Our carefree life hits a brick wall when we are diagnosed with prostate (or any) cancer. At that point we worry, we research, and we make a decision to treat or monitor our cancer. Then we worry about whether we made the right decision. Next we worry about what the future holds. Sound familiar?
A cancer diagnosis injects adrenaline into our worry glands. Our inclination to worry becomes hyperactive, and things that were not even on the radar before cancer now receive heightened attention. Some of us are better able to manage this than others, but we all run the risk of living the rest of our lives as a worrywart. Doing so would be understandable and might even arguably be justified, but it’s certainly not a pleasant way to live.
There are five big concerns I’ve regularly encountered in my life or in conversations with you about yours. While all are legitimate concerns we share, they need not be quite so worrisome. If you need relief from the stress they may cause, consider this post to be a pep talk. If it helps you even a little or at least makes you smile for a moment, it’ll be worth the ink on this page.
Let’s tackle the big one first—the elephant in the room for us prostate cancer survivors.
#1: What if I develop erectile dysfunction?
It’s really not that complicated. If you have not already developed E.D., in all likelihood you eventually will, and you may never know why. This is something I’ve worried about for … let’s see now … about a half century—way before my prostate cancer treatment. There are psychological components, physical aspects, social pressures, and of course, age.
My step dad died almost two years ago at age 101. He never had prostate cancer. I don’t know if he ever had E.D., but I can guess that at some age prior to 101 he stopped worrying about it. Why don’t you and I save ourselves some grief and stop worrying now? As with all things, worrying won’t change anything anyway, and ironically in this case it might actually make things worse. So if E.D. hasn’t hit you yet, enjoy “it” while you can.
Without question, those 300 minutes per year are worth remembering, but compare that to the disproportionate amount of time we waste worrying about it.
Furthermore, the percentage of our lives requiring erectile function is small. There are about 525,600 minutes in a year. Optimistically assuming we would hope to maintain an erection 100 times a year (through all eternity) for 3 minutes (yes, I know that’s extremely optimistic), the fraction of a year devoted to this would be 300/525,600, which is so small most calculators show it in scientific notation as 5.707762557077626e-4. It’s a tiny bit more than 5% of 1% of a year, less than 5 hours annually—a few blips on the timeline of life. Without question, those 300 minutes per year are worth remembering, but compare that to the disproportionate amount of time we waste worrying about it.
The worry of E.D. is also a relationship issue, and if your intimacy is with someone who believes E.D. will not or should never happen to you, some education on the topic might be in order. But this is not likely. Most people understand there is an expiration date on this function, so why not talk about it together and find out where you stand?
Just for fun, if you don’t yet have E.D. try this (I dare you): Ask your loved one, “Hey, I was just wondering if you think I’ll ever have E.D.?” If the answer is, “Why no! That will never happen to you!” … start the education. Otherwise, talk a while longer and you might learn you are more than just a sex toy, and furthermore, there’s more to sex than “that.” There’s first base, second base, and third base—all worthwhile even once your home run hitting days are over. Remember?
#2 What if I become incontinent?
Those muscles will weaken as will every part of our doomed bodies. Like E.D. (along with our eyesight, hearing, bones, muscles, brains, etc.), it’s probably more a question of when, not if. If we live long enough we probably will become incontinent, but should we be worried about it to the degree we are?
There are actually two components to this worry: the actual affliction and its common remedy, diapers. In this case, we perceive the remedy to be at least as bad as the affliction, and this is primarily a public relations failure.
… We independent men don’t want to depend on Depends … Why not instead call this essential and effective product SuckUps™ and put it in the beer aisle?
Let’s compare the incontinence remedy to a popular fix for erectile dysfunction. Specifically, consider the P.R. scenario for Viagra. Everyone loves to talk about it. It’s the basis for many fun, popular jokes forever flying around the email grapevine. And there is a “cool” factor about using it. Even the “more than 4 hour” concern has been turned into a plus for Viagra. In short, this is a P.R. masterpiece. It enables us to shamelessly talk about a condition nobody wants, and even laugh about it in public.
On the other hand, nobody wants to talk about Depends®—universally understood to be synonymous with “diapers,” which of course are for babies. We independent men don’t want to depend on Depends. It is not cool, and jokes about it are considered to be in poor taste. This is an enormous P.R. failure, both inexcusable and unnecessary. 
Why not instead call this essential and effective product SuckUps™ and put it in the beer aisle? Package it in cans and sell it in 6-packs. Promote it with a Joe Camel type man’s man, carrying a 6-pack of SuckUps in one hand and a 6-pack of Bud in the other while riding a stallion into the mountains with a shotgun on his back. Ask Clint Eastwood (please, not Bob Dole) to endorse it. Make my day.
We don’t want to find ourselves in that special grocery store or pharmacy aisle we hoped to never peruse. We don’t want to choose among the boxes of oversized baby diapers, and we surely don’t want them seen in our cart when we check out. That scenario is our real worry, not the actual incontinence. The latter can be managed.
We don’t want Depends. We are real men. We want SuckUps.
#3: What if I made the wrong decision?
After your cancer diagnosis you made a difficult decision, and you deserve fifty points for proactively just making a decision, so good for you! But was it the right one? What if you were wrong? Unless you are a gypsy with a crystal ball, you’ll never know for sure. Any way you slice it, that ship has sailed.
Unless your approach to handling cancer produced 100% perfect results, you might naturally find yourself wondering whether a different approach would have been better. Well certainly another avenue might have been better, but so what? Even if your results were absolutely horrible, another approach might have been even worse, so there’s just no point second-guessing yourself. If we do that, our lives quickly become a mess of maybes. If I order the filet, I’ll savor each bite without wondering whether the ribeye would have been better. Wouldn’t you? After all, the filet is on my plate, not the ribeye.
… there’s just no point second-guessing yourself. If we do that, our lives quickly become a mess of maybes.
Here’s an example of flawed thinking: Suppose Joe had IMRT, and suppose he subsequently developed incontinence. Joe might think, “This is not what I expected. I spoke with five guys who had no problem. I guess I should have had surgery (or HIFU, or proton, or whatever).” Well no, Joe. With any other treatment your results might have been even worse. Or better. Or exactly the same. There’s no way to know. It’s complicated, and you assessed the risks as well as you could, made the best decision you could, and now you must move forward. We all know there are no do-overs, nor should there be any unfounded regrets. Should I quote Forest Gump about the box of chocolates?
#4: What if my cancer comes back?
Well, it probably won’t. But it might. Cancer—first time or recurring—is just one of life’s many landmines. Shouldn’t we at least allocate our worry quota equitably between them all? Should we worry about a car wreck every time we drive? Fear falling down the stairs with each descent? Chew every bite of food with utmost paranoia because we might choke? Live in a bubble because there are infectious diseases that could kill us?
It’s simply not fair to give cancer so much attention. I’ll concede that just prior to each PSA test it’s hard not to get a little antsy, but I’ll concede no more than that. Between tests we need to concentrate and focus on that filet I mentioned. Look carefully at all of what’s been dished out onto your plate of life. Find your filet, chew slowly, and savor the flavor.
#5 What if they find a new and better treatment?
Count on it: they will. But the treatment we had was far better than the more primitive ones of days gone by. We were lucky to have had cancer in today’s world, not yesterday’s. Our future brethren will no doubt say the same, and it will be equally true for them.
We can play the “what if” game with every part of our lives, but what’s the point? I know I’m not telling you anything you don’t know by reminding you that the past is done, the future is uncertain, and the present is all we have.
I might add that despite what my mother led me to believe, it’s really not all about me. I have grandsons. Prostate cancer has a genetic component, and better ways to diagnose, treat, or maybe even prevent prostate cancer will certainly benefit them, and therefore also benefit me indirectly. Hey, I guess mom was right—it is about me (indirectly)!
So there they are: five worries not to have. The point is not that they can’t happen, but that they are but a measly five of 5 million things we could worry about. Why focus so heavily on those just because we had a cancer diagnosis?
In fact, why spend so much time worrying about any of life’s challenges? If you are a natural worrier I know it’s a challenge to stop, and I certainly don’t want you to worry about that. But do ask yourself whether all your worrying leads to better results than those of a non-worrier, and maybe that will help you reign in the terror.
… ask yourself whether all your worrying leads to better results than those of a non-worrier …
It’s admittedly not easy, but at least give it your best shot. With or without cancer, life is a bumpy road, but we can still enjoy the trip. Qué será será.
Pass the A-1 Sauce, please.
PS: I am very curious whether any of these five worries worry you, and whether you have a sixth that should have been on the “top” list, so email me to share your feedback. Thanks!
PPS: You might also want to review my earlier post related to this topic. It’s one of my favorites.
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