I introduced myself to the deceased.
We were both cops.
He lay in his casket, suit-and-tied up. A NYC Transit Police Dept patch was near him. I’d never met him but we’d known each other for about 15 retirement years. Let’s just call him, “John.”
I knew John from our Fraternal Order of Police site. We’d chatted there, and being on opposite ends of the political spectrum engaged in verbal combat in that arena. But we’d never actually met, neither on the job nor after, neither of us attending many reunions and such. He being a Brooklyn boy, me a Long Beach, Long Islander. But as I knelt before his casket, I said, “We finally meet.”
I sat at the wake and spoke to family and friends. John’s best friend said to me, “This didn’t need to happen.” We were speaking of the cause of death, prostate cancer…unchecked, metastasized, deadly. From a bad choice.
Let me tell you a bit about my own choices. I too was diagnosed with prostate cancer in 1997. Back then there were four choices to deal with, watchful waiting, radioactive seedings, external radiation or surgery.
In consultation with doctors I had to decide from those options. The aggressiveness of the cancer cell was one important determinant. There is a Gleason scale which rates the aggressive nature of the cell in numbers, from 2 to 10, ten being the most aggressive. I had a seven.
I was 57 years old at the time, relatively young. If this was dealt with successfully I was told, I could expect to live without recurrence for many years…hopefully.
If I were 75 at the time, and had a low Gleason scale number of say, 2 or 3, watchful waiting might have been a good choice. I had heard, and many of you heard as well I’m sure, “A person with prostate cancer will probably die of something else before that disease kills him.” Not always true for the 1 in 7 men who get it every year.
As part of my research I read a book, Man to Man by Dr. Michael Korda. And as the title implies it was very straight forward. Among other things I learned that if the cancer spread to the bones the person would suffer an agonizing death. Now that scared the beJesus out of me.
As I visited the various doctors who specialized in each option, they seemed to be encouraging their own course of action, no surprise. It was like visiting a Buick dealer, then a Toyota guy. Their glossy brochures reflected their “shiny” option.
We’ll of course I liked the idea of going with the least intrusive intervention, the seedings. But it was suggested to me that to be safe, both the seedings and the external radiation would be best. This “aggressive” approach would hopefully get all the cancer cells I was told. Sounded like a good plan.
But a doctor in my family suggested that I speak to a specialist outside of my health care group. So with his guidance I went to a good surgeon he knew. I told this surgeon about my “aggressive” plan.
He said using both seeding and radiation was just putting two mild approaches together and that didn’t add up to an aggressive attack on the cancer. He told me words that ring in my ears to this day, “If you choose either of those options or both, and you live long enough…the cancer will come back.” And he said it…twice.
I spoke to someone who had prostate cancer. He opted for radiation but nine years later the cancer came back. They opened him up for surgery but he said, “All the tissues had fused. All they could do was sew me back up.”
I now thought surgery would be best.
But who would do it? The doctor in my family said, “Always ask any doctor who was going to perform a surgery, How many of these operation have you performed?” And also to ask about the facility used, “How many operations are performed there?”
I asked my urologist, the one who discovered the cancer, “How many of these surgeries do you do in a month?” He said, “A month? I do about three or four a year.” I thanked him and left. Wonder what happened to the first person he operated on…the one who never asked. Someone has to be the first. Maybe best to ask, right?
I was eventually referred to a Dr. Arnold Melman of the Albert Einstein School of Medicine at Montefiore hospital in the Bronx. He had performed three to four prostate operations per week for decades. I chose him, had the procedure, and 18 years later I’m still cancer free.
John was a very intelligent person, rose through the police ranks, enjoyed a happy retirement. But he knew he had this damnedest of diseases for too long. He never followed through in doing something about it. He did have other issues, triple by pass surgery among them. But this cancer, for whatever reason, was never dealt with.
Then one day he called his friend and said, “I can’t walk, I’m in really bad pain.” An ambulance was called. He went to the hospital. Never to return home again. Never to enjoy the days of simple retirement he cherished. Never to give helpful advice as I try to do here. The cancer had metastasized. He was in very serious pain. He received hospital and hospice care…until he died. He was buried yesterday.
We lost a very good man who had some good years ahead, if things had happened differently. A sad and painful story, sure. But I’m a guy who likes to try to get some good out of the bad stuff-of-life. So I write this in hopes that it might help just one of you to not put off action that might save you from this nasty thing.
My option might not be best for you. Today there are more choices and combinations of choices from which to consider. Some no doubt work better than they did two decades ago. And there are more excellant doctors to choose from.
But the important thing is to get the check up. If something is discovered, do your homework, get consultations, but most importantly… take action. Ya just got to do it, get the damn thing in your rear view mirror and get back home to life.
May no one need say of you, “This didn’t need to happen.”
“John” Rest in pain-free peace, my friend.
And to the rest of you,