Is the Prostate Cancer Plot on ‘And Just Like That’ Realistic?

In this season of And just like that …Harry Goldenblatt could not help wondering if his health had taken a tour. In the episode of June 26 of the show, Charlotte’s affable husband passes to wet his pants in a nightclub to join a club which he preferred not to be part – however, as he points out, he also includes Robert de Niro, Warren Buffett and Nelson Mandela.

During an evening pass after the Guggenheim museum, Harry told Charlotte that there is a reason why he asked her to walk. “To move away from children?” Me too, ”she quips. Not exactly: because of a few strange symptoms he had experienced, Harry decided to go to the doctor for an exam. “What do you know?” I have prostate cancer, ”he said to his wife, who immediately dissolves in panic fear. “All is well,” he reassures her. “We caught it early.”

Charlotte may not be satisfied with Harry’s news, but some experts are satisfied with development. “I am delighted with this intrigue, because awareness and discussion on prostate cancer are often hidden,” explains Dr. Phillip Koo, chief of prostate Cancer Foundation. “Men do not like to talk about it – I think we often put this difficult shell outside, especially when that implies the kind of organs on which men define their masculinity.

However, this does not necessarily mean that the representation of the program is correct. We asked the experts to what extent Harry’s experience is realistic – and what they want men to know about prostate cancer.

Creative freedoms

Harry went to see the doctor after having experienced two symptoms (played for the Laughter of Dédénéspectors). Earlier in the season, he hits clubs with Charlotte, who tries to finish an art sale for the gallery she manages. While the group moves in an after-party, Harry stops at the stand in the bathroom, where he finds, at his great horror, that he cannot undo his fancy jeans fairly quickly. “Oh my boy, oh my boy,” he mumbles. “These buttons! Why so many people? ” And just like that, Harry pees in his pants. “It’s a good thing that these babies are so dark,” he said to Charlotte when he returns it again. “You can’t say they are soaked.”

Then, in the next episode, Harry has trouble performing in the room with Charlotte. While wondering in exasperation what is – or, he clarifies, No– “Let’s go there”, he deplores how much it is out of character for him. “Is that it?” The start of the end? ” Il Spirumonie. “Knock, who is there?” Older! “

Find out more: Why some men secretly keep their prostate cancer

Cut in the last episode, and Harry received a diagnosis of prostate cancer according to these symptoms. “There are certainly creative freedoms that the show has taken,” said Dr. Julia Willingham, an urologist who treats patients with prostate cancer in Texas Oncology. “It makes sense – it helps to advance the intrigue – but prostate cancer most of the early stages has no symptoms.” This is why some people call the disease – which will affect more than 313,000 men in the United States in 2025 – a silent killer. It is almost always detected via a specific routine prostate antigen test (PSA), a blood test that most men suffer every two years from the age of 50 for those who have an average risk. (The exact screening frequency depends on the age and risk factors of a person.)

When the level of PSA of a man is high, doctors generally make a biopsy and, potentially, tests like a bone computed tomography or scanner to confirm the diagnosis. “Sometimes men say,” Oh my God, I feel good, “says Willingham. “” There is no way I can have prostate cancer. I have no symptoms. And then they do.

A more likely path to the diagnosis

Before the PSA test was approved as a diagnostic tool in 1994, men were more likely to understand that something was wrong because they knew a urinary retention, rather than Harry’s incontinence. This can mean the difficulty of starting to pee, a weak flow, a problem to fully empty the bladder, or sometimes an inability to pee. “The prostate is in a very busy neighborhood,” said Dr. Mark Pomerrantz, clinical director of the Lank Center for Genitourinary Oncology in Dana-Farber Cancer Institute. “It is just under the bladder and the urethra – and if there is a large prostate tumor, in theory, it could press against this tube and cause urinary retention.”

Other times, men have been diagnosed because of their prostate cancer, leading to symptoms that affected other parts of the body. “Prostate cancer likes to go to bones,” explains Pomerantz. “It was not uncommon, before PSA tests, that people show up in the emergency room with terrible back pain.” There, they would obtain a radiography which finally led to a diagnosis of cancer of the metastatic prostate which had spread to the bones in the back. “We no longer see as many things now as we have a test that can take cancer early,” says Pomerrantz. “When this causes symptoms, the disease is generally far enough.”

This means that if Harry was a real patient, there would be reason to believe that his illness was advanced. “It could still be local” – which means that it has not yet spread beyond the prostate – “but it would take a tumor far enough to get to the point where it would cause these symptoms.”

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Overall, Harry’s path to the diagnosis is “possible, but certainly not typical,” explains Pomerrantz. That said, he understands why the creators of the show probably chose to highlight urinary incontinence and erectile dysfunction. “These side effects are common consequences of prostate cancer treatment, but are rarely the symptoms that lead to diagnosis.”

Sometimes doctors recommend active surveillance or vigilant expectation. But if a man’s cancer is aggressive, doctors generally remove the prostate, and this is when the side effects enter the image. “The functioning of the surgery is the whole of the prostate must go out, and when you remove the prostate, you must delete the part of the urethra that runs in the middle of the prostate,” explains Pomerantz. “The surgeon takes the remaining urethra which is still in the body and dragging it and the coud at the bottom of the bladder to establish a new connection. This connection can be a little fragile.” Urine may be easier to pass, for example, which can cause leaks. In addition, there are critical nerves flowing next to the prostate and are in charge of the Sphincter muscle, which closes the bladder and keeps urine. “If these nerves are damaged in surgery, you can have the side effects that have been represented in the show,” he said.

A natural reaction

Throughout the episode, Charlotte – who promised Harry, she did not speak to their children of her diagnosis – the tendency of containing her emotions. During a pre-Planified Glamping trip, she sinks several times on her children on the importance of savoring every moment together and appears on the verge of emotional depression. It is a natural reaction, say the experts.

“Everyone always talks about the word C,” says Koo. “I think your mind automatically goes to the worst scenario and the impact it will have on your life expectancy.” Many men are concerned about the way they will continue to work – and the impact that their illness will have on the finances of their family. “Someone like Harry, who has young children,” may wonder: “How will I support them?” “He says.” It’s devastating “, no matter how optimistic the prognosis is.

A welcome projector

Experts hope that Harry’s diagnosis encourages more men to be tested. “Men should not be afraid of prostate cancer screening,” said Dr. Jamin Brahmbhatt, urologist at Orlando Health. “It’s a simple blood test, just as you have your cholesterol checked.”