There comes a time in every man's life when he finds himself squatting in a hospital gown that barely covers his dignity, waiting to be anointed, not by the Holy Spirit, but by the attending urologist and his cold-gloved index finger. It is at this exact moment, bent forward in humble submission, that one realizes: prostate cancer treatment is eerily similar to electing a new pope.
Let me explain.
In both cases, you're surrounded by old men, there's an abundance of Latin terminology no one fully understands, and everyone is pretending to have a plan while silently waiting for a sign from above. For the Vatican, it’s white smoke. For the oncology ward, it’s a PSA test that doesn’t come back looking like the Dow Jones in freefall.
The College of Cardinals is convened behind closed doors, solemn and secretive. So is your multidisciplinary tumor board. And frankly, no one on either side is entirely sure what the hell is going on, but they’re all wearing ceremonial robes and speaking in hushed tones like they’re planning either a coronation or a colonoscopy.
Meanwhile, the faithful (or the family, in cancer terms) gather outside, waiting for news. “Have they chosen a treatment yet?” they whisper. “Is it radiation? Hormones? Immunotherapy? Blessed be the ADT suppressants, for they shall inherit the hot flashes.”
And once the decision is made, it is irrevocable. You can't just say, "Actually, I changed my mind, I’d rather do active surveillance." No, you must now commit to a course of action involving chemicals strong enough to make your testicles weep in Latin.
The similarities continue.
Pope: wakes up at 5am to pray for humanity.
Prostate patient: wakes up at 5 am because his bladder is hosting its own Vatican II council and won’t shut up about it.
Pope: lives in isolation, with minimal physical contact.
Prostate patient: ditto, but thanks to Firmagon, not theology.
Pope: gives up sex, earthly pleasures, and worldly attachments.
Prostate patient: gives up testosterone, erections, and the will to wear tight jeans.
Let's not forget the ceremonial garments. The Pope wears a cassock. The cancer patient wears a gown fastened by a single thread and a prayer. Both outfits expose the ass, albeit metaphorically in one case and quite literally in the other.
There’s even a kind of canonization involved. If your PSA stays low long enough, they call it “biochemical remission,” which is basically sainthood for the oncology crowd. You get a little certificate, some cautious applause, and everyone agrees to pretend the cancer won't rise again on the third day — or the third scan.
And then, of course, there’s the conclave of conflicting opinions.
Oncologist: “We recommend 18 months of ADT.”
Cardiologist: “You might die from the treatment, not the cancer.”
Urologist: “Let’s radiate everything, just to be safe.”
Nurse practitioner: “Have you considered yoga?”
Radiation tech: “Hold your breath and think of the Holy Spirit.”
All the while, you nod like a good Catholic, suppressing the urge to throw holy water at anyone who says “you should be grateful for early detection.”
In the end, much like papal succession, prostate cancer is a test of faith. Not in miracles, mind you, but in scheduling software, hospital parking logistics, and the blessed sacrament of getting a call back from your oncologist before the Second Coming.
And should you make it out the other side, bald, burned, bone-tired but not beatified, you are left not with certainty, but with a new appreciation for mystery. The mystery of medicine. The mystery of why anyone would create a gland this strategically useless. And the grand mystery of why, in a world full of medical marvels, the best they can still offer you for an inflamed prostate is “try not to sit too long and drink cranberry juice.”
But hey, at least I didn’t have to kiss the ring.
