In 2007 I was asked to consult on a patient with prostate cancer. He was a chiropractor. I respect those guys—I’ve got a great one who practices only on horses and dogs. I was a sceptic. I put chiropracty right up there with divination and dowsing. That is, I did until I found my doggy chiropractor. But that’s another story.
Anyway, the chiropractor had been diagnosed with prostate cancer about a year before he was referred to me. He was a relatively young man, in his early 50’s (yes, that’s young to me!). His PSA level, the blood test for prostate cancer, had been slowly rising and he was beginning to have symptoms of difficulty in urinating and frequency. He had resisted treatment for the usual obvious reasons—there is not a prostate cancer treatment on the planet that does not affect erectile function (or “ED, erectile dysfunction” as would better describe most of my patients.)
Anyway, he finally succumbed to the idea that he should at least SEE a radiation oncologist since surgery was out of the question for him—he was NOT having an operation. I approached the treatment options with great care, sensitivity and delicacy, as is my usual custom of course! We discussed continued “active surveillance”, hormonal therapy, nerve sparing robotic prostatectomy, and radiation therapy in all of its various and glorious forms.
At the end of our discussion, I asked the patient if he had any questions or comments. He came right out and said it: “I KNOW that my cancer isn’t growing!” This, despite the increasing symptoms and rising PSA. I said to him, “How do you KNOW that it isn’t growing?”
With a perfectly straight face, he said, “I know it isn’t growing because I EXAMINE my prostate every day!” As my own face started to crumble, I ran from the room. Needless to say, I did NOT shake his hand when he left!