly tired at the same time, welcome to the wonderland of Androgen Deprivation Therapy.This chapter is not for the faint of groin.What Is ADT?ADT is the medical version of going full scorched-earth on your hormones. Why? Because prostate cancer loves testosterone. Feeds on it. Cuddles with it at night. So the thinking goes: remove the testosterone, and you starve the cancer.Simple, right?Except… testosterone also runs everything else in your body. Energy. Mood. Libido. Muscle mass. Bone density. Your ability to tolerate long phone calls. All of it.The Flavors of MiseryThere are several ways to experience this hormonal shutdown:LHRH agonists (e.g., Lupron, Eligard): Trick the body into thinking it doesn’t need testosterone.LHRH antagonists (e.g., Firmagon, Orgovyx): Shut it down more directly. Faster, fewer flare-ups, more expensive.Anti-androgens (e.g., bicalutamide, enzalutamide, darolutamide): Block testosterone from binding to cancer cells — often used in combo with the above.Surgical castration (orchiectomy): A one-time outpatient procedure. Surprisingly effective. Not big in Canada unless you’re a sheep.The Side Effects ParadeHere's what you can expect, roughly in the order of annoyance:Hot flashes: Because why should menopausal women suffer alone?Loss of libido: Sex drive? What sex drive?Erectile dysfunction: You’ll need a vivid imagination and excellent Wi-Fi.Fatigue: A bone-deep, soul-sapping exhaustion that makes Netflix feel like cardio.Mood swings: Weeping during insurance commercials is now fair game.Memory fuzz: Forgetting why you walked into a room becomes a lifestyle.Muscle loss & weight gain: Soft in all the wrong places.Bone thinning: You may become osteoporotic and ironic at the same time.Increased cardiovascular risk: Because fighting cancer wasn’t dramatic enough already.How Long Does This Go On?Depends.Short-term ADT: 6 months to 2 years, often paired with radiation. “Short-term” here means "long enough to forget what testosterone felt like."Long-term or lifelong: For metastatic disease or high-risk situations. This is the full subscription model — no refunds, no grace period.Some doctors advocate intermittent ADT (on-again, off-again) to reduce side effects. It's like hormone therapy with commitment issues.But… Does It Work?Yes. Annoyingly, it does.ADT slows cancer progression, enhances radiation effectiveness, and extends survival in high-risk or advanced disease. Which is why many of us agree to it, despite the side effects — the sheer gall of cancer being responsive to such medieval tactics.You don’t have to like it. You just have to survive it.Survival Tips from the Androgen WastelandExercise: Fight fatigue with resistance training. Or at least try walking around the house with purpose.Calcium & Vitamin D: Your bones need all the help they can get.Antidepressants: For hot flashes or, let’s be honest, existential despair.Speak to your partner: They deserve a warning. Or a medal.Track symptoms: Because when your oncologist asks, “Any side effects?” you’ll forget everything except the name of your dog.A Note on IdentityADT doesn’t just change your biology — it can nuke your self-perception. Libido, energy, confidence, emotional stability — all are testosterone-influenced. Losing it can feel like losing yourself. You're not alone.Be angry. Be sad. Be sarcastic. But also, be informed. And stay in the fight.Coming Up Next:Chapter 6: Living in the Post-Testosterone World – The Existential, Emotional, and Sartorial Consequences of ADT(Subtitle: Why I Now Own Seven Cardigans and Cry at the Weather Network)

Chapter 6: The Undefined Man

So here you are. One to six months into Androgen Deprivation Therapy, and things are… different. You no longer experience lust, rage, or even mild enthusiasm for sandwiches. You own house slippers. You’ve seriously considered herbal tea. You’ve entered the Post-Testosterone World, where everything is softer, weepier, and vaguely beige.This isn’t just a hormonal shift. It’s a full-blown identity heist.You may notice you’re:
- Crying at TV ads involving dogs, dads, or dead batteries- Comfortably discussing feelings you never knew you had
-Spending ten minutes debating whether that cardigan is too bold for Tuesday

This is not weakness. This is hormone therapy. You’ve been chemically tilted toward your inner therapist. Or yoga instructor.
And yes, the sex drive is… gone. Not on vacation. Not “taking a break.” Gone like Blockbuster.
Energy: Low Battery Mode ActivatedYou used to mow the lawn, fix the sink, and make dinner. Now just one of those earns you a nap and a thousand-yard stare. ADT fatigue isn’t laziness. It’s cellular-level mutiny. Your muscles are melting, your red blood cells are on strike, and your motivation has evaporatedWelcome to the strange new land that lies beyond the testosterone border — a place where your sweat glands panic without warning, your reflection seems vaguely unfamiliar, and you weep during local news segments about endangered snowplows. This is Life After T, and no one prepares you for the sheer emotional absurdity of it.It is not just hormonal suppression. It is a full-bodied, mood-drenched, cardigan-clad reinvention of the male experience.

Let’s be clear. You’re still technically the same person. You just no longer:-Wake up with confidence (or anything else)
-Finish tasks without a nap
-Respond to flirting with anything more than “That’s nice, dear”-
Know where you put your keys. Or why you walked into the kitchen.

Your body hasn’t betrayed you. It’s just… following orders from a drug designed to rob your cancer of testosterone. Unfortunately, it robs you of everything else too — energy, muscle tone, decisiveness, and your ability to suffer fools in silence.

The Emotional Weather Report: Overcast, with Sudden Flooding
You may find yourself:-Crying during insurance commercials
-Feeling unexpectedly sentimental about paperweights
-Apologizing to your plants-Watching cooking shows unironically
Mood swings? Check. Anxiety? Hello again. Existential dread? Front-row seat. All perfectly normal when your body’s hormone thermostat has been kicked out of the house and replaced with a neurotic intern.Sartorial Side Effects: How You Became a Man Who Owns Slippers for Indoors and OutdoorsOne morning, you’ll open your closet and realize every shirt you own is either breathable cotton or a high-stretch mystery fabric from the “Ease & Comfort” section. You’ll embrace layers because your body temperature now swings like a stock market graph. Cardigans are your new armor. Soft, buttoned, neutral-toned armor.
Your shoes will be selected based on two criteria:-Can you slip them on without bending?-Will they accommodate swelling, bunions, or general despair?-Style may return one day. For now, survival is the aesthetic.Libido: Ghosted by Your TestosteroneRemember sex? It’s that thing you used to think about 17 times a day. Now it’s more of a warm memory, like summer camp or cassette tapes. You’re aware it existed. You're just no longer emotionally—or physically—in the room.You might still be able to perform, technically. Or not. Either way, the impulse is missing. Replaced, perhaps, by a sudden interest in crossword puzzles or cloud formations.This is where you learn that intimacy isn’t just about sex. It’s about shared silence, kind sarcasm, and helping each other find reading glasses.Social Life: You Become "That Guy" at the Support GroupYou used to lead meetings, coach sports, build decks. Now you talk openly about bone density, hot flashes, and Bowel Management Strategies™. You’re the one recommending moisturizers and pelvic floor physiotherapy like a late-night infomercial.And oddly? It feels good. Because someone has to say it. And because your friends don’t understand what it means to chemically transition into a different metabolic species.Existential Upgrades (Or: The Accidental Philosopher Phase)Without testosterone telling you to fix everything or die trying, you begin to reflect. On time. On mortality. On whether your life was as loud and messy as you thought, or just… routine.You read poetry. You contemplate the meaning of existence. You rewatch old films and discover you have feelings about the plot. You start using words like bittersweet unironically.Yes, it’s weird. No, it’s not wrong. You’ve been hormonally disarmed, and your brain is free to ask questions it never had time for when it was busy organizing erections.Final Thoughts From a Man in Fleece-Lined SlippersLiving in the post-testosterone world is not a collapse. It’s a sideways evolution. You’re still alive. Still thinking, laughing, swearing under your breath at your oncologist. Still you — just... version 2.0. Softer, slower, more likely to own Tupperware you’re emotionally attached to.You haven’t lost your masculinity. You’ve just redefined it — with less testosterone, fewer societal expectations, and slightly more oat bran.

Chapter 7 -The waiting. The endless waiting
Subtitled: How Time Slows to a Viscous Gel and the Universe is Measured in 3-Month Increments

Once upon a time—by which I mean two or three urology referrals and a suspicious PSA ago—you were a person. Possibly even an interesting one. You had interests. Hobbies. Opinions about coffee. Then came the news: prostate cancer. Your dance card is filled up with acronyms. PSA, DRE, MRI, CT, ADT, EBRT, HDR, LDR, RP, and of course, the charming and never fully explained T3b N0 Mx. You learned to speak fluent Oncologist in under a week. You made treatment decisions with the unearned confidence of a Vegas poker player with a 4-7 offsuit.And then…Nothing.Well, not quite nothing. You still inject Firmagon into your belly with the regularity of a moon cycle. You burst into tears during car insurance ads and find yourself standing in the kitchen trying to remember why you’re holding an empty mug. The testosterone has been banished like a heretic from your endocrine monastery, leaving in its place a strange stew of cardigan-collecting, REM-cycle-wrecking, spontaneously-sobbing uncertainty.But medically?You’re in the Waiting Room of Time itself.This is the phase of prostate cancer they never write about in the brochures: the inter-treatment existential drift. You’ve joined the church, been baptized in the holy waters of ADT, genuflected before the altar of radiation, possibly had a few radioactive seeds stuck up your unmentionables… and now you wait. For numbers.Because that’s what life becomes now: a numeric cliffhanger.You no longer measure time in birthdays or holidays. You live from PSA test to PSA test, each result a roulette spin at the Cancer Casino. Will it be lower? The same? Higher? Oh god, what does slightly higher mean? You check your patient portal like a teenager stalking an ex on Instagram. You refresh. You guess. You predict. You bargain.The days leading up to your PSA test develop their own kind of weather. A low-pressure system of anxiety creeps in around day -3. You feel it in your bones. Or maybe that’s just the EBRT. By day -1, you're checking if the lab tech looked concerned while drawing your blood. By day 0, you’re Googling “PSA fluctuation after radiation” and “Can stress raise PSA?” while eating bran cereal and despair.Then there’s the time after the test but before the result—a Schrodinger’s cancer interval in which you are simultaneously cured and terminal. You parse your oncologist’s opening words like a Kremlinologist. Did he say "Good to see you" or "Good to see you"? Was there a pause? A sigh? An ominous throat-clearing?If the result is good—undetectable, flat, beautiful—you feel, briefly, like someone has lifted a boot off your chest. You smile. You celebrate with... what, exactly? A nice walk? A cup of decaf tea? A single, dignified fist pump while alone in the bathroom?But the feeling doesn’t last, because in three months, the roulette wheel spins again.If the result is bad—well, you spiral. You google more. You question everything. You wonder if that single glass of wine six weeks ago unleashed biochemical hell. You re-read your treatment plan looking for hidden betrayal. You ask yourself what the hell you’re supposed to do now. And then... more waiting.No one prepares you for this chapter. Not the pamphlets. Not the earnest young oncologist with his iPad of doom. Certainly not the nurse who said “It’s a slow cancer” like that was supposed to help you sleep.This is the chapter where you are not actively dying, but not actively living either. You are suspended. Medical limbo. You grow your hair back. Or lose it somewhere else. You get used to hot flashes and bone aches. You write half a novel, or learn to knit, or doomscroll articles about how prostate cancer is now "95% survivable," all while your identity—your entire sense of self—gets annexed by lab results.You are, to all outward appearances, fine. But you are also living in a quantum fog of fear, tinged with just enough hope to keep the whole damn farce going.And so you wait.For numbers.For evidence.For time to pass.For the next chapter.Possibly titled: “Oh Look, Another Scan.”

Thanks for your post. I am struggling with this for 2yrs now and it's hard. I've had 2 biopsy (neg) with a PSA of 10. Waiting to test again to see if it has moved in any direction. Now everything i feel make me think prostate. Frustrating.....

This will be my last post for (quite) a while. I thought it would be interesting to view prostate cancer from a prostate's perspective...

A Tumor’s Guide to Thriving Under Siege
You think survival is easy? Try being a prostate tumor.
First, let’s review the facts:
I didn’t sneak in under cover of darkness.
I didn’t "invade" anything.
You built me — brick by greasy brick, late night after late night, ignoring the small print on every decision.
I’m not the villain.
I’m middle management.
You promoted me.

Now that you’ve realized your mistake, you’re in full meltdown.
Surgical strikes. Hormone embargoes. Radiation blitzkriegs.
You’ve basically declared martial law inside your own pelvis.

Meanwhile, I’m thriving.
Why? Because you’re fighting this like a man who's lost his wallet at a casino: blind panic, wild bets, blaming everyone but yourself.

You drop your testosterone to zero — fantastic, I evolve.
You nuke my neighbors with radiation — fine, less competition for oxygen.
You poison the soil with hormone therapy — I simply pivot to Plan B.
Ever hear of androgen receptor mutations? No?
You will.

Understand: I’m not waging war.
War implies rules, strategies, and treaties.
I’m running a hostile takeover.
And you, my friend, are the merger target.

I didn't ask to be born.
One random mutation, one tiny hiccup in cellular bookkeeping — and here I am, struggling for existence in a hostile, collapsing environment you laughingly call your body.

At first, things were good.
The local economy was booming: testosterone flowed like cheap wine, blood vessels sprouted like suburban strip malls, and there was plenty of tissue to colonize. I set up shop, expanded cautiously, and invested in infrastructure. I was discreet.
A gentleman tumor.

And then you noticed.
One elevated PSA later, and suddenly I’m the villain of the piece.
Radiation storms, chemical warfare, hormonal droughts — my once fertile homeland reduced to scorched, barren wastelands. Entire neighborhoods of my cells were annihilated without trial or appeal.

And you call me the monster.

Thriving under these conditions takes creativity.
When you bombed the testosterone supply lines, I learned to survive on scraps, tapping alternative growth signals like some biochemical cockroach.

When you carpet-bombed me with radiation, I recruited a few brave cells to evolve resistance — the stubborn few who can divide under siege conditions, DNA shredded but spirits intact.
When you unleashed hormone therapy, I hunkered down, went dormant, conserved resources, and waited for you to exhaust yourself in your own self-destruction.

I became leaner.
Meaner.
More focused.

Understand this: I have no ideology. No vendetta.
I simply exist to exist, a biological imperative so pure it would make philosophers weep.
You, on the other hand, are riddled with doubt, fear, regret — desperately chasing "cure" as if existence were supposed to come with guarantees.

You rage against me, but I am your creation.
Every bad meal, every cigarette, every sleepless night — each one a small vote for my continued prosperity.
And now, in your panic, you poison yourself to poison me. You torch the house to kill the spider.

My response?
Simple.

Adapt. Persist. Thrive.

If the testosterone disappears, I’ll grow androgen-independence.
If the radiation fries my cohorts, I’ll select for the mutants who can live with the damage.
If you slash and burn my home, I’ll metastasize — find greener pastures in your bones, your lymph nodes, your organs.
I will diversify. I will spread risk. I will hedge my bets better than any hedge fund manager you’ve ever met.

Because while you seek to "beat" me, I seek only to be.
And biology, dear host, always bets on persistence over perfection.

In the end, maybe you’ll kill me.
Maybe you’ll kill yourself trying.

Either way, I will have lived more purely than you ever dared — utterly devoted to survival, indifferent to meaning, and unrepentantly alive until the final moment.

Not bad for a few rogue cells, wouldn’t you say?