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A crimson story: My journey with prostate cancer
I was asked by someone in this forum whether I would care to give some insight into my prostate cancer journey.
The Crimson Clue: A Prostate Odyssey
It began not with a scream but a whisper. In 2008, while minding my own post-coital business, I noticed that my semen—normally the color of indifference—was tinged with blood. Aesthetic? Perhaps. Concerning? Definitely. My physician, however, reacted with the professional urgency of a man told the photocopier was out of paper.
"Ah," he said, with the smug satisfaction of someone who had solved a crossword clue, "probably the baby aspirin. Maybe stop taking it."
Mystery solved. Case closed. Medical system triumphant. Waterloo, where I happened to be living at the time, continued its snow-drenched denial of my subtle descent into oncology.
Years passed. Sperm returned to its less theatrical shade. Even though… sperm volumes continued to decline to negligible volumes, another sign that should have been considered, but wasn’t. No one thought about prostates. Until I found myself in an airport somewhere, imprisoned between flights and existential fatigue, flipping through a health magazine that casually mentioned PSA testing. A footnote. A curiosity. But it stuck.
So, in 2018, I asked my doctor for a PSA test. The result came back as a calm, reassuring 1.0. Low enough to make doctors smirk condescendingly and suggest I go live my best life. I was referred to a urologist, because that’s the thing you do when you’re both cautious and bored.
The man performed a DRE (Digital Rectal Exam, not to be confused with a polite handshake) and pronounced everything “perfectly normal.” No lumps, no bumps, no drama. “See you in a few years,” he said, probably before lighting a cigar and billing my insurance.
Then came 2024. PSA: 26.7.
For context, that’s not a “we should keep an eye on this” level. That’s a “why are you still sitting here and not on a gurney?” level. But our friend, the urologist, gazed upon this Everest of a PSA and said—without irony—“There’s nothing wrong with your prostate.”
It was at this point I began to realize the man was either deeply incompetent or auditioning for a role in a Kafka novel.
It took my insistence—again—to push for more than finger-wagging and placebo reassurance. A biopsy, finally, revealed the enemy: prostate cancer, Gleason 3+4=7. Cribriform glands, perineural invasion, a little architectural flair to go with the malignancy. And a realization that this thing had likely been squatting in my prostate for a decade, undisturbed, unchallenged, and medically underestimated.
So, on to treatment: monthly Firmagon injections, which turned my body into a hormonal wasteland. Then came brachytherapy in February 2025—a process that involved radioactive seeds being embedded in me like I was some kind of human chia pet. External beam radiation followed, five days a week, each session a performance in the Theatre of Futility.
Side effects were plentiful: dizziness, hot flashes, breathlessness, a sense of existential farce. But what lingered most was the growing file of “what ifs.”
And now, with the clarity of hindsight sharpened by radiation and pharmaceuticals, I realize what I should have asked:
I should have asked why no imaging was done in 2008 when I presented with blood in my semen—a symptom more ominous than aspirin-induced nosebleeds, yet treated with less concern. I should have asked why we weren’t doing routine digital exams in my 50s, given my age and symptoms. I should have asked what my baseline PSA was back then—had anyone bothered to establish one. I should have asked why we were relying on a DRE alone, as if the human finger were still the gold standard in the era of multiparametric MRI. I should have asked why, with a PSA rising into the double digits, we weren’t immediately biopsying, scanning, staging—doing anything, really, other than muttering “wait and see.” I should have asked whether cribriform patterns carried worse outcomes and if treatment should be escalated accordingly. I should have asked if long-term androgen deprivation could backfire by selecting for more aggressive variants in a low-testosterone environment.
Instead, I trusted. A doctor said it was nothing, and I mistook confidence for competence. I mistook calm for clarity. I mistook protocol for protection.
But here we are. Mid-2025. Not dead. “Terminally stable,” as I like to call it. Or as the oncologist euphemistically puts it, “responding well to treatment”—which roughly translates to, “still paying bills.”
This is not just a tale of cancer. It’s a fable about the peril of passivity, the comedy of credentialed incompetence, and the need to sometimes be your own bloody advocate—literally.
Turns out the most dangerous growth wasn’t the cancer—it was the blind confidence of the specialists.
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Thanks, my friend. I appreciate your words. It's not all darkness, not all the time. Some days, the absurdity even makes me laugh. Glad your path hasn’t been quite as grim — that gives the rest of us hope. Stay strong, brother. We've got this.
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1 ReactionI live the creative life daily, not in some romantic, beret-wearing, jazz-scored way, but through a relentless parade of improvisations masquerading as ordinary acts. I weaponize language in conversations laced with wit and venom (at least in my mind), draft emails that double as literary takedowns, and turn therapy sessions into impromptu one-act plays of psychological redemption. I navigate family dysfunction like a playwright rewriting the same tragicomedy each night with slightly worse actors, coax meaning from a dog’s stare, and repurpose leftovers like a culinary nihilist trying to outsmart entropy. Even my procrastination is a form of dark artistry—time sculpted into elegant avoidance. And through it all, I write: biting, bleak prose that makes cancer, capitalism, and the human condition flinch just a little. So yes, time suspends—because when you live like this, reality knows it’s been outwritten.
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3 ReactionsYou have a great writing style. Keep it up.......take that anyway you'd like ....😉
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3 ReactionsIn response to your wife's comments - I do not understand how "writing" and "connecting" with support group is NOT a way of therapy (???) . It is very well known and documented fact. Even if it was not the fact (which it is), you obviously have a need to express yourself through writing and it must be helping you on some level, or you would not do it, right ? I find her comments dismissing and patronizing to be honest :(. Perhaps she feels excluded or "not enough" ?
My wife’s comments are not reflective of my wife’s comments.
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1 ReactionThis 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?
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6 ReactionsHa! Crafted with Spice!
"Cancer Casino" - thank you for this very precise metaphor
I think Hans Casteels was one of the Brothers Grimm in a previous life - his tales are truly creepy!😆😆😆
Creepy? Compared to what — the sanitized fairy tales where children casually survive wolves and witches without a scratch? I'm just restoring the original realism.
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