‘You’ll die with it, not of it’
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Ah yes! The sound of doctors whistling in the dark to keep their spirits up.
It is meant to be reassuring but ‘you’ll die with it, not of it’ must rank as one of the least useful phrases known to medical science. It is true, epidemiologically speaking, in medical science - but it is not useful in patient care. It’s the least useful phrase known in patient care.
It's trotted out to men diagnosed with prostate cancer.
Most GPs know the phrase and will use it. It refers to the very high incidence of the kind of prostate cancer from which men won't die, but neatly distracts doctors and the men themselves - the very people who should have it in plain sight - from the probability that certain men will. How else can prostate cancer be the second most common cause of cancer related deaths in men, if ‘dying from it’ isn’t happening? As CR-UK reminds us on its website “The majority of prostate cancer deaths - 93% - occur in men aged 65 and over. In older men aged 85 and over prostate cancer overtakes lung cancer to become the most common cause of cancer deaths in men.”
That shows the ‘die with it, not of it’ phrase is neither illuminating nor helpful to the men who get it and could actually minimise ambitions and expectations for care, especially in older men who are the ones most likely to be doing the dying and whom we resolutely fail to notice.
Since the profile of prostate cancer is higher than it has ever been and has grown hugely over the last ten years but no story of men with prostate cancer over the age of 75 is ever mentioned, certainly not by leading prostate cancer charities, just what are older men meant to gather about having prostate cancer at their age? Put up? Shut up? Don't ask? Who cares?
Prostate cancer is now branded (subliminally) as Breast Cancer For Men. As I’ve said in other posts I am 'unconvinced' that the current public profile of breast cancer is good for women. It certainly isn't good enough for the 80% of women with breast cancer who are diagnosed post-menopause. You'd think it was solely a young woman's problem, if left to absorb the public profile on your own. Linking prostate cancer to breast cancer simply transfers the same ageist principles rampant in breast cancer research and media profile, to prostate cancer, with the same invidious results for older men as in older women.
Since when was this a good idea?
By falling in with this we lose all sight of older men with prostate cancer and concentrate on the narrow band of younger men. I don’t mean younger men aren’t worth a second glance.
What I am saying is that older men deserve a first glance.
