No. Prostate Cancer is not the “good one”
The narrative is tidy. The reality is not.
People say all kinds of things when they find out you have prostate cancer.
“Oh, that’s the good one.”
“If you’re going to get cancer, that’s the kind to get.”
“Uncle Bob had it. He’s fine. Lost a little down there, but hey—still golfing!”
These comments are delivered with the confident tone of someone who once read an article in a waiting room and now believes themselves an authority on urological fate. It’s meant to reassure. But it lands somewhere between tone-deaf and absurd. Let me offer a correction: if this is the “good” cancer, I’d hate to see the bad ones.
I’ve been diagnosed with high-risk prostate cancer. And no, that’s not the warm-and-fuzzy version. It comes with a steep PSA, aggressive cell patterns, and words like “perineural invasion” that make even seasoned oncologists frown into their coffee. There is no “watchful waiting” here. There is no “small bump in the road.” There is a full-court press of hormone suppression, radiation, injections, scans, and silent calculations no one wants to say out loud.
I am not devastated. I’m not shaking my fist at the heavens. I’m on Firmagon, a hormone-suppressing drug that’s left me with the emotional depth of a cold yam. But I am grieving—just not what people expect.
It’s not my mortality I mourn. It’s the system. The ritual depersonalization. The slow and seamless replacement of medicine with manufacturing.
Somewhere along the line, healthcare stopped being about care. It became process. Diagnosis, categorize, apply template, discharge. Repeat. It’s not medicine—it’s operational logistics. And I? I’m not a patient. I’m a barcode. A chart. A line item in someone’s quarterly review.
When I received my diagnosis, it didn’t lead to a thoughtful conversation. It triggered a workflow. PSA? Gleason? Protocol 7A. We’ll beam you, drug you, and file you. Please don’t ask too many questions. You’ll jam the system.
And I don’t resist. I comply. I sit. I nod. I attend my appointments like a citizen of the bureaucracy. But I’m fully aware that if I died mid-consultation, someone would update my file before closing my eyes.
What’s missing isn’t care—it’s thought. The professional curiosity. The raised eyebrow that once said, “This doesn’t quite add up.” That moment is gone. There’s no billing code for nuance. No reimbursement for uncertainty. We’ve replaced judgment with guidelines, and humanity with templates.
If you dare ask for something different—something tailored—you’re marked as “complex.” “Noncompliant.” A threat to throughput. Heaven forbid you need medicine that isn’t pre-approved by flowchart.
I don’t rage. Rage would require more hormonal capacity than I’m currently authorized to possess. What I do is observe. Document. Witness the quiet dismemberment of individuality in the name of efficiency.
They say cancer robs you of power. But let’s be honest: the system got there first. It took my individuality, stapled it to a protocol, and called it care. I’m not angry. Just quietly aware that I am being processed like all the rest.
So no, prostate cancer isn’t “the good one.” It’s just the one we’ve learned to market well. We’ve turned it into a manageable narrative. Not by making it easier, but by making the process more sterile.
Let’s not confuse predictability with compassion. Behind the spreadsheets, the survival curves, and the cheerful pamphlets, some of us are still watching. Still thinking.
So the next time someone tells you they have prostate cancer, maybe skip the clichés. Don’t offer them borrowed optimism.
Just ask how they’re really doing.
And please—don’t tell them it’s the good one.
Interested in more discussions like this? Go to the Prostate Cancer Support Group.
That’s why I wrote the next post: whisk it baby, one more time. When one speaks of “cure”, I have come to believe that it’s no more than waiting for something else to get you first, or to wait when, eventually, this thing roars back. Fact of life is we all have to die of something, as it would be an absolute shame to die of absolutely nothing.
Well said again 🙏
I really appreciate this post. It articulates one of the main reasons I have been so defensive about the inevitable "what kind of cancer is it" questions. My assumption is that the reaction will be that I'm lucky to have the "good one", statistically speaking, and then I will feel compelled to explain all the reasons why mine is not good at all... why I was likely to die from it before ever reaching the recommended age for testing (and the fact that I was even tested for it at all was a complete fluke)... why my continued survival is a choice between life altering treatments vs. life altering (and life limiting) symptoms... how mine is advanced, aggressive, and invasive, and not sleepy or slow-growing or easily controlled... and so on. While I can be grateful for a "better" prognosis than some other cancers, the reality is that the treatments are helping me to extend my life, not to improve the quality of my added time. It may be a reasonable trade-off for now, but at 51, I cannot imagine continuing to live like this for decades, even if I might technically be able to. Statistics be damned; existing is not the same as living.
Yes , I have read those pamphlets ! Write by some Admin Gal in marketing . No clue to reality . Thanks for the laugh . I needed this ! Although I must say after the operation Ed was bad , but 4 years later and a lot of work by me and my wife we are back in the game . A few more curve balls and sliders being thrown , rather than the fastball . But im getting my rotations in as a starter so its working fine ! 🙂
Sir you have a gift with a pen . Boy I needed the laugh you provided /. After hiking yesterday with the Dogs in the mountains around some Alpine lake for 12-15kms , got the dogs...lovely day at 17-18C . I decided to go to the aquatic centre and have a quick swim and Sauna before dinner . Well there she was a ' Karen sitting in the Sauna complete with that angry look and pursed lip and of course a crew cut like haircut ' . I say, " hello, I haven't seen you in a while Ive been out of country for most of the winter , I hope your doing great and your family too ! ' . She then points out a slight hernia I have near my Belly Button . I told her that was from Prostate Surgery 4 years ago . She then professes to know something about Prostate says, they don't recommend surgery anymore, they just the prostate cancer alone now because it's safer that way. Hardly any people died from prostate cancer, thats the MILD ONE ! " . I said, "You have been misinformed. The mortality rate for prostate cancer rivals if not exceeds breast cancer for men and women combined. The treatments although development are still very life-changing. Of course you probably already know this, but breast cancer gets around 98% more funding than prostate cancer even though Prostate cancer has a mortality rate very similar. Where do you get your information that Prostate Cancer Group Regina Saskatchewan. one as you put it, certainly Urologist dont agree with you?" . I didn't have to listen to 10 minutes of her explaining how wrong I was, and how all of my decades of research is nonsense and that should I just eat a balanced diet everything will go away. Truly unbelievable what marketing has done to prostate cancer. Every Canadian should know that the Canadian guideline, and the British Columbia guideline is that you don't get a PSA test your regardless of your age, unless you were showing "...overt and serious urological issues." . So your government is making your treatment plan and is dictating to your doctor what you can and cannot have for treatment, and testing. Imagine, do you have an opportunity to get early detection of prostate cancer through a simple and cheap PSA test yet the government is dictating to doctors you can't have it. There is something seriously wrong with the medical system. And it is a system that is not what it used to be. James on Vancouver Island .
You help me so much , I laughed . Its so good to laugh at your own disease ! God Bless and thanks ! James on Vancouver Island .
This is a great thread. It needed to be said.
You have really summed it up. There is not much more to say.
Thank you.
First, thank you, fellow warrior. James, it’s truly a gift when you enter a sauna seeking peace and get a full-on clinic of unsolicited Karenology. Lots of people pretending to know issues they know nothing about... on everything, including prostate cancer, despite not knowing the first thing about it. Naturally, she’s misinformed—after all, why let our own opinions and experiences, decades of research, medical experience, or actual statistics get in the way of a good old-fashioned opinion?
Her "mild one" line is a gem, though. Mild, like a whiff of cologne or the slow death of dignity in a medical system that won't even let you get a PSA test without permission. She’s got her feelings—and that’s more reliable than decades of actual data and research. Your prostate’s misfortune, I’m sure, is only the result of not eating more quinoa.
As for the government’s rules on prostate cancer testing? Brilliant, isn’t it? A cheap, early detection test is available, but no, the state insists you’ll survive simply fine without it—after all, what do doctors know? Let them spend more time following rules than, you know, saving lives. Keep the torch burning, James—somewhere out there, logic is quietly crying in the corner.
I feel this in my increasingly radioactive bones. There’s something especially maddening about having to justify your own suffering because the branding on your cancer isn’t tragic enough to make it into a Lifetime movie. Prostate? You’ll be fine. Just a little hormonal tinkering, a few searing beams to the nether regions, maybe a chemical castration or two - no biggie, right?
There’s no such thing as the “good cancer.” There’s just cancer that pretends to be polite until it breaks into your house, rearranges your life, and casually tells you you’re lucky it didn’t bring friends. And the treatments. A true smorgasbord of indignities: from hot flashes that would embarrass the sun to a libido so dead it has a gravestone.
You're not being dramatic. You’re being accurate. You’re living in the absurdity of a world that asks you to smile because your misery didn’t come with a skull and crossbones. If you ever need a comrade in this existentially ridiculous trench, I’m here — hormone-depleted, side-effect riddled, and radiated... but with a very dry towel for the next person who gets misty-eyed about your “good cancer.”