Take it like a man.
Funny, but those are the words that keep running through my mind as I listen to Seattle urologist Dr. Christopher Porter tell me over the telephone that I have prostate cancer. Ever since my first elevated PSA blood test months ago and a second one more recently, I have been preparing for this news, steeling myself against gasping or yelping or any other unmanly response.
“It’s a good thing we did the biopsy, Mr. Stuckey,” Porter says as my eyes wander over snapshots on my desk of kids, friends and past adventures, knowing exactly what is coming next. “The bad news is that the cancer is there.”
Determined to be the cool journalist and reveal no emotion, I ask questions calmly and deliberately and take notes as if I were covering a story.
“The big picture here is that the cure rate is fantastic,” Porter continues. We make plans to discuss treatment options — and, I imagine, the death of my sex life — the following week and hang up.
Alone in my small, windowless office, I lean back in my chair and wait for the news to sink in and whack me like I think it should. But nothing comes. No anger, no tears, no hot rush of blood to my face, no tightening in my chest. I feel a bit tired and oddly empty. I begin to worry that I’m in some kind of weird denial. This take-it-like-a-man thing seems to be working too well. Dude! You have cancer!
In fairness, I have read ahead. Now that I have the biopsy results, I know there is nothing particularly special about my case. About 230,000 American men will learn they have prostate cancer this year; 27,000 will die from it, making it the second most deadly cancer for men after lung cancer.
I have a typical case of prostate cancer, caught early these days thanks to widespread PSA testing, which measures prostate specific antigen, a protein produced by the prostate gland. Only the fairly young age at which I find myself in this spot, 49, is a bit unusual.
Rub a little dirt on it
From all that I have read, odds are pretty good that the cancer is confined to the prostate gland itself. Porter is right: My chances for a cure via several options are excellent — up to 94 percent.
In his words, “We just need to figure out what we’re going to do.” Yep, rub a little dirt on it. Piece of cake, can of corn.
I call friends and family and find myself reassuring some of them that this isn’t much to worry about. “It’ll be a pain in the ass to deal with,” I tell my dad, “but I’m not planning on dying from it.” I tell my two sons, both college students, the same thing.
Later that night, the ceiling closes in. Lying in bed, I reconsider a couple of statistics. A 94 percent cure rate is great, but what about those other poor bastards? What if I’m one of them? Suddenly, my future seems to lurch toward disaster because, pre-biopsy, Porter had estimated the chances that I actually had cancer at just 20 percent. If I was in the two out of 10 category, I can just as easily be in the six out of 100 group!
Random thoughts and images roam my mind: the unfinished house I am rebuilding, my unfinished will, the fact that I have never owned a 1965 Mustang or set foot in Europe, my desire to hold my own grandchild in my arms. “Drama king!” I snap at myself. From the stage I’m at, prostate cancer would normally take years to become fatal.
As I comfort myself with visions of what an uproariously self-indulgent time I will be entitled to have in those final years, I realize that my mental meandering about the death issue has clouded a much more immediate concern.
While the main treatment options of radiation and surgery are quite effective at eliminating cancer, about half the time they also can eliminate a man’s ability to have sex. Most guys who have surgery and some who have radiation treatment struggle to regain the ability to hold their pee and about 5 percent never get it back. In the very worst cases, either treatment can even turn taking a dump into a nightmare.
In the darkness, I clutch my crotch and clench my eyes as I try to force visions of diapers, penis pumps and colostomy bags from my brain. Take that like a man.
So this is where the rubber really meets the road. I am a man. I love sex and I want to have it for years. I love peeing when I want, in a toilet or on a tree, and I don’t want it dribbling down my leg at other times. The pooping thing — I can’t even go there.
Intellectually, of course, I know there’s a lot more to manhood than the ability to sport wood and shoot a strong stream of piss, but fear and dread are not emotions that spring from rational thought.
I see you, fear
For the next few days, I maintain my upbeat outward demeanor. Inside, uncertainty bats at me like a cat with a toy. I even suffer a fair amount of shame for thinking that I am greedy to not only want to stay alive, but also to continue to have sex and be “dry,” in the jargon of urologists. My thoughts bog down and I find it hard to move forward in considering treatment options.
A previously planned mountaineering trip looms on the calendar and I tell my partner that I am unsure if I can make it. The excuses flow. I haven’t trained, I haven’t checked the gear, we have no trailhead accommodations, I don’t deserve it. Worst of all, I am afraid that if I try to climb this peak and fail, it will be some kind of grim curse on the coming battle.
Kindly, calmly, wisely, she tells me that she’ll handle the logistics. “All you have to do is climb the mountain, and I have absolutely no doubts that you can do it.”
Previous encounters with fear have set me up pretty well for some of what I’m going through. Another wise friend taught me that simply acknowledging fear, recognizing that I am afraid, is a great start. From her, I learned to say, “Hell-oooo, fear! I see you! How ya doin’?”
And I imagine that it is an object somewhere in my head, a smooth, three-dimensional stone that I can send my little remote-controlled mental cameras around from all angles. And I study it. And that’s it. This doesn’t make the fear go away, but it lets me accept it, it lets me know it. And this is calming, which is way better than the throat-gripping, mind-racing, ear-ringing alternative.
“Hell-oooo, fear!” I say, and pack my gear.
A week to the day after my diagnosis, I find myself struggling up the slopes of Oregon’s Mount Hood. It’s a crisp morning in early May. Drifting cirrus clouds glow tepidly above the peak in the mounting dawn. I follow in my partner’s steps, imagining that she is my doctor and her boots are stomping on my cancer cells, her crampons ripping them from the healthy tissue and grinding them deep below the surface of clean crunchy snow.
The final chute is treacherously icy and fear wells up high in my chest as I carefully plant my ice ax, knowing that a slip here could easily be fatal. But we also need to move as briskly and decisively as we can, to get out from under the overhanging cornices and away from a potential traffic jam of other climbers.
“Hell-oooo, fear,” I whisper.
We clear the chute and trudge up one last slope to the 11,249-foot summit and the sunrise. It is breathtaking. The emotions of the last seven days roll over me all at once. Behind my sunglasses, I cry and cry, fat manly tears rolling down my cheeks until I taste the salt.
MSNBC.com writer Mike Stuckey was diagnosed with prostate cancer in April. He will chronicle his battle in "Low Blow," a series appearing every other Wednesday. In the next installment, Mike checks out his options and wrestles with their consequences.