Faces of Prostate Cancer
For nearly 30 years, Dana Jennings, an editor for The New York Times, has written articles that recount the lives and events of people--occasionally during their time of crisis. His aim has been to inform the public about the world that surrounds them. However, when Dana was diagnosed with prostate cancer last year, he decided to reverse roles by becoming the subject and writer.
From Bad, to Worse
In April 2008, Dana was diagnosed with prostate cancer at the age of 50. Understandably troubled by the news, he thought the cancer could quickly be remedied by a surgical removal of his prostate.
However, after having an open radical prostatectomy three months after his diagnosis, Dana’s Gleason score rose from seven to nine. A Gleason score will range from two to ten for prostate cancer patients - with 10 having the worst prognosis.
Dana’s elevated Gleason results gave doctors reason to be alarmed. Following his prostatectomy surgery, pathology tests showed that the cancer had spread beyond the prostate – invading surrounding tissue. He was then told by doctors that even if the cancer went into remission after hormonal therapy there was still a 50 percent chance of the cancer returning.
“At first there’s just that sense of disbelief that you have prostate cancer,” says Dana. “When you hear about people who have a serious disease, you always figure it's going to be the other guy.”
To treat his aggressive cancer, Dana underwent 33 sessions of radiation in addition to injections of Lupron (to control testosterone levels). The hospital appointments for radiation treatment left him extremely tired as he endured visits five days a week. While difficult, Dana consciously tried to maintain a positive attitude during this period by maintaining a sense of humor while continuing to work at the Times.
“I’ve always tried to keep a sense of humor about things,” says Dana. “If you can’t temper life with humor, you’re going to be very depressed when it comes to these type situations.”
Dana went through a phase of writer’s block while attempting to return to a relatively normal way of life while dealing with his diagnosis treatment. The situation intensified as he regularly “obsessed” over his own mortality at work. To break out of the impasse, he remembered words of wisdom from an old college professor.
“My professor used to say ‘if something is keeping you from finishing a piece of writing then you need to write about what it is that is keeping you from doing that writing,” recalls Dana. “For me, that something was prostate cancer. Basically that’s how I started writing a blog about my condition.”
Dana’s first blog entry for The New York Times was made November 11, 2008. It has become a place where general readers, cancer patients and those touched by someone with prostate cancer can interact with one another. According to Dana, he is gratified that sharing his own crisis has allowed other men and himself the opportunity to open lines of communication for a disease about which most would rather keep quiet.
“There’s a personal satisfaction in being able to start discussion about prostate cancer that gives patients and their spouses a place where they can voice thoughts and gain from other’s experiences.” The blog has also given Dana the chance to become better aware of personal thoughts and feelings.
“Prostate cancer isn’t just about surgery, treatment and survival,” writes Dana in his blog. “It’s also about relationships, sex, self-esteem, embarrassment, hope and fear.”
In addition to writing a blog for emotional clarity, Dana has relied on his family and his faith during the past year in living with prostate cancer. The support and prayers he’s received from his wife, two children, and members of his congregation have given him an added strength he credits for getting him this far.
“I need, even crave, the spiritual antibodies of prayer and song,” says Dana. “I think I’ve been able to turn having prostate cancer into a blessing, although it’s not exactly the kind of blessing I would have chosen.”
Dana’s wife of 28 years, Deborah, has been with him every step of the way for support. Playfully referred to in the home as “chief medical officer”, Deborah accompanies her husband to every medical appointment with pen and pad in hand, diligently taking notes and asking questions.
“Deb’s support and attention to detail allows me to focus on what my doctor is saying because I know she’s taking in the full context of the conversation,” said Dana.
A Candid Discussion
In his blog, Dana openly shares physical side-effects he’s encountered as result of radical prostatectomy surgery. Among these topics he discusses include the private matters of incontinence and erectile dysfunction.
“I get so frustrated with guys sometimes,” says Dana. “It almost feels like we men would rather stay quiet and wither away rather then talk about male health issues. While these topics are uncomfortable, they are a reality for many men who’ve had surgery.”
For men like Dana who have undergone a radical prostatectomy, incontinence is a primary urinary side effect, with surgical techniques playing an important role in determining outcomes. Pre-surgical urinary function can also significantly increase incontinence susceptibility. If there is a pre-existing experience of some hesitation and/or lack of bladder control, it will be harder for the patient to regain full control and function.
On average, approximately 25 percent of men will report frequent leakage or no control and a need to use absorbent pads up to six months after treatment. Following a two years period, fewer than 10 percent of men report using pads at all. The definition of incontinence is very subjective, however, and the degree of incontinence a patient will experience cannot be determined before he undergoes treatment.
“If I didn’t write about incontinence and other personal issues related to prostate cancer then I wouldn’t be truthful with the readers,” says Dana. “I just wanted to be myself and tell the whole story when it comes to prostate cancer.”
To read Dana Jennings' blog, go to http://well.blogs.nytimes.com/tag/jennings/.
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