I knew getting prostate cancer at 48 would change me?

Behind the Prostate Cancer Foundation.

Prostate cancer in Black men.

Stephen Fry: A man willing to talk about it.

Masculinity and prostate cancer.

Men who had prostate cancer.

I’m surprised to find my wife, Michelle, standing in the foyer.

Without even saying hello, Michelle takes my face in her hands and kisses me.

Still without a word, Michelle leads me up the stairs and into our bedroom.

Like many couples, Michelle and I had succumbed to the middle-age cliché of a sex-lite marriage.

Michelle and I met in college and started living together in our 20s.

Michelle worked as a potter’s apprentice, making coffee mugs and quiche plates?

Now, two decades later, Michelle and I were married; we had two young kids, a house in the burbs, and hectic jobs that left little time or energy for intimacy.

Michelle was a social worker, helping kids with complicated lives try to keep it all together.

When I returned home from the wedding to find Michelle waiting, wantonly, I was bewildered.

Michelle had always been a prolific reader with an appetite for erotica?

“Any woman who has kids knows there’s a point where it’s no longer full-body parenting, that you get a little space, physically and mentally, and you can start to reclaim parts of yourself,” Michelle says.

A year or so into our renaissance, a routine blood test revealed the possibility — just the possibility, my doctor stressed — that cancer was lurking in my prostate.

Prostate cancer.

Prostate cancer is absurdly common: Nearly 200,000 men in the United States are diagnosed with the disease annually, and about 30,000 die from it, making prostate cancer the second leading cause of cancer death among American men, after lung cancer.

One in nine guys will be diagnosed with prostate cancer during his lifetime.

Mark Pomerantz, my oncologist at the Dana-Farber Cancer Institute, “we’d find prostate cancer in a majority of them.” The truth is, most men will either die with prostate cancer or die from it.

It’s that prevalent.

All I knew about prostate cancer was that my father had been treated for it, so I was at increased risk.

I learned some prominent men have survived prostate cancer, including Colin Powell, Sidney Poitier, and Robert De Niro.

I found out later that Ben Stiller was diagnosed when he was just 48.

Prostate cancer doesn’t care how you identify.

It took barely two minutes of online sleuthing to discover that the primary treatments for prostate cancer — surgery or radiation — can doom a man’s sex life or put him in diapers.

I’m embarrassed that I knew so little about prostate cancer.

When I asked my friend Sam, a musician whose father died of prostate cancer, what he knows about the walnut-size gland, he said: “Not a goddamn thing!”.

Prostate cancer kills nearly as many people each year as breast cancer, but men don’t talk about it.

Women talk about breast cancer.

Since Betty Ford went public with her diagnosis in the 1970s, women have raised hundreds of millions of dollars each year for breast cancer awareness and research.

Their candor continues to save lives as women across the country now get regular breast exams.

We’ll do anything not to discuss prostate cancer.

But it’s more than that.

You want to know what douses sparkling dinner party conversation faster than a mention of prostate cancer!

In 2018, he posted a video on YouTube announcing that he’d been treated for prostate cancer.

Rarely had anyone spoken so openly about prostate cancer, let alone someone like Fry, who has 12.6 million Twitter followers.

It’s short for prostate-specific antigen, a protein produced by the prostate gland.

Doctors used to rely on digital rectal exams to detect prostate cancer.

But these probes aren’t definitive, so prostate cancer often went undetected.

That’s how rock ‘n’ roll iconoclasts Frank Zappa and Johnny Ramone and poet Langston Hughes died preposterously young of prostate cancer.

Since the early ’90s, when studies showed a link between prostate cancer and an elevated PSA, doctors have used a simple blood test to screen men for the disease.

Most prostate cancer is also slow-growing.

But prostate cancer is pervasive: If you look for it, there’s a strong chance you’ll find it.

There was an explosion of prostate cancer diagnoses.

Doctors in the United States typically start checking men at age 50 — earlier for guys, like me, with a family history, or men of African descent, the population with the highest incidence of prostate cancer.

In England, for example, where Stephen Fry lives, the National Health Service doesn’t recommend screening, leaving it up to men and their doctors to decide if it’s something they want to do.

In 2013, he was treated for prostate cancer.

I had the kids and Michelle.

The prospect of prostate cancer.

It’s my doctor.

It’s not required that your spouse be present when you get your prostate biopsied, but I’m glad she is.

Morrill says I have prostate cancer.

But it’s all brake lights.

But when you’re diagnosed with a disease whose treatment could make you impotent, you begin to resent the clichéd image of the American male — the well-built rake with the emotional intelligence of a freezer pack.

If that’s the masculine ideal, no wonder men don’t talk about prostate cancer.

After I was diagnosed, I didn’t want to dwell on it, either.

And it didn’t occur to me to go to a prostate cancer support group.

Instead, I studied prostate cancer on my own.

The prostate is in there — JetBlue does not fly direct — so how would doctors eliminate the cancer without damaging the rest of me.

After my diagnosis, I was concerned about survival, yes, but I also wondered: Would I still be able to have an orgasm if my prostate was removed.

First, though, Michelle and I had to talk to the children.

Caught in time, prostate cancer is highly treatable.

About 90 percent of patients whose disease is diagnosed at an early stage live at least 15 years after treatment.

But it’s still cancer, and no one wants to be in that 10 percent.

I told her I’d had a test that revealed something called prostate cancer.

At the dinner table that night, Michelle and I talked about the diagnosis and next steps.

I confess I was pretty focused on myself, so it’s hard to know what effect the news had on either of them.

General Hospital, which invites newly diagnosed prostate cancer patients to sit with a surgeon and a radiation oncologist to discuss treatment options.

It’s kind of like a job interview: The specialists explain their respective approaches to removing the cancer — and the possible outcomes, good and bad — and the patient asks questions.

I look at Michelle, who’s staring at the floor.

“Um, no,” Michelle says finally.

Some charlatans on Reddit swear prostate cancer can be cured by eating a huge amount of shark cartilage or habanero peppers, but I’m not willing to test their claims.

Michelle and I conclude that I’ve got three legit treatment options: radiation, surgery, or nothing at all.

In the case of radiation, the black Sharpie line, which I view as a proxy for my penis, sags steadily over a period of years.

Michelle and I look at each other.

Radioactive pellets were implanted in his prostate; it’s called brachytherapy.

Translation: I don’t want to talk about it.

That’s the grading system that doctors use to evaluate the aggressiveness of a patient’s prostate cancer.

Mine, on a scale of 1 to 10, was 7, which is deemed “intermediate risk.” Michelle and I considered “active surveillance” — checking my PSA every three months or so.

But, for nearly a century, the opposite was done to men with prostate cancer.

Generations of guys diagnosed with puny, indolent cancer panicked and sought aggressive treatment.

Some patients didn’t make it out of the operating room, dying of massive blood loss.

And, until the early 1980s, every man who had his prostate removed staggered out of the hospital impotent.

If your prostate was removed, impotence was just an unfortunate side effect.

Dubbed “the Michelangelo of prostate surgery” by a colleague, Walsh became something of a celebrity, the go-to urologist for high-profile men with prostate cancer.

His patients included tennis star Bobby Riggs; Washington, D.C., Mayor Marion Barry; King Baudouin of Belgium; and, in 2003, John Kerry, who stopped campaigning for president to have his prostate taken out.

I’d never heard of Walsh before I was diagnosed, but as Michelle and I researched our options, his name kept coming up.

Walsh has told this origin story many times over three decades — at countless medical conferences, to peers and patients, on TV talk shows — and yet as he and I are sitting together in the Brady Institute’s small, wood-paneled library, he’s on the verge of tears.

Jonathan Simons, an oncologist in Santa Monica, California, and the president and CEO of the Prostate Cancer Foundation, which has raised more than $830 million to support research around the world.

“When [my patients] finally die, their wives write me beautiful letters,” he says.

It’s a pelvic floor exercise.

Still, I was a wreck when Michelle and I arrived at the hospital before dawn one morning in February 2014.

Michelle gave me a kiss and I was wheeled away.

Kibel told Michelle the procedure went well, but, he said, ominously, my prostate was “boggy” — by which he meant mushy.

“People think the prostate is surrounded by Saran Wrap, and you just have to peel off the Saran Wrap,” Kibel says.

Michelle and I had been explicit that preserving sexual potency was important.

If it also encourages patients to get back in the proverbial saddle ASAP, he’s cool with that, too.

“I’m treating a patient who has prostate cancer,” he says.

At home, Michelle tries to make me comfortable, or as comfortable as I can be with a rubber tube draining my urine into a plastic Pop Tart-shaped bag.

It’s Dr.

We agree to talk in a few days.

I turn off the television and, with no idea how bad it’s about to get, begin to cry.

What I’ve learned is there’s no one cause of prostate cancer, but some men do have more reason to worry than others.

Black men are 76 percent more likely to develop prostate cancer than white men and twice as likely to die from it.

Why the disease hits Black men so hard isn’t entirely clear — genetic susceptibility and diet play a role — but the fact that they die at double the rate of white men is appalling.

If we know Black men get the disease disproportionately, why is their mortality rate still so high.

I ask Tom Farrington, who’s been raising the alarm about prostate cancer in the Black community since his own diagnosis two decades ago?

The sad truth, Farrington says, is that most Black men have no idea they’re at high risk for prostate cancer and, as a result, don’t get their PSA checked.

And if they do know, he says, many Black men will delay going to a doctor.

But also, Farrington says, it’s because Black men harbor a deep mistrust of the health care system.

Some still remember the deadly and shameful Tuskegee syphilis study, when the US Public Health Service allowed hundreds of Black men with syphilis to go untreated — for 40 years — so scientists could study the long-term effects of the disease.

“I would certainly use the word ‘suspicion,’” Farrington says of the attitudes of Black men toward the health care system, adding that providers and hospitals can — and should — do more to educate Black men about the risk they face.

The reluctance to talk about prostate cancer, for whatever reason, is an epidemic all its own.

Of all the things I didn’t know, the strange relationship between testosterone and prostate cancer was the most surprising.

I had no idea that the male sex hormone that gives men bulging biceps, body hair, and, if we’re lucky, a voice like Lou Rawls, is the food that prostate cancer needs to grow.

I learned what that meant when Michelle and I sat down with Dr.

He said there was a chance that the cancer had escaped the margin of my prostate so I’d need radiation therapy — five days a week for seven weeks — to eradicate whatever rogue cells survived the operation.

In cases like mine, Kibel explained, it’s best to blitz the leftover cancer when the cells are at their weakest.

Some men whose prostate cancer is so advanced it can’t be cured by surgery or radiation spend years — years — on Lupron.

But my emotional state was still brittle when Michelle and I went with Meredith Goldstein, my dear friend and colleague, and her sister, Brette, to the Nantucket Film Festival.

“I think it’s called ‘The Spotlight’?” Ruffalo said, referring to eventual Best Picture winner Spotlight.

Michelle was interested, so I said OK.

“This guy is insufferable,” I whispered to Michelle.

I was about to lose my grip and Michelle knew it.

They’d been enjoying a few rosés at the beachside bar, leaving Michelle and I to broil on the blacktop outside the school.

She screamed at me, lunging over Michelle, who was sitting between us.

It’s an excruciating memory and it always will be.

“It was incredibly validating,” Michelle says now?

A linear accelerator looks like a gizmo Scotty might fiddle with on Star Trek, but it’s a machine that streams actual radioactive particles into your body with extreme precision.

Developed in the 1950s by Russell and Sigurd Varian — the Wright brothers of radiation oncology — the linear accelerator is the backbone of radiation therapy, strafing millions of cancer patients with invisible rays.

The terrifying thing about radiation — the thing I still worry about — is that it damages healthy cells in the beam’s path, which can lead to profound side effects in the future, including malignancies or, in patients with prostate cancer, a deterioration of sexual function.

Over those seven weeks, my mood alternated between sullen and severe, but Michelle remained steadfast.

It’s meant to be a celebration; everyone in the waiting room applauds.

I rang the bell meekly and Michelle took a picture.

It’s what doctors used then to rid a man of testosterone and curb his libido.

“It’s a feeling of, like, please just let this be zero,” she says, remembering that night at BU?

It’s not my body that’s betraying me now, it’s my mind.

How did Michelle feel about the new me.

The dusty box of sex toys under our bed was tossed out and replaced with sleek new gadgets Michelle ordered from LELO, a Swedish intimate lifestyle company whose products come with a bold promise of “instant gratification” and “permanent pleasure.” Michelle encouraged me to relax.

“It’s not just ‘Am I a man?’ It’s more like, ‘Am I whole.

Am I me?’” she says, recalling our first meeting?

She says our culture sells a myth of eternal adolescence, which is demoralizing to men when age or illness inevitably intervene.

“You have to really make an adjustment, and it’s not about trying to be the way you used to be,” Bober says.

It’s important to expand the repertoire of what sex is, of what intimacy is, of what it is to maintain physical connection.”.

With that in mind, Michelle and I decamped to Mexico in April of 2015, a little over a year after my surgery.

Michelle and I are in the cafeteria at Dana-Farber.

Some of the patients are old and ashen.

There’s an unspoken camaraderie in a place whose patients are all enduring cancer.

Outside the hospital, it’s not like that.

They assume I don’t want to talk about my ordeal, and if I do talk about it, they nod politely and look for the exit.

But it’s not contagious.

What he means — and what people sometimes ask Michelle privately — is: “Does his, you know, his ...

I’m drinking coffee in the cafeteria as Michelle fixes a cup of oatmeal.

Now it’s every six months

Michelle and I take these days off from work

I’ll definitely die, he says, but in all probability it won’t be of prostate cancer

And yet, as Michelle and I are waiting in the examination room, I’m anxious

Michelle knows

He’s a leading expert in the genetics of prostate cancer, but mostly I like him because he seems to have genuine empathy for the dread I feel

“Very good,” he says

I look at Michelle, who’s smiling

Pomerantz says there are patients, like me, whose prostate cancer will “show itself” again in the future, but the disease would be manageable at that point

As Michelle and I walk arm in arm down the hall, I feel relieved

I ask Michelle why I get so worked up before these visits

“You’re never over it,” she says

“Hi there,” the young woman says

Any questions about prostate cancer, diagnosis, treatment, or any related matter should be directed to a medical professional