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A quick Question
why is dying from prostate cancer more dramatic than dying from good health?
by Someone Who’s Had Just About Enough of It
If dying is the inescapable invoice for the simple act of being alive, then why, exactly, are we spending billions trying to negotiate a discount? Cancer care alone gulps down enough money annually to fund a small moon landing, all in service of delaying the inevitable by months, maybe years, rarely decades. It’s a curious economic model: throwing limitless resources at a guarantee. We don’t spend this way on education, on poverty, on mental health, or on people who are actually alive but inconveniently struggling.
No, we save our fortunes for the dying; for those circling the drain in sterile rooms, hooked to machines, generating a tidy profit with every scan and side effect. It’s less about curing and more about extending the invoiceable portion of existence, one billable unit of suffering at a time.
Let’s start with the only real truth worth the copay: life ends. Always. Universally. Irrevocably. A 100% fatal condition, stubbornly resistant to treatment despite centuries of research, prayer, green juice, and good intentions.
So why, if death is so predictable, are we so pathologically afraid of it? Why do we shrink from it like it’s some unthinkable deviation rather than the most democratic event we’ll ever attend?
Here’s a darker question: if the final outcome of prostate cancer is death, whether from the disease itself or from the charming bouquet of side effects gifted by its treatment, why do we fight it like cowards with credit cards?
We nuke our glands, choke our hormones, shatter our bones with bone-sparing drugs that rot our jaws, and then crawl through the wreckage to the next appointment. For what, exactly? Another month? Another scan? Another staged conversation about “quality of life” from a doctor wearing a Rolex and a mask of concern?
If the logical outcome of life is death, and spoiler alert: it is, then why, exactly, are we so hell-bent on prolonging the agony? Why do we clutch our pearls at the mere mention of dying, as if we weren’t all hurtling toward that destination with the same inevitability as a prostate swelling under the guidance of time and testosterone? And why is dying from prostate cancer more dramatic than dying from good health?
We spend billions, yes, with a b, each year on prostate cancer alone. Not to cure it, mind you (heaven forbid we do something so radical), but to manage it. To monitor it. To metastasize the bureaucracy. To fund the glorious arms race of radiation beam penis preservation. Meanwhile, people who are merely alive, a far more precarious condition, really, get sweet bugger-all in support. Can’t work? Can’t eat? Can’t afford rent? Sorry, not dying fast enough to qualify for aid. Come back when you’ve grown a tumor or two, and we might stick a needle in you or, better yet, a radioactive seed.
There’s something perversely elegant about it all. If you die of cancer, it’s tragic. If you live in poverty and die quietly, it’s statistics. We’ve medicalized death and economized life. It's all very tidy. Why the disparity? Why does the oncology wing have walnut paneling and espresso machines while social workers share a single stapler and a bag of off-brand raisins?
Simple: Dead men don’t invoice. But the dying, the dying are a goldmine. We can milk them for imaging, biopsies, hormone therapy, pain management, end-of-life counseling, grief therapy, genetic testing, dietary supplements, robotic surgeries, and yes, inspirational TED talks with titles like “Dancing with My Diagnosis” or “My Tumor, My Teacher.” And prostate cancer? It’s the crown jewel of this carnival. Slow enough to string out for decades, dangerous enough to frighten, and deeply entangled with the organ most closely associated with masculinity, making it a veritable jackpot of fear, shame, virility, and Viagra. The trifecta! Or quadfecta, if you count the incontinence pads.
But here’s the cosmic joke: whether we die of the disease or the side effects of trying not to die of the disease, we die anyway. We march in the same parade, just in different costumes; some dressed in hospital gowns, others in hospice sheets, others yet in three-piece suits. Most without money, some very rich. The worms don’t care. You taste all the same.
The real disease isn’t cancer. It’s our delusion that death is optional, a failure of planning or insurance coverage. It's the irrational belief that if we throw enough money at the problem, the Grim Reaper might accept a copay.
And where did this sectioned, diverse, perverse logic come from? Somewhere between the hospital marketing department and a bottle of Ativan. Somewhere between the priest and the pharmaceutical rep. Somewhere in that uneasy alliance of capitalism and compassion, where the human body becomes a ledger and a life becomes a subscription service, cancelled only upon nonpayment or non-breathing.
Meanwhile, the living who simply can’t go on, who suffer from a chronic condition known as being alive in a system not designed for them, remain overlooked. No radiation. No research grants. No glossy pamphlets. Just another appointment missed because the bus didn't come, and the rent did.
So yes, we fear death. But not as much as we fear irrelevance. And death, at least, still gets top billing. Living poor? That's just bad taste. But really… we keep living, not because we’re brave, but because no one wants to admit the game was rigged from the start. We fight death not to win, but because surrender would mean acknowledging that the emperor not only has no clothes, but has terminal cancer, a ten-thousand-dollar deductible, and a follow-up in six months. And so we persist. Not because it makes sense. But because nonsense, when properly funded, becomes the standard of care.
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I am starting to worry about you, each post gets gloomier.
But the tl;dr version of your post is: « « Why fear death if life is meaningless anyway? »
My best answer to that is evolutionsry conditioning. We are just vessels for our genes to reproduce. But maybe, just maybe, you actually enjoy the experience of being alive. And then, keep in mind that your treatment might cure you. Or give you decades of life. And then it might just be worth it.
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9 ReactionsThis post reminded me of the many trips I made to a nursing home to watch my parents (and everyone else there) suffer for years on end.
But, I think the age of the prostater (prostatee? prostatarian?) matters a lot. If you're in your 50's or 60's when you get the diagnosis, then the battle is worth it; a smart treatment plan can easily add a decade of quality existence to your life.
But if you're in your 80's when you get the diagnosis, well, it's certainly an inconvenience to monitor, but the average life expectancy of a male in the U.S. is 76. So, if you don't get PCa until you're in your 80's, you're a winner!
The more I think about it, I don't feel quite so bad for Biden and his prostate. He has much bigger problems to worry about.
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7 Reactions'"Everyday above the ground is a good day." My former boss told me, quoting his own mother.
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10 ReactionsYes, I know I'm going to die some day, but I didn't want it to be at age 56 when I was first diagnosed (or age 60 now, for that matter). Call it greed or selfishness, but I want at least the bible's promised "three score and ten" (70) years, and more if I can get them. Maybe I'll maybe even be able to meet my hypothetical grandchildren some day if I'm lucky.
After the initial critical hospital care from fall 2021 to early winter 2022 — which probably cost the system at least CA $500K — keeping me alive with stage 4 prostate cancer hasn't been all that expensive for OHIP and the government still gets taxes and a lot of economic activity from me this way, so I think they'll probably end up ahead financially as well (though that should never be the justification for providing healthcare).
tl;dr: I accept that I've been broken and imperfectly mended. You can see the cracks now, but I'm still glad I'm here and back in one piece.
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9 ReactionsWhatever will be, will be. Que sera, sera.
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6 Reactions@northoftheborder Talking of economic activity (or "helping the economy"), your post reminded me of a teacher who told my class (decades ago), that:
Smoking is good; it ptovides jobs to people in the tobacco industry. When smokers get cancer, there's work for nurses and doctors. and the pharmaceutical industry. When the patients die, there's work for people in the funeral homes and memorial parks/cemeteries.
The students laughed, but now I wonder if the teacher was half-joking or serious.
Seriously now, when I was near death in the mid-1980's, I prayed to and begged God to give me seven more years; don't let my daughter be an orphan when she's just months old, younger than I was (at age four) when my own father died. Your wish and expectation to see your grandbabies is reasonable,
I mentioned my "seven-,year" story in public during my daughter's wedding banquet. When we had my grandson, my wife and I brought him to church almost every week pre-Covid. One day, he look amazed at the huge BIble at the rear of the church hall, and although he was just a toddler and couldn't read it, he turned the pages and stopped and left the book open, and right there, I found King Hezekiah of ancient Israel's prayer, that was answered with 15 more years added to his years post-illness (II Kings 20:1-6) -- twice the years I asked when my daughter was little.
I hope and pray that you will get to see your grandbabies. Hezekiah got his wish. I got mine, multiples of 7. I really hope you get yours as well. The Higher Power mightily uses humans (medical professionals) as his struments/hands & feet to help us with what we need.
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6 ReactionsHansel daaaaahling - what is this all about ? 😉
Do I sense some nihilistic sentiments developing now after long weeks of ADT ?
Why do we fight the khloros horsemen ? Well, well !
We do because we are cursed with knowledge after that juicy apple bite in Eden lost ! We know how beautiful is the glow of the dawn and how majestically sweet is the fragrance of jasmine at dusk. We thirst lover's kisses and crave warm embrace, dream of breeze and soft summer rain. Oh how delicious is aroma of fresh bread and enchanting that coffee after long day. What delight is to see such beautiful sights ( insert any of your favorite) and to experience such wonderful delights (remember any ???). Every movie ends but we watch them, every day ends but we live them, most loves end but we love , we love even stronger ! We all will be gone and this wonderful world too, as well as the Sun and all that was or have ever been. What is the purpose we can ask - there is none, no reason, no purpose, just love, just life and beauty all around us.
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10 ReactionsWell there is no doubt, that the healthcare system is driven by profit motives rather than patient well-being. The focus on prolonging life through expensive treatments like radiation, hormone theraystem thrives on treating the dying, with healthcare providers billing for each moment of suffering and surgeries is linked to the billable units in medical billing, where every scan, consultation, and procedure is monetized. The sturning patients into revenue streams rather than offering a solution to their suffering.
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1 ReactionNote that in most of the rich world healthcare isn't as profit-driven as it is in the U.S., but there's still the same focus on prolonging life (rightly or wrongly).
For example, in Ontario (where @hanscasteels and I both live) hospitals receive a fixed stipend based on how many people live in the area they serve (*not* how many procedures they perform). My hospital didn't get paid anything extra for taking dramatic measures to save my life and mobility in 2021 — on the contrary, it just used up at least a few $100K of their fixed budget — but they did it all the same.
I think you're right, though, that the U.S. overtreats in some cases for financial reasons. Expensive equipment is a capital investment that needs to generate ROI. For example, the U.S. is notorious for having far more MRI machines per-capita than anywhere else. They're very expensive, and need to be used constantly to generate a revenue stream. I'm only slightly exaggerating when I say that while doctors in most of the world will order an MRI only if something very serious is suspected, U.S. hospitals will order one if you come in with a sprained ankle (provided you have enough insurance). 🙂
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4 ReactionsAh, Impermanence…