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Tuesday, September 21, 2010

Cancer revisited

This morning I went to a dermatologist, as I do every six months. He checks me for skin cancers, of which I’ve had a few removed. Fortunately those tumors were early-stage and were not melanoma, so they were not a cause for alarm. If you have fair skin, are over 40, have a lot of sun in your past, and have never been closely examined by a dermatologist, I recommend it.

But today's office visit is a reminder that four years have passed since I was diagnosed with an aggressive prostate cancer. Like breast cancers in young women, prostate cancers are beginning to pop up in middle-age men. It’s not “just for seniors” anymore.

2006 and 2007 were difficult years, but I was lifted up by the care of family, friends, and co-workers as well as some very competent physicians and nurses. (I’ll overlook the jerk at Johns Hopkins. Big-reputation hospitals are over-rated.)

I have been cancer-free since treatment. Whether I will stay that way is too early to say. The joke among cancer patients is that the only way to know you've been cured is to die of something else. But the longer I go without recurrence, the more likely it is that the combination of surgery and radiation nailed it.

Every cancer patient has his own story. Here are a few observations I’ll offer for you:
  • Early detection. For both my skin cancer and my prostate cancer, early detection was the key to a good outcome. If I had waited another year or two before having a PSA test, I’d either be dead by now or well down the road of palliative care with no hope of cure. I came that close.
  • Insurance. At list prices, my prostate cancer cost about $130,000 to diagnose and treat – and that was several years ago. Fortunately I had excellent insurance from my employer. Even if Barack Obama is tossed out of office in 2012 like Jimmy Carter was in 1980, at least his administration got something done about healthcare.
  • Knowledge is power. If you or your loved one has a serious disease, learn about it so you can have intelligent discussions with your doctors. Use the Internet as a resource, but read critically because there is a lot of junk medicine out there.
  • Enjoy life. You don’t know how much time you have. I don’t recommend becoming so obsessed with an imminent demise that you try to experience too much too fast, but neither should you endlessly defer the dreams that you have.
I'll conclude with T and S. Some patients receiving external radiation go every day at the same time of day for many consecutive weeks. I got familiar with fellow patients. T was an elderly gentleman with stomach cancer; he and I compared notes on business travels around the world. S was a five-year old with brain cancer; I tried to make him laugh and sometimes succeeded, even though we both felt miserable.

I don’t know, and I'll never know, what became of T and S. I’d like to believe they had as good an outcome as I did. Given their circumstances, though, I doubt that’s the case. But I think of them often, and I wonder.