Men's Health As Survivorship

A quick personal update: it has been a WILD ride since I last posted here. In the past few weeks my wife and I managed to sell our house, pack up all our earthly possessions, and move halfway across the country. (For reference, please see the barely air-conditioned U-Haul that was my home for ~2 straight days of driving.)

Don't let those mirrors fool you, they were just for show.

I graduated residency and took my board exams. I officially started my fellowship in Male Reproductive Medicine and Microsurgery at Baylor College of Medicine. My wife pulled the trigger and started her yoga teacher training. Did I mention that I’m surrounded by the best barbecue I’ve ever had and there are 3 dog parks within walking distance of our apartment?

Life is good.

But enough about me, let’s dive into our topic for today:

What is Men’s Health?

…or rather, what SHOULD it be? If your city is anything like mine, then I’m sure you’ve seen a multitude of billboards advertising for pop-up clinics claiming to treat conditions like low testosterone (aka hypogonadism) and erectile dysfunction. These places often have flashy advertisement, great marketing…and so-so medical care.

I don’t mean to paint with a broad brush, but men’s health is more than just testosterone and erections. Or at least it should be. Let me explain:

I completed my residency at one of the highest volume urologic cancer programs in the country. We did the biggest surgeries in our field and took care of the sickest patients. For reference, I performed more retroperitoneal lymph node dissections (RPLNDs) in training than I did vasectomies. It wasn’t even close. Every day I had the chance to be part of a team that saved lives and did what few others could. I will forever be grateful for the experience.

But all of that care came at a cost.

Nothing in life is free, and that is nowhere more apparent than in cancer care. Patients make incredible sacrifices when they’re staring death in the face. It’s a testament to the strength of the human spirit and should be celebrated.

But what happens when the enemy is beaten back and the dust settles? I cared for prostate cancer patients that were still leaking urine over a year after their surgery. Their marriage at the breaking point because they weren’t able to perform sexually and their confidence as men shattered.

I treated young testis cancer patients that were haunted by the specter of infertility. Massive amounts of chemotherapy and surgery had shocked their system and threatened their dreams of starting their own families. We had saved their lives, but what next?

Survivorship

These questions go to the heart what I believe to be one of the core missions of men’s health: survivorship. While cancer treatment is about saving lives, survivorship is about putting those lives back together. This takes many different shapes and forms.

For young men facing a diagnosis of testis cancer, this may mean fertility preservation and sperm banking prior to surgery and chemotherapy. For difficult cases it may even mean saving sperm surgically at the time of cancer treatment. For men who are struggling after prostate cancer treatment, this may mean procedures to restore their ability to hold their urine (aka continence) or regain their erections.

Survivorship is reassuring patients that, no matter what, we as their physicians are with them all the way. It’s about giving them the hope and security that they won’t just survive their disease, but rather that their life will continue to go on and thrive.

Looking Forward

Each year we’re reaching new milestones with cancer care. Survival is the best it’s ever been and new therapies are emerging faster than they ever have before. But as we get better at curing patients, we need to work just as hard to help them recover and help them live their best lives as survivors.

Check the video below for an in-depth look at what survivorship is from the American Society of Clinical Oncology. As always, feel free to reach out in the comments below or on social media. Thanks for reading.

-Alex

Bonus shots of Roland enjoying our walk to one of the three dog parks near us.

I'd say he's adjusting to Texas just fine.