The Visitor

My six-year dance with cancer

An unwanted visitor showed up. I’d been expecting it. It was not a matter of whether it would drop in, but when.

For nearly two decades, every three months, I had made the solitary trek to visit Ed, my trusted urologist. Ed is a gentle, soft-spoken, relaxed physician. With traces of a European accent and at times sporting a full beard, if he were to gain some weight he would resemble a mall Santa.

Over the years we developed a friendly relationship; he’s an avid traveler so we often share stories of places we’ve visited. The medical reason for my initial visit to his office was a case of prostatitis — an inflammation of the prostate gland.

Prostatitis turned out to be a chronic condition that would disturb the rhythm of my pleasant life for many years. As part of his treatment regime, Ed began requesting regular PSA tests.

The test measures the level of Prostate-Specific Antigen (PSA) in the blood. PSA is a protein produced by cells of the prostate gland. Test results are reported as a number: nanograms of PSA per millimeter (ng/mL). There is no specific “normal” level of PSA, as many factors (prostatitis for example) can skew the number.

A result above 4.0 ng/mL, however, could lead a doctor to recommend a biopsy of the prostate gland to determine whether cancer cells are present.

To no one’s surprise, the result of my initial PSA test was well above 4.0.

Subsequent tests continued to show increasingly elevated levels of PSA. In order to confirm the suspicion that prostatitis was responsible for the high results, Ed requested a biopsy.

The procedure is rather unpleasant. Twelve 5mm tissue samples are taken, dried, re-hydrated with wax, thinly sliced, and then examined under a microscope.

The results came back negative. No cancer cells were present.

Over the years the bouts of prostatitis became less frequent and eventually disappeared. My PSA levels, however, continued to rise. Ed was puzzled.

Digital examinations of the prostate showed no abnormalities, yet the PSA numbers had climbed above 20.

Time passed. Four biopsies followed with negative results.

By the fall of 2014 my PSA level had reached 41.33.

Although my lovely wife had never gone with me to Ed’s office, I asked her to accompany me to find the results of the latest biopsy. A lunch date was to follow the appointment.

I walked into Ed’s office and he said “You want the good news or the bad news first?” With that sentence, he confirmed what I already knew. The visitor had arrived.

I fetched my wife from the waiting room because I knew that whatever Ed was about to say would make my head spin and turn my world upside down.

There was a good reason why this was my partner’s first visit to Ed’s office. I instinctively knew I would need some clarity. Four of the twelve samples taken from my prostate contained cancer cells.

Now, I’m not the first nor the last man to be diagnosed with prostate cancer. In Canada 23,300 men were diagnosed with the same condition in 2020. The tiny gland accounts for a quarter of all new cancer cases in men.

You know someone, or you know someone who knows someone affected by the illness. I know a good friend who has been cured and I have a relative who died of the disease. Those are wide goalposts.

Cancer is a difficult conversation. People reached out to me to give support, to share comforting stories, to let me know that they were there, to show their love. I know it’s a difficult, awkward, delicate, thorny subject; so if you’ve read this far, thanks.

I gained perspective on cancer from a dear old friend who, some years ago, was diagnosed with Waldenstrom macroglobulinemia, a rare form of blood cancer.

I traveled to visit him shortly after I received the news of his illness. I was not prepared for what I witnessed. His bright and soulful spirit encased in a shell ravaged by the disease.

Some years later he would return the favour. We sat in conversation after my diagnosis and he shared stories of his treatment, recovery, and the lessons learned from living with cancer.

The message that spoke to me was the idea that in order to live with cancer you have to develop a relationship with it. Understand it. Become his friend.

A position so diametrically opposed to conventional attitudes that it would take me months to fully realize its wisdom and to integrate it into my healing process.

So I decided to not fight cancer, battle cancer or f*ck cancer as popular wisdom dictates. Aggression breeds aggression. Battles and wars are for video games.

I allowed the unwanted visitor to linger, relax and become my friend. It returned the gesture. I lived with cancer for six years until my medical team said: “it’s time.”

I had successful robotic surgery to evict the visitor two years ago.

My PSA level is now 0.001.

Go ahead. Do a happy dance.