How to Live with Prostate Cancer

By A Formerly Intact Man With a Prostate (RIP)
Adaptation. A beautiful word. Darwin liked it. Therapists love it. And in the prostate cancer world, it’s less a noble evolutionary arc than a panicked, middle-aged man yelling "What the hell is happening to my body?!" while trying to meditate with a YouTube monk named Chad.

Let’s begin with something simple, something primal, something masculine: buying a car. That moment where a man reasserts control, power, and personal agency by choosing between two identical shades of graphite grey. Post-diagnosis, however, it’s less “Vroom Vroom” and more “How many lumbar supports does it have, and can I survive the ADT hot flashes in leather seats?”
Then there’s the paint colour agony. Hell. The paint. Once a non-issue, now a full-blown existential crisis. Obsidian Black Pearl? Luminous Titanium Mist? Champagne Ice Metallic? You stare at swatches like a man picking out a coffin lining. You want something bold, but not “compensating.” Understated, but not invisible. A car that says, “I’m alive,” not “I’ve accepted my fate.”

And then you discover ventilated seats. Sweet. Merciful. Technology. It’s like God himself whispered, “You know what this man needs while marinating in medically induced menopause? Cool air on his backside.” You turn them on during the test drive and nearly weep. Forget torque. Forget 0-to-60. THIS is the real innovation. You’d pay extra just to sit in the driveway with a cold breeze hitting your hormonal hindquarters. You’re genuinely unsure whether to buy the car or just move in with it. Maybe name it Kevin too.

Of course, your psychiatrist wife is there, calmly observing the whole scene like a documentary narrator watching a wildebeest slowly lose the will to live. “What you’re experiencing is called decision fatigue,” she says with the voice of someone who has never had to choose between Midnight Storm and Dusty Pewter. She’s probably right. You did spend 35 minutes earlier that morning choosing between two nearly identical organic deodorants, only to abandon both and leave smelling faintly of rage and despair.

She suggests you make a pros and cons list. You suggest she test drive a hot flash while being told you might leak urine for the rest of your life. Later that evening, over a dinner of something ethically sourced and emotionally beige, your psychiatrist wife leans back, sips her wine, and says with clinical serenity,
“You know, your inability to choose a car colour without spiraling into an existential crisis? Classic decision fatigue. But underneath that, it’s likely rooted in unresolved paternal dynamics. You’re not really choosing between Graphite Thunder and Arctic Steel, you’re choosing between who you wanted your father to be… and who he actually was.”

You blink. You were pretty sure you were just hot and mildly constipated from hormone therapy, but apparently, you were also having a breakthrough.
She continues:
“The part of you that wants the bold red coupe is the inner child, still seeking approval. The part that chose silver is your learned compliance. And the ventilated seats? That's just you finally choosing comfort over performance. Which is progress.”
You stare at her. She stares back. You reach for your wine and whisper, “Sometimes I miss when we just fought about the thermostat.”

She nods sympathetically and adds, “That’s another father wound, by the way.” She doesn’t laugh. She never laughs when you're being your most honest.
And then, the emotional stress. Not the noble, Shakespearean kind, but the kind where you cry because the grocery store moved the gluten-free section again and it was the one place you still felt competent. Your sense of self collapses faster than your testosterone levels, which, thanks to Firmagon, now hover somewhere between “prepubescent choir boy” and “houseplant.”

But let’s discuss the real battlefield of adaptation: the soap aisle. Once, you bought soap like a man—whatever was cheap, unscented, and didn’t actively strip your skin like acid. Now? Now you stand paralyzed between Sandalwood Rain, Bourbon Spice, and Charcoal Citrus Fusion, wondering which one might make you feel like a virile demigod instead of a neutered housecat. You finally pick Mountain Forest Musk and cry in the car because it reminds you of that one camping trip in 1987 when your prostate still had ambition.

Then there’s the toilet paper—that unsung, underestimated test of man’s fortitude. Your once-iron constitution, now softened by ADT, stool softeners, and radiation, is assaulted by the coarse, industrial-grade sandpaper your partner insists is “recycled and environmentally responsible.” Every trip to the bathroom becomes a tragic negotiation between environmental ethics and your burning ring of regret. “This is what we’re saving the planet for?” you mutter, applying another layer of Vaseline like a war medic dressing shrapnel wounds.

And then there’s your catheter. Yes, that catheter. Once a foreign object, now an old friend. You’ve named him Kevin. You have full-blown conversations with him. “Kevin, we’ve been through a lot together,” you whisper at 3 a.m. as he swings gently beside the bed like a cursed wind chime. “You know me better than most men do.” You start leaving Yelp reviews for medical tubing. “Five stars. Flexible. Honest. Always there when I need him.”

Meanwhile, your wife, who just so happens to be a psychiatrist (because karma is not without a sense of humour), sits across from you with the expression of a professional trying not to diagnose her dinner companion. She listens, nods, occasionally uses words like “somaticized displacement” while you try to explain why you’re crying over the theme music from Downton Abbey. “It’s the violins, Karen. They remind me of my prostate.” She suggests mindfulness. You suggest wine. She recommends journaling. You write passive-aggressive haikus about your hormone injections.
Adapting to life after a prostate cancer diagnosis is a lot like being given a new job, with no training, in a foreign language, while wearing shoes that are slightly too tight and being judged by an audience of indifferent urologists. It is absurd. It is exhausting. And it is, at times, hilarious.
Because if you don’t laugh when your catheter gets caught on the kitchen drawer handle or when you realize the reason you’re dizzy is because your testosterone is lower than a monk on tranquilizers, then what’s left?

Well—soap shopping. And Kevin. Always Kevin.