A Movember Story from Italy from La Republica
By Tiziana Moriconi
On the occasion of Movember, the men’s health awareness movement, Salute dedicates a special to prostate cancer, gathering the voice of many experts and telling the story of Cosimo, who has lived with the disease for three years
“The first thing the urologist told me was that I would have three possibilities. It’s certainly not what he expects to hear from those who get a cancer diagnosis.” Speaking is Cosimo Pieri, former manager from Milan, born in 1952, with a great passion for skiing and a pilot’s license taken when he was 56 years old. He has been with prostate cancer for three years.
We collected his testimony on the occasion of the month dedicated to male health and, in particular, to the prevention of prostate cancer: the one that more than any other affects men over 50 years of age. There are many initiatives for this Movember, the awareness movement on this cancer. And to his early diagnosis and treatment, Salute dedicates the special Prostate, do not forget about health of the male, with interviews with some of the leading Italian experts among urologists, radiotherapists and oncologists, and with an in-depth study of benign prostate hypertrophy [BPH].
Diagnosis and illusion
“I was under the illusion” – Cosimo says – “that I was informed about prostate cancer: I knew that it was common among men and with a high survival. I thought, taken in time, it was something that is taken off and away, everything like before. Let’s go back to the three possibilities: I could have an operation or have radiotherapy, but with possible side effects. Or not have active treatment at all and enter the active surveillance program, because my cancer – the doctor told me – was not a very serious problem. I had already had a melanoma removed in the past, so his comment that a tumour was not a very serious problem was a strange and new statement for me”.
Cosimo’s story actually began seven years before this episode, in 2010, also in the study of a urologist, from which he had gone for urinary disorders due to benign prostate hypertrophy (enlarged prostate). Everything had been resolved with an intervention and since then Cosimo had started doing the PSA test and checked it every year. This is how in 2017 the doctor discovered a lump in the prostate. At the same time, the PSA was twice as high as the previous value (from 0.7 to 1.4), although still below the value considered a “threshold” in oncology. Subsequent tests confirmed the suspicion: it was a tumour, but fortunately grade 1, which means non-aggressive.
Finding information
“I needed more information to decide and confront someone, so I went to Europa Uomo, an association of patients and doctors. And I found the answers I was looking for,” Cosimo continues. “It may seem like a cliché but it is true: we men always try to solve problems ourselves, not to ask for help. But in the short time of a visit doctors can’t give you all the information you need to make certain decisions. And often the patient when he leaves the hospital is left alone. Sometimes the ground underfoot is missing: after the diagnosis you are led at certain times to depression or to want to overdo it to fully experience everything”.
state cancer, the psychological consequences
Cosimo’s conscious decision was to enter the active surveillance programme, in which it is still, with regular checks, established by a protocol. “Doctors like Prof. Valdagni really made a difference for people with prostate cancer, because until a few years ago we just intervened, with all the consequences that this can have for the quality of life. I’m not his patient, so I don’t have conflicts of interest,” Cosimo jokes.
Knowing makes a difference
One aspect that must always consider who enters the surveillance is the psychological one: “Having spent my life solving problems and managing stress I think has accustomed me not to suffer too much from anxiety”, he says: “For me this was the best solution, also strong in the support of my family. On the other hand, I see many men who live uncomfortably from having to undergo tests and do not know how to deal with the fear of cancer, who see it as a stigma. In these cases you have to be psychologically assisted, because support is more important than you think. The other really fundamental aspect is to be followed not by a single doctor, but by a multidisciplinary group, as happened to me. I figured that out later, but now I know it makes a difference.” There is an important social message to pass on to Cosimo: “Men need to know that a very high percentage of those who discover prostate cancer can do active surveillance, and this is an important incentive to get checked out. In Europa Uomo Italy, of which I am a member today, we organize free visits and awareness-raising campaigns. “In recent years I have learned a lot of things that can make a difference to how you experience the disease. Whichever way you choose to go, there’s so much you can do to live better.”