Every week, New York Times editor Dana Jennings shares his experiences coping with prostate cancer.
By Dana Jennings
I have prostate cancer, and sometimes I get mad. Not upset. Not annoyed. Not nettled. Mad. This isn’t mere “why me” moaning. My rage is pure and primal, like that of a wolf caught in a steel trap.
Dana Jennings. (Lonnie Schlein/The New York Times)My anger, though, doesn’t arrive when and where you’d think it would. Gliding into the radiation machine, getting a hormone shot and wearing mini-man-pads don’t set me off. It’s smaller, less expected, things, like a fellow customer being mean and rude to the server behind the counter at Starbucks, or a car busting a red light as I walk to my New York office.
That kind of behavior has always bothered me on some level. But since I learned that I have cancer, I react differently. I’ve walked the streets of New York for decades, and not thought twice about the cars that run red lights and nearly nail me and other pedestrians. It’s a fact of life in the big city, like rats on the subway tracks. I used to shrug and keep walking.
Prostate Cancer Journal
One Man’s Story
Dana Jennings blogs about his experience with prostate cancer.
Since my diagnosis last April, though, and especially since my prostatectomy last July, it has not been so easy for me to shrug it off. Perhaps it’s because prostate cancer and its treatment have left me feeling vulnerable. Now, it’s as if a heedless speeding car pulls some small biological trigger of agitation that too quickly metastasizes into rage. Suddenly, I’m howling at the traffic. If I could, I’d turn green and bellow: “Hulk smash!!!”
In utter mortification, I admit that I have shocked at least a couple of drivers with a quick thump to the rear-ends of their cars. I’m not proud of this. But it’s almost as if, in certain situations, my cancer is granting me permission to tap a dark and ugly passion. My tolerance for bad behavior has vanished, and I have trouble keeping my mouth shut. And anger, no matter how bitter, still tastes good, at least for a moment.
But I hate it. It’s bad enough having a cancer of the body without having a cancer of the spirit, too. It’s all part of the emotional Tilt-a-Whirl that arrives with cancer — not just anger, but the occasional sighs and tears, the despair and depression. Doctors do a good job of treating the physical aspects of prostate cancer, but what about the psyche that’s been scraped red and raw?
I work hard not to let my cancer get me down. I believe in the power of kindness and gratitude, and my good cheer is not a pose. But we all have our weaknesses. I’m haunted by the uncertainty caused by my aggressive cancer. And when I see people plowing through this world, self-centered and unaware, their obliviousness strikes me as a deadly sin. I can’t lash out at my cancer … but I can lash out at them.
I am trying to cope, trying to damp those flash fires. Spending time with my wife and family helps; so does writing in my journal. But in scanning my large collection of CDs a few months ago, I noticed a few heavy-metal albums I hadn’t listened to in a long time. It struck me as the right music for my mood, and the result has been my own unorthodox form of music therapy. I’ve learned that heavy-metal music leaches away my fury the way a poultice draws poison from a wound.
I crave heavy bands like Slayer and Meshuggah, Pantera and Sepultera, Isis and Neurosis. Prostate cancer seems especially suited for heavy-metal music therapy. According to Dan Nelson’s book “All Known Metal Bands,” I could let my ears pound and bleed to such disease-specific headbangers as Cancer and Metastasis, Scars of Chaos and Scars of Suffering, and Surgikill Incision.
So you know, I don’t fit the music’s clichéd demographic. I have no piercings (my 25 surgical staples are long gone) or tattoos (except for the four black microdots used in my radiation treatment), I do not scrawl hexagrams on my walls, and I like goat cheese but not goat sacrifice.
But music has always been one of the ways I understand myself, interpret myself and this world. I’ve written about bluegrass, Cajun music and the Grand Ole Opry for The Times, and I wrote a book about classic country — “Sing Me Back Home: Love, Death and Country Music” — that was published last spring around the time of my diagnosis.
Different kinds of music say different things to me. Country retells my story of growing up poor and rural, reminds me that I come from a small town in New Hampshire where my relations lived their lives through the songs of Johnny Cash, Hank Williams and Patsy Cline. Jazz, especially the slowest, the bluest notes and tones of Miles Davis and Cannonball Adderley, settle me down before I fall asleep, can soften the edges of my melancholy. But it’s metal that helps see me through when my temper tumbles over the edge. Its anger blunts my anger, in the same way that a backfire can be used to fight a forest fire.
I rasp and roar along with System of a Down on the song “Toxicity.” As I sing the lyrics, “How do you own disorder, disorder?” I’m also hurling that question at the health-industrial complex and the bureaucracy that has nothing to do with making people well. As I listen to Metallica’s album “Master of Puppets” or Mastodon’s “Leviathan” (wearing the black System of a Down hoodie that my sons gave me), I grit my teeth and perform air-guitar exorcisms. Songs like Metallica’s “Damage Inc.” and Mastodon’s “Blood and Thunder” resonate in my gut and feel like heavy-metal radiation therapy.
Never mind scalpels or robots, the squall of those razor-wire notes seems sharp enough to cut out any cancer.
It seems to be helping. All my fear, anger and alienation are vented in those bands’ savage, guitar-driven engines. Heavy-metal inoculation talks me down from the ledge of my rage, lets me take a deep breath, then shrug — even at a car running a red light.
Healthy living doesn't happen at the doctor's office. The road to better health is paved with the small decisions we make every day. It's about the choices we make when we buy groceries, drive our cars and hang out with our kids. Join columnist Tara Parker-Pope as she sifts through medical research and expert opinions for practical advice to help readers take control of their health and live well every day. You can reach Ms. Parker-Pope at 
The easiest and most pleasurable way to eat well is to cook. Recipes for Health offers recipes with an eye towards empowering you to cook healthy meals every day. 
From 1 to 25 of 105 Comments
Had heavy metal or other types of music gotten you through periods of anger in your past? If so, what brought on such anger?
“Music soothes the savage beast.”
FROM DJ: Jack, ever since I was very, very small, music of all kinds has helped me make it through. Heavy Metal is just one of the moods that helps me.
— jackCorrection to my post #1:
AUTHOR: William Congreve (1670–1729)
— jackQUOTATION: Music hath charms to soothe the savage breast, To soften rocks, or bend a knotted oak.
ATTRIBUTION: The Mourning Bride. Act i. Sc. 1.
So give us the top 20 on your iPod… I’m a nurse, I think about death every day and am sometimes infuriated myself by mindless behavior from people who seem to think they will live forever. Thank the gods for music!
FROM DJ: Kate, I’m thinking about a music-specific cancer essay at some point. But here’s a couple that are indispensable, and that will help your curiosity: “Hurt” by Johnny Cash and “Who Knows Where the Time Goes” by Sandy Denny.
— KateI am in a similar situation living with metastatic prostate cancer and having hormone suppression treatment. I too get angry more than in the past.
— Rex StoessigerI wonder if the hormone treatment contributes to this. We hear of ‘grumpy old men’. Maybe the natural testosterone decline with age makes men more likely to be bad tempered?
Love your articles.
- Rex
I too am a nurse and work with end of life patients. The rage is there but we know that for whatever reason the comfort of music does help to alievate the anger. I recommend the likes of Bach to my patients. Most of them are a little bit too old to dive into Metallica!
— NurseTerryhttp://www.caringisnotenough.net
Do you think releasing anger makes you feel more alive, Dana?
— HeronFROM DJ: Heron, it doesn’t make me feel more alive. But, to paraphrase John Lee Hooker in “Boogie Chillen,” it’s in me, and it’s got to come out. In my current situation, I’m making sure I feel alive every moment of each day. Honest.
System of a Down is great.
I am not generally a metal fan, but it is better than some of the corn syrup pop that is out there.
I think hard music goes with hard times. Paradoxically, it makes them easier.
Good luck in your fight.
— rini10i think everyone can relate to this to some extent. there’s a lot to be said about complementary and alternative medicine… especially music therapy. it can get people through rough times…keep you sane… and has physiollogical effects that we don’t even realize.
— EMILYSo, so you think you can tell Heaven from Hell, blue skies from pain? I am a cancer patient, choreographer, and just finished writing a book about living with cancer in your 20’s and 30’s. When I get bad test results and am tired of thinking and writing about illness, I lock myself in the studio and dance up a storm to Pink Floyd. It is the perfect combination of loud belting it out song and slow melancholy music.
I never try to make myself okay with or happy about my cancer. I just ride the waves as they come and take them full on: gratitude, ball busting anger, and deep sadness alike. As long as I stay out of jail and don’t injure others, I let the anger flow.
http://everythingchangesbook.blogspot.com/
FROM DJ: Kairol, thanks for your beautiful sentiments. And Pink Floyd does help, doesn’t it?
— Kairol RosenthalI love your column - but I take offense with the “goat sacrifice” and ‘hexagon” references. The heavy metal demographic absolutely spans a much larger population. The tattoos, piercing, black clothes - all warranted stereotypes. But goat sacrifice?
— AshleighFROM DJ: Ashleigh, I wasn’t trying to paint all metal fans with that brush. I was trying to be funny, and going after the cliches of heavy metal, especially the early days with all that silly Satanic iconography. Even the original members of Black Sabbath admit that the created their “dark image” as a goof based on old horror movies. I still prefer goat cheese, though.
“I’m also hurling that question at the health-industrial complex and the bureaucracy that has nothing to do with making people well.” Dana writes.
While the situation described is not being worthy of anger, this quote does reflect a need to understand that unfortunately the medical care received (MCR) does in fact often have little to do with health or wellness and in many cases has the opposite effect.
In another story in today’s NYTimes.com, there is a story on the value of scans, the vaulted new technology that let’s us see where and what we never saw before. Please read it to learn how that new technology can lead to unnecessary treatment with no positive outcomes. Coming on top of studies earlier this year by orthopods that all medical and surgical intervention technigues that they do is equal to doing nothing over the course of six months in the matter of lower back pain, a pattern arises that requires understanding and correction. Add in the expense, anguish and adverse side effects and the MCR is worth even less.
Now that could be a reason for anger. But what needs to be done for better health and wellness can be done by Americans outside the medical model in many cases.
Dana’s forthright description of outrage, feelings of vulnerability and present deterioration in a quality life need to be examined. How we treat disease and in the other story how we diagnose disease are less important than how we primarily prevent the disease. In Dana’s case, the disease’s name given by the medical people is cancer of the prostate. But what it really is a cellular dysfunction the cause of which now seems unknown. Primary prevention avoids learning how underinsured we really are and the horrors or treatment that are poisonous and dangerous in their own right.
— ed gDana: You do whatever it takes to help you get through this rough, tough time ! As I posted before to you, I too am a prostate cancer survivor. I was diagnosed at the age of 41. That was six years ago and am doing fine to date. Only those of us having gone through this awful disease can truly appreciate and understand what it is like. I also had a nerve sparing prostatectomy, Lupron injection and radiation therapy. You cannot possibly function the same sexually after going through the grinder with all these treatments. The main thing is you have improved your chances for survival substantially. Look around and appreciate all the things you have in life. Now is the time to truly evaluate what the important things are ! It is tough being on hormone therapy. Believe me, I truly understand what it is like. Your whole body feels and functions differently. Hopefully you will be able to go off the Lupron even if for intermittant periods. Your libido will return and there is an assortment of medical help for impotence. Don’t be afraid to try them . Some of them work quite well actually. Give ‘em hell Dana and may God bless you in your fight.
— dwerI smiled at the thought of you bumping the cars of careless and dangerous drivers. However, had you bumped me in the year (or two) after my catastrophic divorce, I might have been in your face screaming expletives. My divorce included abuse of me and my children by my ex, bankruptcy, foreclosure, a fight for my career, and a nasty custody battle for the children ex was abusing. I’ve always thought only cancer, or a great threat to my health, could have been worse. And I’ve yelled myself hoarse to Melissa Etheridge’s version of Take Another Little Piece of My Heart, always keeping in mind that if she could show up bald at the Grammys and belt that one out, then I, too, would survive.
Peace to you.
FROM DJ: I’m off to radiation in about 40 minutes, so I wanted to make my weekly general response to all of you kind enough to comment on this post. As always, I read all comments, and I do respond to some specific comments.
— drkOne thing I’d like to know — for those of you who are angry/or sometimes angry — how do you deal with your anger? I’d be very interested in knowing that.
And reading your comments today has reminded me that since my surgery last July — and I’ll be writing more on this — is that all my senses seemed heightened: Physical, Mental and Spiritual. I absolutely swear that I can hear better and smell more sharply than before, and certainly all of my emotions — the good and the bad — are finely tuned these days. And thanks.
Can i just say that you’ve articulated something that I’ve been feeling a lot lately. My father had (past tense!) stage IV lymphoma, and is still recovering from his recent stem cell transplant.
People ask how he’s doing, and I go through the regular speech about white blood cell counts, hair growth, etc. They inevitably ask me how I’m doing and a lot of the time I want to say how angry I am, but I don’t. People don’t understand that cancer can make you so much more than sad, even if it isn’t you. My dad has crying jags a lot, but I can tell they’re out of frustration and anger most of the time. We (along with my mother and sister) get angry about the stupidest things most of the time. It sets in so quickly.
The thing that gets me going fastest is when people complain about stupid little things, like how food is cooked at a restaurant, or how dry it is and the effect it’s having on their hair. Arg! I want to punch something!
If I were a fan of Pantera, I would listen to that, but for now I’m sticking with gangster rap.
— M FoleyAs an acupuncturist I’ve seen many people in various states of rage at big and the smallest things. I’d like to think I’ve been able to help many of them. If not acupuncture, try some other forms of relaxing therapy to help you. Anger shouldn’t be suppressed but it doesn’t help the situation. Best wishes to Dana.
— D. EisenstarkThis is not so much a reaction to the current column, but a thought on prostate cancer: I am 56 and was diagnosed with the cancer 18 months ago, confirmed by biopsy. So far I am treating it with a variety of nutritional therapy and many other treatments designed to strengthen my immune system.
I get my PSA checked every 3 months and so far it has trended downward (occasionally up slightly, but now more consistently lower). I remain symptom free. Soon I will have an ultrasound or MRI to confirm the cancer isn’t growing.
I am also an RN, so I know the realities of what medical care can be like. Also I had the benefit of helping my wife through breast cancer when she was 43–she did have surgery & radiation therapy.
So I am suggesting that men consider other treatments besides what your urologist offers. I don’t say this lightly–this is serious business and we know your life can be in the balance. But you don’t have to panic and there are alternatives. When I considered the side effects of surgery, radiation, etc, I said, “let me try the alternatives first……”
PCS
— Paul Schneider#16 I’m sorry you have prostate cancer.
But I’m also sorry that you chose to gamble your life on unproven treatments. The time you’ve wasted on such treatments may well result in the need for even more extensive, painful treatments, or it may even cost you your life.
What I do hope is you are paying for these alternative treatments out of pocket, since society can’t even afford the cost of conventional treaments, let alone snake oil.
If you want a great example of people frittering away their life’s savings and exhausting their hope on unproven cancer treatments, look up the LAETRILE debacle of the 70’s. It is featured prominently on Quackwatch.
— jackThe lower threshold to anger may have another source. I think more people are becoming aware that about three percent of the population is soiopathic–they have no conscience, and they enjoy making fools out of other people. Some are brilliant, some are stupid. Some are running our country. Becoming less tolerant of their sociopathy is rational, adaptive behavior. Managing your own anger, whether by exercise, music, or some other manner, is also rational and adaptive. Basic message is that a lot of us are becoming less tolerant of assholes, and it is not necessarily a function of age or illness, although it may be related to overall life stress.
— Joshuadana, mine was diagnosed 10/08, robotic(divinci) surgery 12/11/08. gleason score 9, stage t3a. had two months of radiation, third hormone shot. after the first hormone shot, i hated myself so bad, hit a wall with my fist and broke my hand. thanks to my best friend and wife, i’m on PAXIL and able to cope much better. you drive like i do . love it. sacrifice that goat, whatever makes you go, we are fighting for our lives. thank you dana, ed turner
— ed turnerMr. Jennings,
Have you had a 25-hydroxy vitamin D level done? It’s a simple blood test. 2/3rds of Americans are low, and there are many studies show that people with prostate, breast, and colon cancers have lower levels than the general population. This is important because vitamin D, in addition to preventing osteoporosis, prevents hyperproliferation of all cells in the body. I have listened to a lecture by a Vitamin D expert who is trained in Philadelphia and spent several decades working at Massachusetts General Hospital, and he has said that he corrected low levels of vitamin D in newly diagnosed men with prostate cancer, and the PSA levels went down. There are studies that show benefit.
OTC Vitamin D is only 400 or 1000 units and is not enough, in fact that study last month about vitamin D and breast cancer used only 400 units a day (which only raises the level 5 nanograms). To correct a low level, 50,000 units of vitamin D by prescription is used, usually weekly and then after 3 to 6 months the dose can often be reduced. 32 nanograms to 100 nanograms is the normal range; too much vitamin D only occurs at levels over 200 nanograms.
I am in Internal Medicine Primary Care. I have obtained levels on 1200 patients in 4 years with 800 abnormals and have treated those 800. Among the 1200 patients there were 2 dozen men with prostate cancer and 3 dozen women with breast cancer. Although the studies show 80% low, I have had 100% low (below 32 ng.) And the average low level in these patients are much lower than the non-cancer patient - frequently in the teens.
Because vitamin D is so inexpensive, there are not a lot of research grants to do vitamin D research, however several studies have been published in the past years, and there are many small studies in the past decade or so.
Best wishes on your treatment. I know your doctor gets periodic blood tests, it would not be difficult to simply add a 25-hydroxy vitamin D level so that if your level is low it can be corrected. The evidence is that this is a vitally important additional treatment for anyone with prostate cancer. If you are deficient (the odds are you are) than perhaps you could share this information on your blog, and you could benefit many readers with breast, prostate, or colon cancer.
Best wishes on your treatment.
I have additional information available on vitamin D if you are interested.
Robert Baker, M.D.
— Robert Baker, MDCherry Hill, NJ
rcbaker200@comcast.net
Why would you not be channeling rage? This, as they say, is not effin’ fair! Even at my tender age of 66, I don’t think it’s effin’ fair!
Ok. So who ever told you life was fair? Lots of things have implied it, and maybe I was too willing to believe those signs.
I went through radiation therapy (seeds and EBR), and my PSA is almost invisible, but so is my prostate, and some of the hormonal things that used to be happening down there.
As it happens, normally with the aging process there comes a point in one’s life when we suffer fools less gladly than has been recommended. (Usually around age 50).
You’re going through treatment, you’ve had some considerable pain and concern, you’re coping with enormous changes and there are enormous threats still hanging over your head, AND THIS STUPID TAXI DECIDES THAT HE”S SO IMPORTANT HE DOESN”T HAVE TO PLAY BY THE RULES SO HE PUSHES HIS WAY THROUGH THE CROSSWALK INTO A STREET THAT”S ALREADY FILLED WITH CARS???
“WASSAMATTA? YOU COULDN”T WAIT TILL THE ‘DON”T WALK’ SIGN?”
Then, having released a bit of steam, you can push on through the day and deal with the usual stuff that we all encounter.
I’d say you’re doing just fine. It’s justifiable resentment, and it passes and we go on with living and caring and teaching. We shop, eat, love, help.
Heavy metal is a nice alternative, but yelling out your lungs at some arrogant S.O.B who doesn’t even care is a pretty good way of burning off some unused adrenalin. If NYC traffic is a risky arean for venting your anger, go to a football game or a soccer match and yell like hell.
— EdgarI was diagnosis with Pancreatic Cancer on 4/10/06. And i got some information for everybody who went through a life changing event in their lives.
Anger is a destructive energy it blocks communication and creates fear.
No fear no anger.
— Gene MazzoliDana and other cancer patients / survivors: the National Academy of Sciences has recently published a book about taking care of the cancer patient in all his or her aspects: not just the physical, but also the emotional, and also the family. It’s called “Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs.”
You can read NAS publications online for free, and this one specifically, at: http://www.nap.edu/catalog.php?record_id=11993
Best wishes to you, Dana. Thank you for your honesty and courage.
— ShanaI look forward to these columns every week.
As much as I wouldn’t wish anything so threatening or terrible on Dana or anyone else, his cancer is focusing his mind in ways that enable me to focus mine.
For me, it’s uplifting to feel somehow harmonious and synchronized with my world. I aspire to feel connected with and benevolent toward everyone and everything.
But sometimes, it’s essential to rail. Whether it’s to literally STAY ALIVE, or to FEEL ALIVE, it’s sometimes necessary for survival to let out a scream or give someone the what-for (my occasional rant: to those who poke me in the eye with their selfishly oversized umbrellas on crowded sidewalks).
And in a world where most of the rewards are for rational expression and behavior, it’s so important–for survival–just to FEEL. Dana’s column reminds me of this.
— WesleyDana, I found there are two aspects to prostate cancer — medical and emotional. The medical needs proper analysis, evaluation of treatment options, decision on what course of action if any, a decision tree to help you evaluate.
The “other side” of the disease, the emotional, weighs heavily on your mind and can overwhelm you — or you can learn to handle this aspect. YOUR choice.
I did a book on the emotional aspects after encountering prostate cancer and having brachytherapy in 2000.
This was my “music” and helped me realize that what goes on in your mind every day requires direct attention.
Glad you have turned this challenge into an opportunity for others to learn from your thinking — and discuss theirs.
Larry Eiler
— Larry Eiler