Finding Out

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Why Me?

Prostate cancer is usually a slow-growing cancer and, if caught at an early stage, can be cured. With all the advanced technologies that today allow for early detection and successful new treatments now available for prostate cancer, the disease can often be controlled for years and can even be cured.

The exact causes of prostate cancer are still unknown. Some research seems to indicate that certain factors may put men at a higher risk for developing it: being over the age of fifty (the risk increases with aging), having fathers or brothers who have had prostate cancer, being of African-Canadian ancestry, and habitually consuming a diet high in animal fat.

The diagnosis of prostate cancer is a stressful event which often creates feelings of helplessness, hopelessness and uncertainty about the future. It can provoke important psychological and emotional reactions – worries, fears, isolation and a feeling of loss of control over one’s life.

One may experience some of these feelings even before the actual diagnosis. Elevated PSA reading, scheduled biopsies, the waiting until a possible eventual diagnosis of prostate cancer are all events that can be psychologically devastating.

Since childhood, we have seen or known people who have died of cancer – a dreadful disease that is too often perceived as one accompanied by pain, suffering and death. We often think, and always hope, that cancer will not hit home, but unfortunately sometimes it does. And when it does, it not only affects the patient but also his whole family.

When a man learns that he has prostate cancer, he may be too numb to actually register anything else than the word “cancer.” He may then start questioning himself. “Why me?” “What did I do wrong for this to happen to me?” “This is not fair!” As a consequence of this guilt, anger may result. All the unknowns about the disease, the treatments, the temporary changes of roles at home and what the future will bring can be very frightening.

In reality, being diagnosed with prostate cancer is no one’s fault. Thinking that one is alone, not knowing who to turn to, what the resources are, and not wanting to burden anyone can make one feel really isolated. In reality you are not alone. It is estimated that this year, 26,500 Canadians will be diagnosed with prostate cancer. One in every seven men will be diagnosed with prostate cancer at some point in their lives.

Educating yourself is a good starting point. It may help decrease some of the anxieties created by this new diagnosis and help you regain some control over your life. It may also facilitate any decisions that need to be made regarding this new crisis. There are medical and support resources available to help you move forward. We encourage you to read through this web site and become an informed partner with your healthcare professionals concerning your treatment plan.


Sharing the News with Family and Friends

No one should attempt to go through a major crisis like cancer alone. Support is available all around you. After the initial shock, one may wonder: Who do I tell? How much should I tell? When should I tell them? And how will people react? A wide range of emotions are created in the wake of the initial shock of the diagnosis. You may undergo a variety of mood swings, ranging through denial, fear, depression and anger, and can temporarily seem to alter your personality. To those people close to you and who know you well, these changes may become noticeable and may indicate that something is wrong. People will learn about your diagnosis sooner or later; in many cases, it is better that they hear it from you.

You will eventually find the inner strength and the right timing to share the news. You will make the choice as to who you tell within your family and/or your closest friends. Most people agree that even children should know, even though the instinct may be to shield them from this fact. They too can perceive when something is wrong. How much you tell others will depend on the age and emotional maturity of the individual, and on your own comfort level.

People will react differently to the news. Don’t be upset if they don’t respond right away. They may require different amounts of time to adjust but, by talking about it, you allow communication to take place. This gives everyone an opportunity to share feelings, provide reassurance and to support each other. In time, most people will find their own way of adequately dealing with this new stressful event.


Coping with Your Feelings

Reactions such as shock, disbelief, anger, fear and denial are all normal responses to a life-threatening disease. They can impede your quality of life and must be addressed so that you can move forward. The more you try to ignore these fears, the more they will grow and consume energy that should be used to fight your cancer.

We know that everyone is unique and has different ways of coping with stressful situations. Coming to terms with the reality of prostate cancer is an important first step in planning how to face the new challenges brought on by your situation.

Here is a list of coping strategies to help you deal with your prostate cancer :

  • Express your emotions.
  • Reach out for support: family members, close friends and/or support resources are there to help.
  • Educate yourself on prostate cancer, its treatments and side effects: this will help you take an active part in the decision-making process about your illness.
  • Don’t be afraid to ask your doctor questions.
  • Maintain your self-esteem by living one day at a time, sustaining a positive attitude and finding optimistic meanings and realistic goals that will fulfill your life.
  • Keep in touch with your spiritual beliefs and come to terms with your mortality.

Understanding Your Options

Talking To Your Doctor

People recently diagnosed with prostate cancer experience heightened levels of stress and anxiety, which can interfere with the ability to process information. This makes it very difficult to make informed decisions, especially when they are some of the most important ones you can make in life. That is why the relationship between doctor and patient becomes crucial – it should be based on open communication and trust. Your doctor should see you as a human being with psychological, psychosocial, emotional and cultural needs in addition to medical treatments. You must work as a team to treat the cancer most effectively.

Here are a few points to make your visit at your doctor as efficient as possible:

  • Don’t be afraid to ask questions about your disease, its treatments and side effects.
  • Keep a running list of your questions as they come to mind.
  • Take a relative or a friend with you.
  • If your doctor is giving you too much information at one time, let him or her know. There is nothing wrong with indicating how much you can absorb at one visit.

Here are some questions you may want to ask your urologist, radiation oncologist or medical oncologist. They are classified into different sections to meet your needs:

General Questions

  • When is prostate cancer curable?
  • Is the cancer confined to the prostate?
  • What are the treatment options available for me?
  • Which one will give me the best chance of survival without interfering too much with my quality of life? (Specify to your specialist what you mean by quality of life, for example: is preserving your erectile function or your bladder control important to you?)

Observation (Watchful Waiting)

  • Is watchful waiting an alternative for me? Why? Why not?

Radical Prostatectomy

  • Is a radical prostatectomy an alternative for me? Why? Why not? What are its side effects?
  • If a radical prostatectomy is indicated to treat my cancer, should it be done by a retropubic approach or by laparoscopy? Why?
  • What is the likelihood that I will lose control of my bladder if I undergo a radical prostatectomy? Are there any exercises or therapy I can do to prevent this side effect?
  • What is the likelihood that I will experience problems obtaining or maintaining an erection if I undergo a radical prostatectomy?

Radiation Therapy / Brachytherapy

  • Is radiation therapy an alternative for me? Why? Why not? What are its side effects?
  • Could brachytherapy be an option to treat my cancer? Why? Why not? What are its side effects?

Hormonal Therapy

  • Is hormonal therapy an alternative for me? Why? Why not? What can I expect as side effects?

Chemotherapy

  • Is prostate cancer chemotherapy very toxic?
  • How effective is chemotherapy to treat prostate cancer?

Palliative Care

  • If the prostate cancer is not responding anymore to the available treatment options, what is next in store for me?

It is important for you to have enough information to understand what is going on. This will help you feel more in control of your life and will make decision-making easier. If you don’t feel at ease with your doctor for any reason, you should ask for a second opinion. By doing so you are not questioning his or her competency. Certain elements in the doctor-patient relationship might influence you to consider taking this action. Ask yourself the following questions:

  • Does my doctor spend enough time with me?
  • Are my questions being answered?
  • Is the language my doctor uses clear, or is it too medical or technical?
  • Is there a language barrier?
  • Does my doctor practice too far away from my home?

Perhaps you and your family members simply need more reassurance about the possible treatment options and what would be the best approach to treat your cancer.

Seeking a second opinion is a perfectly acceptable action to take if you feel the need. Just let your urologist know – he or she may even suggest someone or give you information on how to get a copy of your chart.