“I have cancer,” was the title of my column last winter. It’s cancer of the prostate gland, an obscure, walnut-size gland in the male anatomy.

Prostate cancer is about as common as breast cancer. It’s a leading cancer killer among American men, second only to lung cancer.

It kills by spreading, typically to the bones, liver and lungs. Bones ache and break, the liver shuts down, and the lungs fill with fluid and blood.

If caught sufficiently early, however, the cancerous gland can be surgically removed in a five-hour operation. The anesthetized patient is strapped into an operating table 45 degrees upside down so that gravity pulls his guts away from the prostate gland deep in his lower abdomen. Half a dozen incisions are made across his middle. With the help of a computerized robot, the surgeon dodges intestines, nerves and blood vessels to access, cut free and extract the scoundrel.

The surgery often results in side effects such as incontinence and sexual dysfunction. An alternative treatment is to kill the gland with a radiation regimen, but that tends to produce the same side effects.

Another approach is to just carefully monitor the cancer. The growth of prostate cancer is usually (but not always) slow. Patients often live for years or even decades.

They call this “watch and wait.” What they’re watching and waiting for is to see if the cancer is spreading quickly enough to kill the man before something else does anyway.

Watch and wait didn’t fit my cancer profile. It was already Continue reading →