ANDREW:
Hello, and welcome to the American Cancer Society's Cancer Survivors' Network, the service created by and for cancer survivors. I'm your discussion leader, Andrew Schorr. Our topic: Prostate cancer for men between the ages of 50 and 65. Now on the phone with us are four prostate cancer survivors from across the country. These are men who are all between 50 and 65, and have completed their treatment for prostate cancer. Over the next few minutes we'll discuss issues such as: planning for the rest of your life as a survivor; choosing to help others as part of your life as a survivor; the fear versus the reality of impotence; and how side effects become less important over time.

Well, let's begin. Joining us is Bill, from Toledo, Ohio. Bill, I know you're 54 and had a radical prostatectomy in 1997. As a cancer survivor, I know you've become very active in helping other men get information about and access to prostate cancer screening. As part of that you made a career change, after 27 years in broadcasting. Is that right?

BILL:
That's right, Andrew.

ANDREW:
And now you find yourself as communications director for the American Cancer Society in Toledo.

BILL:
That's correct. I made a career change, the big jump.

ANDREW:
Tell us about some of the things that you've been doing as you've chosen to help others. How come, beyond dealing with your own prostate cancer, you found it so important you made a career change to help others with it?

BILL:
It's kind of ironic how everything happened, Andrew. I was in the middle of a career change. I was working with the United Way of Greater Toledo, after getting out of broadcasting. Halfway through the campaign for the United Way, I was diagnosed with prostate cancer, in October of 1997. And I made myself a promise back then that if I came through this personal crisis as well as I have, that I would do everything in my power to get the word out to get men in to get checked. Early detection being, of course, the big word.

ANDREW:
And so, you're doing that. But also, I imagine in your job with the ACS you must communicate with men who are diagnosed with prostate cancer, too. How do you help people who have been diagnosed get through it?

BILL:
Well, I think a very important part is for the public to meet survivors. That's been very, very important to me when I'm going out and speaking with the Speakers Bureau with the American Cancer Society. To speak to the gentlemen and answer frankly questions that they may have. I get calls anonymously at the American Cancer Society almost on a weekly basis. In fact, I had a call yesterday from a lady who lives in Alabama and whose husband, believe it or not, is 39 years old and was just diagnosed with prostate cancer. She was very fearful and such, and she had read an article that I'd written and wanted to talk to a survivor. So I make myself available. I think it's very important for me, and I feel like I'm giving something back to the community.

ANDREW:
You mentioned you got a call from a woman about the man's case. Is there a message there, do you think? That prostate cancer doesn't have to be a secret and that men can speak out about it? We've seen, in breast cancer, women talk about it a lot. It's a very big community issue. Prostate cancer, some of the issues that go with it, or can go with it-incontinence, impotence, and the fear of dying, of course. Men don't always talk about this so easily. What's your message about that?

BILL:
That's very true. I agree. And that's one of the biggest problems that we have today, Andrew. Getting the word out and talking about it. Years ago when I was a youngster growing up in the 50s and early 60s, we never used the word breast. Obviously, you didn't see mammograms on television, on the evening news, and now it's being talked about daily, over and over and over again. I think that we need to do that with prostate cancer. Bring it out in the open, talk about it, have people meet survivors and answer questions, and face it head on. You know, let folks know that there is life after cancer.

ANDREW:
Well, let's bring into our discussion another man. Steve, I know you live in Sandy, Utah. You're 56, you were treated with external beam radiation and seed implants. I understand you started a "Man to Man" program in Salt Lake City when you found that there was not a support group there, right?

STEVE:
Yeah, and that was one of the things that occurred to me when I was first diagnosed with this. I was looking around for some group of people who had gone through this process and there wasn't anything here. I think men really do need and appreciate being able to talk to other men who have gone through the process, and that's what this program does.

ANDREW:
I'm sure you've seen men come to your support group who've had things bottled up inside for awhile. They've been having all these feelings of not knowing what the future is. Or, depending on how certain treatments may have affected them, maybe not feeling like the man that they were. Does getting men to talk about it make a big difference?

STEVE:
Absolutely. Particularly for those men who have just recently been diagnosed, which we've all gone through. It's a really traumatic experience and we just don't know which way to turn. We're getting recommendations from doctors to do this, perhaps very strong recommendations that this is the only way to do it, and yet we somehow feel as though we need to have some more information from other people. So, coming to a group and getting other people's experiences opens things up. There's a number of times we've had men who have had only one opinion from one doctor. They come to the group and hear other types of experiences, and go away saying, "I'm going to go see somebody else. I'm going to get some more information. I'm going to go read some books and get on the Internet."

ANDREW:
Steve, let me ask you about this. I mentioned a minute ago that you had radiation and seed implants. Whether it's that, or whether a man has had surgery or various treatments, there can be lingering effects. What effects have you had and how have you dealt with it?

STEVE:
Well, one of the primary reasons that I chose to have radiation as opposed to the radical surgery was the hope that I was going to be able to come out of this procedure with perhaps fewer side effects than I had heard one gets with the surgery. As it turns out, I'm somewhere in the middle. I didn't come out completely free of side effects, but I had perhaps not as many as some others. Personally, I didn't have any problems with incontinence through the whole process, but I have had some struggles with impotence and not being able to maintain an erection as I used to.

ANDREW:
How do you deal with that?

STEVE:
Well, it varies. It comes and goes, so my wife and I work on other types of stimulation. There are times when I can have an erection that's good enough for intercourse and sometimes I don't. I have looked into some of the treatments that can help that. I've used Viagra to a degree and it was helpful for awhile. I think if it gets considerably worse, I will probably talk to someone who is versed in some of the other treatment techniques for maintaining an erection.

ANDREW:
And the communication, the relationship between you and your wife through this period, how have you worked on that?

STEVE:
Well, it's been an absolute must for us. Right from the very beginning she was a part of the whole process, she came to all the appointments that I had with the doctors and helped me do the research. Also we are working on perhaps a changing sexual relationship. I think many of us men who have gone through this process are now understanding that prostate cancer does change our lives to some extent. And to a larger extent for some people. I think you need to have a partner to whom you can talk and discuss how you're feeling about your impotence and loss of manhood, and get some feedback from there.

ANDREW:
Keeping it to yourself makes it really difficult.

STEVE:
Oh, yeah. Absolutely.

ANDREW:
Let's be joined by a man who certainly knows about talking about it with his wife. Dennis is from Wappinger Falls, New York. Dennis is 57 and had a radical prostatectomy for his prostate cancer. And Dennis, you too formed a support group. You've been extremely active there in New York and your wife is active, too. Spouses have been playing a role with a support group whose discussions parallel the men's. That's been really helpful to a lot of families in your part of New York, hasn't it?

DENNIS:
Oh, yeah. It's getting more and more important as my wife's group is growing at each meeting, just like ours. You know, the ladies, they need to have a time to vent and talk about their fears and anxieties away from their husbands or their loved ones that have prostate cancer. This side-by-side group allows them to do that.

ANDREW:
And of course wives and friends, sexual partners, and people who love you worry when the diagnosis comes. But for the most part you found there is life after prostate cancer.

DENNIS:
Well, yeah. There's a lot of life after prostate cancer. Personally, I've really become an advocate. This turned out to be a full-time job. There is a lot of life after prostate cancer. Most of you gentlemen have talked already, like Bill...He turned his whole life around with broadcasting and now he's doing something to help others. And Steve, he started a support group and it sounds like he's doing a real great job out there in Utah. There's a lot of positive things that we can do with prostate cancer. You know, taking a real negative thing like prostate cancer and turning it into something positive, it really makes you feel good about your life and life in general.

ANDREW:
Let me ask you...I know you told us earlier that younger men, maybe in the back of their minds, have to have a plan B. Tell us about what plan B means.

DENNIS:
Well I was, not very young, but I was 49 years old when I was diagnosed.

ANDREW:
Sounds young to me.

DENNIS:
Well there are guys in their 30s now. We're seeing more and more men in their 40s and late 30s coming home with prostate cancer, and some of it is very aggressive, also. There is no definitive treatment for prostate cancer, so you've got to have a plan B in effect in case your plan A fails. And it seems that five, seven, eight, nine years down the road, a lot of the plan A's are failing. So we've put a lot of emphasis on "what if...." What happens if your cancer returns? How do you handle it and how do you deal with it? And it seems to be working very well with the men. It really reduces a lot of stress in your life, not worrying about if you have a recurrence. I know I have a plan B in effect and if prostate cancer returns, I just fall into plan B and go on my merry life.

ANDREW:
So, how do people go about forming this plan B? Steve was saying, and I'm sure Bill believes in this, that you've got to get information. So how do you get information so you can have those plans?

DENNIS:
Oh, I think one of the best sources is of course your "Man to Man" support groups or your "Us Too" support groups. Or the African-American men have their "Brother to Brother" groups, and these groups have the cutting edge of treatments. At every meeting there's something new that comes up that the medical professionals haven't seen yet, or heard yet, or tried yet. But we know about it and we kind of implement a lot of that stuff, in our area anyway.

ANDREW:
So there's strength in numbers because everybody's asking questions, and then you start trading information?

DENNIS:
Yeah. Our motto is "Knowledge Equals Survival." The more knowledge you have about your disease the better chance your survival rate's going to be, especially if you have a recurrence. You're able to handle what returns with a plan you already know. On the sidelines, so to speak.

ANDREW:
But it's often said, maybe more in older men, but I hear it said, "You know about prostate cancer. If you live long enough, you're going to have it. And you'll probably die of something else." You know, I went to the doctor recently and was asking about PSA. I'm almost 49, and he said, "Oh, I don't know about a PSA test. You get false positives," and this and that. So the idea of needing a plan B maybe isn't that important. What do you say to that? Because that's out there sometimes in the medical community, people saying get off it, get past it, you're through with it.

DENNIS:
Well it's really not the case. The medical community would like you to think that you're through with it. But if we're through with prostate cancer after we've been treated, why do we got to go back every four months for a blood test, or every six months for a PSA, or every eight months for a PSA and a digital rectal exam. You know when you have a toothache and you have a cavity, an abscess, the dentist pulls the tooth out. Goodbye, you don't see it no more. But Jesus, if it's like that with prostate cancer, why do we have to keep coming back? You know if we're through with it why does the urologist or the radiologist or oncologist want to see us in six months. So it really doesn't make sense.

BILL:
I agree totally with what Dennis is saying. I just went and saw my surgeon last week and my PSA was less than 0.1. I asked him, "How long do I have to keep coming to see you every three months?" It will be one more visit. Three months from now I go in and see him again, and then we'll move it on to six months. But I think the big thing is you have to have total trust in your physician and what he is doing, and obviously follow his direction and talk to him openly about the plan B's as we're calling them.

ANDREW:
But it sounds like there's another part of it, too. You never give up your control or your responsibility to seek out information and make decisions for yourself. Wouldn't you say that, Dennis?

DENNIS:
Oh, yes. I don't put blind trust in the guy who fixes my muffler, so I'm not going to give the guy who's going to handle me for the rest of my life blind trust. I gather everything I can about my disease. I learn all about what's new out there, the new blood tests that are coming up, the new markers, besides PSA. Because sometimes you can have a very low PSA, like Bill...less than 0.1, like myself...less than 0.1. And the cancer could still be on the move and your PSA could be stable. So there are other blood markers to do on a semiannual basis to track your prostate cancer, just in case PSA fails.

ANDREW:
That's a good point. Let me bring in our fourth and final team member as we have this discussion. Ron is in Emporia, Kansas. Ron, I know you're 62, and you were treated with hormone therapy following the surgery that you had about three years ago. And you have grown kids. Ron, what's your view of staying on top of things as a prostate cancer survivor?

RON:
You know, Andrew, I really have not dealt with that aspect of it. In fact, it's been a good education for me tonight to think of Plan B. I never thought of Plan B. I'm through with Plan A. I feel healthy and okay. But boy, some great points have been made there, especially by Dennis. I guess I ought to give some thought to that.

One major thrust for me has been...I'm a teacher and there's certainly no lack of availability to speak on this subject. At the time, when I was 59, I was head basketball coach at Emporia State University, and people in the sports world are sort of household names. Well, I hit the front page of the paper. A little bit embarrassing, you know. "Coach Slay has prostate cancer." Not the headlines that you want.

But my situation was a little bit unique in that, as has already been mentioned to you, that PSA is not foolproof. I had just had a PSA and it was 1.07. For a "quote" 59-year-old man at the time it was very low. But the rectal exam indicated an unusual aspect to it. So I went to another doctor who did the biopsy, and there it was-full-blown cancer. The thing that really caught everybody's attention was the simple fact that...Not that you have to be in sports to be in great condition, and a lot of coaches probably can't walk across the room. But I was a jogger, and just never allowed sickness to become a part of my life. So I was kind of a picture of health to everybody, certainly in Kansas and a little bit here in the Midwest. And here I've got cancer. So I became a little bit of a poster-boy type of a person.

All of a sudden I'm finding opportunities to speak everywhere, be on the radio, be on television, write articles. And always, always, within a few hours, I'd get those phone calls from men who were there. Once you indicate you're willing to talk about impotence, wow, does that open the door. Yesterday I had two phone calls. One I'd talked to previously. The gentleman was getting along just fine. Now all of a sudden he doesn't feel his erections are quite what they should be, and he's concerned. He had a friend that did this and that, you know. It was just an ongoing thing. I think that that area of impotence is something that men need and want to talk about. And as we've already mentioned it tonight I hope we can further that discussion.

ANDREW:
Well, let's do that now. I'm not from Kansas but I have this image of a very fit, long-term leader in the sports world in your state. As you said, you were the picture of health and you got hit with prostate cancer. In sports, and in men's basketball certainly, there's a virility that goes along with it. So how did prostate cancer and the treatment affect you? And what do you say about it to other men?

RON:
Well, there is life after all of this. I think we've already mentioned that. Certainly most men-I won't say all men but most men-are very concerned about their sex lives. Even at age 62, or whatever age it may be. I was certainly no exception there, and it was a major, major concern of mine. Probably even more than will I live or die. There never seemed to be a question that I was going to die, but it seemed like death that my sex life was over. Of course, I was exaggerating that in my own mind. First of all, my surgery, which was preceded by the hormone therapy...I tell you, that opened up many, many avenues to relate with other people in my life. Not very many men can take three months of hormone therapy, which are female hormones, by the way, and handle the side effects. One of which is hot flashes. I can talk to any menopausal group of women now with some degree of authority, and I get a lot of fun out of that.

ANDREW:
You've been there.

RON:
Yes, I've been there. But, back to your question. My nerves were saved. My surgeon guaranteed they were there, and of course I was hopeful that things would return to normal. They've not returned to normal, and I waited about a year before I finally accepted the fact that it was not going to be like it used to be. So I went to other alternative methods. The first thing I tried was Muse, a little insert into the head of the penis. Then I went to Caverjet. I'd read about it...it's the shot in the penis. And then I even tried Viagra once. I could get an erection, I'm sure just like the other guys, but it was just not strong. I couldn't maintain it. I have stuck with Caverjet. In terms of my impotence, my surgeon uses the word "partial." It's not there all the time, or it's only to certain degrees. Caverjet is a wonderful thing if you can get past the first shot. I'm sure the other gentlemen are at least aware of it and read about. It works. I guarantee it works. My sex life's better than it ever was.

ANDREW:
As you said, it was a year after your treatment and you were still wondering would your ability to have a full erection come back. So what about your communication with your wife during that time? Frustration, anger, what?

RON:
No, I never did feel angry about it. There was frustration because I was impatient. I faked it a lot, which is not the way to go. You know, it just took me a year to accept the fact that that's the way it's going to be. And again, I could get that partial erection, so I was partially having sex. But it wasn't very good. I'm sure it wasn't very good for my wife. And we'd communicate about that. One of the other gentlemen mentioned that. I think it's extremely, extremely important to have that line of communication open. My wife had a heart attack 30 days after I was diagnosed as having cancer, so she's had her own problems. We've kind of gone through these things together.

STEVE:
One of the things that I've dealt with somewhat myself, and also heard from some of the members of our group, is that you have a kind of external sense of not being able to maintain an erection. And that causes perhaps some decrease in one's sex life. But what this can also do is lead to some depression. When we realize that we are no longer teenagers, we're no longer even middle-aged men anymore who can maintain an erection, we feel as if we have lost our manhood. And looking toward the end of your life it can be really, really hard to think about those things that you've lost that you perhaps had when you were younger. This can kind of eat at you. Many people have felt as if they were less than they were before. And it can definitely cause some depression.

ANDREW:
And so, in your support group, what do you advise for men who are feeling that?

STEVE:
Well, I think probably the biggest thing is to talk among ourselves, to realize that we are not alone in this. And that this disease may have accelerated it, but it is a natural process of life that we get older and our body parts don't always work the way they used to.

ANDREW:
Somebody mentioned Viagra. This is not a commercial for Prozac or those sorts of drugs, but sometimes antidepressants might be appropriate as a man goes through this.

STEVE:
Absolutely. And at that point, of course, we refer the man back to his physician so that they can get a work up and diagnosis. And get treated if they care to.

ANDREW:
Dennis, I understand you have an example from your support group. Someone you spoke to who was really at the end of their rope. Tell us about that.

DENNIS:
I get a lot of calls. And I got a call one day from a man who was very upset. His PSA was somewhere in the area of 400, he was in his 60s, the cancer had metastasized already to the bone and to his bladder. His diagnosis was very poor. And he was so upset that he was ready to kill himself. He was actually going to commit suicide. You know, I had never talked to anybody about committing suicide before. My wife is yelling, "Dinner's ready!" And I'm telling her I've got this guy on the phone and I can't hang up, and she's getting angry at me. I talked to this guy for about two hours about how committing suicide is the craziest thing in the world. Prostate cancer is not worth it. And he hung up the phone on me. He didn't leave his name, number or anything like that. Several days later he called back again, and he was really convinced about killing himself. He was in the garage and he had the gun loaded, you know. Sweat's pouring off of my head and I think, "My gosh, what the heck did I get myself into with this support group business." I finally convinced him. I said, "Before you do kill yourself, why don't you come to one of our meetings?" So he did. He came to a meeting, and when he walked into the room and he saw the 40, 50 guys in there, he had a complete emotional breakdown. And that's what he needed. He cried like a baby, you know. He just had an emotional collapse. And he needed to see these men in there, who were in a similar situation with him. He didn't know anybody else was feeling like he was, and he needed to vent by just breaking down and almost collapsing. He was so emotionally spent from thinking about killing himself over a stupid disease. And now he's turned out to be one of our best members. Still kicking. It's like five years now.

ANDREW:
Still kicking despite the metastases and all that.

DENNIS:
Yeah. He's learned through the knowledge that our group has how to seek treatments. If this treatment fails, well, we'll try that treatment. If that treatment fails, well, I tried this and you should try it. And this guy's doing all right.

ANDREW:
That's a great story. Dennis, it seemed from your story, you see the humor in lots of things. Your wife is yelling at you, and that kind of stuff. There are tremendous stresses going through a diagnosis of prostate cancer. Plus the anxiety that Ron talked about that can come afterwards with the effects of treatment, surgery, hormones, whatever. Do you have to have some humor as you go through this? And Ron, you have some views on that, don't you?

RON:
Well, yeah. I really do. Again, I'm not any more unique than anybody else, but I'm a pretty positive guy. I like to play the little game-what's good about it. And within 30 minutes of my diagnosis I had already started a list of what was good about it. First thing was we all know that all men are going to have problems with their prostate if they live long enough. If you don't have a prostate you can't have a problem with it. May seem a little weird, but there's some truth. I have a son who's a doctor and I called him right after that thought hit my head. He agreed that it was a pretty good thought. So that's the way I've dealt with the humor. You know, some people may find that offensive, but anything funny I can find about myself, about the situation, about the experiences I've had, that's the way I deal with it. Other people may not, but I think to talk about it, not to take it so seriously, is the way to go. That could be different for someone else.

ANDREW:
Dennis, you tell jokes about it, don't you?

DENNIS:
Yeah, we have a lot of humor in our group. We talk about a company that we formed for men who were impotent and are worried about their sex life. We just tell them, "Call our 800 number, 800-RENT-A-DICK."

ANDREW:
Bill, in Toledo, what do you tell people going through the trauma of diagnosis, the treatment, going on with their lives? What's your attitude and what do you advise people?

BILL:
Well, let me back up for a second if I could, Andrew. I have kind of an ironic, well, not ironic but a different situation. Two weeks after I was diagnosed with prostate cancer, my kid brother, age 48, was diagnosed with it as well. I call him a kid because of the fact that he's 48 years old. He chose to have the radical surgery as well, and I'm very happy to say that he came through it with flying colors like I did. So, misery loves company, I guess, and we kind of helped each other. The support system is so important through this entire experience, of course. I had my surgery in November, my brother had his in December. So we were going through it basically at the same time, and that was a big, big help. I was very up front and very open and honest with him and his wife, and told him what to expect and what I was going through personally at the time. We had a very, very frank conversation throughout, and still do to this day, as a matter of fact. We're a very close family and get together very often.

But I agree with the other gentleman who said you have to find humor in this. There's a way to laugh about it and laugh at yourself and let other people make jokes about it. It makes it so much easier on yourself and your loved ones and your support group and friends. I think all that's very, very important. And frank discussions are very important.

ANDREW:
So, you're looking now towards your future, and you're very active in speaking out and educating others. What's your view of your future as a prostate cancer survivor?

BILL:
Very, very positive. My doctor told me that I had the cancer and I said, "Now what do we do?" He gave me my options. I wanted to get in the car and drive right over to the hospital that afternoon. "Let's take care of it and let's move on with life." And that's been my whole philosophy ever since. Like one of the other gentlemen said, I never thought about dying, I thought about living. I have a very positive attitude. That's because of a wonderful support system. And my faith in God, faith in my doctor, faith in myself. And from just being an all-around positive thinker. I've had my moments, of course, as we all have. When you're lying in bed at night staring up at the ceiling and you can't fall asleep, you think of some negative things. But I just find a way to get myself right back on track again and stay very positive. So my future is very bright. I have a wonderful new career. I feel like I'm making a difference. And just being a part of this program and this project is a very positive move. I look forward to doing other positive things.

ANDREW:
You know, there are men who would go through their treatment, grapple with and hopefully overcome the effects, if there were any, and just say, "I'm going to forget about it." Contrary to what Dennis said about plan B. Just go on and put it away somewhere in a back corner of their mind, and feel that they've handled it that way. Dennis, is it your experience that men can do that? Would you advise that? You talk about speaking out, but couldn't it be okay for some guy to just say, "That's the past, I'm looking at the future. See ya later."

DENNIS:
Sure. But I really don't think that that person has really looked into the logistics of prostate cancer, and how there are so many recurrences, and there are so many treatments available. It's like an ostrich burying its head in the sand. I would want to just keep in the back of my mind, "what if..." And know there's an organization here that I can reach out to if I need it. Then go on with my life.

I mean, I go on with my life every day...I get up. Like the other guy just said, there are moments when you stare at the ceiling. One time I was staring at the ceiling for 24 hours worrying about cancer. And then I just decided, after a while, "Well, cancer's had its bid. I'm just going to worry about it when I wake up for five minutes. Then I'm going to get on with the rest of my life for the rest of the day." And the next day, I worry about it for five minutes again, until PSA time comes around. Then I worry about it a little bit more. But just to bury your head in the sand, I haven't found that too much. Not in the gentlemen I've spoken to. They've either called because they're in trouble, or they're seeking some information about a certain type of treatment.

ANDREW:
Bill, since you're divorced, do you have relationships with people where you talk about yourself as a prostate cancer survivor?

BILL:
Yes, I most definitely do, Andrew. The person in my life and I have been together 18 years. I've been divorced, it seems, forever, and I say I'm a single man, which I am. But yes, they're very aware of my situation, obviously. And the fact that I've been so vocal in the media regarding my personal situation...It's known.

ANDREW:
What about a guy who's not in a committed relationship and is dating, or meeting new ladies, new partners? What would you say to him? Should he just keep it to himself?

BILL:
I would hope that each gentleman would be open with the lady that he is dating or socializing with. I think it's very important, as I said, to be frank and discuss the personal situation. Especially if it's a relationship that you feel will develop into a long-lasting relationship.

ANDREW:
And Ron, you're sort of a role model for a lot of people in Kansas. Younger men and older men. You're a celebrity in your state there.

RON:
Bob Dole and I.

ANDREW:
Yeah, Bob Dole and you! That's true.

RON:
Bob's a Kansan.

ANDREW:
That's true. So for you and Bob Dole, but for you in particular, what do you say to men? Let's say they're not married. Where do you stand about this whole idea of being out front about it?

RON:
I don't think there's any question, as Bill said, that you just can't hide things like that. You would be disloyal to yourself if you did, and certainly disloyal to those you were trying to develop a relationship with. It would be a lie from the beginning. First of all, there's nothing to be ashamed of. We are what we are, and we must take full advantage of all the good things that we have. We still have our lives and, as I referred to before, there is a sex life after prostate cancer. And a lot of that develops from a person's attitude. We have choices to make. We can think of it negatively or positively, and we can make it work or not make it work. I think all that needs to be shared with...certainly not a casual date, maybe. You don't have to bring it up every time you go on a date with a new person. But certainly any kind of a committed relationship, I'd think it would be a must.

ANDREW:
Bill, I've been told that you've been pretty active in getting the message to the African-American community about prostate cancer. How come?

BILL:
Well, the main reason, Andrew, is because the mortality rate is 50 percent higher in African-American men. Since I've been involved with the American Cancer Society I've found, in trying to get the African-American community to the free screenings that we have here in Toledo twice a year, that there's a very low turnout of African-American men. One of the main things that I did when I first started going out and talking was trying to approach the African-American churches. To go in and let them meet a survivor. And try to get the word out how important it is for them to have the annual PSA and DRE. Fortunately, it has worked. Obviously not as much as I would want, but we've been to a couple of different churches now and had free screenings. There's been very good attendance in the African-American community.

ANDREW:
Is there a message for African-American prostate cancer survivors? A message to carry back into the community?

BILL:
Oh, I think that's very important, as the four of us gentlemen tonight are doing. I think it's very important for the African-American men to speak to their church groups, and the fraternities and such that they belong to, and spread the word. Most definitely.

ANDREW:
Well, let's start in reverse order. Ron, what would you like to leave men with? Men between the ages of 50 and 65 who have been treated for prostate cancer, and are asking themselves: How should I think about this now? What should my relationships be now? What should my care be now?

RON:
Well, I think there should be an atmosphere of hope. I think you always have to ask yourself, what are your choices? Which way do I think about this? What kind of life do I want to lead? And I think it's extremely important that you live a life of hope. Believe in the God almighty and count the blessings of what you have. A lot of people are a lot worse off than we are, and I think that's the way you've got to look at it.

ANDREW:
And, while your prostate cancer was a wakeup call, and made news because of your notoriety as a coach in Kansas, you expect to be around for a long time.

RON:
My parents...My dad is dead now, but lived to be 85. My mother is 86, and if heredity means anything...I always said I wanted to be 100. I happen to be a lucky person in that I don't look like I'm 62. I don't know what bearing that has on anything, but 100 sounds pretty good to me. Certainly, hopefully, it's with a good, healthy body and mind.

ANDREW:
Thank you. Well, I'll see you when you're 100. And Dennis, what about you? What's your key thought that you want to leave with men who are post-treatment? What do you want to tell them?

DENNIS:
Well, like I said, our motto is, "Knowledge Equals Survival." I finally believe the prostate cancer is not going to do me in after seven years. I finally got that through my head. I'm going to croak from something else, which I'm very happy about. Whether I'm going to make it to 100, I don't know. But I think that men should not bury their heads in the sand. They should keep abreast of what's going on. Everything that Bill said, hope, your faith in God-that's important. But also be aware of what's around you as far as prostate cancer is concerned. Maybe watch your diet a little bit, stuff like that. But mostly, get some knowledge about the disease. Because if you do have a recurrence, you want to be able to handle it.

ANDREW:
Thank you. Steve, in Utah, what would you like to leave men with?

STEVE:
One of the most important things that our group has emphasized among its membership is that we take charge of our own medical health. Many people come in asking a lot of questions, and we try to point them to resources where they can get information. We found that those men are very successful. The ones who gain as much information as they can and make decisions for themselves, rather than leave it up to someone who's not in your body. So take charge, and get out there and learn as much as you can about your own particular condition.

ANDREW:
And as we were saying before, keep those lines of communication going with the people you love. Absolutely.

STEVE:
And just to add... One thing I've found, and I know that Dennis will probably agree with me, is that you get an awful lot back from doing this kind of thing. That is, being willing to talk about prostate cancer with people and sharing your experiences. You open up those lines of communication and it's really very rewarding. So once somebody has perhaps gone through their own treatment, look into staying with a group, and helping out other people in a similar situation.

ANDREW:
Well, Dennis, you would second that, right?

DENNIS:
Oh, yeah, a hundred percent. You've got to be open about this with your entire family, your wife and your kids, and everybody that's involved. It's a sentence that we've all been given for the rest of our lives, and our families have received the same sentence. We're going to be cancer survivors for the rest of our lives. The family has to be able to share your emotions and your feelings and all that kind of stuff.

ANDREW:
Well that's a positive thing, for a lot of families, to be able to reach out to one another. Bill, how about you? You, like the other gentlemen, get to get up on a podium pretty often and talk about this. What do you want to leave with our listeners who've all had prostate cancer, been treated, and say "Well, what now?"

BILL:
Right. The first thing that comes to mind to me, Andrew, is that after going through something as frightening, and as personal and unknown as cancer, I feel that I personally have grown stronger in both mind and body. As the other gentleman has said. I consider myself, and my brother, very, very fortunate.

And to reiterate what the other guys have said, keep that line of communication open. I know a lot of people don't get up on podiums and don't feel as though they are good speakers. You don't have to be to get up and tell your story. If you're just genuine, and tell folks the experience you went through, and show them that you are alive, and that there is life after cancer, and that you're going to go on and have a terrific life...I think that's very important. And it's important to applaud the wonderful support systems that we have in our family and friends.

ANDREW:
Well, nobody would vote to have a cancer diagnosis. Nobody would want that, but it sounds like there's a little bit of a gift here, or an opportunity. You've certainly taken it, changing careers. And all of you are very outspoken about your prostate cancer. There's a bit of a gift, that you can leverage that to make a difference for so many other men and their significant others.

BILL:
Well, you know what I say when I'm out talking to folks is, "Out of bad things, good things happen." To me, this is what's happened to Bill. I have a wonderful new career, and I am able to speak up. And hopefully...I feel that I am helping other men and their loved ones.

ANDREW:
Well, Bill in Toledo, Ohio, Steve in Sandy, Utah, Dennis in Wappinger Falls, New York, and Ron in Emporia, Kansas, I know all of us thank you so much for sharing your insights and your experience, your personal stories. And also for working as hard as you are for so many other men who follow you. Thank you all for being with us. With that comment we will have to end, and I want to thank you again. For the American Cancer Society's Cancer Survivors' Network, and from our HealthTalk Interactive Studio in Seattle, I'm Andrew Schorr.