Cancer Journal 1# Nov 16

    PSA-17. Oh. That’s high! Let’s check back in three months. PSA-24.4. We need to do a prostate biopsy this week. The news of the biopsy, delivered over the phone is business-like, maybe two or three degrees less warmth from the doctor than before. I think of wartime telegrams delivered at the front door by uniformed officers. It’s the message, not the messenger, that is important. Still, the manner of how the message is given stays in the memory. 

     No need to say, “Give it to me straight, Doc.” I get it straight. Prostate cancer is in there with a Gleason Score of 8 which is at the low end of aggressive. I think of Jackie Gleason who really doesn’t have much to do with the situation. They do a bone scan within the week. More bad news. It has metastasized into various parts of my bones. Again the doctor, a different one, gives it to me straight. Once it has metastasized, prostate cancer is incurable. The average life expectancy for me is three to five years, although that can vary, depending on health and attitude. Probably how good a home my body is providing the cancer has a bearing too. 

     I tell the doctor that death holds no terror for me. I expect to go to heaven and although I have no interest in hurrying up that blessed day, decades of old age decline hold no great attraction either. He says he’s glad to know all that. I tell him I intend to pray for my recovery. He seems very happy about that. I imagine that studies show that treatment is more successful when patients have hope from a spiritual source. Still, it seems incongruous that the doctor should be endorsing my holding out hope that an omnipotent diety should stick a finger in to disrupt the natural course of the disease. I suppose he would see a therapeutic delusion, a spiritual placebo effect. 

     I’m being ungenerous. The man is just trying to do his job well—and succeeding. He has a nice blend of empathy and business. Steadfast eye contact. He makes a personal connection which at one level is remarkable considering that our relationship is terminally temporary.  I will see more of him and will report on how we get on.