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Cancer Again

Listen Up, Guys

WebMD Feature

Nov. 6, 2000 -- It was supposed to be just another visit for another routine test, the eighth time I'd been asked to come back to the hospital since my prostate cancer was treated. This time they wanted to take an ultrasound image of my bladder and conduct a "voiding trial." (In other words: Could I empty my bladder?)

"Come back tomorrow," the nurse had said, "and we'll check your bladder on the ultrasound."

I dutifully return and drink two liters of water. Two hours later, it's time for the ultrasound. The technician, a young woman with violet eyes, squirts jelly on my abdomen and begins sliding a transducer -- a microphone-like instrument -- across it. Strange black and white images appear on the screen, to the apparent satisfaction of the technician.

"Right," says Violet Eyes, "the bladder's looking fine. Totally empty. But while we're about it, I'll just have a look at your liver and kidneys."

She slides the transducer over my abdomen, and there, quivering on the screen, is my liver, to me just an amorphous mass, but to Violet Eyes something meaningful indeed.

"Lovely," she says, enthusiastically. "Pepper and salt."

She moves the transducer to my left kidney and pronounces it "pristine." Then over to my right kidney. She pauses. I crane forward to look at the image. This time, there is no commentary, no vivid description.

"I'll be back in a moment," she says quickly. "I want to ask my colleague something." Before I can ask why, she's out of the room. While she's gone -- a seeming eternity -- my imagination works furiously: What's wrong? What has she seen?

She returns with a colleague, a 50-something veteran, who takes his turn peering at the screen.

"There is something here that the doctor ought to, er, evaluate," he says, pulling a printout off the machine. Five minutes tick slowly by before he is back in the room.

"You've got something on your kidney we don't like the looks of," he says, his even tone underscoring the gravity. "The doctor has called downstairs to tell them you're coming down for a CT scan."

Less than an hour later I'm sitting in the office of Jay Gillenwater, MD, professor of urology at the University of Virginia Hospital, the very doctor who had operated on my prostate and ordered the tests that led to today's ultrasound. In measured tones he gives me the news: I have a tumor on my right kidney.

Gillenwater keeps talking as I sit stunned, tuning in and out as bits and phrases seep through: "early stage ... no symptoms ... remove kidney ... soon as possible." I can't believe it. Not again. Surely, this isn't for real. First a hip procedure, then a hip replacement, then my prostate, and now this. Four general anesthetics and four operations in nine months.

"That ultrasound has saved your life," I hear Gillenwater add grimly.

Later that night, talking it over with my wife, I realized that he was right. Strange as it may sound, I'd actually been quite lucky. My prostate cancer had been diagnosed because I'd had regular check-ups. And now this tumor was found while still quite small because I'd gotten good follow-up treatment. Thinking about it this way made me feel not only blessed, but pleased that I'd taken good care. I'd made my own luck -- and gotten superb care -- in a way an awful lot of guys don't.

A recent survey by Louis Harris and Associates makes that abundantly clear. The poll of 1,500 men found that in the previous year one in four did not see a physician, one in three didn't have a regular doctor, and more than half did not get a physical exam or a blood cholesterol test. Six of 10 aged 50 or older weren't screened for colon cancer; four in 10 weren't checked for prostate cancer.

Had I adopted the attitude typical of my gender, I'd probably be dead right now. It was my yearly PSA screening that had found the cancer in my prostate early enough that I could be treated with brachytherapy (radioactive pellets that are implanted directly in the prostate tissue). And now a timely check-up was, I hoped, allowing me to treat another cancer before it could do major damage.

"Why don't men seek help?" was the question Fred Tudiver, MD, and Yves Talbot, MD, sought to answer by conducting focus group interviews with Toronto physicians. They discovered, as they wrote in the January 1999 issue of the Journal of Family Practice, that men shun medical attention for a wide range of reasons. Some adopt a macho attitude, seeking help only when their health problems are serious. Others are embarrassed to discuss their problems with staff members -- especially women -- and thus avoid calling their doctor's office. In general, the doctors interviewed agreed, men are a lot more likely to make an appointment with a doctor if their wives or female friends urge them to.

I know lots of men who fit that profile. My friend Simon, a rugged 53-year-old, never goes near a doctor and doesn't think he needs any sort of testing. I tell him my story and he's not persuaded. "You're wasting your time," his wife Becky tells me. "He's just not interested." I feel sorry for them both, but especially for Becky, who understands the implications.

My wife and I discuss health matters easily, and now, faced with yet another operation, I felt her support once again. Only later would I learn that she had been furious and frustrated, wondering whether she was now married to a permanent invalid.

So far, at least, it hasn't turned out that way. The kidney operation was highly successful -- no cancer had entered the organ or traveled anywhere else. Subsequent tests have revealed no abnormalities except a mild iron deficiency, for which I'm now taking iron pills. Another test taken, another problem corrected.

I've never had the slightest doubt that check-ups and testing were crucial in maintaining the good health I've enjoyed all my life. I'm far from being a fanatic, but it's always seemed to me that if it makes sense to take your car in for routine servicing, the same must be true of the human body. It is, after all, a rather fragile and continuously aging organism, yet it possesses remarkable powers of recovery -- especially when problems are detected early.

Sixteen weeks after having my kidney removed, I'm able to say that I'm strong again. My scar has healed quickly. And after six whole weeks when I was not permitted to carry more than five pounds, I'm now back at the gym three times a week weightlifting.

Next week, between trips to the gym, I have a couple of plans: I'm starting work on a comedy screenplay and enjoying the gorgeous fall colors -- best we've had for years. And, as a two-time cancer survivor, I'm scheduled to have a colonoscopy. Just a routine check, you know.

Anthony Hamilton is an actor and writer who lives in the Blue Ridge Mountains in Virginia.

 

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