Guest guest Posted December 13, 2007 Report Share Posted December 13, 2007 , a good old friend of mine used to shock people by saying that he wanted his ashes scattered under a beautiful jacaranda tree on the golf course where he was Club Secretary. " But, " he would caution, " Make sure you know which way the wind is blowing. I've never been out of bounds on that hole. " I know that many are also uneasy when my darling wife Anthea and I talk about death and dying. Our ideal death would be to have an excellent meal in one of those sidewalk cafes in Rome - near the Trevi Fountain perhaps - to keel over as we sipped the last of the wine and for the restaurateur to find that we didn't have enough to pay for the meal, having spent every last razoo on living. So, with that background, perhaps I am not typical in my outlook. I guess it would be somewhat of a surprise if I was, but I do believe that it is healthy to contemplate our end, and to discuss what fears we might have. Death and dying is the elephant in the room as far as prostate cancer is concerned. It is very rarely even mentioned except as a dire warning of the awful death that awaits those who do not take immediate action to deal with their diagnosis. Some prostate cancer deaths can indeed be awful and I don't want to make light of that, especially for people who have experienced the pain of losing a loved one - father, husband, partner or son. Old timers may recall some years back the harrowing blow by blow description of the last days of a man in Ireland, described by his loving wife Jan - that was on another List, long gone unfortunately so the account cannot be read in Archives. There are other well told tales of death and dying - one of the most visited individual pages on my Yana site is Alan Bacon's, written by his widow and available at http://www.yananow.net/Mentors/AlanB.htm ; Young also vividly told of the three years plus that passed from his diagnosis to his death - you can read that at http://www.phoenix5.org/essaysry/menuryessays.html while Ric Masten still details his long battle - nine years and counting - with terminal disease at http://www.ric-masten.net/Prostate.Series.html These men battled the pain of the disease that had metastasised to the bone, but this is not the only route which the disease takes, in fact it occurs in a minority of cases, according Jan, the lady I mentioned above and Dr Myers. In those cases where it does occur, Dr Glode has this to say at at this URL http://tinyurl.com/2rmplc : <snip> It is highly unusual to have a patient in whom pain cannot be well controlled with radiation, opiates, NSAIDs and attentive care. <snip> I cannot quote any studies to support these statements, but they do jell with my personal experiences. , my old pal I mentioned above, Mike another old pal and Reg, a colleague of mine from work all died of prostate cancer within 18 months of my diagnosis. and Reg and I went fishing in the Zambezi Valley three months before Reg died and twelve months before went. Reg was on hormone therapy at that stage and was suffering badly from hot flashes - no surprise since the ambient temperature was about 40C - say 104F - but a bit of river water poured over him and some well chilled beers cooled him down. We caught fish, yarned about the good old times and despite the shadow of death that hovered over both of them, we had a great time. Mike lived in Cape Town, where we lived at the time. He had been diagnosed about three years before me. He didn't know anything about his diagnosis, but clearly it was late stage when it was diagnosed because he had an orchidectomy and then went onto what his widow refers to as 'female hormone drugs'- presumably some kind of estrogen therapy. He developed osteoporosis and broke a leg, some ribs and eventually his spine was so fragile that he had to wear a cervical collar. But none of this stopped him doing several things that he had planned to do all his life, but was too busy to do. The chief of these was to visit France, the Loire Valley in particular, on an extended wine tasting tour - he was a vintner by trade. A little over six weeks before he died, we had dinner with him at his favourite restaurant. As ever he was bubbly and bright and had us in fits of laughter describing the problems he had at a recent wine tasting in getting full glasses which he needed to taste the wine - he couldn't tilt his head back far enough to sip from a normal tasting glass because of his cervical collar. Shortly after that he was admitted to the hospice, where I visited him on a frequent and regular basis. The staff of the hospice were kindness personified and although Mike was more and more heavily sedated, he would slip in and out of consciousness, sometimes chatting about old times, sometimes away with the fairies. I wasn't with him when he died, but his brother was and he said he just slipped away. That was four months after my diagnosis. I wouldn't mind going like that. I know it can't be guaranteed, but in the meantime, I'm living my life to the full, making the most of every day. All the best Terry Herbert I have no medical qualifications but I was diagnosed in '96: and have learned a bit since then. My sites are at www.yananow.net and www.prostatecancerwatchfulwaiting.co.za Dr " Snuffy " Myers : " As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data " Dying because of prostate cancer ********** A question was recently posed to me in a personal email questioning if there have ever been exchanges discussing just what occurs when men are unable to arrest their prostate cancer and their advanced stage and metastases lead to their demise. He remarked that whenever he brings this topic up at support group meetings, it is brushed aside and no one wants to talk about it. As he made note, we discuss every other area of prostate cancer from prevention to the variety of treatment, even to the treatment of advanced and metastasized disease. But we make little, if any, mention on what the patient can expect and prepare for when all treatment options fail. I expect this is a normal, human reaction to not want to address the issue of dying because of prostate cancer. Yet, there is an importance to this topic, and that is the awareness that if we, as patients, choose to put off treatment and rather make our option one of denial to the importance of early attention to our insid ious disease, there can, and more likely will, be very unfortunate complications that could result in our early demise. I provided this gentleman my observation of a personal friend who had been an important part of our Us TOO support group chapter leadership whose cancer became extremely aggressive during a two year span when he had missed just one annual PSA and DRE check. In what would be considered a short time span, the aggressiveness of his disease developed to a Gleason 5+4/9 with metastases having already occurred on diagnosis. He had been checked annually but missed just one year! Complications were numerous, quality of life became of little concern because his primary concern became life itself. From what I witnessed and from what he described to me, the effects of his cancer were not pleasant. He said he wished he could communicate to men the absolute importance of annual testing for prostate cancer and serve as a reminder of what can occur when men procrastinate when experiencing urinary problems and miss even one annual check. His explanation to me was graphic and honest and all the while concerned about those following in his/our journey. And it was his demise that served as an impetus to my eventual advocacy to help others. I open this topic for discussion on behalf of the patient who addressed this concern to me and who wishes to remain anonymous. It may be unpleasant to some, but important to others. (Chuck) Maack Prostate Cancer Advocate Bio: http://www.ustoowichita.org/leaders.cfm?content=bio & id=1 Email: maack1@... Quote Link to comment Share on other sites More sharing options...
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