New York Times editor Dana Jennings writes every Tuesday about coping with an advanced form of prostate cancer.
By Dana Jennings
Prostate cancer and its treatment breed anger and confusion among the men who have it and those who love them. And in the wake of studies released last week that question the value of screening for prostate cancer, I find myself even angrier and more confused.
I’m angry because the two studies confirm my gut feeling – based on comments to this blog and on the stories of many men I know – that millions of men, especially those in their late 60s and beyond, have received unnecessary prostate cancer treatments that have, at the very least, damaged their bodies and lives, if not outright ruined them.
I’m confused because I’m the statistical exception. I’m the one man in 49 whose life may have been saved because I had the PSA blood test. Most prostate cancers are slow and lazy. But my doctors and I learned after I had my prostate surgically removed last July that my cancer was shockingly aggressive. There’s a good chance that it would’ve killed me if I hadn’t been screened. And, to be blunt, it might yet.
Basically, the two large studies – one American, one European – found that screening tests for PSA, or prostate specific antigen, do a great job of discovering prostate cancer. But that knowledge doesn’t translate into many lives saved, the studies state, and for many men it can lead to needless treatment that diminishes quality of life.
My biggest problem with the studies – and, of course, this is the nature of such studies – is that they reduce me and all my brothers-in-disease to abstractions, to cancer-bearing ciphers. Among those dry words, we are not living, breathing and terrified men, but merely our prostate cancers, whether slow or bold.
The most chilling sentence I’ve read in the past week is this one from The New York Times: “In each study, the two groups were followed for more than a decade while researchers counted deaths from prostate cancers, asking whether screening made a difference.”
The researchers counted “deaths,” not men who had died. As Charlie Brown once said to Lucy as she detailed his baseball team’s shortcomings: “Tell your statistics to shut up.”
My own experience with prostate cancer started pretty typically. My PSA was elevated more than a year ago. That fact led to a biopsy last spring, and on April 7 I learned that I had prostate cancer.
It was determined that my cancer was a probable Stage 1, and that my Gleason score was a 6 or 7 on a scale of 10, with 10 being the worst possible number. It appeared that I had an “ordinary” case of prostate cancer. My doctors recommended surgery. In my case, because of previous operations, I had a radical open prostatectomy.
Now, cancer is a powerful card for any doctor to play. Cancer is a serpent in our bodies that we cannot abide. When most of us learn that we have cancer, we want it out right now. We want it annihilated. And for me, surgery was the right decision, because it was only through the post-op pathology report that we learned that my cancer was an aggressive Stage 3 – a T3B – and that my Gleason was an ominous 9. I was actually that somewhat rare man who could die from prostate cancer, not just with prostate cancer. There are still about 30,000 men who die each year from the disease.
Even so, I will still tell you that I was damaged by the surgery, with impotence and incontinence being the major issues; those were also complicated by my follow-up treatments of radiation and hormone therapy.
And given the findings in these two studies, if my case had been typical, if the cancer had been the slow-growth kind and confined to the prostate, I would feel like an absolute fool for having gone through the physical indignities caused by surgery.
Doctors can tell you and tell you that impotence and incontinence are probable side effects. But until you actually experience them as man trying to regain his life, you have no idea what those multisyllabic curses truly mean.
In our competitive medical marketplace, there is no shortage of surgeons out there who aggressively promote themselves and who do a volume business in prostates. But these two studies indicate that maybe that volume should be reduced.
So, I sit here in limbo. And I wonder whether I’ll be that rare man who ducks death from a cancer that would’ve killed him – because I got screened. But all I can confess to you, in all honesty, is this: I’m still angry and confused.
By Dana Jennings
Prostate cancer and its treatment breed anger and confusion among the men who have it and those who love them. And in the wake of studies released last week that question the value of screening for prostate cancer, I find myself even angrier and more confused.
I’m angry because the two studies confirm my gut feeling – based on comments to this blog and on the stories of many men I know – that millions of men, especially those in their late 60s and beyond, have received unnecessary prostate cancer treatments that have, at the very least, damaged their bodies and lives, if not outright ruined them.
I’m confused because I’m the statistical exception. I’m the one man in 49 whose life may have been saved because I had the PSA blood test. Most prostate cancers are slow and lazy. But my doctors and I learned after I had my prostate surgically removed last July that my cancer was shockingly aggressive. There’s a good chance that it would’ve killed me if I hadn’t been screened. And, to be blunt, it might yet.
Basically, the two large studies – one American, one European – found that screening tests for PSA, or prostate specific antigen, do a great job of discovering prostate cancer. But that knowledge doesn’t translate into many lives saved, the studies state, and for many men it can lead to needless treatment that diminishes quality of life.
My biggest problem with the studies – and, of course, this is the nature of such studies – is that they reduce me and all my brothers-in-disease to abstractions, to cancer-bearing ciphers. Among those dry words, we are not living, breathing and terrified men, but merely our prostate cancers, whether slow or bold.
The most chilling sentence I’ve read in the past week is this one from The New York Times: “In each study, the two groups were followed for more than a decade while researchers counted deaths from prostate cancers, asking whether screening made a difference.”
The researchers counted “deaths,” not men who had died. As Charlie Brown once said to Lucy as she detailed his baseball team’s shortcomings: “Tell your statistics to shut up.”
My own experience with prostate cancer started pretty typically. My PSA was elevated more than a year ago. That fact led to a biopsy last spring, and on April 7 I learned that I had prostate cancer.
It was determined that my cancer was a probable Stage 1, and that my Gleason score was a 6 or 7 on a scale of 10, with 10 being the worst possible number. It appeared that I had an “ordinary” case of prostate cancer. My doctors recommended surgery. In my case, because of previous operations, I had a radical open prostatectomy.
Now, cancer is a powerful card for any doctor to play. Cancer is a serpent in our bodies that we cannot abide. When most of us learn that we have cancer, we want it out right now. We want it annihilated. And for me, surgery was the right decision, because it was only through the post-op pathology report that we learned that my cancer was an aggressive Stage 3 – a T3B – and that my Gleason was an ominous 9. I was actually that somewhat rare man who could die from prostate cancer, not just with prostate cancer. There are still about 30,000 men who die each year from the disease.
Even so, I will still tell you that I was damaged by the surgery, with impotence and incontinence being the major issues; those were also complicated by my follow-up treatments of radiation and hormone therapy.
And given the findings in these two studies, if my case had been typical, if the cancer had been the slow-growth kind and confined to the prostate, I would feel like an absolute fool for having gone through the physical indignities caused by surgery.
Doctors can tell you and tell you that impotence and incontinence are probable side effects. But until you actually experience them as man trying to regain his life, you have no idea what those multisyllabic curses truly mean.
In our competitive medical marketplace, there is no shortage of surgeons out there who aggressively promote themselves and who do a volume business in prostates. But these two studies indicate that maybe that volume should be reduced.
So, I sit here in limbo. And I wonder whether I’ll be that rare man who ducks death from a cancer that would’ve killed him – because I got screened. But all I can confess to you, in all honesty, is this: I’m still angry and confused.
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