P.C.

BUILDING YOUR TEAM We're men. We've been watching lone male heroes on the large screen and, more recently, small screen since we were kids. We've heard about them and read about them. We know that male heroes are tough, courageous and cool. When provoked or challenged, they battle back. Odds don't faze them. They take on big problems. They're self contained. They don't go running to mama. (Most of us are aware of female heroes, too, but, hey, we're men.) Think of private eyes like Philip Marlowe, Sam Spade and Spencer. Think of Frederick Douglass and Martin Luther King. Think of one-man armies like Achilles, Hector and Sergeant York. Think of the Lone Ranger, Gary Cooper on that empty street in High Noon and James Stewart in Mr. Smith Goes to Washington. Think of Superman, James Bond, Luke Skywalker and Frodo Baggins. Despite the evergreen popularity of "buddy movies," the spirit of the lone hero continues to loom large in our consciousness, and… It's the last self image you should cultivate right now. Dealing with prostate cancer or any other cancer is a team enterprise. At its smallest and most obvious, the team is comprised of the patient and one or more doctors. Ideally, the team also includes a partner -- wife, lover, domestic partner, close relative, close friend -- someone who loves you, cares very much about you or is at least unquestionably on your side. At no time is this partnership more important than at the front end of the process, as you traverse the learning curve of treatment options. (If there's no one in your life who fits the description, read on anyway. You might gain some insights into the issue, and your situation comes up later in this chapter.) If you've just found out about your condition, you're about to undertake a comprehensive research program. To the extent that you can, you'll gather data by reading books, health letters and other materials; checking valid internet resources; attending any relevant seminars or lectures within reach; and talking with other members of the fraternity. Most important, you'll confer with doctors -- including those who specialize in the various treatment options. You'll assess your data and decide what protocol, doctor and institution will be best for you -- the ones that will give you the greatest sense of confidence. This task may sound more difficult than it is. Sure, it can involve a considerable investment of time and attention, but virtually any man can get his arms around the information he accumulates. Most of it is available in straightforward English, and no medical expertise is required for a basic understanding. Nevertheless, a committed partner can make the entire process easier and ultimately more successful. Wait a minute, you might be thinking. This won't be the first time I've gathered information and then made tough decisions. You're right, of course. If you have ever chosen a place to live…or planned a vacation…or voluntarily changed jobs…or bought a new car or major appliance…or figured out an approach to your retirement plan, you've done this kind of work. This research project, however, is different in several ways. The need for this work probably came as a surprise and instantly rose to the top of your priority list. No matter how laid-back you might appear, you feel a sense of urgency, and it's appropriate. The discovery of this cancer has created a crisis in your life. In a crisis, people behave differently from their norms, and most are completely unaware of the change. The only exceptions are police officers, fire fighters, military personnel, medical professionals and others trained and experienced in dealing frequently with crises. In a half-century-plus as a public relations professional, I have often helped companies and institutions respond to crises, including many that involved life and death. In the process, I've observed what happens: When a crisis strikes, the kind that costs or threatens human or even just business life, people separate from their own minds. Their reasoning function stops cold. Whether it's the chairperson of the board, the president or a down-the-line administrative assistant, shop steward or machine-tool operator, this effect takes place. "We've got to do something!" is the most frequent reaction even before the shock of discovery wears off. It is most often accompanied by this one: "We've got to do it right away!" Only rarely do people react by saying, "Stop! We've got to think." As humans, most of us are just not built that way. Adrenaline kicks in. Our heart rate and other systems speed up; time seems to slow down; our awareness is heightened. All too often, people in a crisis do something, all right, but it's the wrong thing. It is specifically because panic severely curtails the ability to think rationally that cities, companies, schools and other organizations develop crisis-management plans and train their people in using them. Fire drills offer the most familiar example. Underlying virtually all these plans and training programs is the same simple message: "When you're suddenly faced with a crisis and 'have to do something,' do what it says in the crisis plan -- no more and no less." What does all this have to do with me? you might be wondering. I was shocked when I heard the diagnosis, sure, but I'm OK with it now. I can handle it without burdening anyone else. Noble, but this crisis is not an event; it's an ongoing situation. You will probably encounter additional moments in which your crisis response takes hold. Not least among them are your meetings with doctors during the early months of your research and treatment, along with your checkups later. How could it be otherwise? Every one of these consultations will provide hugely important information about your personal future. Even if they don't involve imminent life-and-death issues, they may seem to. Result: You may not be at your absolute-best at these important sessions. Let me give you an example: I had done a lot of homework before I had my first appointment with a major oncologist at a major institution. I knew my PSA and Gleason count, as well as the range of accepted treatment protocols. What I didn't know were "my chances." Sitting in the subdued, well populated waiting room with my wife, I realized that all these other people had cancer. Soon after, a routine reading by a medical technician showed that my blood pressure was elevated. Off the charts, to be specific. But I had no doubt that my mind was operating as well as ever. I was acutely aware of every detail of my surroundings and thinking clearly. No doubt about it. We were directed to a small conference room with an impressively large, bright window. When the doctor entered in his well-starched, knee-length white jacket, he greeted us and sat in front of the window, which cast his face into partial silhouette. It was hard to read his facial expressions. He glanced at my charts, which had begun to accumulate and accompany me from appointment to appointment, and he proceeded to describe my situation. He didn't sound encouraging. He placed particular emphasis on my Gleason 9 and its precarious implications. I wondered aloud about the most effective protocols in these circumstances (having by now learned how to use the word protocols with reasonable proficiency). Instead of discussing the treatment options I had read about, however, he described an approach that included procedures I had never heard associated with prostate cancer. He explained them clearly, but they still sounded radical to me. "Your Gleason count," he explained. I thanked him, said I'd think about it, retreated from the meeting as swiftly as I courteously could, and decided never to deal with him again. He had scared the hell out of me. It wasn't until evening, when my wife and I discussed the meeting, that I found out about the word I hadn't heard. "He said it was an experimental procedure," my wife said. "No, he didn't," I repl