The Uneasy Grace of Healing: Reflections on a Decade with Cancer

This is the tenth anniversary of my diagnosis with prostate cancer. I suppose the more clickable way to express that thought is that ten years ago, I began my journey as a prostate cancer survivor. Except it was not a journey, nor am I a survivor; both descriptors suggest an “otherness” that I resist.

There is undeniably a threshold between being at ease and being dis-eased; more so, when your whole life has been as a physician rather than patient. However, describing crossing that threshold as a journey gives it an underlying “holidayness,” a separation from your everyday life. For myself, and I suspect this is true for others, there is never really remission; there is always a nagging whisper that the pain in your knee may be more from a met than a sprain. The diagnosis and care of my prostate cancer ushered in a new normal; that putative journey would leave me a different person. You never go back, truly, to that earlier state of ease.

To be fair, at least for me, a part of that permanent transition is heightened by the turning of the tables, actually, the desk, as I moved from objective, powerful, certain physician to subjective, powerless, uncertain patient. My goal remained clear: to eradicate my cancer; however, suddenly, the best path forward was less clear. My objective self knew that the difference between 2 or 3% was random; my subjective self was looking for any advantage I could find. 

My informed consent was as equal a shared decision might be, after all, I was a physician just like those advising me. But I remained powerless, not so much from the process of deciding, but the aftermath of treatment. When formerly, as a member of the health system I could pick up a phone and speak to a human rather than a telephone chain, I was now a patient, no longer entitled to “Press 2 if this is a doctor or a doctor’s office.” (Yes, I still pressed 2 when the other options lead me to the moat established to prevent human-to-human contact). I had no juice, and I found myself increasingly in the queue. 

It has taken me years to accept that change. Early on, I thrashed about. Not in an offensive, I know better, way, but in a quieter insistence on choosing my own adventure, deferred to by my physicians when they might have been more adamant. “It’s up to you to decide.” Abandoning advocacy is not shared decision-making. All that sturm und drang was about control —a critical need for a surgeon or one with a surgical “personality.” As I learned that a call for help was not a sign of weakness, that allowing others to care for me was not so much a loss of control, but an issue of faith and trust, I leaned a bit into being a patient. I learned to recognize, if not control, when I started to “help,” so I could be helped. 

I resist the term survivor. For me, its emotional gist is more pejorative than affirmative. It was intended to shift the narrative away from victimhood and toward empowerment. But prostate cancer leaves me less empowered. My successful care, at this juncture, has turned a lethal disease into a chronic illness. Survivor implies that the uncertainty I occasionally feel is unwarranted; it erases the mark my dis-ease has left on me. 

Alternatively, I might choose warrior, a mainstream cancer as a battle metaphor, whose origins ironically go back to World War I. Warrior implies courage, endurance, and agency. To be real, I have endurance, agency, not so much. And as to courage, I am not sure that was ever at play. The choices I made allowed me to live as best I can in the face of uncertainty, a choice based on hope, habit, and obligation. 

I might also consider a more neutral term, an individual experiencing cancer – how zen; or a person living with cancer. I prefer to be known as Chuck, my way of acknowledging that cancer remains with me despite all the objective tests, and there have been many, that demonstrate its absence. Most days, it lives quietly, silently, below the level of conscious concern; on other days, it comes alive, taking up more emotional space and energy than it objectively warrants. Over the past ten years, I have learned how to settle those concerns. 

Prostate cancer is the most common cancer in men globally. It is estimated that 1 out of every eight men in the US will develop prostate cancer. Fortunately, few of us will die from prostate cancer, as modern therapy, as I can attest, has turned prostate cancer into a manageable chronic illness. While the two most significant risk factors, age and male gender, cannot be modified, prostate-specific antigen (PSA), determined in a simple blood test, will convince you and your physician to undergo further evaluation. And as with colon cancer, there seems to be a younger age group increasingly impacted. 

The screening for prostate cancer comes with its own baggage, a large group of individuals with slow-growing tumors that might better be served by watchful waiting, and the usual concerns over false positives and negatives, which vary with the population at risk. The guidelines suggest that men discuss the value of a PSA test with their physician between the ages of 55 and 69, the age range providing the “most benefit.” For men who have a family member with prostate cancer or for black men who have a more aggressive form of prostate cancer, PSA testing can be done earlier. 

It has been a decade. I’ve come to see prostate cancer not as a battle won or a journey completed, but as a companion whose presence has reshaped my life’s rhythm; teaching and reminding me of humility, patience, and the uneasy grace of relinquishing control. I am not a survivor or a warrior—just a man named Chuck, still learning what it means to live with the echoes of disease and the quiet gift of another day.