Generally, I acknowledge two types of cancer: Bad and Really Bad. The difference between the two, you'd think, would have something to do with duration: Bad takes a while to kill you, while Really Bad seems to start out at Stage Four, or 3.9 anyway, and wipes you out in a matter of months. But maybe it's not that simple. Suppose a merely Bad cancer makes you sometimes almost wish you were dead? D. G. Myers has one of those:

For more than seventy years, or ever since Charles B. Huggins discovered that tumors would shrink if deprived of testosterone, the treatment of metastatic prostate cancer has varied little. The treatment is castration.

[Excuse me for a moment while I wince.]

And this was a big deal; Huggins, a native of Nova Scotia who short-circuited testosterone by massive infusions of estrogen, won the 1966 Nobel Prize for Physiology or Medicine, though it took a while for the medical community to come around to this sort of thinking. (Huggins and his partners published their research in 1941.) Now, of course, it's the rule rather than the exception:

Since the 1980s, luteinizing hormone-releasing hormone (LH-RH) agonists have gradually replaced surgery — that is, chemical castration now achieves a similar medical effect to cutting off a man's balls. The psychological effect is only slightly better.

It has taken me six-and-a-half years to talk about being castrated. Only this past weekend did I confess to two of my closest friends that hormone treatments have left me impotent. And not merely impotent: I have been entirely drained of any sexual feeling whatever.

The effects of castration have a comical side. My pre-adolescent sons are not the only ones to groan "Yuck!" now when a man and woman start necking on screen. A sex scene in a contemporary novel transforms me into a thin-lipped censorious prude, flipping pages to escape the humidity. Feminine beauty is an abstraction: a Playboy Playmate arouses about as much physical response in me as the election results in Nauru.

I hate like hell to bring it up, but some of us got to this yucky state before the onset of hardware impairment. I've always been something of a prude, though I'm not particularly censorious and my lips are anything but thin. And the desire hasn't gone away, exactly: most of the stuff that turned me on in the 1970s still does the trick today, not that it makes any difference. (Fran Lebowitz: "If your sexual fantasies were of interest to others, they would no longer be fantasies.")

Then there's that whole "Use it or lose it" business. Being heavily into maintenance in general, I occasionally perform equipment testing: some indicators are down, others are about where they've always been. This is, however, a solitary task — yes, I'm aware that it doesn't necessarily have to be — and it has little to recommend it except for a vague sort of peace of mind.

Not that I actually have peace of mind, of course. Dr Huggins, who died in 1997 at ninety-five, might have had prostate cancer himself, just by dint of being ninety-five:

More than 80% of men will develop prostate cancer by the age of 80. However, in the majority of cases, it will be slow-growing and harmless. In such men, diagnosing prostate cancer is overdiagnosis — the needless identification of a technically aberrant condition that will never harm the patient — and treatment in such men exposes them to all of the adverse effects, with no possibility of extending their lives.

Gee, doesn't that make you feel wonderful? D. G. Myers is seventy-one; this means he came down with it some time before sixty-five, which is a hell of a lot closer now than I ever imagined it to be.

Still, I feel for Dr Myers, and for his lovely bride:

My sexual passion for my wife is a happy memory, like nostalgia for staying out till after dark playing pick-up baseball with friends. Our marriage really is between true minds; my body stays outside the door.

And that's the scary part: two people suffering from a single disease. Perhaps I am better off alone after all.

The Vent

#879
  1 August 2014

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