The Sword of Damocles

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This is about the psychological effects of living with advanced prostate cancer, in my case castrate sensitive metastatic prostate cancer with lung only which is very unusual. I am in remission but the trauma continues and I think we men need to talk about the psychological impact of this disease on us and our partners.

In Ancient Greece there was a mythological story about a king called Damocles. He angered some god and as punishment he had to sit on his throne under a sword suspended by a thin thread which could break at any moment. The story has become a metaphor for living under a constant threat. 

That’s the way I feel. I go for 3 month PSA tests and each time so far the result shows PSA is undetectable. But at one of these tests it will rise indicating castrate resistance and the transition to the final stages of the disease. I try to enjoy my time and carry on as normal as much as I can but there is always a background of anxiety and sometimes nightmares. I practice CBT exercises as well as the ancient philosophy of Stoicism which is undergoing a big revival ( not the same thing as “stoicism” as we commonly use the word meaning emotional repression). This helps but really my quality of life has been permanently degraded.

  • Hi

    Like you but mine is in my bones, not certain when your PC was found, but mine was undetectable for over three years maybe four, even now it’s only gone up to 4.9 after starting on new meds. 
    I have to admit I’am a very easy going person, my wife is just the opposite worries about everything, we have never sought help as my wife hates talking about cancer. Being my carer also puts a bit of extra strain on her, but she looks after all my meds and appointments etc.

    The one thing I’am big on is listening to your body, need rest then rest. Getting to the final stages can be many years away, your both doing the right thing enjoy life as best you can with covid about.

    Damocles has a lot to answer for, when I get my three monthly tests, I always hope my PSA has stabilised or gone down, but if not, I ask the oncologist what plan B is, they always reply they have other treatments they can use, their a good team.

    In all I know what your feeling and my wife certainly does, so as everyone says just keep positive your half way there in your mind that is to keeping this thing at bay.

    Stay safe

    Joe

  • we’re at the limbo stage, we know we’ve got cancer, it’s unlikely that hormone therapy will work forever,  I struggle with fatigue, each ache and pain brings new anxieties,  I’m too young to retire, work has written me off so I’m treading water (took some adjustment but happy with that now)

    ive done various things latest being mindfulness, unsure how beneficial but has to help, being on here is also a two edged sword, great to know we’re not alone, other men feel the same but also hard because being on here too much reinforces that cancer will get me.

    you are so correct, it’s good to talk, essential I would say.

  • Hi Joe thanks for telling us about your experience and that of your wife. The distress of our partners is something that does not often get a look in here. I think the key thing, at least for me is balancing hope with acceptance. We have to accept whatever happens to avoid depression. But not too soon. Until things get worse we have hope and I think there is always something to hope for. But not irrational “hoping against hope”, refusing to face reality. It’s a tricky balancing act but staying in the present and trying to forget about the Sword for some time anyway is essential.

  • Hi YoungMan, that is an excellent description. It is a limbo like experience. We are not dying, we can still do a fair amount but our experience is not the same as those who are well and can continue to ignore the Grim Reaper. You are right about not being on here too much. We have to live, to be in the present as much as possible for ourselves and our families. I can do that much of the time but not all of the time and hence my post today after an attack of anxiety. This is an area of men’s experience of prostate cancer that needs much more attention from the professionals and if any of the moderators of this site see this I hope they take note. In many ways psychological pain is worse than physical pain and we are in a lot of psychological pain that is largely ignored by the doctors. It’s not just anxiety about dying. There is also the worry about declining physical faculties (fortunately not affecting me yet), the physical side effects of HT such as hot flushes and fatigue, the loss of libido, the femininizing effects of HT, the loss of a sense of masculinity. I hope this is not bringing you down but I just have to talk about all this psychological pain that nobody understands except those going through it.

  • Hi PatBe

    I had the da Vinci over four years ago. Since then psa has been undetectable.

    At one of my urology appointments I got talking to someone who had had PCa for seventeen years.

    I'm on here most days because I want to help the newbies if I can. However if it wasn't for this site I would not have discoveredI have that I have been drinking cranberry juice instead of pomeganate juice. Apparently the former can artificially depress the psa score so the next test should be interesting.

    Some of the posts are heart-breaking but there is also good news too now and again.

    It is harder for the partners I think. But we all just get on with it the best we can.

    Good luck.

  • . You didn’t bring me down, it’s good to know your not on your own, we all go through similar difficulties, 

  • Thanks Dennis 

    It is great to hear about your long term recovery.

  • I don't have a sword of Damocles, more of a dagger.

    My PC is slow and not left the prostate.   Recently finished hormone treatment and radiotherapy,  so I am skilled in the blankets off, blankets on, hoodie off, hoodie on flushes and cold sweats.  The libido has taken a knockout punch too. 

    Interested in you mentioning stoicism.   I am on the lookout to read Meditations by Marcus Aurelius.  I am a glass half full sort of guy, and try not to worry, but it's hard.   

    I get by knowing that I have had it real easy with this, especially reading the experiences of others here.  

    I'm going to try and live for today and not worry about the future, this hit home to me, as a friend of mine, who had no illness, no problems that I know of, except probably covid19,  as we all did, got killed in a motorcycle road traffic accident.   

    One minuite here, the next gone.   

    Sorry if this post is a bit of a downer.    We're still here though.  

  • Hi PatBe I was diagnosed in January with advanced prostate cancer which has spread to my bones, lymph nodes and soft tissue around it, both my wife and I felt very low to start with, we come to the decision that it was no good looking at the dark side.

    We grab every opportunity to go go out together, and I do a lot more woodwork to keep me busy.

    I can understand how everyone feels and fully agree with everyone who has responded to your post, all the best to everyone.

    Ulls

  • Hi JoJoGunne

    Sorry to hear about your friend. It reminds to make the most of our time. Your cancer is still local which is great so I would imagine that apart from the hot flushes you can live a fairly normal life. There are things they can do about ED but I’m not sure what can be done about low libido. In the past I would have imagined that I would feel dreadful about such a state but actually I feel indifferent which I guess is part of the effect. 

    in relation to Stoicism it is great to read the original texts but modern books are also very worthwhile. Two that I recommend are Lessons in Stoicism by John Sellars and How to Think Like A Roman Emperor (Marcus Aurelius) by Donald Robertson which combines CBT techniques with Stoicism.