a story lives forever
Sign in
Form submission failed!

Stay signed in

Recover your password?
Form submission failed!

Web of Stories Ltd would like to keep you informed about our products and services.

Please tick here if you would like us to keep you informed about our products and services.

I have read and accepted the Terms & Conditions.

Please note: Your email and any private information provided at registration will not be passed on to other individuals or organisations without your specific approval.

Video URL

You must be registered to use this feature. Sign in or register.


Facing death


Learning I have prostate cancer
Sherwin Nuland Surgeon
Comments (0) Please sign in or register to add comments

About four years ago… my PSA went up; PSA is so-called prostate-specific antigen, and it's a relatively new test that tells men whether they're in danger of having prostate cancer. There's a certain level it's not supposed to be above, I think it's four, and if it starts going above that level, sometimes you have to have a biopsy of your prostate. So, mine went up to 12, and I had a prostate biopsy, and lo and behold, I had prostate cancer, about four years ago. It didn't bother me one bit, and I'll tell you why. When I was in medical school, Averill Liebow and his colleagues had taught, and this was confirmed in textbooks and still textbooks of today, that if you were to autopsy every man in his 50s, a perfectly healthy man, let's say he dies of cardiac disease, let's say he's in an accident or brain tumour. At age 50, 50% of men would be found to have microscopic cancer in their prostates. At 60, it was 60%. At 70, it was 70%. Well, 70% of men at 70 don't die of prostate cancer. Turns out that about one in five men who gets prostate cancer dies of it. And with the others, it's a slow, indolent thing, and big deal, who cares if it's there or not?

So, I was convinced, based on the fact that this was completely microscopic, couldn't be felt on examination, and the numbers looked pretty good, that I would never hear from my prostate cancer again. I did agree to radiotherapy, reluctantly. I had a course of radiotherapy. I wish I hadn't done it, but I did do it. And so, everything is fine, and my PSA remains at a very low level. And then, about a year ago, it started going up. And so instead of having it once every six months, I was having it once every three months, so I had it four times in this past year. And about six weeks ago, it was found to have risen from .3 to 6, which is in the abnormal range. And I talked to my urologist, and I talked to a very close friend, who had been the chair of urology at Yale, and all three of us agreed it has to mean that there's a recurrence, in spite of the fact my numbers had been good in both of them when I first got the microscopic diagnosis. It said, you know, you're going to live to be 250, you'll never hear from this thing again. I was sure of it, but then my PSA is going up and what else could it be? We all agreed that in spite of all the good stuff I had thought, I had a recurrence of my prostate cancer and I was going to die from it. Because, you know, you have a recurrence, it takes a while, two, three, four, five years, but it gets you. So, for the first time, this man, who was sure who was going to live to 120, because he's special, he's been special since he was three years old, you know, this tremendous egotism…

I guess we all think we're never going to die. We all think there's something special about us. But, you know, I had some pretty special experiences. I wrote a book that won the biggest award… literary award in the United States. I wrote a book that translated, as I said, earlier, into all these languages. I had a great surgical career. You know, I walk around with the title of Professor. I am special, but I'm going to die. Isn't that amazing? I'm not going to live to 120, I'm not going to live to see my three-year-old granddaughter's wedding, I'm not going to continue with this wonderful life I've found as a writer. I'm not going to be there for my wife, who is 18 years, 17, 18 years younger than I, to have all those wonderful years with. And you know something? This surprised me: I didn't get scared and I didn't get worried.

Sherwin Nuland (1930-2014) was an American surgeon and author who taught bioethics, the history of medicine, and medicine at the Yale University School of Medicine. He wrote the book How We Die which made The New York Times bestseller list and won the National Book Award. He also wrote about his own painful coming of age as a son of immigrants in Lost in America: A Journey with My Father. He used to write for The New Yorker, The New York Times, Time, and the New York Review of Books.

Listeners: Christopher Sykes

Christopher Sykes is a London-based television producer and director who has made a number of documentary films for BBC TV, Channel 4 and PBS.

Tags: How We Die, Averill Liebow

Duration: 4 minutes, 49 seconds

Date story recorded: January 2011

Date story went live: 04 November 2011