By Ralph Blum
You had surgery, or radiation, or both, and you may have been doing just fine for years, enduring all the anxiety-provoking PSA tests, and regular check-ups without alarms going off. So you thought and hoped that you were cured or permanently in remission. But apparently the treatments failed to wipe out the cancer completely. Because it’s back!
Your first reaction is bound to be shock and heavy panic. But remember: a relapse is not an imminent death sentence. The odds are excellent that with the new drugs on the market, and new ways of thinking about the various treatment options newly available, relapsed prostate cancer can be effectively controlled. You are now among the millions of men who had to learn that they can live with prostate cancer—that with care and management, they will die with the disease, not from it.
I know it’s easy to say, “Try not to panic.” The fact is, you have work to do. Depending on the type of treatment you had initially, and on your age and any concurrent illnesses, and to depending to what extent the cancer has spread, you will now need to select the best treatment for dealing with the cancer in its current stage. Your options will usually include radiation, hormone therapy, chemotherapy, immunotherapy or a combination of therapies.
After undergoing the tests to determine how advanced the cancer is and whether it has spread beyond the prostate, as mine did years ago in order to make an educated decision your best bet is to consult with a urologic oncologist—a doctor who specializes in treating cancers of the genitourinary system. If you ever needed a truly excellent medical ally, it’s now. And be aware—especially if you live at a distance from a major center—that you will find the most highly trained specialists at major medical centers or academic centers. These doctors are in the best position to judge the benefits of the latest therapies based on their experience with a significant number of relapsed prostate cancer cases.
Your fear and frustration are nothing to be ashamed of. Fear of dying, fear of pain, fear of impotence and incontinence, fears about how the recurrence will affect your work and how you will be able to provide for your family—all those fears hammer your immune system and diminish its ability to come to your defense. Fear and the pervasive loss of control that relapsed prostate cancer injects into your life are the hardest things you’ll ever have to deal with. And have no doubt: your fears can be compounded by a lack of knowledge. You need to know that no matter what initial treatment you underwent, a variety of treatment options are still open to you. There are currently more than twenty new promising prostate cancer therapies in development. Go online. Consult with “Dr. Google.” Find out what’s available—in the experimental stage or newly FDA approved—to support you right now.
My wise friend and courageous ally, Harvey, who has been living with advanced prostate cancer (metastasized to two places to his bones) for almost a decade now, said this: “When nothing else is left in your control, you can always decide one thing: Your attitude. And with a good attitude, you will discover that there are freedoms: Especially, the freedom to choose what to do next.”
Above all, remember this: You are not alone. Although the five-year survival rate after initial diagnosis is almost 100 percent, prostate cancer will stage a relapse after the five-year mark in about 20 to 30 percent of cases. So when your anxiety skyrockets, look for knowledgeable allies. Go to your local prostate cancer support group and find a fox-hole buddy who’s been through what you’re experiencing, and who will gladly offer both emotional support and valuable advice based on their own experience. And someday, God willing, you will find yourself providing someone else—someone who is going through what you are now—the counsel and hope only available from a long time relapse survivor.
About Ralph Blum (1932-2016):
Ralph H. Blum was a cultural anthropologist and author, graduated Phi Beta Kappa from Harvard University with a degree in Russian Studies. His reporting from the Soviet Union, the first of its kind for The New Yorker (1961—1965), included two three-part series on Russian cultural life. He wrote for various magazines, among them Reader’s Digest, Cosmopolitan, and Vogue. Blum has published three novels and five nonfiction books. He lived with prostate cancer, without radical intervention, for twenty years.