When Your Doctor Says “Cancer”

About a month ago, I was diagnosed with low-grade prostate cancer. It was not discovered because of symptoms, but through a regular blood test during my annual physical exam. In fact, I feel great. Back in the summer, my annual physical showed a slightly elevated PSA, the common test for prostate cancer. My primary doctor referred me to a specialist at George Washington University Hospital. He repeated the PSA and since it came out the same, he did a biopsy. This revealed the low-grade cancer. At present, I am waiting for a genomic test to come back, then another test, then some kind of treatment. The initial treatment might be what they call “active surveillance.” A kind of careful watching.

When the doctor said “cancer,” it felt like the weather changed. I experienced a kind of super-focus. We were listening very carefully to him. He was clear and precise in his language. His manner was calming, which I’m sure helped. His knowledge and experience inspired confidence. Beforehand, I knew the meeting would reveal either no cancer, yes cancer, or yes pre-cancer. In the weeks before the meeting, I tried not to imagine its outcome. I tried to just rest in the waiting. But once I knew, my life changed. I knew it, immediately. What still seems strange to me, is that my life didn’t seem to have changed for the worse. I was fine. If anything, I was a little surprised that I didn’t flip out. But I didn’t. I was, and I remain, calm. Sometimes, I actually forget about it. In the midst of a  good day of teaching, during an invigorating trail run, it often leaves my mind. Then I have the odd, but not bad, experience  of remembering. I’ve said it aloud to myself a couple of times: “I have prostate cancer.” Then I go back to washing the dishes. How strange are the ways we adjust ourselves to new information.

One of my first thoughts was of gratitude. I am among the world’s most fortunate people. I have a good job that offers me decent health insurance. I live in a city that has some of the world’s best physicians. I will probably get the best guidance and care one could get. For this, I am deeply grateful.

Who knows how one’s life will unfold, but I think this is unlikely to be what takes me from this world. The diagnosis seems manageable. There seem to be many options. For that, I am grateful too. One lesson in this is the importance of getting an annual physical exam. I know everyone can’t afford this and we need to work to change that. My annual physical might be saving my life right now.

I have been drawn back into memories of my friend and mentor at Notre Dame, John Gerber. John lived for about a year after a diagnosis of liver cancer, a far more serious cancer than mine. I was privileged to walk with him through that year, until his death on Easter Sunday, 1995. I’ve recovered a letter he wrote to his friends before he died– his raw honesty, his quiet humor, his constant kindness to me. My diagnosis is nowhere as serious as his was. But it has been useful, even calming, to go back into my memories of his last months. I helped him move out of his chaplain’s apartment at Notre Dame’s O’Hara-Grace Apartments. I remember him laughing as we packed up a huge Mac desktop computer. He laughed that he was grateful to leave this world without having to learn how to use “that thing!” There was a small community of friends who stayed with him during his last days and I was grateful to be in that community. Those memories have been healing memories for me.

What does this diagnosis mean to me today? It means I want to write more poems, be a better husband, brother, uncle, and friend. But in truth, I always feel those urgencies. I will do my best to stay in this place of “active surveillance.” That’s not a bad way for anyone to live this life. Careful watching. I like the idea of making my own life a vigil.

I will occasionally use this space to write about this journey as it continues to unfold. But mostly, my life will go on much the same. I’m sending out a new manuscript, my American Literature students will end the semester becoming friends with Emily Dickinson and Paul Laurence Dunbar. I ran four miles this morning. I’m madly grateful for this sweet and ordinary life.

Photo: Boulder Bridge, Rock Creek Park, Washington, D.C. by J. Ross