Prostate Cancer and Consulting: A Case of Malignant Expertise

Management consulting and prostate cancer — a match made in the hollowed-out core of corporate despair. One infiltrates your body quietly, feeding off your testosterone; the other infiltrates your company, feeding off your budget. Both arrive in a tailored suit, speak in euphemisms, and promise transformation while slowly removing what made you feel like a man. The real synergy lies in their shared business model: identify a slow-growing problem, rename it “strategic,” charge a fortune to make it

If you’ve ever wondered what it’s like to be diagnosed with prostate cancer, but you don’t want to go through all the bother of having a prostate or, say, a pulse, might I suggest spending a few months inside a management consultancy? The parallels are so striking that one begins to suspect a shared origin story—perhaps a malignancy of intent metastasized from a Harvard case study gone rogue.

Let us begin with discovery. In both prostate cancer and consulting, things start with a vague, gnawing discomfort. For cancer, it’s the subtle shift from peeing like a stallion to peeing like a reluctant sprinkler. For consulting, it’s the uneasy silence after someone in senior management says, “We need fresh eyes on this.”

You ignore it at first. After all, who hasn’t woken up drenched in sweat from either hormone imbalance or a strategy offsite with slides titled "Unlocking Synergy: Phase 3"?

But then come the tests. In oncology, they call it a biopsy—an invasive, mildly humiliating probe into your most private self. In consulting, it's the Discovery Phase™—an equally invasive probe into the corporate psyche, during which some twenty-something in a fitted suit asks your executive assistant, “So, what would you say you do here?”

Next comes the diagnosis. With cancer, it’s a solemn, scientific declaration: “You have a Gleason 7 with cribriform involvement.” With consultants, it’s more upbeat, but no less grim: “Your procurement function lacks strategic alignment and operates in a fragmented, siloed environment with insufficient data governance.” Both statements mean: You’re screwed, and we’re going to need to take aggressive action. Immediately.

Enter the treatment plan. Cancer gives you options like radiation, surgery, and chemically castrating yourself until you cry during cereal commercials. Consulting offers a choice between “Transformation Roadmap,” “Digital Reinvention,” or “Agile Replatforming”—each as euphemistic as “watchful waiting” and about as effective.

And the consultants, like oncologists, arrive in teams. You’ll meet a senior partner who swoops in, speaks for four minutes in polysyllabic riddles, and is never seen again. This is akin to your oncological surgeon, who performs the biopsy and leaves the follow-up to a registrar who once Googled “prostate.” The bulk of the work is then done by junior staff who are, in both fields, astonishingly young and somehow already exhausted.

Side effects? Abundant.

With cancer, you lose testosterone, hair, dignity, and any illusion of bodily autonomy. With consultants, you lose budget, staff morale, and the will to attend another meeting titled “Change Champions Check-In.”

There is also pain management. Cancer patients get opioids, medical cannabis, and the occasional “hang in there” mug from HR. In consulting, you get slide decks. So many slide decks. You are shown bar graphs indicating how much better things will be once your staff stops resisting change and starts embracing synergy. The only graphs cancer gives you are PSA charts that rise with such malicious cheer that they seem to be taunting you.

There is, of course, the false hope of a cure. In cancer, it’s the promise that if you survive five years, you might die of something else. In consulting, it’s the idea that after this engagement, your organization will be "future-ready," which roughly translates to "gutted, confused, and outsourcing HR to a chatbot in Hyderabad."

Then there's follow-up care. With prostate cancer, you’re monitored quarterly: bloodwork, scans, and a haunting familiarity with your urologist’s ceiling tiles. With consulting, they call it “Phase II Support,” which involves the same people returning to clean up their earlier recommendations using the next year’s budget. If your PSA goes up, it’s a recurrence. If your cost-savings projections go down, it’s “implementation drift.”

Ultimately, both cancer and consulting teach you the value of existential humility. Cancer says: “You are mortal.” Consulting says: “You are replaceable.” One attacks your body. The other re-orgs your soul. Both will make you question the point of it all. Both will cost a fortune. And neither will tell you where your prostate actually is.

In the end, you survive not through science or methodology but through sheer, obstinate endurance. You outlast the quarterly check-ins, the consultants’ PowerPoint transitions, the PSA scares, and the Slack messages from a 27-year-old “engagement manager” named Tyler who uses “leverage” as a verb.

So if you find yourself diagnosed with either prostate cancer or a major consulting engagement, take heart: the good news is, statistically, you’re likely to outlive both. The bad news is, you’ll never piss in peace again—figuratively or literally.

“Prostate Cancer and Consulting: Two Great Malignancies That Taste Awful Together” is part of the upcoming anthology: “Terminally Stable: A Memoir of Malpractice, Metrics, and Other Medical Thrillers.” Pre-orders are available pending biopsy results.