Chapter 5: Side Effects May Include the Collapse of Your Entire Life

Dry mouth, fatigue, tits, a belly that looks like a Chef's hat, the moodiness, the irritability, loss of muscle mass... and spontaneous loss of identity

Side effects. That charming little footnote in the Book of Oncology, nestled between “don’t worry” and “just a little discomfort.” Side effects are where the real magic happens; the part of the treatment where you realize that surviving cancer might be the easy bit. It's the living afterward that requires a user manual, a support group, and possibly a small exorcism.

Let’s begin with “manageable,” the oncology world's most elastic word. It can mean “mild skin rash” or “I’m sorry, did you say your teeth are now radiating Wi-Fi?” Your doctor, in all their serene detachment, will rattle off a list of possible side effects in a tone normally reserved for ordering lunch. “Fatigue, brain fog, emotional lability, hot flashes, erectile dysfunction, bone thinning, muscle loss, depression, dry mouth, dry eyes, dry skin, dry soul… but it’s all manageable.”

Manageable. By whom? An immortal Buddhist monk with a morphine drip and no attachment to worldly functioning?

You, meanwhile, are staggering through a minefield of medication-induced existential decay. You're so tired you can't lift your own self-pity. You cry during toothpaste commercials. You forget where you put your keys, then forget what keys are for, then forget why you went into the kitchen and weep into the cutlery drawer for reasons even your psychiatrist wife can’t quite untangle (though she’ll try, bless her, with a clipboard and a theory about unresolved attachment trauma).

Your friends, if they haven’t quietly ghosted you out of discomfort or contagious mortality vibes, suggest you “focus on the positives.” Which is a fascinating psychological technique, if you define “positives” as “no longer caring that I just peed a little while sneezing.” They send you inspirational memes with butterflies and messages like “You’ve got this!” as though you're facing a promotion, not a biochemical lobotomy.

Then comes the identity erosion. A sneaky side effect, that one. No leaflet mentions it. One day, you’re a father, a strategist, a man who knows how to change a tire and fake enthusiasm at office birthday parties. Next, you're an irradiated hormone husk with mood swings that terrify the dog. You find yourself weeping because your soap smells too confident, and you haven’t had a genuine erection since the Trudeau government still had approval ratings.

Loss of libido is described, again, as “manageable.” Which makes sense if you consider total sexual extinction to be the adult version of manageable. They don’t warn you that you might mourn your penis like a fallen comrade. You’ll find yourself having surreal inner monologues: “He served me well. He was loyal. He rose to the occasion. He died in silence.”

Let us not forget “fatigue.” This is not “I stayed up too late binge-watching murder shows” fatigue. This is “my cells are on strike” fatigue. It’s lying down after taking a shower because the act of washing your own armpits has become an extreme sport. You start to measure your energy in teaspoons. You try to read a book and forget how the plot works.

And weight gain. Because it’s not enough to be castrated chemically—you also get to resemble a bloated garden gnome with endocrine issues. Meanwhile, everyone’s telling you how well you look, which is code for: You have that waxy glow of someone who’s recently joined the undead.

In the end, “manageable” turns out to be a flexible term. It means: You’re not dead, are you? It means: We gave you a 5% chance of incontinence, and you won the cancer lottery. It means: The treatment worked; pity about the rest of your life.

So you adapt. You survive. You “cope,” which is just another word for slowly going mad with intermittent grace. And one day you’ll look in the mirror, see someone vaguely familiar, and whisper:

The Tits. My God, the Tits… Of course, no discussion of side effects would be complete without mentioning the tits. Yes, you will grow them. Slowly. Softly. Like a betrayal in silk.

Nobody quite prepares you for this. They’ll mention “gynecomastia” in passing, as if it’s a quaint pit stop on your scenic route to chemical castration. “Some breast tenderness,” they say. Which is adorable. What they mean is: Your nipples will become sentient rage buttons, and you’ll develop a pair of B-cups that make hugging relatives an act of strategic choreography.

And the worst part? They’re not even good tits. If you’re imagining something voluptuous or symmetrical, don’t. Think more: deflated pastry and misplaced sorrow. They're not proud, bouncing affirmations of femininity. They’re hormonal booby traps designed to punish you every time you put on a T-shirt or reach across your body too fast.

My psychiatrist wife, of course, takes it all in stride. “It’s a symbol of your therapeutic surrender,” she says, handing me an ice pack and a copy of Judith Butler. You, meanwhile, are Googling sports bras at 2 a.m. and wondering if this is how all superheroes start: sobbing in the dark, nipples like landmines, breasts of doom rising slowly in the night.

And just when you think you’ve accepted them - bam - someone you haven’t seen in months says, “You look different… fuller, maybe?” and you have to resist the urge to shout: “I have cancer tits, Deborah. Let it go.” “My God… what have they done to me?”

And then you'll laugh. Because it hurts less than screaming.

…So you adapt. You survive. You “cope,” which is just another word for slowly going mad with intermittent grace. And one day you’ll look in the mirror, see someone vaguely familiar, and whisper:

The Brochures, because, of course.

And just when you think you've hit rock bottom, a nurse slides you a beige brochure. It features two aggressively cheerful elderly people on bicycles; helmeted, wind-kissed, and suspiciously dry. Not a pad, diaper, or ounce of dignity loss in sight. Just pure, unsoiled delusion pedaling through a golden field of bullshit. The title? “Living Your Best Life After Treatment!” Which is rich, considering you now time your errands around bathroom proximity and the half-life of your next hormone-induced hot flash.

You take the brochure home anyway. Not because it helps. But because someday, you’ll need kindling for the fire where you plan to burn your old underpants, your dignity, and the last remnants of your former self.

And then you'll laugh. Because it hurts less than screaming.

And just when you've accepted that your life has been reduced to a daily roulette of bowel predictability and soul fatigue, they invite you to a “Post-Treatment Wellness Workshop.” The flyer promises reconnection, renewal, and resilience, which, translated from cancer-support Esperanto, means lukewarm herbal tea, breathing through your trauma while sitting on a gym mat that smells like feet, and pretending everything’s fine.

The room is always softly lit, because bright lights might reveal how truly done everyone is. You’re greeted by a facilitator named Kendra, whose eyebrows have never known hardship. She speaks in tones so gentle they could lull tumors back to sleep. “Let’s begin by grounding ourselves in gratitude,” she says, as if gratitude can reverse pelvic radiation.

You're handed a journal and told to write down “what your cancer taught you.” You fight the urge to scrawl Never trust a brochure, or if one more person tells me to breathe, I will set this building on fire. But you don't. You write resilience because you're tired and it’s what they want, and the tea is free.

Then comes the breathing. In. Out. In again. You’re told to feel your body. Which is unfortunate, because you do. You feel every broken, hormone-flattened, insomnia-ravaged corner of it. You feel the heat flash rising in your chest like Satan’s own vape cloud. You feel the back pain that never left and the pelvic numbness that just arrived. Kendra floats past, whispering, “Beautiful work,” as if surviving without screaming qualifies as art.

Someone cries. Someone else shares. You’ll be handed a Survivorship Plan—a document so vague it might as well be a horoscope. “Continue a healthy lifestyle. Monitor symptoms. Seek psychosocial support.” It is, in essence, the IKEA instruction manual of post-treatment life: missing pieces, unreadable symbols, and no clear way to assemble anything resembling normalcy.

Your medical team, once attentive and borderline clingy, now vanishes like interns after a failed merger. The radiation oncologist disappears first, slipping into the night after mumbling something about long-term effects “possibly” resolving in “some patients.” Your urologist goes on sabbatical, your nurse navigator is reassigned to someone younger and more marketable, and your family doctor begins to greet you with “Oh, you’re still around!”

You're told to “rebuild your life.” But rebuild with what? Your stamina is wrecked. Your emotions are on a rollercoaster powered by hormone withdrawal and quiet dread. Your sense of identity has been reduced to vague metaphors about “resilience” and “new beginnings.” You’ve lost hair, function, desire, certainty, and in exchange, you’ve gained a commemorative tote bag and crippling medical PTSD.

And just to keep things spicy, every new ache, twitch, or unexpected sneeze now triggers an internal monologue that sounds like an episode of Dateline:
"He thought it was just indigestion. It wasn’t."

Psychologically, you’re trapped in a Schrödinger’s box: both fine and not fine, cured and doomed, functional and emotionally composted. People expect you to be grateful. You are grateful. But you’re also pissed, traumatized, and haunted by your own medical chart.

Survivorship, as it turns out, isn’t a finish line. It’s a cul-de-sac. A confusing, poorly lit neighborhood with too many specialists, not enough answers, and a permanent low-grade hum of existential vertigo.

So you settle in. You keep your calendar open. You pack a bag for every scan. You smile for the people who need to believe you’re okay. And when someone says, “Wow, it must feel amazing to be done,” you nod politely and say, “Yes. Amazing.”

Then you go home, microwave something beige, and try to remember who you were before all this began. You nod empathetically while thinking about dinner and wondering if the salmon will betray you again. At the end, they give you a rock. A literal rock. To symbolize your journey. You take it, quietly naming it “The Weight of My Repressed Rage.”

Then you go home. You put the rock next to the beige brochure and think: These people mean well. But so did the Trojan Horse.