My beloved and I went yesterday to the funeral of my cousin’s partner, who had acute myeloid leukemia. This was obviously a tremendously sad occasion for my cousin, his partner’s family, and their extensive network of friends, several of whom spoke. (Although held in a church, it was not a religious service.) The love in which my cousin’s partner is held was obvious; she was someone who touched many people’s lives. On a personal level it was challenging for both of us. Of course I have thinking about my mortality since the diagnosis. I found it difficult not to think about my life being commemorated in this way, the river of life then resuming its remorseless flow without my few drops. Knowing something as an objective reality is relatively easy. Feeling the reality, knowing it emotionally, is a lot tougher, and something that only gradually reveals itself.

It was fascinating and reassuring to read the latest issue of a journal about prostate cancer aimed at those affected by this condition. The issue was devoted to the role played by anxiety, stress and depression in prostate cancer. Sounds like a fun read, I know! Actually, there was a lot in it that is relevant to me and my beloved. (The impact on her of my having cancer is something I do try to be mindful of. There is not much good news, so I try and make sure that we spend time together doing enjoyable things, plan for trips that we have always wanted to take, and just to show appreciation for what she does for me, and little kindnesses. Restraining my occasional irritability is something else that I work on constantly.)

I learned from this journal issue that the emotional toll of prostate cancer can be felt as much by the carer as by the patient. This applies to things like worrying about PSAs going up, and dealing with the uncertainty of which treatment to have at which stage of the illness. There was an interesting checklist of the symptoms of depression: sleeping more or less (as compared with regular sleeping habits), loss of interest in daily activities, an unusual increase or decrease in energy, changes in appetite (eating either more or less as compared with regular eating habits), increased irritability or impatience, or difficulty concentrating. I have had almost all of these. They are not new symptoms, and I have medications for depression and ADD, some of which I still take. I just hadn’t thought of them being associated with prostate cancer.

A part of the issue of even more relevance to me was an interview with a patient. He is secretary of the survivors’ group meeting that I attend, so I read his story with interest. After his PSA rising several times, he had his operation in 2005. His second PET scan, in his words, lit up like a Christmas tree, with three big red dots well away from the prostate. After receiving a prognosis of two to five years, he is still around exercising, playing golf, and enjoying time with his grandchildren. Like several PC survivors I have met, he is an advocate of weight bearing exercise. This strengthens the bones, compensating for the effects of hormone therapy, and has numerous mood benefits as well. I have resumed walking and going to the gym, and will be checking with the radiation oncologist whether there is anything he particularly does or doesn’t want me to do.

Last, I was pleased to see distraction mentioned as a valid coping mechanism. Mindfulness is known to be helpful in managing pain, depression and stress. But sometimes just doing something in which you can lose yourself for a little while can also be beneficial. (Like anything else, one can overdo this; I suppose if one goes overboard buying gadgets, that can put a strain on both one’s finances and relationship with partner!) As well as fiddling with gadgets and gardening, I find cooking a great distraction. We have our niece to stay once a week, and I really enjoy planning, shopping for, and cooking a meal that will be interesting and that will cater to my beloved’s various food intolerances. The emphasis in this issue on the various psychological and emotional facets of prostate cancer, and the ways in which they are being considered by medical professionals, was extremely interesting. It was reassuring also that the various things I have been thinking about and grappling with are real for other people as well.