Tuesday 23 August 2011

Jack Layton and Our Prostates

Jack Layton is, well, was a Canadian politician. He was the MP (Member of Parliament) for Toronto-Danforth, leader of the New Democratic Party and Leader of the Official Opposition and he is dead at the age of 61. According to 2007 numbers from Statistics Canada, the life expectancy of a man is 78 years however on average; a 65 year old man in 2007 could expect to live until the age of 83.

Mr. Layton was diagnosed with prostate cancer on February 5, 2010. His father had suffered the same type of cancer 17 years earlier but had recovered. On July 25, 2011, after the 2011 federal election, Mr. Layton announced a temporary leave of absence to fight an unspecified, newly diagnosed cancer. He died on August 22, 2011 at his home in Toronto.

I do not know Jack Layton personally. Like many people, my knowledge of the man comes from news reports and video interviews in the media. However my impression of this gentleman is someone who is passionate about his work, dedicated to his job and in general, a nice guy. But I will leave the eulogizing to others better acquainted with him both personally and professionally to describe the man, his life and his career. I would like to discuss an element common to both of us, actually to all men, namely our prostate.

As I said above, a man can expect to live to about 80. However, we do have a number of things which may prevent us from making it there. Some things like smoking which could lead to lung cancer can be labelled as self-inflicted. You did have a choice; you just decided to not exercise your options prudently. And yes, there are other health related issues which can be corrected to a certain extent if one considers exercise and diet, but, at the end of the day, we all can succumb to something, a thing which is completely outside our control and beyond the scope of modern medical science. When your number is up, your number is up.

In the United States, the leading cause of death in men is heart disease followed up cancer while in Canada, it's the opposite: cancer followed by heart disease. According to Statistics Canada, prostate cancer is the second most commonly diagnosed cancer in Canadian men, and it ranks second behind lung cancer in cancer mortality. In 2002, an estimated 18,200 men were diagnosed with the disease, and about 4,300 died from it. (Canada's population in 2002 was 31.3 million) In the United States, it is estimated that 217,730 men were diagnosed with the disease and 32,050 men died from it in 2010. (U.S. population in 2011 was approximately 312 million)

Wikipedia's article on prostate cancer states:

Prostate cancer tends to develop in men over the age of fifty and although it is one of the most prevalent types of cancer in men, many never have symptoms, undergo no therapy, and eventually die of other causes. This is because cancer of the prostate is, in most cases, slow-growing, symptom-free, and since men with the condition are older they often die of causes unrelated to the prostate cancer, such as heart/circulatory disease, pneumonia, other unconnected cancers, or old age. About two-thirds of cases are slow growing, the other third more aggressive and fast developing.

In my blog My Prostate: something near and dear to me I point out what I hope is obvious to everyone: being preventative is easier than being curative. Yes, preventing disease is easier than curing disease and getting regular check-ups with the idea of discovering a problem early is the best chance of avoiding the problem altogether. The recommended course of action is that starting at the age of 40; every man needs to have an annual physical which includes checking the prostate. A prostate examination should include the infamous RDE (rectal digital exam) and a PSA test although; the two should not be done on the same day. See my article for further details and don't forget about a colonoscopy!

Famous People
A number of well-known people have been diagnosed with the disease. Some have died from it but some have been successfully treated, whether through radiation treatment or by prostatectomy, that is, the removal of the prostate gland. (Health Diaries)

Harry Belafonte: He was diagnosed with early-stage prostate cancer in 1996 and successfully treated. He is now a prostate cancer advocate, raising awareness of the disease in men.

Bill Bixby: Diagnosed in 1991. He succumbed to the disease on November 21, 1993.

James Brown: The Godfather of Soul was diagnosed with prostate cancer in 2004 but survived. He died of heart failure in 2006.

Robert De Niro: The Academy Award winner was diagnosed with early-stage cancer in 2003 at the age of 60. He has kept details of his treatment private. His father died of prostate cancer at the age of 71.

Sen. Bob Dole: Diagnosed in 1991 and successfully treated by prostatectomy. He became an outspoken prostate cancer advocate. He became a spokesperson for Viagra because of the problems prostate cancer survivors often experience with erectile dysfunction.

Rudy Giuliani: The former New York City mayor was diagnosed with prostate cancer in April 2000 and had surgery to implant radioactive seeds in September 2000. Giuliani's father died from prostate cancer in 1981 at the age of 73.

Robert Goulet: Diagnosed in 1993 at the age of 60 after a routine blood test for insurance purposes, Goulet underwent a radical prostatectomy and is now free of prostate cancer. He has remained an outspoken prostate cancer advocate.

John Kerry: The former presidential candidate was diagnosed in late 2002 with early-stage prostate cancer and had successful nerve-sparing prostate cancer surgery in 2003. Kerry's father died of prostate cancer in 2000 at the age of 85.

Nelson Mandela: Diagnosed in 2001 with early-stage cancer. He underwent seven weeks of radiotherapy and made a full recovery.

Roger Moore: The former 007 was successfully treated with surgery in 1993.

Laurence Olivier: Diagnosed in 1967 and underwent radiation treatment that successfully eradicated the cancer.

Jerry Orbach: The Law and Order star died from the disease in Dec. 28, 2004 at the age of 69.

Colin Powell: In 2003, he underwent surgery for early-stage prostate cancer and made a full recovery.

Telly Savalas: The "Kojak" star died of the disease in 1994 at the age of 70.

Gen. H. Norman Schwarzkopf: Diagnosed in 1993 and underwent successful surgery.

Pierre Elliot Trudeau: The Prime Minister of Canada died of prostate cancer in 2000 at the age of 80.

Bishop Desmond Tutu: Diagnosed after a routine exam in 1996. He was treated in the United States with hormone therapy and radiation.

Frank Zappa: Died of complications from the disease on December 4, 1993 at the age of 52.

Jack Layton's last letter to Canadians
Mr. Layton died on August 22. However on August 20, he penned a "last letter to Canadians" to be published after his death. It is an interesting scenario to contemplate yourself in similar circumstances. If you knew this would be your last letter, what would you write?

To other Canadians who are on journeys to defeat cancer and to live their lives, I say this: please don’t be discouraged that my own journey hasn’t gone as well as I had hoped. You must not lose your own hope. Treatments and therapies have never been better in the face of this disease. You have every reason to be optimistic, determined, and focused on the future. My only other advice is to cherish every moment with those you love at every stage of your journey, as I have done this summer.

Final Word
Death is something we all will face sooner or later. Later is preferable to sooner but I'm given to understand that any time is usually too soon. Mr. Layton seems to have been a nice man. It is stunning to think of him recently campaigning for the 2011 federal election, a vibrant man full of life, full of vim and vigour, and now so soon afterwards to think of him in terms of his life lived. Life is short. Life is precious. It's all we've got. What are we going to do with it?

Mr. Layton closed his "last letter to Canadians" by stating:

My friends, love is better than anger. Hope is better than fear. Optimism is better than despair. So let us be loving, hopeful and optimistic. And we’ll change the world.

In reading this and wondering about my own "last letter", I thought of the song "Live Like We're Dying" by the Script (see video below) which has the line "And if your plane fell out of the skies, Who would you call with your last goodbye".

Let's all make it a good one, a good life. It's all over too soon.

We only got 86,400 seconds in a day to
Turn it all around or to throw it all away
We gotta tell them that we love them
While we got the chance to say
Gotta live like we're dying

- The Script: Live Like You're Dying

Good-bye Jack Layton (1950-2011).


Wikipedia: Jack Layton
John Gilbert "Jack" Layton, PC, MP (July 18, 1950 – August 22, 2011) was a Canadian social democratic politician and the Leader of the Official Opposition of the 41st Canadian Parliament. He was the leader of the New Democratic Party from 2003 to 2011, and previously sat on Toronto City Council, serving at times during that period as acting mayor and deputy mayor of Toronto. He was the Member of Parliament for the constituency of Toronto-Danforth from 2004 until his death.

Statistics Canada - 2007
Life Expectancy
On average, a 65-year-old man could expect to live an additional 18.1 years in 2005-2007, an increase of 2.0 years from the previous decade. A 65-year-old woman could expect to live an additional 21.3 years, up by 1.3 years.

Wikipedia: Prostate cancer
Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, there are cases of aggressive prostate cancers. The cancer cells may metastasize (spread) from the prostate to other parts of the body, particularly the bones and lymph nodes. Prostate cancer may cause pain, difficulty in urinating, problems during sexual intercourse, or erectile dysfunction. Other symptoms can potentially develop during later stages of the disease.

Wikipedia: prostatectomy
A prostatectomy is the surgical removal of all or part of the prostate gland. Abnormalities of the prostate, such as a tumour, or if the gland itself becomes enlarged for any reason, can restrict the normal flow of urine along the urethra.

Sexual effects of prostatectomy
Surgical removal of the prostate risks an increased likelihood that patients will experience erectile dysfunction. Nerve-sparing surgery reduces the risk that patients will experience erectile dysfunction. However, the experience and the skill of the nerve-sparing surgeon, as well as any surgeon are critical determinants of the likelihood of positive erectile function of the patient.

Remedies to post-operative sexual dysfunction
Very few surgeons will claim that patients return to the erectile experience they had prior to surgery. The rates of erectile recovery that surgeons often cite are qualified by the addition of Viagra to the recovery regimen.

Centers for Disease Control and Prevention -
Leading Causes of Death in Males, United States, 2006
1) Heart Disease: 26.3%
2) Cancer: 24.1%

[Note: The U.S. and Canada are reversed in the number one and number two slots.]

Statistics Canada
Leading causes of death: 2007
1) Cancer: 30%
2) Heart Disease: 22%

[Note: The U.S. and Canada are reversed in the number one and number two slots.]

National Cancer Institute
Stats on prostate
It is estimated that 217,730 men will be diagnosed with and 32,050 men will die of cancer of the prostate in 2010.

Statistics Canada - May 2003
Prostate cancer-testing, incidence, surgery and mortality by Laurie Gibbons and Chris Waters
Prostate cancer is the second most commonly diagnosed cancer in Canadian men, and it ranks second behind lung cancer in cancer mortality. In 2002, an estimated 18,200 men were diagnosed with the disease, and about 4,300 died from it.

my blog: My Prostate: something near and dear to me
For all us guys, this is something of a touchy subject. Talking about the prostate leaves us prostrate. However let's face up to the fact that prostate cancer is the most common cancer in men. This cancer is detectable; it is for the most part preventable. All we have to do is to do something: proactive as opposed to pronounced dead.

my blog: Where the sun don't shine: my colonoscopy
Colorectal cancer, the second leading cause of death from cancer in the United States, will cause 57,100 deaths this year, but only 53% of Americans over the age of 50 have been screened. When caught in its early stages, colorectal cancer is approximately 90% curable.

CBC - Aug 22/2011
Jack Layton's last letter to Canadians
August 20, 2011
Toronto, Ontario
Dear Friends,

Tens of thousands of Canadians have written to me in recent weeks to wish me well. I want to thank each and every one of you for your thoughtful, inspiring and often beautiful notes, cards and gifts. Your spirit and love have lit up my home, my spirit, and my determination.

Unfortunately my treatment has not worked out as I hoped. So I am giving this letter to my partner Olivia to share with you in the circumstance in which I cannot continue.
My friends, love is better than anger. Hope is better than fear. Optimism is better than despair. So let us be loving, hopeful and optimistic. And we’ll change the world.

All my very best,
Jack Layton

my blog: The Script: Live Like We're Dying
[video, lyrics, references]


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