BY RALPH BLUM
The slamming emotional impact of learning that you have cancer—that if it is untreated or defies control it may kill you—is difficult to describe, even when you have been though the shattering experience personally. At moments, you forget, and then truth floods your mind and emotions in a rush, and you are suddenly sick to your stomach with fear. Or the knowledge disrupts your sleep, leaves you starkly awake in the darkness, eyes wide open and staring at the ceiling, anguishing about those who depend on you, those who love you, need you. Everything is different. The world is a changed place. And regardless of what the “best authorities” will tell you, some sneaky, menacing part of you is convinced that the world may soon be going on without you. And that it can happen at any time. Because you have been sentenced, and the cancer will be your executioner.
What will you do? Face the music—howl, shudder and weep—and then get on with living? No, nothing of the sort. Actually, there are specific, positive actions you should take. In a previous blog, I described how to deal with the psychological impact of a cancer diagnosis and laid out eight basic rules to help cope with the fear and loss of control that invariably zap you when you are first diagnosed. In this blog I have made a short list of things you need to do in order to become empowered; in order to take back control of your life by adopting a strategy that will play a key role in your recovery. And right up front, let me tell you that acting “brave” or “keeping a stiff upper lip” is not anywhere on that list.
Start by doing the work. Educate yourself. Become an expert on prostate cancer. Learn everything you can about your disease and the various treatment options available to you, the possible side effects, the risks that accompany unwise delay of treatment In effect, become a knowledgeable partner with your doctors in making the best treatment decision for you.
Know the reasons—the pros and cons—for undergoing any test. In particular, make sure that you fully understand the nature of PSA tests, Gleason score, clinical stage and, therefore, your risk category so that you can make a fully informed treatment choice.
Be careful not to let statistics terrorize you. Some prostate cancer survivors I have met would advise you to ignore statistics in any form. You may be given various numerical tables and graphs detailing survival rates; do not feel compelled to read them! Statistics do not determine any individual’s outcome—including yours. As New York Times Science Editor Dana Jennings put it, “I am a person, not a statistic.”
Trust your instincts in selecting your doctor. Do not hesitate to fire any doctor—up to and including world-class specialists with huge reputations—if he or she makes you uncomfortable for any reason, including feeling their lack of sympathy. Choose and stay with doctors in whom you have confidence, and consent only to treatment that you believe in. Consult specialists in urology, oncology, and radiology who have state-of-the-art knowledge and equipment. And who, at the same time, are not “selling” their specialty.
Obtain copies of all your medical records so that you have them for your own understanding, and also to provide them for any specialist you consult. These would include PSA test results, urologist’s notes and reports, biopsy pathology report, written reports and digital copies of any scans, and reports on any of your current other medical conditions.
Do the no-brainer stuff. Adopt and maintain a healthy lifestyle: eat a nutritious diet (with recommended supplements) and obtain sufficient exercise. Like it or not, sweat is a formidable supplement! Boost the quality of your lifestyle and, Scout’s honor, you will not only feel better, more in control, you will actually improve your chances of a good long-term outcome.
And most important, create a supportive environment around you. Surround yourself with positive, optimistic people—both friends and medical professionals—who are convinced that you will get well. And in order to be in touch with others who have survived what you are facing, find a good support group. Behave the way you would knowing you still have a long time to live.
Add all of this together and you have a beginner’s course called “Strategy for Self-Empowerment 101”—a course I have yet to see taught in even the best medical schools!