A personal reflection on prostate cancer, anger, and the slow work of accepting what’s true.
It started at a regular annual checkup.
My doctor said we were due for routine blood work, and somewhere in that ordinary conversation I said, almost casually, “What do you think about adding a PSA test? My dad had prostate cancer, so it seems worth checking.”
He said sure.
That was it. No alarm. No dramatic pause. No sense that anything important had just happened. Just one more item added to a lab order.
A few days later, the result came back. My PSA was around 8.
Even then, I knew enough to understand that a number like that, especially in a man in his late thirties, was not something to ignore. My doctor did not ignore it. He referred me to a urologist, and I had a biopsy.
It came back negative.
I remember the relief of that moment. I exhaled hard. I wanted the story to be over, and a negative biopsy felt like permission to believe it was. Some men have elevated PSA levels for reasons that never become cancer. I decided I must be one of them. I held onto that explanation because it was comforting, and comfort can be very persuasive.
For the next three years, I kept getting blood work. And over those years, the PSA kept rising. Not all at once. Not with any dramatic moment. Just a little at a time. Quietly. Steadily. The kind of change that is easy to explain away when you badly want your original story to stay intact.
My first urologist never pushed for another biopsy. That was fine with me. I was not looking for someone to talk me into more testing. I had found a doctor whose approach matched the story I wanted to believe, and I was comfortable leaving it there.
I say that knowing full well that as a veterinarian, I should have understood the stakes better than most. But doctors — and I include myself in that category — are often the worst patients. The truth is I did not want to go through the procedure again, and I did not want to face what the results might say.
Eventually the number climbed from 8 to 16. By then, the story I had been telling myself was getting harder and harder to believe.
I switched to another urologist. He reviewed everything with fresh eyes and told me that we absolutely NEEDED to try another biopsy. So, we did. In May 2017, it came back positive. The story I had been telling myself for three years was finally over.
That was the moment the waiting ended. It was also the moment reality became impossible to negotiate with.
I think that was the beginning of radical acceptance, though I would not have called it that at the time. Back then, it did not feel like a concept or a framework. It felt like the slow and painful recognition that no amount of wishing, arguing, or explaining was going to change what was true.
What made the diagnosis harder to absorb was the timing. I was in one of the healthiest stretches of my life. I was active. I was eating well. I was taking care of myself. By any ordinary measure, I was doing the right things. I felt strong. I felt well.
And I had cancer.
I would like to say I responded with immediate wisdom, calm, and perspective. I did not.
I got angry. I asked God why more times than I can count, and I never found an answer that felt satisfying. Worse than that, my mind went to places I am not proud of. I found myself looking at people who seemed to neglect their health entirely, people who ate terribly, never exercised, never went to the doctor, and I thought: how is this fair? How is it that my life gets turned upside down while theirs seems to continue untouched?
Terrible thoughts that I am so ashamed of feeling.
Serious illness has a way of stripping away the polished version of yourself. It does not always reveal grace first. Sometimes it reveals fear. Sometimes resentment. Sometimes a childish, wounded part of you that wants the world to explain itself.
There was another part of it too, one that unsettled me in a different way. Every time I sat in a urologist’s waiting room, I was the youngest person there. Not by a little. Most of the men around me were twenty or thirty years older. I would sit there and look around and feel as if I had wandered into the wrong part of my own life, as if I had somehow shown up chapters too early. I was not supposed to be there yet. At least that is what I kept thinking.
But I was there.
After the diagnosis, I moved forward with treatment. I chose a prostatectomy. Getting to that decision was its own ordeal, full of hard conversations, sleepless nights, and the quiet weight that settles over a home when the future suddenly feels less certain than it did a week earlier. Then the pathology came back from the removed tissue, and surgery alone was not enough. The cancer was aggressive. I underwent more than thirty radiation treatments after that, finishing in December 2017. Seven months from diagnosis to the end of active treatment. It is a strange thing to move that fast through something that changes you that permanently.
Dec 12, 2017 – St Mary’s Medical Center, WV
A urologist has remained part of my life ever since. The crisis chapter ended, but the relationship did not. Now it is checkups once or twice a year, long-term follow-up, conversations about side effects, medications, and the kinds of lingering issues people do not always understand when they imagine cancer as a battle you either win or lose in one clean moment.
That is not how it works.
I am deeply grateful that my PSA has been undetectable since treatment. Every time I see that word on a lab result, I feel something close to reverence. Gratitude, yes, but also relief. It matters. It matters immensely.
But gratitude does not erase reality. I still live with the physical and psychological effects of prostate removal and radiation. There are days when my body reminds me what it has been through. There are days when my mind does the same. Some of the losses are visible, and some are not, but they are real all the same.
And even now, the old anger occasionally returns. Not often. Not like before. But sometimes, especially when I am tired or frustrated, I can feel it rise again. I have learned not to be too surprised by that. Radical acceptance is not a one-time achievement. It is a practice. A return. A decision made again and again whenever reality presses against the parts of us that still want life to be fair.
Somewhere along the way, I came across the phrase itself: radical acceptance. It is often associated with psychologist Marsha Linehan and dialectical behavior therapy, but by the time I found the words, I had already been inching toward the idea.
At first, I thought the phrase sounded a little too polished, like something fit for a poster rather than a life. But over time it became one of the most useful ideas I have ever come across.
Radical acceptance is not approval. It is not pretending something does not hurt. It is not surrender, and it is certainly not passivity. It is the decision to stop wasting energy arguing with what is already true.
That distinction changed something for me — and I think it can change something for anyone carrying a weight they did not ask for.
Maybe yours is not a diagnosis. Maybe it is a marriage that ended. A career that went sideways. A relationship with a child that is not what you hoped it would be. A dream you had to let go of quietly, without anyone noticing. The details are different. The resistance looks the same.
I had spent years resisting reality in different forms. First in denial, then in anger. But reality does not soften because we resent it. It does not reverse because we build a persuasive case against it. It simply remains.
Once I stopped fighting what was already true, I could finally direct my energy somewhere useful. I could make decisions. I could show up. I could have honest conversations instead of frightened, circular ones. I could stop asking why me and start asking the only question that ever moves anything forward:
From here, what’s next?
Acceptance does not mean skipping grief. Grief is real and necessary. But radical acceptance gives that grief structure. It is the difference between feeling the pain of what is real and adding a second layer of suffering by refusing to accept that it is real at all.
It is not something you master once and keep forever. It is a practice. A return. A decision made again and again whenever life gives you something you did not ask for and cannot change.
That is not just a cancer lesson. It is a human one.