Coping with a Prostate Cancer Diagnosis and Reluctance to Tell Others About It
- Defense Secretary Lloyd Austin, 70, has been diagnosed with prostate cancer. He was hospitalized for several days after experiencing complications from a prostate cancer procedure called a prostatectomy.
- A prostatectomy is an option for men with any risk group of prostate cancer that hasn’t spread outside of the prostate gland.
- During this procedure, the surgeon removes the entire prostate, along with some tissue around it, including the seminal vesicles that release fluid into the semen. Side effects may follow this procedure, which may include erectile dysfunction and urinary incontinence.
- Sec. Austin’s reluctance to share his diagnosis is a common sentiment many cancer patients wrestle with. Psychiatrist Dr. Lori Plutchik tells SurvivorNet that there is no “one right way” to seek support while coping with a diagnosis. She adds some people are comfortable talking openly about their diagnosis, while others prefer to keep it private, and both approaches are normal.
- She encourages those close to a person going through cancer to be respectful of their wishes when it comes to how they are comfortable seeking support.
- Some cancer patients can continue to work during cancer treatment, while others may need to take some time away. Doctors recommend returning to work, if possible, as it helps cancer patients regain a sense of normalcy.
United States Defense Secretary Lloyd Austin, 70, is battling prostate cancer that’s caused him to spend several days in the hospital. He was reluctant to share his diagnosis publicly for several weeks until an extended stay at the hospital raised suspicion among Washington insiders. The 41-year military veteran’s cancer journey so far highlights a predicament many cancer patients wrestle with. Deciding whether to share your diagnosis publicly and risk possible shame and if working through your treatment is a viable option.
WATCH: Why Prostate Cancer More Aggressively Impacts Men of Color?
According to the Centers for Disease Control and Prevention, “Aside from non-melanoma skin cancer, prostate cancer is the most common cancer among men in the United States.”
In the wake of U.S. Defense Secretary Lloyd Austin’s recent prostate cancer diagnosis, added focus is drawn to this type of cancer among Black men.
“Prostate cancer affects men of all walks of life, but it affects them differently,” Dr. Edwin Posadas, Medical Director of the Urologic Oncology Program at Cedars-Sinai, previously told SurvivorNet.
The incidence of prostate cancer in African-American men is 60 percent higher, and they are two to three times more likely to die from the disease.
RELATED: Check Out SurvivorNet’s Digital Guide to Prostate Cancer.
Deciding Whether to Go Public With a Diagnosis
Secretary Austin underwent surgery for prostate cancer in December 2023, according to a Department of Defense press briefing. In early January, Austin experienced complications from surgery, causing him to be readmitted to the hospital for several days. The revelation of his whereabouts caused an uproar among lawmakers and the Executive branch in Washington, D.C.
Austin was reportedly reluctant to reveal his diagnosis. During a recent press briefing, Maj. Gen. Pat Ryder called Austin’s diagnosis “deeply personal.”
Sharing a diagnosis is never easy, and SurvivorNet experts recommend cancer warriors disclose such personal information when they’re ready and to trustworthy people.
WATCH: Sharing Your Diagnosis
“People should do what feels right to them,” psychiatrist Dr. Lori Plutchik tells SurvivorNet.
It takes time to cope with a diagnosis, and part of that process includes how to talk to other people about what you are going through. Some people are more open about their diagnosis for reasons that may consist of showing others battling cancer that they are not alone. However, other people prefer to keep their diagnosis close to the vest to avoid unwanted judgment from others.
“Going through a cancer diagnosis, through treatment, is often a very long process. And then, if you include after treatment ends where a person is in a kind of limbo, waiting to see if they are clear and get their scans. It may be three months or six months into the future. People are still dealing with uncertainty at that point.”
What’s Next for Sec. Austin’s Cancer Journey?
After discovering he had prostate cancer, Austin underwent a prostatectomy procedure.
Surgery is an option for men with any risk group of prostate cancer that hasn’t spread outside of the prostate gland. The surgery procedure is called a radical prostatectomy. During this procedure, the surgeon removes the entire prostate, along with some tissue around it, including the seminal vesicles that release fluid into the semen. Your doctor can perform this through a traditional open procedure called laparoscopic surgery with one large or several small incisions.
Side effects may follow this procedure, which may include erectile dysfunction and urinary incontinence.
WATCH: Surgery side effects may or may not be long-term for prostate cancer.
This type of surgery, a radical prostatectomy, is known to affect a man’s sexual function since it requires removing the seminal vesicles.
According to the Washington Post, Austin experienced complications stemming from the prostatectomy. The complications included “nausea and pain in the abdomen, hip, and leg” in addition to a “urinary tract infection.”
A Pentagon statement says, “He is no longer in the intensive care unit but is recovering in a more private area of the hospital. He continues to experience discomfort, but his prognosis is good.”
Research Suggests Servicemen More Likely to Experience Prostate Cancer
Research published in the medical journal “Cancer” suggests men serving in the U.S. military are reporting higher rates of prostate cancer compared to men within the general population. The data was compiled from the U.S. Department of Defense’s Automated Central Tumor Registry, and the National Cancer Institute’s SEER program pinpointed the disparity. Among white and men of African descent, Black men had a slightly higher incident rate ratio of prostate cancer, 2.29 to 2.32, respectively, according to data published.
Choosing to Work During Cancer Treatment
Sec. Austin indicates he will remain in his post while treating prostate cancer.
“We always encourage people to continue to work if they can,” says Sarah Stapleton, a clinical social worker at Montefiore Medical Center.
If you can work, you’ll be busy, and you may not be worrying about how your treatment is going, Stapleton adds.
Sometimes, cancer can make you feel isolated and lonely, and being around people for work can alleviate feelings of loneliness.
It would be best to talk with your doctor before continuing to work during treatment. Ask your physician what you can and cannot do so you don’t disrupt ongoing treatment.
Remember, sometimes cancer treatment can cause fatigue, leaving you unable to fulfill your duties as you once could.
Fortunately, some on-the-job accommodations can make working during cancer treatment much more manageable.
It’s important to remember people with job problems related to cancer are protected by the Rehabilitation Act or the Americans with Disabilities Act. The Family and Medical Leave Act (FMLA) may also benefit others. This law allows many people with serious illnesses to take unpaid leave to get medical care or manage their symptoms.
Your human resources department should be able to share with you your options.
In some situations, employers must accommodate a qualified applicant or employee with a disability unless the employer can show it would be an undue hardship to do so. This could mean making changes to work schedules, equipment, or policies.
How Is Prostate Cancer Screened?
When you do get screened for prostate cancer, your doctor will run a few tests.
One of the tests is the PSA test, a simple blood test that screens for prostate cancer. It looks for larger amounts of protein-specific antigen (PSA) in the blood. An elevated PSA test does not always mean you have prostate cancer. It could also reflect that your prostate is enlarged, which is common, or it could signal an infection or inflammation.
Your doctor may also conduct a digital rectal exam (DRE) to check your prostate for lumps.
Depending on the results of these tests, imaging scans and a biopsy may be ordered.
WATCH: How Gleason Grade Determines Treatment
After tests, your doctor analyzes the results to give you a Gleason Score. This score ranges from 6 to 10. The higher the score, the more aggressive the cancer.
This score, along with your other test results, helps doctors determine if your cancer is “low risk,” “intermediate risk,” or “high risk.”
More on Prostate Cancer
Prostate cancer is the most common cancer in men. It starts in the walnut-shaped prostate gland, located between the rectum and bladder, producing the fluid that nourishes sperm. Fortunately, most prostate cancer is caught with screening examinations.
Prostate cancer does not always behave the same in every man it impacts. The cancer can be considered “low-risk” and can be slow-growing, and treatment might not be necessary. In other men, the cancer may grow faster or more aggressively, requiring more immediate treatment. Because of this, there is some debate about screening.
The United States Preventive Services Taskforce recommends men at average risk between the ages of 55-69 years old should talk with their doctor about the pros and cons of prostate cancer screening. Most doctors agree that men over the age of 70 do not need screening.
SurvivorNet experts suggested that men consider factors like their family history, genes, and age when deciding whether and when to screen.
Symptoms of prostate cancer may include:
- Urinating more often
- Waking up in the middle of the night to pee
- Blood in your urine
- Trouble getting an erection
- Pain or burning when you urinate
- Pain in your back, hips, thighs, or other bones
- Unexplained weight loss
- Fatigue
Treatment Options for Prostate Cancer
After testing and establishing your risk, your doctor will discuss possible treatment options. Treatment ranges from “active surveillance,” usually for men with low-risk prostate cancer, which again involves regular testing every six months to monitor the prostate and check for any progression of the disease.
More aggressive treatment options include surgery and radiation therapy.
Surgery is an option for men with any risk group of prostate cancer that hasn’t spread outside of the prostate gland. The type of surgery most often used is called a radical prostatectomy.
During the procedure, the surgeon removes the entire prostate, along with some tissue around it, including the seminal vesicles that release fluid into the semen. Your doctor can perform this through a traditional open procedure with one large or several small incisions called laparoscopic surgery.
Surgery side effects may include erectile dysfunction and urinary incontinence. Fortunately, the side effects are usually temporary, and there are ways to help you manage them.
Radiation therapy is often done when prostate cancer is caught early and confined to the prostate gland.
Questions for Your Doctor
If you have experienced symptoms associated with prostate cancer or have a screening coming up, here are some questions you may ask your doctor:
- If I have elevated PSA levels, what could be causing that besides cancer?
- How long will it take to learn if my PSA levels warrant further testing?
- What are the treatment options that are best suited for me based on my risk level?
- What financial resources exist to help me with the costs associated with treatment?
- How long will my potential treatment prevent me from working or continuing normal activities?
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