Kubler-Ross identified five stages that patients go through as they come to terms with their terminal illnesses. The stages—denial, anger, bargaining, depression, and acceptance.
The grief stages haven’t been linear for me. I’ve skipped around these stages and perhaps even skipped some.
At the time I was diagnosis, in December 2017, I thought I could deal with the disease without treatment.
I sought second opinions and researched studies to understand how the watch and wait criteria fit me.
I was more concerned with the potential side effects of getting treated than I was with the survival rates.
Most men fear prostate cancer treatment and the potential side effect of impedance or incontinence more than they fear death.
There have been improvements in treatment robot-assisted prostatectomy (robotic prostatectomy).
According to the American Cancer Society the 5-year relative survival rates of 95%.
During this procedure, a surgeon removes your prostate by guiding a robotic arm from behind a control panel. The robotic arm allows for greater precision than if they perform the surgery by hand.
Some newer techniques deliver higher doses of radiation in fewer treatments, reducing the overall treatment time.The sexual side effects are low, like what is experienced with more extended external radiation techniques.
I read every prostate cancer comparative outcome treatment study I could find. But I delayed my decision to have treatment as long as I could.
There was a lot of debate on the online support forums about treatment options. Those who had been treated advocated for the treatment they received and dismissed or negatively reacted to treatment questions that differed from their own treatment.
At the same time, I was angry that my family doctor had stopped testing my PSA in 2012.
The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine that had recommend that men not be annually screened with a PSA test. They were worried too many men with having their prostate removed based on the PSA results.
My family doctor resumed testing My PSA in December 2017. However, I had been taking a 5mg Finasteride pill since 2006 prescribed by my urologist to treat my symptoms of benign prostatic hyperplasia.
The drug lowers PSA level and my PSA level in 2012 of 2.5 should have been assumed to be double that level. By the time I was tested in 2017 my PSA was at 14 and with the Finasteride could be assumed to be 28.
Rates of PSA testing increased significantly after the USPSTF’s 2017 draft statement reversed the prior recommendation on prostate cancer screening.
There was a significant increase in advanced prostate cancer after the PSA testing resumed.
My research and online discussions were therapeutic and I finally accepted that I would ultimately need treatment.
Two large clinical trials for intermediate high risk prostate cancer showed long term survival benefits from six months of hormone therapy combined with radiation from 86% to 95% at five years.
My jump from the bargaining stage to acceptance of being treated took me nine months. My anger was still with me, but I couldn’t blame anyone. I just had to accept that I had cancer that needed to be treated.
Similarly, when I was diagnosis with chronic lymphocytic leukemia in 2021, my biggest fear has been starting treatment and how the side effects of that treatment impact my running.
Because I don’t need treatment now, I still worry how I will deal with it when I do need treatment.
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