How to Keep from Driving Yourself Crazy: 1st Part Getting Over Denial

Welcome Richard, I am looking forward to your contributions and wish you the best with your treatment.

No denial for me, it was never an issue. My wife had just had a double masectomy (her second breast cancer in 15 years) and said to me "it has been two years, go get a physical". So I did, and was handed a PSA of 59. It doesn't take much high level research to know that is a problem. Within two weeks I had the urologist DRE (felt a nodule, gp didn't), a biopsy, a diagnosis, and had made at least three appointments for additional opinions.

Since my wife was going through something far more surgically invasive then I probably would and her chemo and radiation was already scheduled; and since my PSA was not even something to discuss... I took it very matter-of-factly and said "it is what it is. Now let's get on with beating it." No denial.

My unprofessional advice as to the denial is to be matter of fact....not matter of feeling, or wonderiing, or wishing or hoping.

Of the men I know that have gone through this the ones that moved most decisiveily and quickly were men that had military traing and service. They seemed to see it in the overall scheme and were taught early on to make a factual assessment and then determine the best course of action to stay alive. I think that attitude is waranted whether it is bullets or PCa that is flying.

I did not have such training or service, but my circumstances were that it was about my wife....not about me. If she could be doing what she was doing....who was I to be in denial??

Richard, I applaud your addition to the site and no doubt will help many men with the denial that affects some but not all. I will be very interested in your views as to working through the potentially serious effects of Hormone Therapy as so many men become very depressed. This is my personal concern as I expect to be on HT for at least another year.

Welcome aboard and it is good to see your progress. Our dx and treatment timeline is very similar.

Richard - this was, of course, not the subject of your post, but I will ask you anyway, if you don't mind:  how did you come to the decision to be treated with seeds (as opposed to some other treatment such as proton, IMRT, surgery, etc.).  I am particularly interested in your decision making because your signature shows that you have some pretty high-end medical advisors (Strum, Bonkoff, Grimm, Duke Bahn...   (By the way, is Dr. Strum still practicing medicine, or  has he retired?)

I have to say I've never seen denial being a big issue here or with anyone I know who has PCa. Anger sure but not denial

Post Edited (Ziggy9) : 4/4/2011 11:52:27 AM (GMT-6)

Richard,
Thanks for posting your personal experience with PCa. I'm looking forward to your future posts on the subject.
For me, denial was not an issue at all. My GP suggested that I see a urologist due to an increase in my PSA from one year to the next. I immediately schedule an appointment with a Urologist, had another PSA and free PSA test. The result was not encouraging. I scheduled a biopsy shortly after and surgery 6 weeks after the biopsy result showe that I had an aggressive Gleason 8 PCa.

Thanks JNF, David, Zig, Tud, Ed Mel and Joel et al-- all you guys for the warm welcome. I think denial was pretty minimal for you. Denial literally means turning off the awareness of truth in one's own mind. You have obviously faced the truth and taken action. Lets go on to the 2nd Stage since thats the way my organized psychologist/ writer brain works.

2. Reacting and Overreacting. I was every frightened by the diagnosis and wanted to take action (I was an Army and Naval Officer (psych) I became obsessed with knowing everything about PC and with in one week post diagnosis attended the PCRI meeting at LAX. It freaked me out at first and I came home crying the first day but I meet a ton of good guys who were recovering as well as their docs: Strum, Scholz, Myers etc. But I was overwhelmed and wanted to make a decision quickly even though everyone around me told me to totally slow down until I could make an informed decision. I realized I actually knew very little. I went to USC Norris and saw a surgeon and he said "You are the perfect candidate" but I kept hearing about BT. My buddy had it 10 years ago with Gl 7 4+3 a little more aggressive than mine. He also had EBRT and ADT. But he was there for me and kept feeding me info, support groups and on line sites. I realized I needed someone not so invested in the decision and I found Strum's number in Oregon thinking I would set up an appt with him to discuss options. To my surprise he came on the phone and spent an hour with me. I hired him to advise. Now I calmed down a bit. I had to take in the truth that PC is the least aggressive of the cancers that most men get and is totally treatable and yet it can be deadly if it gets out of control outside the prostate. Strum suggested extensive testing, supplements to improve my immunte system and worked to empower me by not telling me what to do but laying out several options. One was a trial of ADT as a possible long term treatment with the goal of 5-10 years of psa nadir. I tried it and hated the sexual and emotional sideeffects of Lupron.

JNF: I get your concern about being on HT for a year. That was my concern but I was willing to at least try it knowing with my intermedidate level of disease and no obvious sign (endorectal MRI) of ECE's or seminal vesicle involvement. Unfortunately for me I tried it and my quality of life went into the crapter. I was crying twice a day and erupting in rage at the wrong times in addition to being a eunoch (though that only happend for maybe six weeks). Strum had me on Cialis and dostinex and I could masterbate and have orgasm for the first 6 weeks of it but not much desire to even try. But Strum tells me my reaction was more extreme than the vast majority of guys to ADT long term. My buddy who had seeds and ADT 10 years ago got depressed but says he would do it again. Another worry I had was John Mulhall's warning about ADT last longer than 4 months possibly doing lasting harm to the penis. But I dont think there are good studies and I of course have no personal experience with it.

Everyone reacts to the diagnosis. Some of us overreact and make impulsvie decisions. The trick is not to go back to a different kind of denial-- where we pretend we are not afraid or we pretend that we quickly know what to do or we pretend that getting this over with as soon as possible is a good idea. It helps to acknowledge what you are feeling and thinking-- even the nutty crap that goes through our minds-- and reason it out with someone we trust. Some times we get really nutty (meaning me) and need help from a psych or we need to take a med that helps us calm down or be less depressed or help us sleep. It also helps to learn ways of managing the stress of it all. Exercize made a major difference in how I felt-- elevated mood. But we will talk more about that in the next installment.

Keep chiming in guys. I hope I responded to the comments you have made.
Best wishes
Richard

Good post Richard and welcome aboard. Denial is one of those sneaky things that can be lying in the bushes and you never see it. I probably had it, but really cant recall. Shed a tear or two when I called my wife with the news as I just knew that I wouldnt have cancer. So that was the point of "why me." Once it sank in then I began to educate myself about PCa and it eventually lead me to this site. But I really have to say that my treatment choice was made from reading books and listening to friends who had PCa. Military thinking is usually black and white, but there is so much gray matter in this disease that hopefully one can think outside of the box and look at all options. When I had  the BCR once again I couldnt imagine the reality of the news as my thought process was that, I can beat anything. Will deal with HT if need be, but not something that I look forward to.

Michael

Michael and Mel
To show how really new I am at this despite the hours and hours of research, I had to google what BCR is: biochemical cancer reocurrence. When I heard, my heart sank because of course I have the fear of the same thing-- and you guys are now experiencing it. I hope you will talk about what you are going through in depth if you want to. Im no longer in practice as a psychologist so I am not a therapist in any way but I can be a fellow PC guy and a friend and maybe deal with my own fears at the same time. As I was weighing treatment strategies during my reaction phase to the diagnosis, I began the process of accepting that I might have a life threatening disease. This meant dealing with my own death which I did not want to deal with at all-- who does. But lets face it most of us are over 60 so even before my PC diagnosis I was fully aware that my life was a lot more than half over and that I was headed down the slippery slope of the other side of life. But then PC made me truly start to think about what I would want to have happen if I knew it was coming soon. It helped me a lot with my fear of dying or being sick and in pain, that I met a guy at a prostate support group who had been a Navy pilot during the Viet Nam war (the same time I was stationed in hospitals here in the US) He has metastatic prostate cancer and is in his 70's. When I met him he looked 50 because he takes care of himself and is living his life to the fullest. He keeps his med records meticulously, he becomes a expert on new and old therapies and he makes it his business to help other guys. He seemed content even happy though I am sure he has his days. We had both spent a lot of time (not at the same time) in Pattaya, Thailand carousing in our past so we had a lot in common. He told me what it was like to be on ADT with humor and accuracy and listened to my goals and helped me sift through the info. Knowing my stage and wishes to stay sexually active he definitely discouraged RP and of course wondered outloud how I would like ADT but more than that he gave me a model for what I could be like if the worst happens. My Partin says its 30-40% chance of being ECE, sem ves or lymph nodes but the extensive testing by Strum makes that number likely much smaller -----nevertheless--it could happen and I accept that. If it happens, I suspect I will be down for the count for awhile. Yet what I learned from my pilot friend is that I would live my life to the fullest no matter what and that I will live my life to fullest now whether I am cured or not. What we all have is right now. It is the only time and place we can be happy or miserable. The past is over and the future does not exist. When I am in the eternal now of my life I am usually very happy. Sometimes the now is painful but it is usually because I have tried to bring the past or the future into the now--- and it ruins the moment or at least distracts me from the gifts of the everyday: my papyrus plants going crazy with life in my yard, my Cavalier Spaniel laying her head on my lap and rolling those big eyes at me, my partner holding me in the night and whispering that he loves me, one of my 11 grand children visiting and running screaming through the house chasing the dog. And writing this to you now-- what a joy!
Richard

the mental aspect of the entire process/disease are a challenge to control/master. I look forward to hearing what I am sure will be good news for you in a couple of days. Some of us will always be anxious, I'm surprised I didn't get full blown anxiety attacks from this whole thing.