Dr Su­ru­jrat­tan Ram­bachan

There are some lessons in life that we learn in class­rooms. Oth­ers we learn from books, from our par­ents, from our suc­cess­es and fail­ures. And then there are lessons that life teach­es us per­son­al­ly—some­times through ex­pe­ri­ences we would nev­er have cho­sen.

My di­ag­no­sis of Stage 4 metasta­t­ic prostate can­cer has been one of those ex­pe­ri­ences.

I nev­er ex­pect­ed to find my­self writ­ing an ar­ti­cle about can­cer from the per­spec­tive of a pa­tient. But life has placed me in this po­si­tion, and I have de­cid­ed that if I am go­ing to walk this jour­ney, I should try to make my ex­pe­ri­ence use­ful to oth­ers.

I am not writ­ing this ar­ti­cle to in­vite sym­pa­thy. I am writ­ing it be­cause there are things I wish I had done dif­fer­ent­ly. And if shar­ing my ex­pe­ri­ence can per­suade an­oth­er man to take his health more se­ri­ous­ly, then per­haps some­thing pos­i­tive can come from my own ex­pe­ri­ence.

The mis­take I made

One of the hard­est things for me to ac­knowl­edge is that I did not have reg­u­lar prostate checks as I should have. That is my re­spon­si­bil­i­ty, and I say it open­ly be­cause I want oth­er men to learn from my mis­take.

There is ab­solute­ly noth­ing em­bar­rass­ing about hav­ing your prostate ex­am­ined. There is noth­ing shame­ful about hav­ing a PSA blood test. There is noth­ing un­man­ly about telling your doc­tor, “I need to have my prostate checked.”

In fact, I now be­lieve that tak­ing re­spon­si­bil­i­ty for one’s health is an act of courage.

We take our cars for reg­u­lar ser­vic­ing. We ser­vice our hous­es. We check our fi­nances. We re­new our in­sur­ance.

But some­times we fail to ser­vice the most im­por­tant thing of all—our bod­ies.

I made that mis­take. I do not want an­oth­er man to make it.

Gen­tle­men, please

get checked

My mes­sage to men, par­tic­u­lar­ly old­er men, is sim­ple: Talk to your doc­tor about your prostate health. Ask whether you should have a PSA blood test and a prostate ex­am­i­na­tion. Your doc­tor can ad­vise you about the ap­pro­pri­ate ap­proach based on your age, fam­i­ly his­to­ry, symp­toms and oth­er risk fac­tors.

And please do not wait un­til you have symp­toms be­fore you be­gin pay­ing at­ten­tion to your health.

One of the lessons I wish I had un­der­stood ear­li­er is that prostate can­cer can de­vel­op with­out ob­vi­ous warn­ing signs. A man may feel per­fect­ly well and still have a prob­lem that re­quires in­ves­ti­ga­tion.

The PSA test is not a per­fect test, and an el­e­vat­ed PSA does not au­to­mat­i­cal­ly mean that a man has prostate can­cer. There can be oth­er caus­es. But it can pro­vide an im­por­tant warn­ing sig­nal that should be dis­cussed with a doc­tor.

So let us re­move the em­bar­rass­ment. Let us re­move the fear. Let us re­move the ma­cho at­ti­tude that says, “Noth­ing is wrong with me.”

Know­ing is bet­ter than guess­ing. Check­ing is bet­ter than ig­nor­ing.

When I re­ceived my di­ag­no­sis of metasta­t­ic prostate can­cer, I had to con­front a re­al­i­ty that I had nev­er ex­pect­ed.

My can­cer had spread to my bones. That is a se­ri­ous di­ag­no­sis, and I do not pre­tend oth­er­wise. But I have al­so learned that there is a dif­fer­ence be­tween un­der­stand­ing the se­ri­ous­ness of an ill­ness and sur­ren­der­ing to it.

I have cho­sen not to sur­ren­der. I have cho­sen to be­lieve that I shall over­come.

That does not mean that I de­ny the med­ical re­al­i­ty of my con­di­tion. I know that metasta­t­ic prostate can­cer is gen­er­al­ly re­gard­ed as treat­able and con­trol­lable rather than cur­able.

But “not cur­able” does not mean “noth­ing can be done.”

There is a tremen­dous dif­fer­ence. There are doc­tors. There are treat­ments. There are med­i­cines. There is re­search. There are sci­en­tists work­ing every day to im­prove can­cer treat­ment.

And there is hope.

The pow­er of the mind

One of the great­est dis­cov­er­ies I have made dur­ing this jour­ney is the im­por­tance of the mind.

I have de­lib­er­ate­ly cho­sen not to ap­proach can­cer with a mind­set of de­feat. I know there will be dif­fi­cult days. I know there will be un­cer­tain­ty. I know that treat­ments can be de­mand­ing.

But I al­so know that I have a choice about how I re­spond.

My doc­tors are re­spon­si­ble for the med­ical bat­tle. They ex­am­ine me, mon­i­tor my progress, pre­scribe my treat­ment and make de­ci­sions based up­on med­ical sci­ence and their pro­fes­sion­al judg­ment.

But there is an­oth­er bat­tle tak­ing place with­in me—the bat­tle to re­main hope­ful, de­ter­mined and spir­i­tu­al­ly ground­ed.

That is a bat­tle I in­tend to fight every day.

My phi­los­o­phy has be­come very sim­ple: “I have can­cer. Can­cer does not have me.”

Can­cer is some­thing I am fight­ing. It is not who I am.

Faith has sus­tained me

My faith has al­so be­come an enor­mous source of strength.

I have al­ways be­lieved in God, but ill­ness has a way of mak­ing one’s be­liefs more per­son­al.

For me, faith does not mean sit­ting back and ex­pect­ing a mir­a­cle while do­ing noth­ing. Faith means be­liev­ing that I am not alone. It means pray­ing. It means main­tain­ing hope. It means ac­cept­ing med­ical treat­ment while keep­ing my spir­it strong.

It means wak­ing up each morn­ing and say­ing:

“I am still here. I still have work to do. I still have a pur­pose.”

That be­lief has helped me through the dif­fi­cult days.

There have been mo­ments of fa­tigue, un­cer­tain­ty and anx­i­ety. There have been mo­ments when I have won­dered what lies ahead. But I have de­lib­er­ate­ly cho­sen not to al­low can­cer to de­fine me.

My ill­ness may have changed my cir­cum­stances, but it does not have to de­ter­mine the qual­i­ty of my spir­it.

I can­not change the past

Some­times I think about what might have hap­pened if I had been more dili­gent about hav­ing my prostate checked.

Per­haps things would have been dif­fer­ent. Per­haps they would not. I can­not know.

And I can­not change the past.

But I can try to in­flu­ence the fu­ture.

That is why I am speak­ing pub­licly. I want my ex­pe­ri­ence to be­come a warn­ing to oth­er men.

I want men to un­der­stand that there is no shame in be­ing ex­am­ined. There is no shame in hav­ing a PSA test. There is no shame in dis­cussing uri­nary changes or oth­er symp­toms with a doc­tor.

And there is cer­tain­ly no shame in be­ing di­ag­nosed with can­cer.

Can­cer is a dis­ease. It is not a re­flec­tion of a per­son’s mas­culin­i­ty, worth or char­ac­ter.

Fam­i­lies have a role to play

This mes­sage should not be di­rect­ed on­ly to men. Fam­i­lies can make a tremen­dous dif­fer­ence.

A wife can en­cour­age her hus­band. A daugh­ter can en­cour­age her fa­ther. A son can en­cour­age his fa­ther. A broth­er can en­cour­age his broth­er.

A friend can say to an­oth­er friend: “Broth­er, go and get your­self checked.”

Some­times a con­ver­sa­tion that lasts on­ly a few min­utes can change the course of some­one’s life.

We need to make health con­ver­sa­tions nor­mal. We need to make prostate ex­am­i­na­tions nor­mal. We need to make PSA test­ing nor­mal. We need to make can­cer con­ver­sa­tions nor­mal.

Si­lence does not pro­tect us. Knowl­edge can.

Can­cer has giv­en me

a new pur­pose

I nev­er asked to be­come a can­cer pa­tient. But per­haps I can choose what I do with the ex­pe­ri­ence.

I can choose fear or courage. I can choose de­spair or hope. I can choose si­lence or ad­vo­ca­cy.

I choose ad­vo­ca­cy.

I want to be­come an ad­vo­cate for can­cer aware­ness, par­tic­u­lar­ly prostate can­cer aware­ness. I want to use my voice to en­cour­age men to take re­spon­si­bil­i­ty for their health.

I want to tell them what I wish some­one had told me more force­ful­ly:

Do not ne­glect your prostate.

Do not as­sume that be­cause you feel well, every­thing must be well. Do not al­low em­bar­rass­ment to stop you from be­ing ex­am­ined. Do not be afraid of a blood test. Do not be afraid of know­ing your PSA.

And do not wait un­til some­thing is se­ri­ous­ly wrong be­fore seek­ing med­ical ad­vice.

My jour­ney con­tin­ues

Can­cer has changed my per­spec­tive on life. It has made me ap­pre­ci­ate fam­i­ly more deeply. It has made me val­ue an­oth­er sun­rise. It has re­mind­ed me that time is pre­cious.

But it has not tak­en away my de­ter­mi­na­tion to live.

I in­tend to con­tin­ue my sat­sang and my bha­jans. I in­tend to con­tin­ue speak­ing, writ­ing, serv­ing and en­cour­ag­ing oth­ers. I in­tend to con­tin­ue do­ing what­ev­er good I can for as long as I am able.

And if my ex­pe­ri­ence can per­suade even one man to get his prostate checked, then some­thing worth­while will have come from my jour­ney.

I can­not change the fact that I have can­cer. But I can de­cide how I face it.

I can face it with a strong mind. I can face it with faith. I can face it with hope. And I can face it with the best med­ical treat­ment avail­able to me.

From pa­tient to ad­vo­cate

Per­haps this is the next chap­ter of my life.

I be­gan this jour­ney as a pa­tient. I now want to be­come an ad­vo­cate.

I want to use my ex­pe­ri­ence to en­cour­age men to take charge of their health be­fore can­cer has the op­por­tu­ni­ty to take charge of them.

So my mes­sage is sim­ple: Check. Know. Act. Hope.

Check your prostate and dis­cuss ap­pro­pri­ate test­ing with your doc­tor.

Know your health sta­tus, your fam­i­ly his­to­ry and your risk fac­tors.

Act when some­thing does not seem right.

And hope, even when the di­ag­no­sis is dif­fi­cult.

If you are a man read­ing this and you have been post­pon­ing that doc­tor’s ap­point­ment, make the call. If you have been avoid­ing the PSA test be­cause you are un­com­fort­able, talk to your doc­tor.

If you have been telling your­self, “I feel fine, so there is noth­ing wrong with me,” re­mem­ber my sto­ry.

I made the mis­take of not check­ing reg­u­lar­ly. I can­not go back and change that.

But per­haps you can learn from it.

And that would give my ex­pe­ri­ence a pur­pose far be­yond my own life.

I will face this can­cer with a strong mind, a strong faith, med­ical treat­ment and an un­shak­en be­lief that I shall over­come.

And while I con­tin­ue my own fight, I will do every­thing I can to help oth­ers fight theirs.

I am a can­cer pa­tient. But I am al­so be­com­ing a can­cer ad­vo­cate.