Remembering P.J. O’Rourke

P.J. O’Rourke, the writer and humorist has died aged 74. He styled himself as a Republican but was generally loved by all sides of the political divide as an hilarious curmudgeon. According to his publisher the cause of death was complications arising from lung cancer. So not prostate cancer but I think PJ showed us how to live in a dignified manner with this dreadful disease and be funny at the same time.

If you’re not familiar with his work, it was not all political. One of his first books ‘Modern Manners: An Etiquette Book for Rude People’ contains the quote ‘A hat should be taken off when you greet a lady and left off for the rest of your life. Nothing looks more stupid than a hat’. As someone who regularly wears a hat this always got a laugh from me.

Back in 2008 he announced he had contracted a very treatable form of anal cancer. In an article in the LA times titled ‘Give me liberty and give me death’ he wrote in typical PJ style: ‘I’m told I have a 95% chance of survival. Come to think of it, as a drinking, smoking, saturated-fat hound, my chance of survival has been improved by cancer’. He also wondered why God couldn’t have given him a more dignified form of the disease.

I had the good fortune to meet PJ in Somalia in 1993. The US had sent troops as part of a peacekeeping effort to help the war-torn country. Incessant warfare had led to the destruction of the agriculture system and there was widespread famine.

Initially the troops were welcomed by the locals, though that welcome didn’t last long as anyone who has seen the movie ‘Black Hawk Down’ will know. At the time I was working for ABC News and where the marines go, journalists are sure to follow. Around thirty of us lived in a walled villa on the outskirts of the capital, Mogadishu. This was to be the first of my three visits to the country and definitely the most pleasant.

PJ showed up soon after I arrived. He was writing for Rolling Stone and doing radio slots for ABC. He insisted on chewing the local drug Khat, a kind of natural amphetamine, while the rest of us were drinking whiskey. He was utterly charming, and I discovered he had a great love of poetry. This will sound incredibly pretentious, but I remember he and I quoting half-remembered verses from WH Auden and WB Yeats at each other. Anyway, don’t blame me, blame the whiskey.

He went on to write about Somalia saying: ‘Imagine a weight-loss program at the end of which, instead of better health, good looks, and hot romantic prospects, you die. Somalia had become just this kind of spa’.

Now PJ has died, and the world is a sadder much less funny place for it. Following his first cancer diagnosis he looked at the nature of death and his own mortality and had a parting thought: ‘Thus, the next time I glimpse death … well, I’m not going over and introducing myself. I’m not giving the grim reaper first daps. But I’ll remind myself to try, at least, to thank God for death. And then I’ll thank God, with all my heart, for whiskey’.

Cancer got him in the end, but he remained a man who lived and died with dignity and perhaps a glass of whiskey in his hand. RIP PJ.

Side Effects Sidelined

The treatment has stopped, now when are the side-effects going to quit?

It was a question I was constantly asking and now, as I have a little inside information, it’s a question people are starting to ask me. You may well recognize it: “When are the side effects going to stop?” “Side effects” is often preceded by a punchy Anglo-Saxon verb that’s unlikely to get past the diligent editors of this website. It’s often a heartfelt question, sometime almost a plea.

For the absence of doubt, the side effects I’m referring to are of course related to prostate cancer, which are brought on by the medical profession’s prodigious use of hormone and radiotherapy. As everyone reading this will know, they are used to shrink the tumors that may be lurking in our prostate and beyond.

Hormone therapy side effects

My experiences with these two regimes are clearly not as bad as some patients I’ve read about here and elsewhere. I’ve just dug out the paperwork I was handed prior to starting hormone therapy, and the potential side effects cover two pages of A4.

Read on…

Calling time

It’s annoying when they don’t call on time. Yesterday, at 4pm, I was expecting my six monthly check up call from the oncology department at Guys. A week ago, my blood had been drawn at the Cancer Centre to check my PSA level. Having been off any form of treatment for 18 months, was my PSA set to rise?

Following three years of hormone therapy and two months of radiotherapy my PSA had stood for more than a year at a highly acceptable 0.02. My prostate cancer was barely detectable. At 3.55 I was in a mildly anxious state waiting to find out my fate. By 4.40 no one had called so I took the dog out for a stroll to alleviate the stress.

Walking up the road, the phone goes, and I duck into a side road pulling Bucket after me to find out the latest instalment of Jim’s cancer capers. In short, the news is good. My PSA has increased, a small amount, and now stands at 0.23. The lady from the Cancer Centre described this figure as ‘magnificent’ which rather surprised me but hey, I now have magnificent cancer or rather lack of cancer. At diagnosis my PSA was 5.03.

This time they also measured my testosterone level which is not something I’d had done before. The hormone therapy reduces testosterone in men to something like zero which as you can imagine produces some irritating side effects. (hot flushes and loss of libido etc.) Testosterone is like catnip to cancer, hence the need to irradicate it for a while.

My testosterone level is now a plucky 18.6 which meant absolutely nothing to me until I learnt that in men the range is generally somewhere between 9 and 30. Of course I’ve no idea what my level was prior to my treatment but it seems to be in a relatively good place.

The brutal reality is that my PSA level will probably continue to rise, but it’s impossible to say how far and how fast. Once it hits 2.0 some of the dreary treatments may have to recommence but now, I have another six months until my next call and I’ll be putting cancer to the back of my mind. It’s something I’ve become rather good at. But next time Cancer Care at Guy’s, can you please respect the calling time.