The Cancer Diaries, Part 29

Prostate cancer newsI began to write this post on the anniversary of my prostate surgery, July 8. Anniversaries are a time to reflect on the past and look to the future, even for events that are not always the happiest to recall. I took some time for such reflection and contemplation this week, and here are some of my thoughts.

Twenty twenty was a tough year for everyone, what with the pandemic spreading, the lockdowns that shut businesses and services often for weeks or even months, the fears, the isolation, and the economic devastation that hit many Canadians. On top of that, I had a diagnosis of severe and aggressive prostate cancer that required immediate surgery to remove my prostate and a good deal of surrounding tissue and nerves.

After I recovered from that, I had a second, minor operation that attempted to resolve a stricture in my urethra (it did only temporarily and that remains a problem that has no easy solution; I am reluctant to undergo more surgery in part because I really dislike the catheter I will be forced to wear for a week or two after). That surgery was followed by seven weeks of radiation treatment, driving 60kms every weekday to the hospital and back. And I also had hormone therapy (chemical castration) and its lingering physiological effects to contend with.

It was easily the worst year of my life (the weeks post-surgery were the toughest). If I had not had my partner, Susan, with me to help and support me, I am not sure I would have coped with it all. She was my rock, my anchor.

And I owe my thanks to my friends who gave me words of comfort and support during this time. It was nice to know you cared. And still do, of course.

A cancer diagnosis makes one consider mortality in an intimate, deeply personal way. It made me reflect a lot on life and death, more so at the start than post-treatment. To be frank, there were some days when I wondered whether the treatment was worth the emotional and physical effort. But as I recovered, my optimism did, too.

During these tribulations, I turned increasingly to my favourite sources of consolation, comfort and wisdom: the Stoic philosophers — in particular Marcus Aurelius, Cicero, and Seneca — and my muse, Michel de Montaigne. I am fortunate to have a personal library with their books and could pluck a title from the shelves and open it any time of the day.

I read them for their views on life, how they met challenges, and, of course, their thoughts on death. Not to be morbid about it, just to get some perspective that I could apply to my own circumstances. Since I lack any religious faith, I have no comforting myth about an afterlife to console me in the face of death. Philosophy helped. But then again, so did watching my collection of Godzilla films and Columbo reruns. Simple pleasures like that often lift the spirits and help us forget our troubles, albeit perhaps only momentarily.

But here I am, a year later, still alive, and, if not entirely recovered, at least I am walking around and participating in daily life. Carefully, mind you, since I am still a bit fragile and cautious, not least because I am also older and more prone to damage than a younger person. And I’m still reading philosophy, Montaigne mostly.

July 8 was also significant in that Susan and I travelled to Penetanguishene to receive our second COVID-19 vaccination. We were originally booked for it on July 30, but managed to get it moved up. While it does not offer 100% surety of protection, it offers enough to make us feel safer and more confident (or will, after the two-week antibody development period is up). I heard on the news this morning that pharmaceutical companies are recommending a third booster shot six months after the second. We’ll get that when it’s available.

(I cannot express without egregious vituperation and invective the utter contempt and disgust I feel for the anti-vaccination idiots who continue to hold back our collective recovery because of their self-made ignorance and selfishness. Were I religious, I would consign them all to a deserved eternal damnation.)

I still feel and see the effects of the hormones quite strongly. Most of my body hair is gone: chest and underarms are bare, pubic hair is greatly thinned (the areas shaved for my surgery remain bare), as are my arms and legs. Even hair that I had growing on my knuckles and the back of my hands is almost entirely gone. My facial hair (beard and moustache) is thinner and spottier (although what comes in is wiry and white). The hormones don’t seem to have affected my head hair, but perhaps that is thick enough that it seems to be still full, and losses are not as easily noticed. 

I’m not sure when or even if that hair will grow back, but the effects of the hormones will last at least all of this calendar year, maybe longer. My oncologist suggested the effects might last longer. I’ve spoken to other men who have had similar treatment and they say it continued two or more years after their last treatment.

Hot flashes still rage, mostly at inopportune times. During those hot summer days, having one can be quite debilitating. They often wake me from sleep, two to four times every night. They can (and do) happen any time, with no warning or apparent trigger. The strongest of these surges are accompanied by a sense of weakness and sometimes shortness of breath, but most are uncomfortable inconveniences that encourage me to pause and rest until they pass. 

I was warned that hormones might affect moods and memory, too. I can’t tell how much they have done that is different from my usual irascible self and my eroding-from-age memory. I may be crankier and more forgetful than before my treatments, but I can’t say. Is it the prolonged effects of the pandemic isolation and restrictions that make me (and the rest of us) like that? Or just being older? I simply cannot measure the psychological effects within me. (Curiously, long-term memory seems reasonably intact and I can still sing along to songs from the ’60s and ’70s, although my dance steps may be a little less graceful… but that might be the wine…).

The radiation played havoc with my intestines; a part of them was inevitable collateral damage during the treatment. While somewhat recovered, I still suffer some upsets with digestion. Recovery from that, I’ve learned, might take a year, might take two, or might never occur. The damage might be permanent. Like the Borg Seven of Nine in Star Trek Voyager, I must learn to adapt.

My next blood test and consultation aren’t until the fall, so I won’t learn for several months if my cancer has proven resistant to the hormone therapy, has returned and is growing again. I may need further treatment, or I may not. Until then, there’s nothing I can do but continue on as I’ve been doing, and continue to read my philosophers instead of worrying about my future.

I’ll follow up when I’ve passed the next hurdle. If you wish to read more of my cancer diaries, look here: ianchadwick.com/blog/the-cancer-diaries/.

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