My Cancer Year (with apologies to Harvey Pekar)
Two things happened one year ago today: 1) A urologist used what felt like a staple gun to biopsy my prostate gland; 2) A murderous mob treasonously stormed the US capitol. For me, the anniversary will forever be about violation. Two days later I received my diagnosis: “aggressive” prostate cancer, which I soon learned had spread to my bones.
Like so many others, a single phone call divided my life into a Before and an After. Before the call, I’d been cooking dinner four or five times a week and had just started publishing 250 words every day. All that came to a sudden halt. I didn’t publish a 250-word piece again until October, and only in the last few weeks have I cooked even the very occasional dinner.
My work developing Our Better Future took a turn — since many men with my same diagnosis live only 14 or 18 months, I decided my work could have the most impact if I focused on writing up my ideas as a book. And I did some work organizing and shaping some of my many hundreds of pages of material into book form.
Mostly, I lived life with my family, contended with being without a home of our own, and wrote occasional pieces on my cancer journey, and had cancer. At the beginning of November the immunotherapy Keytruda proved to have a dramatic positive effect which was confirmed in the middle of December. And now it’s now. We moved back into our home in October, more than two years after it caught fire. My birthday, the twins’ birthdays, Thanksgiving, Christmas, and New Years were all very well-celebrated since our move.
As I said, now it’s now.
I no longer have a very strong or particular sense of self. There was something simple about having a sense of self as a cancer patient. Compared with what many men go through, my symptoms and side-effects were essentially non-existent. Now that my treatment is working, I don’t really feel like a cancer patient any more. But after a year, I can’t quite find my previous sense of self.
I’m endeavoring to embrace my current weak sense of identity as I endeavored to embrace my previous cancer patient identity. Maybe, after so many months of confronting the possibility of imminent mortality, this is a kind of mini-satori. Maybe it’s a time of recalibration, of setting new goals and priorities.
It’s strange to experience the complete removal of testosterone from my system, and with it, the cessation of libido. It’s peaceful here; and it’s extraordinary to see how much of my sense of self since the onset of puberty had been created / mediated / guided by the concentration of a hormone in my bloodstream. And the sense of self of nearly all other male human beings. Brings up some profound questions.
There’s been a kind of paralyzed panic that I wouldn’t live long enough to accomplish even my modified life-goals. Now that the deadline has been eased, that sense of ineffective panic has begun to diminish.
I’ve learned a lot. I learned that I’d somehow acquired a mutation in my process of Mismatch Repair function during DNA replication. This mutation meant that if I lived long enough it was far more likely (inevitable?) that I’d develop prostate cancer. From my first inkling of understanding of this I’ve been increasingly in awe. The body, all bodies, are profoundly amazing. All life has this correction capability. It has to. Otherwise cellular replication would become a disease-filled mess. It’s obvious once you think about it, and no less miraculous for being obvious. And it’s lucky I have the mutation, because Keytruda only works for such cancers, and additionally lucky because it only works for half of them.
Healthy cells and tumor cells are staggeringly complex and amazing. I am so grateful to have months and years ahead of me (however many) because tens of thousands of microbiologists, doctors, geneticists, researchers, nurses, ethnobotanists, patients and so many others have devoted so many millions of person-hours over the course of decades toward understanding the cellular mechanisms involved and trying countless approaches to alter the course of cellular replication gone terribly wrong. And that every single person who walks through an oncologist’s door lives in a body compounded of trillions of cells, most of them functioning flawlessly as they have for years, and some of them slipped into pathology that will bring the whole biological enterprise to a crashing and terrible end unless there’s an exquisitely targeted intervention. And the fruits of all that labor is available to me, and any other schmo who manages to come through the door. (And I’m still haunted by the tens of thousands of men suffering from similar disease who aren’t afforded the privilege of treatment.)
And this anniversary is an excellent time to express once again my deep gratitude to all the health care professionals who have delivered care to me in particular, and everyone among my family, friends, and the hundreds of people who have offered to me our mine love, support, prayers, and a wide variety of positive juju. Thank you from the bottom of all my cells. Love you.
Meditate on these images — the most detailed illustration of the cellular landscape ever created (stitched together from a variety of imaging techniques), and a schematic representation of how the immune system can be encouraged to confront tumor cells. Somewhere on that chart is the mechanism by which my treatment works.
I am grateful and humbled to be given this second chance to revel in the ecstatic cellular life of a human on earth, and I’m filled with curiosity and optimism to see what I might do with my extra months and years of health and lucidity. And so, Happy New Year to me. And Happy New Year to all of us, every one.