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Prostate cancer patients and other wildlife along the road less traveled

Apr 8, 2023

Most days, for the past 15 years or so, I have walked the trails in a nature park near my house.

Izaak Walton Preserve in Homewood, Illinois, formerly was a racetrack, Wahington Park, that was turned back to nature. The preserve is named after 17th Century British writer Izaak Walton, an advocate of the outdoor life and author of “The Compleat Angler.”

I call it prairie because many plants on the nearly 200-acre property were found on the grand prairie that once covered this part of the country. But it is also a woodland with oaks and dunes created by Lake Chicago, the ancient ancestor of Lake Michigan.

Prairies are made up of grasses and wildflowers. New England aster, black-eyed Susan, conehead flowers, compass plant, and rattlesnake master are found there.

I can identify over 200 plant species there, natives as well as invasives.

I could toss a salad with wild garlic, wild asparagus, mushrooms, onions, burdock (a popular Asian root vegetable known as “gobo”), and wild carrots. I said I could, but I haven’t. I am a bit suspicious about contamination from nearby traffic.

I laid off a bit this winter, but I have returned to the trails this spring and hope to spend quality time in the coming seasons.

It’s my main source of exercise in these post-COVID days, having given up the swimming pool and track at the local health club.

(Monarch lands on a rattlesnake master. Howard Wolinsky.)

(“Swallowtail makes a beeline .” H.W.)

I walk a lot. I have walked the distance between London and Paris, the distance across the Sahara, and soon I will have walked the distance to the Earth’s core. Sounds like a hot summer ahead on the prairie on this trek to the core.

(“Blue, blue, my love is blue.” H.W.)

I observe the wildlife: Eagles, ospreys, egrets, great blue herons, wood ducks, Canada geese, mallards, scarlet tanagers, kingfishers, white-tail deer, mink, voles, beavers, coyotes, and lots more.

I take photos, lots of photos and have even co-organized an annual photo competition.

(“Fell in love with a pretty ballerina.” H.W.)

I even interact with fellow humans from time to time.

The odd thing is how many I have encountered who have prostate cancer or whose spouses and relatives have prostate cancer. Maybe. I should have expected this based on the prevalence of prostate cancer, the most common cancer in men after skin cancer, affecting one in eight of us.

I’ve learned a lot on the prostate path in the woods about how others handle—or don’t—their cancer diagnoses.

There’s the botanist who had another serious health problem that led to his discovery—too late—that he has metastatic prostate cancer. He had never bothered with routine screenings that might have made a difference. He seems very philosophical about it, resigned to where his path will take him ultimately.

(“Caspian tern, tern, tern.” H.W.)

Then, I met a recently retired college professor diagnosed with what I think—he wasn’t sure—favorable intermediate-risk (Gleason 3+4) prostate cancer. He probably could have benefited from Active Surveillance, close monitoring. But he was very anxious about the idea of living with a cancer in his body—the counterintuitive mantra of AS—and concluded he felt safer undergoing radiation therapy. He seems to be doing fine.

(“Frog Day Afternoon,” H.W.)

Then, I got a call from a former exec for a major corporation., who lives in the boonies outside Chicago. He left the working world after being disabled in a traffic accident. His cancer was found inadvertently while undergoing prep for unrelated surgery.

I know his sister from my walks in the woods. She referred him to me.

Out of the blue, after years of monitoring, his urologist told him he needed a radical prostatectomy. STAT.

(“Three ducks, one turtle and an egret went to a sandbar.” H.W.)

The man was puzzled. He didn’t understand what had changed. So I asked him the basics:

—What is your prostate-specific PSA level now and what has been the trend?

—What is the Gleason score from your biopsy? How many cores were positive?

—What is the PI-RADS number from your MRIs?

(“Warts and all.” H.W.)

He drew a blank on all the questions. He was defenseless in the face of the prostate cancer industrial complex—let alone he whole medical system, for that matter.

I told him I don’t play a doctor, even on the internet, but I could help him formulate the right questions to ask his current urologist. I also urged him to get second opinions.

He was unsure if he could get a second opinion covered by his Medicare Advantage plan.

(“Great Blue on guard duty.” H.W.)

Here is a bright guy who can discuss international and Chicago politics, but whose health literacy was surprisingly low. He knew little about what his prostate was let alone how to manage cancer, the medical system, and insurance—something we all must do unless we can count on a spouse, a sib, or a friend to do it for us.

(Compass plants help you find your way. H.W.)

I urged him to get on the learning trail—or at least enlist his sister to help him along his cancer journey.

Health literacy can be a steep slope—higher than anything we face on the prairie. But it’s not insurmountable. We need to get on this road to advocate for ourselves and navigate the system. Our lives depend on it.

(“Scarlet tanager surveys the road ahead.” H.W.)

(“Coming in for a soft landing.” H.W.)


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