Active Surveillance Takeaways on My Prostaversary
Last updated: October 2021
About a year ago, my urologist told me those three little words: "You've got cancer." 2020 just didn't have enough issues for me, so I found something to do besides ZOOM calls.
What has happened since my diagnosis
So what has happened during the last 525,000 minutes? I was given three options: radiation, surgery, or see what happens. I have the handicap of being an engineer, and have an abiding love of cost-benefit analyses and decision algorithms. I've learned that if you study a problem long enough:
- Sometimes the problem goes away ("The Best Moves are the Ones You Don't Make"), or
- Sometimes you find the best you can do is exchange one problem for another ("The Law of Conservation of Aggravation"), or
- Sometimes the problem morphs into greater or more numerous problems ("Anything That Can Go Wrong, Will" - Edsel Murphy).
So it's not surprising I opted for active surveillance.
What active surveillance has been like
You get active in learning, and testing, and adjusting. It has meant second opinions, more imaging, more blood work, and an additional biopsy. It has meant long discussions with friends who have had success with a range of treatment options which my first urologist and first oncologist didn't mention to me.
It has meant webinars and books and videos. I’ve lost weight and exercise more because that’s something to do while waiting. I'm still pretty ignorant about things, just operating on a healthier level of ignorance.
When it comes to active surveillance:
- It's like owning a lottery ticket where you pay if your number gets called!
- Others may succeed or fail with their choices, but you are not obligated to choose the same course they followed. You are not guaranteed the same results they had, either.
- The man with one urologist always knows what his condition is, and the man with two urologists is never sure. Two doctors have at least three opinions, all of which are valid, like, "You're only a Gleason 6 ... your tumor looks to be very slow-growing ... you might want to get treated before it's too late ... your condition is practically medically irrelevant, so let's do a PSA every six months, even though the PSA is far from a perfect indicator ... let's do another biopsy in 18 months."
- Like Clint Eastwood in "Dirty Harry," your conscience continually asks you, "Do you feel lucky, punk?"
- As Winston Churchill said about democracy, active surveillance is the worst option until you compare it with all other options.
- Prostate-wise, maybe the best thing that can happen to me is to have more 2020s.
- Three old guys come to a park bench. The first one sits down and says, “Oy.” The second sits down and say says, “Yeesh.” The third one sits down and says, “Hey, didn’t we promise not to talk about prostates today?”
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