Does the answer matter?

For the past week I have been lurching about the house, lying in bed, and feeling generally lethargic as my body heals from the RPLND I underwent at IUPUI. Nothing new has come up with regard to my cancer, and in all honesty I have been focusing on the idea that this will all soon be over and I can get back to the business of being a healthy, happy person.

And then tonight Dawn said to me, “So-and-so said she read about a link between marijuana and testicular cancer today.”

My initial response: “Why would she say that to you?” This came from a place that Dawn and I have been forced to dwell for a year and a half now — a place where the question “why?” is irrelevant. More importantly, it is unanswerable and the process of questioning is futile and counter-productive. Why? Why? Why? Or, more to the point perhaps: How? No one can tell us, and the answer wouldn’t matter much anyhow. Would it?

Though I am a regular peruser of news online — my day usually starts out looking over the online version of The New York Times, and occasionally the BBC — this was a nugget of news I missed today. So, I Googled it. The page trickled out a handful of news stories about a newly released study funded jointly by the National Institutes of Health, Fred Hutchinson Cancer Research Center, and (the most interesting) National Institute on Drug Abuse. The mainstream media outlets have given it typically sensational headlines like “Just Say No…Or Else You Get Cancer?” (ABC News). I sought out the study itself, or at least it’s abstract, and was stunned:


A population-based, case-control study of 369 men ages 18 to 44 years who were diagnosed with TGCT from January 1999 through January 2006 was conducted in King, Pierce and Snohomish Counties in Washington State. The responses of these men to questions on their lifetime marijuana use were compared with the responses of 979 age-matched controls who resided in the same 3 counties during the case diagnosis period.

Men with a TGCT were more likely to be current marijuana smokers at the reference date compared with controls. In analyses according to histologic type, most of the association between current marijuana use and TGCT was observed in men who had nonseminomas/mixed histology tumors. Age at first use among current users and frequency of use appeared to modify the risk.
An association was observed between marijuana use and the occurrence of nonseminoma TGCTs. Additional studies of TGCTs will be needed to test this hypothesis, including molecular analyses of cannabinoid receptors and endocannabinoid signaling, which may provide clues regarding the biologic mechanisms of TGCTs.

(A more journalistic explanation of the study and its findings can be read here, at the LA Times)

There is no reason to begin a new trend of being dishonest on this blog, so I will say this: though I never smoked a wisp of weed until I was eighteen, I did smoke it in a revolving, undulating pattern ranging from regularity to rarity throughout my twenties, and even a bit into my early thirties. When Dawn and I thought we might consider starting a little brood of our own, I stopped. I stopped because I knew that it could be detrimental to my fertility. I stopped because it seemed like a good time to stop.

But suddenly, in a moment’s time — in the time it took someone to utter a simple sentence, relating a nearly forgotten moment of the day — the questions, the whys, the hows, have cropped up again.

Could it be? And if it could, does it matter?


6 Responses to “Does the answer matter?”

  1. I think why we got our cancer matters a whole lot. Forget the individual, guilt laden, head banging, ‘what caused this and could I have done something different’ type of ‘why me’. I’m talking not talking ‘why me’ but ‘why us’. When science starts to research the causes we’ll find the keys to prevention (which is even more important than finding a cure).

    For my individual cancer, I figure what’s done is done. Other people are way more eager to know the cause of my cancer so they can figure out how not to get what I got. They are pretty shocked when I tell them that the thought rarely crosses my mind.


  2. It only matters if new knowledge doesn’t change future behavior. And I am not speaking to you or your past behavior in particular when I say, in general, we don’t know what we don’t know. We feel something is unfair, and maybe it still IS unfair, but I think it’s wrong to assume that just because we don’t understand “why bad things happen to good people,” that good people doing perfectly good things can still cause (or have a hand in) bad thiings to happen (bad things happening).

    Some might call that the blame game. I don’t think blame is worthwhile. I think it’s mature to find a cause or causes of something bad, and then take responsibility for whatever one’s part might be in the bad thing, even if it’s a small fraction of responsibility. I am still struggling with this myself in regards to nutrition/exercise.

    Going back to you, I’d say that you tried to take whatever responsibility you could by living an even “cleaner,” healthier life than you had been, pre-diagnosis. At the time, I thought you were grasping at straws, like trying to find a talisman to make the cancer go away. But now I think that maybe you took responsibility for what you could. And with new information comes perhaps more responsibility to take on, though you’ve already given up the marijuana.

    You’ve shared the info here, which is wonderful. People need to know and make their own decisions about how much risk they are willing to take (especially after seeing that scar)!

    It would be easy to dismiss this study as just one study that could be disproven, especially if a person didn’t want to accept the results for their own reasons. After all, it’s not cool to be anti-marijuana. But my gawd–think of all the men who MIGHT be doubling their risk! It’s sobering, if you’ll pardon the pun.

  3. And even though I already said a lot, I will also say that the fact that there’s a question should matter to the people you share this information with, because you might not be engaged in potentially risky behavior, but others are, and they might not even know there’s a possible risk. The answer doesn’t matter–the question does, just not for you.

  4. I’m right there with Tara (strange, with her being my daughter and all). All we have is right now, this moment, this day. Engaging in shoulda wouda coulda is a waste of time. The important thing, as Tara says, is that you’re doing what you need to be doing now. And I think she makes a good point about sharing this information. Love you and wish you well!

  5. Felicia Tabanico Gelsey Says:

    Hi Mike, speaking as a statistician and highly trained medical researcher, I would not even think about this. It’s a correlational analysis – meaning it does nothing to show cause and effect. In the world of research, it’s interpreted as a possible association at best. But never interpreted as a cause and effect relationship. There could be a million different reasons for the association that have nothing to do with cancer. Also, when 20 statistical tests are conducted 1 in 20 will come up as a false positive. I’m certain that was an exploratory analysis in which more than 20 tests were conducted. That is why the authors/investigators stated that more studies were necessary to confirm this association. Most of the time when these “associations” are tested in a prospective experimental trial, the “association” doesn’t hold. As a result, I never pay attention to such findings. I just thought I would mention this in case you were concerned. It really doesn’t mean anything. Glad to hear the surgery went well. Still thinking of you…Felicia

  6. Naturally, I know you are right about the study. For the most part, I knew it as I was writing, but my posts are usually more personally, or rather inwardly, motivated than that. I think it is highly unlikely that my cancer was caused by the pot I’ve smoked in my life (as well as other potential root causes that have been suggested to me) — but it was another mental catalyst in my own search for…for what? For coping, I suppose. Coming to terms.

    Thank you to everyone who has shared their thoughts online with me (and the world) — Tara makes a fine point about the need to talk about this sort of thing.

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