It was with a strong sense of trepidation that I went to my latest meeting with the urologist, earlier this month. Although it was still rather too early to make a fulsome diagnosis, I was anxious about what my latest blood test might show. My biggest worry was that I would need further treatment, including chemotherapy. I have to admit that on the drive to Barrie, I was frankly asking myself if it would be worth it to do more.
Although I was a couple of weeks past my last radiation treatment, I was still having side effects, albeit slowly diminishing. And I was still on hormone therapy: I got my second shot of Lupron in his office that day. I’ve read hormone therapy described as “chemical castration” because it is meant to stop the testes from producing testosterone (the hormone that fuels the growth of the prostate cancer cells). Better, of course, than surgical castration, although at my age and treatment my testicles are more decorative than functional.
But more to the point for me, Lupron has other effects, aside from dampening my sex drive down to zero. I mean really zero: I cannot find anything, cannot think of anything, read anything, watch anything in a movie that motivates or arouses me sexually. I suppose in part it’s also because the cancer was aggressive and had spread outside the prostate. During surgery, the surgeon had to cut the nerves that enable an erection. But before I started on Lupron, I could at least think salaciously. Since the Lupron kicked in, I’m all agape, and no eros. *
I find myself re-reading Cicero’s De Senectute for his wisdom on the diminishing passions that come with age. ** Cicero wrote that there are many people who grow old with diminishing sensuality without complaint, “who don’t miss the binding chains of sensual passion.” Well, not that I had a choice, but I’m there with him at least in spirit. It’s like the weather: no matter how much I complain about it, I cannot change it, so I might as well accept it and move on..
And Cicero said that one should take pleasure in old age and the loss of sensual passion, and instead turn to philosophy and culture:
…the arms best adapted to old age are culture and the active exercise of the virtues. For if they have been maintained at every period—if one has lived much as well as long—the harvest they produce is wonderful, not only because they never fail us even in our last days (though that in itself is supremely important), but also because the consciousness of a well-spent life and the recollection of many virtuous actions are exceedingly delightful… For pleasure hinders thought, is a foe to reason, and, so to speak, blinds the eyes of the mind.
Besides, as Mervyn Peake wrote in his novel, Titus Alone, “Lust is an arrogant and haughty beast and far from subtle.” I try to turn my energies these days to reading, writing, cooking, and the occasional computer game. And I still have a passion for reading, of course. ***
The hot surges (or flashes as some call them) that the hormones generate come without warning and can wake me up, make me uncomfortably hot while walking the dog or shopping, and distract me from my reading or computer work. This is the most noticeable physical effect of hormone therapy so far. My sleep is broken often by these heated moments, waking me up to cast off the blankets or shift the dog or cat lying against me, and seldom allowing me to drift from REM to deep sleep.
My hair grows less and slower, too. When I stopped my radiation treatment, I decided to let my beard grow in as an experiment to see how my facial hair growth was affected. By now, four weeks later, I should have grown a significant amount of beard and mustache as I had in the past, but the current state of my hirsuteness has only produced a scraggly, somewhat spotty beard; barren or thin in some places. This might be a more suitable style for a young man, except of course for the white in it. I mean to continue growing it for a few more weeks or months to see what develops. Or until Susan wearies of looking at it and demands I shave.
I did notice that my other body hair seems to more spare as well. Pubic, underarm, and chest hair seem thinner as if they had fallen out and not been replaced by new growth as usual. I was never burdened with a lot of body hair, and it was never very thick, but what I have seems to have lessened. Where I was shaved for surgery has not regrown fully or thickly, seven months later. Curiously, though, the hair on my head seems unaffected.
I’ll be on Lupron for the rest of the year, though. Whether that continues past 2021 is something I’ll discover much, much further down the road, following subsequent blood tests and scans. Will there be increased or escalating side effects from being on hormones that long? I don’t know.
The most annoying side-effect of radiation was my upset bowels. That seems to be subsiding after a couple of weeks, which is very welcome, indeed.
The big question is: did the treatment kill the cancer? If not, has the cancer metastasize and spread? No one can say, of course, not at this early stage. My doctor told me my PSA level is now comfortably low, suggesting I have been fortunate, and that was a real relief to hear. But that only means the prostate cancer is not reacting or growing. Other forms may exist within me. I may learn more in the coming months when I consult again with him and my oncologist again.
On the brighter side, I am able to enjoy my mornings much more, these chilly winter days, without the bustle and stress of driving to Barrie and back every day, trying to drink enough water to have a full bladder when I arrived. Now, I read, write, check my email, walk the dog, eat my breakfast muesli, and enjoy my wife’s company.
In the meantime, I continue in my daily life hoping I will recover fully, the side effects will diminish, and that I will face no more threats from cancer. I don’t think anyone ever really “beats” cancer; we just hold it at bay. Still, that’s something to look forward to.
* Maybe a bit of storge — the love of community and family — in there, too. I certainly feel romantic love towards my partner, but no sexual urges.
** Not cancer, of course. Cancer was known for millennia under various names and descriptions, even before Cicero’s time. The ancient Greek doctor, Hippocrates described several kinds of cancer in his writings and referred to them as karkinos, the Greek word for crab, from which we get the terms cancer and carcinoma. Cancer was not fully diagnosed as a spreading disease until the English surgeon Campbell De Morgan formulated it between 1871 and 1874. Prostate cancer was first recognized in 1853.
*** Peake’s remarkable Gormenghast trilogy is among my current reading. I first read it many, many decades ago. It’s a difficult book at times because of the number of odd characters and their Kafka-esque environment. But aside from reading, I’m trying to thin out my library, and have already put aside four boxes of books to take to a used-book store or perhaps donate to the library or the Humane Society’s store. More will be winnowed. I have decided, reluctantly but pragmatically, that a lot of the reference books I kept for my work as a writer and editor are no longer needed, and the shelf space can be used for more current titles.