Beating A Killer
Cancer was once the end of the line. Today, it can be managed and defeated
In 1997, Joe Fred Starr was a vigorous and successful 63-year-old businessman in Fayetteville, Ark., when he became one of the 200,000 men who are diagnosed every year with prostate cancer. Starr knew prostate cancer was a killer. Each year nearly 30,000 men die of the disease, and among cancers it's second only to lung cancer in claiming male lives. So he opted for the most aggressive treatment possible. "I was chemically castrated," he says simply, when describing the hormonal oblation treatment that made his PSA level drop to zero. "It was a choice between a knife and an old man's ego."
The first year after diagnosis, Starr was so busy reading everything and finding the right doctor that he didn't have time to think of much else. But then, he says, "a kind of sadness built": The treatment "makes you feel kind of grubby, you gain weight, and they take all the testosterone out of you." Two years passed, each one cancer free, yet the second more desperate than the one before. He remembers driving around southern Colorado visiting family, in such despair that he couldn't sleep and was crying uncontrollably. At one point, Starr walked into a pawnshop, not having slept for days, unshaven, his face streaked with tears. He asked to buy a gun. The owner looked up and said, "You crazy son of a bitch, you are buying a gun to kill yourself, and I am not selling you one. If you want to kill yourself, go drive into that lake back there." Starr didn't drive into the lake but headed home instead. Finally, he found a psychiatrist who could address his depression, the price he paid for surviving his cancer.
The stories of cancer victims vary widely, but the basic scenario is always the same. First comes the terrifying diagnosis: cancer, the big C. The news is followed by some combination of surgery and/or chemotherapy and radiation treatments. Then there's the fear and the terrible sadness, compounded by the nausea and bone-wearying fatigue. And, of course, there's the existential loneliness at 3 in the morning.
And yet, after all that, perhaps in six months or a year, life once more begins to lose its blur and hold promise. Hair, scorched by chemotherapy, returns--though sometimes with a surprisingly different color and texture. The birthday party that was an impossible dream six months before is now a treasured gift. The return to normal life comes with visits to the oncologist's office and the unavoidable counting: six months later, one year later, two years later, and, finally, the triumphant five years later--the marker of a successful cure. Case closed. Another cancer patient, miraculously, has become a survivor.
Sea change . But can life after cancer ever be said to be truly normal? It's not just the emotional stress of living beneath a diagnostic sword of Damocles. Even after cancer no longer inhabits the body, the treatments that conquered it often leave in their wake debilitating physical and emotional scars. Or simply a profoundly changed approach to life.