Grief, Anger, and Coping With Loss

It was my six-month cancer call with the oncologist recently. Thankfully my bullet-dodging skills seem to be in good shape. Two years after completing 36 months of hormone therapy and nearly four years since my last ride in the radiotherapy donut, my PSA stands at 0.41.

Back in February it measured 0.23, so although it has nearly doubled, the figures are still small. With testosterone back in my system, and a welcome drop in side effects, this was to be expected.

So far so good, but if my PSA were to hit 2 then all kinds of alarm bells will start to sound. Obviously, things don’t always go right, which got me thinking about grief and loss and how we deal with those two tormentors.

What grief looks like

I’m guessing many people reading this will have heard the phrase or perhaps even used it themselves. It usually comes in the form of a question: “Is there anything I can do to help you get through this?”

Perhaps I need to back up a little. Some explanation is required. In Hollywood when a character is hit with a life-wrenching event such as the death of a friend or child, a certain amount of destruction seems to be required. Televisions will be smashed on to coffee tables and crockery swept to the floor. Good visual shorthand for grief and anger.

Perhaps it’s my staid middle-class upbringing, but in times of grief our glassware has little to fear as all the action takes place off stage in my head. The hurt and anger is internalized, which is not much use to a film director.

Read on…

Pausing or Quitting Prostate Cancer Treatment

How do you know when it might be right to pause your cancer treatment? And an even bigger question to follow: How do you know when it’s time to quit treatment altogether? Before I continue, let me just say for those whom this might concern, I’m not about to be packed off on a one-way trip to a hospice; well, not anytime soon, I hope.

Considering pausing treatment

Pausing cancer treatment has been on my mind. As of my writing this, there’s nothing to pause, as I’m currently not undergoing any therapy. Soon I’ll be having my next PSA test, which rolls around every six months. For around the last 18 months, my PSA has stood at a highly desirable 0.03 and long may it remain that way.

The reason mildly-anxious thoughts have been occupying my mind is that my last hormone injection was way back in August 2020, and little by little the side effects have started to depart. My interest in sex is back, the hot flashes have gone, and something like normal life is starting to return. And you know what? I like it!

Read on…

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.

Speak Up About Your Mental Health

By the time you read this, Movember will have been in the rear-view mirror. Did you grow a mustache to raise money to help beat prostate or testicular cancer? The focus on last Movember was not so much on physical ailments but rather on men’s mental health issues.

A whole slew of fellow correspondents wrote moving articles on this website about mental health issues. They took many themes, but if there was one overarching message, it was the importance of speaking up and telling people you have concerns about your mental health.

Difficulty talking about mental health

I’ve had various brushes with my mental health, which we will get to in a moment, but talking with my wife, she asked if my male friends and I ever discussed this topic among ourselves. She and her girlfriends regularly enquire and check up on each other’s health both mental and physical. I’m very open about my cancer, and my friends do ask me about it. But discussing our mental health is not high on the agenda when we get together.

Read on…