Advice: Outside the Box

outside-the-box(Authors note: This month’s column is a personal experience rather than a question from a reader.)

My last column described my recent experiences learning that I had prostate cancer and having a prostatectomy. This month, I wanted to share some new developments which I hope will help readers become more informed about prostate (and other) cancer, as well as become a better friend and supporter to those dealing with it.

Last time I reported on a successful surgery, with few serious after-effects. My convalescence was so smooth that all my treatment providers told me they had never seen a patient recover so well, and I was inordinately pleased with myself. What’s that old saying about “Pride going before a fall?”

In my latest follow-up appointment with my urologist, I learned that cancer was present in several biopsy samples taken during my surgery. Another high PSA score, when it should be zero after a prostatectomy, suggested that the cancer was still very aggressive and continuing to spread rapidly.

Yet there was also reason to be optimistic. Radiation therapy and hormone injections to suppress testosterone, which feeds cancer growth, promised to bring remission or at least slow the cancer down. Unfortunately, this treatment will probably need to be repeated for the rest of my life.

I saw my oncologist for the first time six weeks after my surgery and began hormone therapy then. It was still too early to begin radiation, so he encouraged me to go on and spend the month of October in Florida, as I always do, and start radiation treatment when I returned home.

Since then I’ve spent my days reading at the pool or beach, trying to keep my mind occupied in positive ways. However, I can’t forget I have cancer, a bad one, and it’s not going away easily. I’m going to have to fight it and fight it hard, apparently for a very long time.

As a therapist, I’ve been teaching clients coping skills for over 40 years. I also know¬ how to practice those skills myself. I’m a survivor, with a strong faith life, and positive attitude, and I’ve been utilizing those pretty effectively since this journey began.

But there’s still that drowsy moment every morning when I wake up and don’t remember I have cancer. . . then suddenly I do, and it’s like hearing the bad news for the first time all over again. Other friends with cancer have shared that they experience this same phenomenon.

In my last column I shared my thankfulness for loving friends and family, for recent treatment advances, and for early detection of my disease making remission more likely. I’m still thankful for all of those things, though a little less confident about the last one.

I’m also a little more opinionated on the matter of “support.” Having received lots of it lately, which I’m grateful for, I’ve learned what is and is not effective support. I’d like to share some do’s and don’ts for those of you who want to be truly helpful to a friend or loved one with this disease.


First off, don’t minimize their risk with cheery reassurances that everything is going to be OK thanks to the wonders of modem medicine. And by all means, please never tell anyone with prostate cancer, “That’s a good cancer to have because it’s seldom fatal.” The reality is, neither of these things is true. For all too many people with cancer, including prostate cancer, everything isn’t going to be okay; and there’s no such thing as a “good cancer.” The very idea is insulting to people fighting the disease.

It’s far more helpful to say you can imagine how concerned they might be since cancer is a serious illness, but that you are wishing/praying for the best, and will be glad to help in any way you can — period. If they don’t ask for specific kinds of help, volunteer suggestions; offer to bring and share a meal, give rides to appointments, etc. — then you take the initiative. Don’t make them call you, which might make them feel needy or dependent.

Spare the advice to your friend about exploring miraculous new treatment options you’ve heard about on the news. They’re probably already overwhelmed with medical information as it is. Respect their need to trust in their own professional caregivers. Avoid questioning your friend every time you talk to them about their cancer status.

No matter how concerned and well-intentioned it might be, this quizzing makes your friend’s cancer seem like the most important thing in their life, something they probably already feel, but would rather not have emphasized.

Your friend isn’t a cancer “patient.” They’re the same person they’ve always been, but one who also has cancer now. Talk to them about the things you normally do, not just their cancer.

Finally, don’t avoid your friend because you’re unsure how to comfort them. If you’ve said you’re going to call or visit them, do it. They may already feel like a pariah, just through being sick. If you fail to connect with them as promised you just reinforce their sense of isolation.

Having prostate or other cancer isn’t a certain death sentence . . . but it can be. Tread carefully with those experiencing it. Listen, smile, nod and affirm them. Let them speak their truth and accept that as their reality, without presuming to fix or change anything. They’ll appreciate your loyalty and attentiveness more than any well- meaning but ineffectual pep talks.


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