Cover image for Prostate cancer : a doctor's personal triumph
Prostate cancer : a doctor's personal triumph
Fine, Robert, M.D.
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Publication Information:
Forest Dale, Vt. : Paul S. Eriksson, [1999]

Physical Description:
xvi, 239 pages ; 24 cm
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RC280.P7 F53 1999 Adult Non-Fiction Central Closed Stacks

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A personal history of a doctor's battle with prostate cancer describes his decision to choose a breakthrough cancer treatment instead of a typical one, and discusses how he managed to survive.

Author Notes

Saralee Fine has taught at the high school and college level for years and has had hundreds of her poems published in journals and anthologies. Robert Fine, MD , has been a practicing radiologist since 1965. They live in Atlanta, Georgia.

Reviews 3

Booklist Review

Radiologist Robert Fine and his wife, Saralee, a deeply mutually supportive couple, tell the story of his prostate cancer. Most of the book is cast in dialogue form, which makes reading easy but raises some questions about its strict nonfictionality. As the text progresses through the diagnosis, test, treatment, and "triumph" aspects of the Fines' experience, other physicians, friends, and relatives join in the conversation. The book contains much useful, clear, up-to-date information that will be helpful to other prostate cancer patients and their partners. Yet the book isn't geared for the typical middle-class patient. Robert is a physician, who well understands medical literature and discussions with colleagues and appropriate specialists at any hospital or group practice in the country. The Fines don't have to worry about expenses or access to the best facilities. Finally, the short time span between treatment (radioactive seeds were inserted near the tumor) and writing the book makes the nature of Robert's "triumph" questionable. --William Beatty

Publisher's Weekly Review

After Saralee and Bob, her husband of 40 years and a practicing radiologist, learned that Bob had a low-volume cancerous tumor of the prostate, she insisted that they keep a tape-recorded journal of his experiences. Although their alternating accounts present a good deal of worthwhile information, the Fines' extensive, often tedious conversations with their doctors, which appear to be reproduced here with minimal editing, require a strong interest in the subject. The three treatment options that were offered to BobÄprostatectomy (radical surgery), external beam radiation and radioactive seed implantationÄthrust the Fines into an agonizing decision-making process. After personal research and consultation with other physicians, Bob, with Saralee's enthusiastic support, opted for the latter approach, which, according to his physician, is effective when the cancer is limited to the prostate and entails fewer complications than other treatments. Both Bob and Saralee were anxious to avoid surgery because of the common side effect of impotence. Although their frankness about their sex life is at first disarming, their persistent references to it rapidly slide into cloying cuteness. However, their detailed descriptions of the actual medical procedure will be reassuring to anyone who is contemplating it. Since the number of men diagnosed with prostate cancer continues to grow (200,000 were diagnosed in 1997), this account, though awkwardly crafted, will find an audience. Bob, now retired, is recovered and doing well. (Oct.) (c) Copyright PWxyz, LLC. All rights reserved

Library Journal Review

Like many men confronted with a diagnosis of prostate cancer (PCa), Dr. Fine, a radiologist, writes: "I've read so much medical information my head is spinning. ...I still can't decide which treatment to choose." Both Dr. Fine and his wife kept a journal of their quest for the right cure for them. This bookÄconsisting of their alternating, frighteningly personal diary entries and transcriptions of taped medical consultationsÄrecords their reasons for eventually choosing brachytherapy (in which radioactive pellets are implanted directly into the tumor). This book is valuable because few men with PCa will be able to tap into the healthcare network and scholarship as capably as the Fines have. Offering a uniquely expert point of view and a wealth of detailed information, it will be a wonderful guidebook for the less-advantaged PCa patient. Recommended for academic and public libraries alike.ÄJames Swanton, Harlem Hosp. Lib., New York (c) Copyright 2010. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.



Chapter One Discovery * * * SARALEE Saturday, August 30, 1997     I keep hitting wrong keys on my computer, because I'm shaking. The result is a worse hodge-podge than usual. The delete button is working hard. It's 11:30 A.M., and I'm already drinking wine. Yesterday we learned that Bob has cancer of the prostate gland.     That morning, I fed Praise, our Siamese kitten, worked out on our exercise machine, and watered all my plants. I stroked Praise, snuggled beside me in bed, as I read Salman Rushdie's incredible and dense prose. Hours and hours of quiet luxury and peace of mind that I may never find again.     When the phone rang about 3 o'clock, I realized it had rung for the first time that day. I picked up the receiver, and a woman said, "May I speak to Dr. Fine?"     "He's not here. This is Mrs. Fine. How may I help you?" I said.     "Can I reach him at his office?"     "No, he probably left his office about 2 and is driving home now. Would you care to leave a message?"     "No. We'll be here until 4:30 or 5. Have him call his urologist when he gets home."     Bob's urologist had done an ultrasound exam and a biopsy of his prostate gland on Monday. The receptionist's refusal to leave a message saying that the test results had been normal was a bad sign. I was too anxious to read any more.     An ultrasound exam is a study using sound waves to penetrate the body and evaluate tissue anatomy. The patient feels nothing. A wand is moved over whatever area is to be studied. Bob does ultrasound exams frequently.     Bob had told me that an ultrasound of the prostate gland is more involved. Because the gland is housed deep within the pelvis, the wand needs to be placed in the rectum. There, it will be right up against the gland, and the pictures will be good.     That sounded painful. My gynecologist had recently examined me. To feel the shape and tilt of my uterus, she had simultaneously placed a finger in my vagina and another up my rectum. The end of my anus had felt swollen for days.     For the biopsy, the urologist had taken slivers of tissue removed from Bob's prostate gland and sent them to a hospital, so a pathologist could see if any cancer was present. Neither of us had expected that the urologist would biopsy Bob.     I had asked Bob to let me go with him for the ultrasound. He said no. It would be the last time he'd go to a doctor alone. He deserved and would get all my comfort and support.     I got back into bed and wished Bob home. When he arrived the telephone rang. It was his radiology tech with an emergency exam for him to read on his tele-radiology. This computer setup sends films from his hospital, ninety miles away, and enables him to read emergency exams on the screen beside his desk.     I had almost called Bob earlier. It was the Friday before Labor Day, and he'd want to check with his urologist to see if his biopsy results were back. Otherwise, we wouldn't know until Tuesday. But I didn't call him. Neither of us anticipated abnormal results.     Bob's universal good health during our forty-year marriage has made us come to take his well-being for granted. We both knew the ultrasound had proved normal. The biopsy had been thrown in for completeness.     Bob turned on the tele-radiology in his library and called his urologist. I was in the kitchen when he called to me. I walked into his study. He was hanging up the telephone.     "Saralee," he said, "my urologist says the biopsy is positive. I have cancer of the prostate."     Instinctively, we reached out to one another and held each other close, hugging. We didn't say anything. We were incredulous, not believing what we'd been told. In shock.     "I think my doctor was surprised, too," Bob said, "but his last words were `with treatment, you will be cured'."     Bob and I repeated "you will be cured" over and over again, a mantra to get us through the endless holiday weekend. With that, he turned, walked to his desk, and read the exam that had arrived on his computer screen. I was amazed at his self-control. BOB     Before a routine physical exam with my internist six years ago, I had blood work done at the country hospital where I practice radiology. My chief tech suggested that a routine PSA, a prostate specific antigen study, be included, because I was almost sixty.     A PSA exam, done from a blood sample, measures what's given off by both the normal prostate and by cancerous tissues of the prostate. Little antigen escapes from a healthy gland, so an elevated PSA is a possible danger signal of prostate cancer.     My PSA result was 2.0, and the normal range is anything less than 4.0. My internist found my prostate gland enlarged during a digital rectal exam, but that is normal in a man my age.     In March of 1996, another blood test was done in preparation for a physical exam, and the PSA result was 2.2. My internist and I agreed that this minimal increase was to be expected along with the enlarging of the prostate gland with age. Neither of us thought much about that then.     Blood tests were done in preparation for my routine physical exam this month. These showed a few red blood cells in my urine, insignificant, and my prostate specific antigen at 3.7.     I was worried about the sudden rise in my PSA, but I didn't want to scare Saralee. So I told her nothing.     "You'll be fine. You always are," Saralee said as we drank mugs of my hazelnut coffee in bed and read the newspaper on Thursday, the morning of my physical.     "I hope so, but my PSA has jumped from 2.2 to 3.7 in sixteen months," I said.     "How long have you known that?"     "Since my blood results came back. About a week."     "Why didn't you tell me?"     "I couldn't see any point in both of us worrying about a test that's still within normal range."     My internist did not examine me that day. He called a urologist instead, told him about the jump in my PSA, and made an appointment for me to have an ultrasound exam the following Monday morning. Then we sat in his office and talked, mostly about investments and retirement. We've both been threatening to retire, and we both keep putting it off just a little while longer.     I gave myself an enema on Monday morning in preparation for the ultrasound. Just after 10 o'clock, I was sitting on the urologist's examining table sans shoes, trousers, and underpants. I covered my privates with a disposable waterproof sheet. When the door opened, a man in surgical scrubs entered, smiled, and shook hands with me.     "Bob, you've come to the right man. Prostate cancer runs in my family. Though I'm not fifty yet and my PSA is normal, I'm going to have an ultrasound done soon, just to be extra sure."     "How long does this exam take?"     "About five minutes," he said. "And I'll be as gentle as possible."     I winced.     "Please turn on your left side and bend your knees toward your chest."     I did that, and he examined me first with his finger.     "So far so good," he said. "No nodules I can palpate."     A nodule is a localized area of enlargement that can be felt. It increases the likelihood of malignancy.     "Now I'm going to do the ultrasound study."     He tried to insert the ultrasound probe into my rectum, but my sphincter was too tight.     "Relax," he said, "and I'll put more lubricant on the probe."     I tried hard to relax, and he was successful in sliding the tube far up my rectum to envision my prostate gland. As he did the study, he rotated and angled the probe. I stiffened my neck muscles and clutched the examining table edge. Five minutes had never seemed so long.     "I don't see any obvious abnormal echoes," he said, "but there are a few dark areas. I want to do a needle biopsy."     The biopsy seemed superfluous.     "What will it feel like?"     "Like a pin prick."     "How many pin pricks?"     "About six, but don't hold me to an exact number. They make a loud sound, so I'll warn you by counting backwards--3, 2, 1--and then I'll do a biopsy. Three, two, one."     `Bang.' He was right about the noise, but the pin pricks were punches jammed deep inside me. The pain reverberated down through my balls. He repeated the process five more times. I was exhausted when he finished, as much from the stress as from the pain.     "We'll call you when the biopsy results have gone through the lab. It's usual to do a PSA exam every six months, but I prefer having it done every four months," he said.     I was relieved. If he was talking about routine PSAs, I was far from cancer.     I cleaned myself up from the lubricant and blood. I stuffed tissues between my rectum and underwear, so I wouldn't stain my clothes. The receptionist handed me some capsules and a sheet of directions on the way out. I shuffled out of the office and walked gingerly to my car.     There, I read the directions, divided into three sections. Under things not to do for 24 hours were strenuous physical activity, sex, and straining while moving my bowels. The thought of needing to move my bowels was unnerving.     Under what to expect was blood in the rectum, in urine, and in semen. Under problems to call about were excessive bleeding or clots in urine or stool, difficulties in voiding, and chills or fever over 101 degrees.     The capsules were Floxin, a state-of-the-art antibiotic. If I still hurt or felt a burning sensation while urinating after taking them for 3 days, I had an infection and needed more Floxin.     Saralee had asked to come with me that morning, but I refused. My brother, Howard, had this exam done several years before, and he claimed it was nothing. I wished I had taken her with me. Saralee would have driven me home. She would have comforted me.     She was waiting for me when I got home.     "You look pale" she said.     I handed her the sheet of directions.     She read it and said, "How bad do you hurt?"     "Enough to cancel any errands you might have in mind and sit quietly at a movie this afternoon."     The pain continued through the day. We went to sleep early, and I felt decent by the next morning.     I work on Tuesday and Wednesday mornings. I had a bridge game scheduled for Tuesday afternoon and would do my billings that evening. I sleep at a motel on Tuesday nights to minimize my ninety mile drive on the Interstate to and from Atlanta. SARALEE     I sat on Bob's plaid sofa as he read the emergency CT scan after he talked with his urologist that Friday, and we learned that he had cancer. He seemed calm, efficient, and professional.     A CT scan, properly called a computerized axial tomography scan, is a circular series of X-rays taken by a machine that goes around the body. A computer puts the pictures together, generating images that are like slices of anatomy.     "What happens now?" I said when Bob had finished calling in the report to his hospital.     "We're both going to meet with my urologist at 4:30 next Wednesday. He says that by the time we've finished talking, we'll both know as much as any internist about cancer of the prostate."     "Isn't he at his office now?"     "Yes."     "Call him back. Let's drive there and see him right away."     Bob called, but the receptionist told him his urologist was leaving to do surgery. Wednesday at 4:30 was the earliest time he could meet us. I felt hostile toward this urologist.     It is not unusual for me to view doctors with animosity, I have lupus which took years to diagnose. I encountered plenty of doctors along the way. Most of them viewed me as an interesting object. I wanted to be a subject, subjected to a cure. Most of them gave up on me fast when they couldn't figure out what was wrong.     "If your urologist is so busy, who can we talk to?" I asked.     We sat thinking, until I realized that we knew a radiotherapist, a horseback riding buddy of years past. Because he was a class act as a person, I anticipated he'd be the same as a physician.     Bob began looking through the yellow pages but had trouble finding a listing of therapeutic radiologists, those physicians who treat cancer with radiation. I grabbed the business directory. We found the radiotherapist's number simultaneously.     I sat on Bob's sofa and listened as they talked. Afterwards, Bob told me what he had said.     "He told me that cancer of the prostate can be treated with surgery, radiation therapy, or both."     "What's his advice?"     "He recommends radiation therapy, because the surgery is so radical. Not only is the prostate removed, but much of the adjacent area as well."     "Why?"     "To get rid of any lymph nodes that may be cancerous as well. Radiation has the same wide-spread effect of deadening the prostate and adjacent lymph nodes without radical surgery."     "If it's so wide-spread, what else does it take away?"     "Good question. I'll research that in my radiology journals."     "I'll write about how miserable we feel." BOB     We called our daughters that first night. Wendy, our computer whiz, advised me to use the Internet as a research tool. She kept crying and saying "Daddy, I love you so much" over and over again. She made me cry with her.     Jody, our clinical psychologist, told us to get into bed and hug a lot. We followed her advice. During that dark night, our two warm bodies curled comfortingly together like spoons.     I called my brother Howard who told me that every man gets prostate cancer if he lives long enough. Cancer of the prostate is an inevitable by-product of old age. He advised caution in treatment.     I read medical journals that endless weekend, and Saralee wrote on our computer. Busy work to make the time pass until we could meet with the urologist.     I began a compulsive folder of my PSA results augmented by edited comments based on what I'd read. I bored Saralee with endless specifics. I would learn later that these facts I'd read were outdated, but nothing could curb my zeal in amassing them. I compiled data like the coin collection of my boyhood. Yes, I was panicky.     She was panicky, too. She agreed to let me do whatever I felt was beneficial, any procedure I felt would make me comfortable.     "It's your cancer," she said, "and our lives."     Then, one of us remembered we had planned a fortieth anniversary gift to share; we were going to Italy in October. That trip got put on permanent hold.     My life was at stake. SARALEE     During the weekend, I remembered that my cousin Larry in California was a medical oncologist, a doctor who treats cancer patients. The three of us talked by phone. What I learned made me decide to monitor as many of Bob's phone conversations as I could.     "Don't do surgery," he told Bob. "Your prostate is buried deep behind a mass of bones and is impossible to reach. The procedure is bloody and none too discrete."     "But with surgery, my prostate will be gone."     "The post-surgical complications are a nightmare. Choose something less radical. I put my patients on Lupron immediately."     "What's that?" Bob asked.     "Cancer of the prostate depends on testosterone for growth. Lupron lowers testosterone."     "What are its side effects?"     "Lupron lowers libido."     "Libido, as in sex drive?" I asked.     "Yes."     "Thanks, but no thanks," I said. "Sex is one of the great things we've got going for us."     "We want to keep sex in our lives forever," Bob agreed.     We were already aware our days as sexual partners could be ended by any treatment Bob chose. BOB     I met Saralee the spring she graduated from high school, just before I began medical school. At a friend's house, I was looking at the latest copy of my high school yearbook. I was bored with everyone I was dating and looking for someone new.     I saw her photograph and said, "Who's that? She's sure a looker."     "I don't know. Maybe my sister does."     His sister knew Saralee and introduced us by telephone. Saralee agreed to meet me that afternoon. I dressed in a blue oxford cloth button-down with my monogram embroidered on the pocket and properly scruffy saddle shoes. She must have found me appealing, because she accepted a date for that evening.     While we talked and began learning about one another, the telephone rang.     Her grandmother answered the phone and said, "It's your parents."     "What do they want?" Saralee asked.     "To tell you they'll be late and won't be taking you to dinner."     Saralee shrugged.     "You'd better get here sometime soon," Grandma said to them. "The man who will marry your daughter is sitting beside her on your sofa."     That was clever intuition on her part.     We dated steadily for the next several weeks, until I left for a cross-country tour of the forty-eight states with a friend. We took my car, a Chevy convertible that needed a quart of oil every hundred miles. We bought oil by the case. The trip was one last fling before the rigors of medical school.     I wrote Saralee some letters, not exactly love letters. Mostly, I described what I was seeing. I usually told her "I miss you" at the end. She still has those letters, tied with a faded blue ribbon. I called her when we reached California.     On the way back to Pittsburgh, we stopped at Phoenix. I visited the fiancée of a good friend.     "I've met the girl I love," I confided to her. "Can you help me choose a gift for her?"     "Sure," she said and chose a bottle of cologne for me.     Soon after I got back from my trip, Saralee stopped dating anyone else. She told me that other men made her uncomfortable. She felt on stage and obliged to make endless small talk. With me, she could talk or be silent. She felt comfortable with me. We both knew that we already belonged to each other.     Many couples who meet and marry young grow apart as they mature. They divorce. We were lucky. During our forty-some-year relationship, we grew closer. We depend on one another even more now, as we approach old age.     Since I sleep at a motel on Tuesday, Saralee and I reunite with glee every Wednesday afternoon, as if we'd been apart for weeks. We fall into bed together to make glorious and horny love. Afterwards, we nap and shower; then, we fix dinner together. SARALEE     As we hugged in bed one afternoon that endless Labor Day weekend, Bob said, "I'm afraid to move. I might be metastasizing."     "What's that mean?" I asked.     "It means I could be spreading cancer cells all over my body."     I sat up in bed, pointed at the ski machine we had exercised on earlier, and said, "Did you think you were metastasizing when you worked out this morning?"     "No."     "Then you're probably not spreading any cancer around now either."     "I'm a mess," he said and came close to crying.     "You're definitely not a mess. You're dealing with a new concept. Mortality. It takes a while to adjust."     "Yes. It stinks."     "Definitely. Foul black stench of death. But we've smelt it before."     "When?"     "Ages ago. Fifteen, maybe twenty years ago. When we found out I had lupus, and it could kill me."     "Yes. I haven't thought about your dying from lupus for years."     "I remember begging you to cut back on your practice, so we could travel more."     "That's true."     When lupus attacks the organs--kidneys, liver, heart, brain--any of the vital organs, it destroys the membrane that surrounds each organ. Without the protective membrane, the organ begins to deteriorate and eventually can no longer function.     "Look, we got so comfortable with the stench of lupus, we can't smell it anymore."     "I guess so."     "My grandma used to say that if you hang long enough, you'll get used to hanging. We'll adapt."     "Lupus isn't cancer. The word cancer conjures fear."     I had no consoling answer for that, so I hugged him. I tried hard not to cry. I didn't want my fear to make his cancer more difficult. A couple of times in the middle of the night, I woke up wailing, way out of control. He'd wake, too, and hold me in his comforting arms.     Once, tears came rolling down my face as we walked our miles together. I hoped he didn't notice, or, if he did, he thought the wind had made my eyes water. We walk four miles in an hour. Exercise is especially important for us now. A fabulous way of lowering stress. Some days, I'm so scared that my knees shake. Then, I can hardly keep up our pace.     My cousin called again on Sunday morning to extol the virtues of Lupron. Bob answered the phone, on his side of the bed, and handled the call. We were reading The New York Times in bed and drinking coffee. Both of us had temporarily forgotten about cancer. I wished my cousin hadn't reminded us.     Bob is so much more rational than I, so cool and controlled. What does he feel beneath that impeccable exterior? BOB     I felt horrible, and Saralee was hounding me to tape-record emotions that I wanted to hide. I use a recorder for my X-ray dictations, and she uses it as a writer's tool. We fooled around for a while comparing tape recorder techniques. Our hands were none too steady. The shaking recorder expressed our emotions.     We sat in her library with its computer desk and her grandmother's desk where she does any business I can con her into doing. I sat on a bentwood rocker, while she sprawled on her sofa. She set the recorder beside me on a drop-leaf table.     "Testing, 2, 4, 6, 8, who do we appreciate?" I said.     "Please forget all about being taped," she said and moved the recorder to a table between us. "We'll have a normal conversation."     I wondered how any conversation about cancer could be considered normal.     "The most comforting words I've heard were my urologist's. He said, `the worst scenario is that after you are treated you will be cured.'"     Minimize, I thought. Keep the mood light. If you let her know how frightened you are, you'll both collapse in a pool of tears. I must stay cool and figure out how to deal with this.     "Even though cancer of the prostate is known to be a disease of older men, I never thought of myself as older."     "Because you don't act like an old man. You're very active."     "Here I am."     "Yes. And here I am, right beside you. I'd do anything to make this easy for you."     I stood up, afraid to give vent to my emotions. We took a break. I made myself a sandwich and fed her a bite. We each drank a glass of wine. Then, we began recording again. She kept bugging me to tell her how I felt about having cancer.     "When I hit 65, I did have a big emotional hit," I said. "Now, I know I'm vulnerable."     I stuttered over the word vulnerable. I hoped she didn't notice, because I needed to control my emotions and think rationally. I needed to control her emotions, too. We mustn't break down.     "Why did I get this blood test early? Am I fixated on my anus, prostate, and penis?"     This was a banal assessment of myself, meant to lead us away from carcinoma, a concept we were both finding difficult to confront.     "Of course not," she said.     "I felt I should have a physical exam and blood work-up every two years. Fortunately, I didn't wait two years. That was not just luck. It was very skillful."     I might as well give myself a little credit. It made the messiness of what lay ahead more tolerable.     I wanted a rational mind-set for her. Intellectual. Thought through. Prepared. Nothing like the terror I felt now.     "But I should have remembered that I had my blood work and physical exam done by my birthday, at the end of January. This time it was six months before my birthday. Very fortunate."     "Yes, fortunate."     I wanted Saralee to see the problem in its best light. That it was good to have discovered this early. I wanted to convince myself of this as well.     "Now that I have this diagnosis, I'm looking forward to talking with the urologist on Wednesday. I know he will be encouraging."     I was dreading the discussion, too. Saralee's cousin and our radiotherapist friend had both warned me about the dangers and complications of surgery.     "We'll start to get the program planned and get the treatment going," I said. "We'll have to decide when the treatment starts."     "You'll have to decide."     "When I have something to do, I like to do it immediately."     "That's you."     We were drinking much more wine than usual. Saralee claimed they were making the bottles smaller.     "Do you hurt at all when you move?" she asked.     "Not a bit. But I'm slower and more conscious of how I move, probably because of all the wine we drink."     It would hardly do to tell her I felt myself destructing with every wary step I took.     "Okay, so you feel your body is fragile."     "Of course it's fragile. The ass area is fragile."     She laughed out loud. I made her find something humorous about my rectal exam and the residual blood in my urine and semen. Her laughter cheered and comforted me.     "The rest of me is not fragile," I assured her. "I'm in very very good shape."     That was daytime talk. Everything was more frightening at night.     "I dread the results of the acid phosphatase test and the MRI exam."     An acid phosphatase exam is a blood test to determine bone metastasis. Whether the cancer has spread into surrounding bone.     MRI stands for magnetic resonance imaging. It gives a three-dimensional scan of the body. Like a CT scan, an MRI produces images that are like slices of the anatomy.     "My brother, Howard, had an MRI. He said being in the tube gave him claustrophobia."     "I remember his saying that."     "I don't expect either of these tests to be positive. But you want to deny, you want to hide from tests. Because of any slight chance they might prove positive."     "Yes, I understand."     "I'm beginning to realize knowledge is not necessarily beneficial."     That was both true and false. My intellect demanded information. My emotions despised it.     "And my PSA is low. Chances should be wonderful."     I desperately wanted this to be true.     "Typically, I know it's a slow growing cancer--except in some cases. And in the worst scenario, even if it's not cured, it'll be many years until I succumb."     Hogwash. I wanted it cured, all cured, definitely cured. With no threat left hanging over me.     "Fortunately, I have you to share life with. I'll grill a steak for us tonight. My biggest worry is whether I'll get it done right."     Saralee chuckled. She likes hers rare, and I like mine medium rare. We share a steak by giving her the less cooked center and me the crisp ends.     "Let's worry about which wine we should have with the steak." SARALEE     It takes extra effort to grill outdoors when you live in an apartment building, but a charred sirloin is worth the work. Bob went downstairs and lit coals on our hibachi, then he came back up. I opened wine and fixed a salad--greens and a tomato he had grown.     When we thought the coals were hot enough, we went downstairs together. We rarely grill out anymore. It takes two elevators to get to our cook-out site, the public pavement. Grilling is prohibited on our condominium grounds.     We sat on wood planks that bordered the garden next door and watched the steak sizzle. When we agreed it was done, Bob carried our prize through the garage and onto the elevator that took us to the lobby. We crossed the lobby; our desk attendant sniffed approvingly. A young woman on the elevator asked if we wanted help eating dinner.     I had eaten little since Friday. The bad news had stolen my appetite. Tonight, we both ate with gusto and dunked crusty bread chunks in the steak's juice.     "Bob," I said, "do you remember my going to a psychologist when we planned Wendy's wedding at the farm?"     "Yes. You didn't want a farm wedding. You wanted it in Washington D.C."     "That seemed logical. They both live there. Ralph since birth, Wendy for over ten years. I thought none of their Washington friends would come to our isolated farm, and few family members would show up either."     "Yes."     "You insisted on personally grooming our acreage. I thought you'd kill yourself, and there'd be nobody to give the bride away."     "You were wrong about that."     "Yes. It was a wonderful wedding. Tons of people showed up. They thought the farm was a super setting for a wedding."     "Wendy and Ralph did, too. They thank us whenever they go to anybody else's wedding and on every anniversary."     "Anyhow, the psychologist told me to put together a support team. People I could talk with when I got anxious."     "You did that."     "It helped. I think we need a support team now. Not a big team. Just a few friends who will listen to our dilemma and comfort us."     "I don't know. We'd have to keep it small. I don't want many people to know anything about this. I need my disease to stay private."     "I know about your sense of privacy. I'll respect that."     "People don't want to talk about cancer. They want to talk about happy things. After a while, illness cancels a relationship."     "A few special friends will want to help. Your internist's wife has called to say they'll do anything to ease us through this. She ended with `I love you.'"     "Keep it small. Cancer is so ominous. I wonder if friends will think shaking my hand, hugging me, or kissing me may contaminate them."     "That's crazy. Let's call Piera and Addison and tell them."     They live four floors from us. We've shared many good times together. When Piera and I have problems with our daughters, we share that, too. I knew they'd relate.     Our doorbell rang in half an hour. Bob opened the door, and Ad wrapped both arms around him in a bear hug. Piera kissed him. So much for his contamination theory.     We sat in our living room, as we normally did with nibbles before going out for dinner. Ad sat beside me; and Piera, beside Bob. To say that they were sympathetic would be British understatement. We were blanketed in the warmth of their support.     "We want to put together a small support team to help us," I said.     "We're honored to be included," Ad said.     "Thanks," Bob said. "We'll try not to be a burden."     "On the contrary, we want you to lean on us. We'll be here for you when you need us."     The next day was Monday, Labor Day. We drank coffee in bed and read The Atlanta Journal-Constitution , loaded with sale ads. Neither of us wanted to shop. We couldn't find a decent movie either. We had a bad case of the blahs. Maybe we'd stay in bed all day.     "I've run out of journal articles," Bob said. "I need more prostate-cancer information. So I can decide what treatment to have. I need recent information."     "We researched together at Emory University's medical library when I started menopause. It's a super medical library. I'll bet they have the latest cancer journals.     "Good idea. I can find current information there. Articles that have just been published and focus on my problem."     We went together. Bob did research and xeroxed pertinent information. He created a list of articles to be read by using the authors' names and the bibliography at the end of each article he read. He seemed stimulated by what he was learning. More in control. Less of a victim.     I sat quietly, a mute spectator. I tried to concentrate on Salman Rushdie's literary style but found myself more concerned about Bob Fine.     After a few hours of intense research, he said, "I've had as much information as I can handle for today."     We returned to the medical library frequently. It became a focal point in his education and eventual ability to make a decision that might work for him.     Late that afternoon, we called Mark and Judith. They are relatively new friends; Mark and Bob respect each other's minds, and Judith and I could have been hatched from the same egg. They weren't at home. We left a message on their voice mail that asked them to call us.     We also called John and Nancy in Denver. We've remained close friends since we all lived in Milwaukee more than twenty years ago. Our first spring, we planted a perennial garden in our side yard beside their house. We dug the bed, smashed clods of earth into fine soil, added fertilizer, and planted the flowers. It's the blue delphiniums I remember best. The project lasted all weekend.     On that Sunday afternoon, John crossed from their lawn to ours. He carried a tray in his hands. On it were an icy pitcher and frosty glasses.     "You look like you need a break. Shall we drink martinis?"     We promptly christened our project "the martini garden" It was the start of a great friendship.     John and Nancy weren't at home, so I left a message. John had dealt with prostate cancer. His voice on their recorder was both calm and congenial.     "John," I said, "hearing your voice is reassuring. Bob has prostate cancer. We need your help. Please call when you can. Love from both of us."     On Tuesday morning, Bob left for his hospital. On Tuesday morning, I learned how to cry. Judith returned our call.     "What are you doing?" she asked.     "Crying. Can't you tell?"     "Saralee, what's wrong?"     "Bob has prostate cancer, and I don't want to cry in front of him. He's not crying, and I know he wants no tears from me."     "Then you have plenty of reason to cry. I want to help you as much as I can."     "I don't think anyone can help us until 4:30 on Wednesday. We'll meet with the urologist who diagnosed Bob's cancer, and he'll explain what to do."     "Let's have dinner together soon."     "Okay, but Dutch treat, like we always do."     Bob didn't want people to think of him as disabled, to pity or shun him. Judith instinctively picked up on how he felt.     "Dutch treat, it will be."     We set a date for dinner.     I'd like to say I exercised on that Tuesday and Wednesday, but I probably didn't. I'd like to claim I wrote on Tuesday and Wednesday, but I certainly didn't. I frequently write for six or eight hours at a stretch, often more. The two days when I'm alone are normally my productive writing corridor.     Nothing felt normal anymore. I couldn't even read. I spent protracted periods in my closet, curled like a fetus, hidden and howling. Copyright © 1999 Saralee Fine and Robert Fine, M.D.. All rights reserved.