To Beat Prostate Cancer, I Faced the Real Killer—Fear

Cancer. The word alone is enough to strike fear. For men, the words “prostate cancer” are even more frightening. Yes, you can die from prostate cancer. But the thought of surviving it and facing incontinence and erectile dysfunction can be even scarier than death. And that’s not to mention the anxieties associated with treatment options, cures that often seem worse than the disease, including strength sapping radiation or nerve-threatening surgery.

This is why Berkshire Hathaway CEO Warren Buffett’s announcement last Tuesday that he’d been diagnosed with early stage prostate cancer (which followed a similar announcement from actor Ryan O’Neal) was such big news. It’s also why Buffett made the effort to reassure his company’s shareholders that his condition was “not remotely life-threatening.” There is nothing like fear when it comes to shaking up the financial markets. And while it is natural to feel and acknowledge such fears, it’s critical for both the health of those markets and, more important, the fight to treat and survive the disease, to not be ruled by fear.

These are not mere hypothetical musings for me. I am a prostate cancer survivor. With April now designated as National Minority Health Month by the U.S. Department of Health and Human Services, I’m here to tell you that the ability of prostate cancer to kill you depends largely on whether you allow fear to keep you from acting to protect yourself.

The most important words to focus on in Buffett’s announcement are “early stage.” These words are the difference

between prostate cancer being a survivable, though serious, condition or a life-threatening, quality-of-life destroying health crisis. And that’s why it’s important that we address and stand up to our fears about prostate cancer, especially us Black men. Our fear keeps too many of us from catching the disease in its early stages. Fear of doctors. Fear of digital rectal exams, where doctors literally feel for signs of an enlarged or misshapen prostate gland. Fear of prostate specific antigen (PSA) tests and what they might reveal. Fear of how the mere thought of erectile dysfunction might jinx our mojo in bed. Even fear of the lifestyle changes–including diet, exercise and medication–that preventing, fighting or recovering from prostate cancer might require.

If prostate cancer is a murderous home invasion, fear is what allows the disease to bypass security systems to break in and terrorize us. When it comes to my health, I decided 20 years ago that the time to deal with a home invasion is before it takes place, not once it’s inside. I was 32, when I decided to reject my lifelong fear and distrust of doctors and commit to finding a personal physician and getting annual physical exams. My turning point: an episode of a television news magazine show following the lives of three men who suffered disability, the collapse of a small business, bankruptcy and premature death by simply avoiding doctor visits as if they were the plague. All it took was one look at my two older daughters (ages 9 and 3 at the time) and my infant son, and the story of one of the subjects of the TV program who sentenced himself to death from a totally treatable disease, who would never see his children graduate from college, get married or give him grandchildren. Within two weeks, I found a physician, Dr. Bruce Yaffe, and scheduled my first annual physical since high school.

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My newfound commitment to taking personal responsibility for my health was as serious as a heart attack. When the subject of blood tests came up, I told my doctor to “give me every test available, including a pregnancy test.” That included the PSA test, even though conventional wisdom was that men didn’t need to begin getting PSA tests until age 50, and even Black men, who are at higher risk, could wait to age 40. Fortunately, my doctor granted my request (which is why he’s still my doctor today), testing for my PSA levels every year since.

Nearly 18 years later, that decision would be the key to saving my life. I was 49 when my PSA levels, which had been stable for more than 15 years, had a small uptick, just as it did with Buffett. That led to me to see a specialist, urologist Dr. Jonathan Vapnek, who conducted additional PSA tests, and ultimately a biopsy, that confirmed that I had early-stage prostate cancer. Discovering the disease at such an early stage gave me a number of advantages, the

forwp-incontent-custom-banner ampforwp-incontent-ad3"> main one being the luxury of time. Instead of having to choose a treatment option in panic and desperation, I could afford to start with a strategy of “watchful waiting,” monitoring my condition with quarterly PSA tests for a year while I explored and considered treatment options. With the recommendation of Dr. Vapnek, I ultimately chose to have my prostate removed via robotic prostatectomy, performed by Dr. David Samadi, the world-renowned surgeon who developed the Samadi Modified Advanced Robotic Technique (SMART), which, among other advantages, spares the nerves critical to continence and healthy sexual function (both are at greater risk with both traditional surgery and radiation). Had my prostate cancer gone undetected until a later stage, or if I did not have the time to explore treatment alternatives, this option might not have been open to me.

I knew that as a Black man, my prostate cancer risk was increased. (It’s not lost on me that Buffet is more than 30 years older than I was when I was diagnosed.) I also knew that genetics and family history are major risk factors. However, I knew next to nothing about my family health history. My father was not a part of my life growing up and my maternal grandfather died when I was an infant. I’ve since learned that my father, now in his late 70s, is a prostate cancer survivor, as was his father, who lived to the age of 98 before succumbing to the disease. My doctor–who has always credited my passion for exercise, fitness, vitamin supplementation and nutrition with protecting me from disease–once bluntly told me that when it comes to prostate cancer, the question is not “if,” but “when.” His directness was further motivation to stay vigilant as I got older.

It is important to note that I have never experienced any of the symptoms–enlarged prostate, difficulty with urination, erectile dysfunction–commonly associated with prostate cancer, either before or since my surgery more than a year ago. (In fact, today it often seems as if my prostate cancer diagnosis and surgery never happened.) To wait for prostate cancer to announce its presence via symptoms, instead of seeking it out via early and regular digital rectal exams and PSA tests, and other means as they become available, is literally playing Russian roulette. As each of my doctors told me, if you wait until you’ve got symptoms, you’ve waited too long.

Men, make an annual physical non-negotiable. If you’re over the age of 30, make annual PSA tests a part of your preventive health regimen, not because you’re likely to get prostate cancer that early (you’re not), but because the sooner you can establish a baseline for your PSA levels, the easier it will be to detect a threat if it inexplicably spikes. Prostate cancer can be a deadly killer–all the more reason not to turn your back on it. The earlier you engage this invader, the more power you have to repel it before it can kill you or damage your quality of life.