It’s Prostate Cancer Stage 4

Nicholas Poussin, Blind Orion in Search of the Rising Sun

That’s the diagnosis by the Queen Mary team. It adds no tragedy to Dr Jamieson’s 25 May diagnosis of a “metastasizing adenocarcinoma” nor Dr Lau’s confirmation of that at QMH on 1 June. A Stage 4 prostate cancer is a metastasis. The only difference in my case is that so far we have not found the original prostate tumor, and prostate is inferred from my sky high PSA (Prostrate Specific Antigen) levels (80, should be 4).

The diagnosis is unconfirmed by any sort of “smoking gun” but we need an action plan and the sky high PSAs mean we need to assume that it’s a prostate and get started on minimizing malignancy based on that diagnosis (malignancy cannot be eliminated almost by definition).

Stage 4 is associated in an old fashioned Bette Davis Dark Victory way with remaining lifespan estimates but these are almost without meaning as probabilities. The reason they are without meaning is that today, more so than in the 1940s, patients are exceeding the number owing to rapid changes (all for the better) in medical science. And, there are statistical anomalies where a subset of patients does not respond well to treatment and their lifespan is shortened.

This, and because my spiritual plan is based on the one day at a time deal, means that I shall simply ignore the lifespan numbers. The doc did say, if you meant to do something do it, but as it happens what I meant to do was on my list before this debacle. I have as it happens been following my dream for many years and not living a phony life. The end of the rainbow, les foullis d’arcs en ciel pour l’ange qui announce la fin du temps, might be Queen Mary and there are far worse places to wind up.

The diagnosis presented so well by Dr Jamieson on 25 May is the fact, the weenie, the wall, wondrous high: from the old English poem the Wanderer:

weal wundrum heah,
(a wall, wondrous high,)
wyrmlicum fah.
(wound round with serpents.)

It is the same wall, and the good news (and there is good news) is that the initial therapy is hormonal and not chemo: basically my testosterone has to be lowered and my estrogen increased. This would be a big deal if I were some young stud but as it happens I have two children and (through “God’s Grace Abounding”) two grandchildren circulating in a womb in Chicago, eyes opening to the dim light of the maternal ocean. As far as I am concerned, I will turn into an old lady like Guan Yin if that is what is necessary to survive.

For I want to survive. The Me part of me could care less and only asks to drift away without pain in terminal dreamland. But the We part of me says two things.

First of all it says that this is very interesting and I want to see how it plays out for somewhat the same reason I watch the credits at the end of movies.

Second it says that I have been given so much and would like to return the favor through art that heals and eleemosynary actions, even if the latter are merely teaching jobs at a pay that’s so low it makes it somewhat eleemosynary.

More good news is that I am now free, as of a week, from my nicotine addiction that started in the Chicago and Northwestern Station in 1966 when, burning with shame and exhausted because I could not figure out how to hold a minimum wage job, I bought King Edward cigars. I’ve been on Nicorette for seven years but last week I just stopped. And I have had no withdrawal symptoms.

ne sceal næfre his torn to rycene
(a warrior must never speak)
beorn of his breostum acyþan,
(his grief of his breast too quickly)
nemþe he ær þa bote cunne,
(unless he already knows the remedy) –
eorl mid elne gefremman.
(a hero must act with courage.)

Source for the Wanderer is here. I read it the first time years before the Internet.

My father never liked my sang-froid. Perhaps he saw too much in the war, too much sang-froid that ended up with men falling from planes. Perhaps he thought my sang-froid was associated with my apparent fecklessness, a fecklessness that is exaggerated in a family like mine for in fact I took care of business.

In the 1990s, I was between jobs and was looking for one. After my cheerful status report to Dad, he grumped that I was “whistling in a graveyard”.

I mean, give me a break. Unemployment isn’t a graveyard, Pop.

But I have to hand it to my father. I’d just started running in 1981 and met him at a bar on the near north side. I was slim and had a killer suit and tie, grey flannel and rep. Children of the Depression, and my father was one, loved this look for to them it meant survival. In Shanghai of the time, it was the New Thought look.

My Father said, “you’re looking well, Edward. Quite well, in fact. In fact…you remind me of my older brother Edward.” Now, his older brother Edward (o anima cortese Mantoana) was a war hero and his accolade was undeserved. But I’ve never forgotten it.

Spinoza’s definition of sanity might be: I cannot hate God and God, if God exists, does not hate me. My spiritual program is about a Power greater than myself who restored me to sanity more or less in the course of going about that Power’s business. A loving God in fact raises all sorts of problems such as conditional love based on rule-following. But Yosemite was too silent to be real, and lofty, and there I was happy.

In his creaky deductive psychology, Spinoza’s gratitude was a zeal arising from love of him or It that has benefited us. But Spinoza doesn’t say what I would say in addition. Gratitude is itself a pleasurable emotion as we think happy thoughts about what has happened in our life that is blessed.

Foolish individuals mocked “philosophy majors” at fourth rate universities in the 1970s. As it happens I find it useful to have majored in philosophy.

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One Response to “It’s Prostate Cancer Stage 4”

  1. Wow. Thank you for sharing. We will keep you in our thoughts and prayers.

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