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

On this season of And Simply Like That…, Harry Goldenblatt could not assist however surprise if his well being had taken a flip. On the June 26 episode of the present, Charlotte’s affable husband goes from wetting his pants in a nightclub to becoming a member of a membership he’d reasonably not be a part of—though, as he factors out, it additionally contains Robert De Niro, Warren Buffett, and Nelson Mandela.

Throughout a night stroll previous the Guggenheim Museum, Harry tells Charlotte there’s a purpose he requested her to go for a stroll. “To get away from the children? Me too,” she quips. Not precisely: Due to a pair unusual signs he’d been experiencing, Harry determined to go to the physician for a check-up. “What are you aware? I obtained prostate most cancers,” he tells his spouse, who instantly dissolves into panicky worry. “The whole lot goes to be tremendous,” he reassures her. “We caught it early.”

Charlotte may not be comfortable about Harry’s information, however some specialists are happy with the event. “I’m ecstatic about this plotline, as a result of the attention and dialogue round prostate most cancers is commonly hidden,” says Dr. Phillip Koo, chief medical officer on the Prostate Most cancers Basis. “Males don’t like speaking about it—I believe we regularly put up that robust shell on the skin, particularly when it entails the kind of organs that males outline their masculinity primarily based on. I believe it’s great we’re elevating consciousness.”

Nonetheless, that doesn’t essentially imply the present’s depiction is correct. We requested specialists how real looking Harry’s expertise is—and what they need males to learn about prostate most cancers.

Inventive liberties

Harry went to the physician after experiencing two signs (performed for cringey laughs from viewers). Earlier within the season, he hits the golf equipment with Charlotte, who’s attempting to finagle an artwork sale for the gallery she manages. Because the group plots their transfer to an after-party, Harry makes a pit-stop on the rest room, the place he finds, a lot to his horror, that he can’t undo his fancy denims rapidly sufficient. “Oh boy, oh boy,” he mutters. “These buttons! Why so many?” And similar to that, Harry pees in his pants. “It’s a very good factor these infants are so darkish,” he says to Charlotte when he meets up along with her once more. “You may’t inform they’re soaked.”

Then, within the subsequent episode, Harry has bother performing within the bed room with Charlotte. As he wonders in exasperation what’s—or, he clarifies, isn’t—”happening down there,” he bemoans how out-of-character that is for him. “Is that this it? The start of the top?” he spirals. “Knock knock, who’s there? Previous age!”

Learn Extra: Why Some Males Hold Their Prostate Most cancers a Secret

Lower to the newest episode, and Harry has been recognized with prostate most cancers primarily based on these signs. “There’s undoubtedly some inventive liberties the present has taken,” says Dr. Julia Willingham, a urologist who treats prostate most cancers sufferers at Texas Oncology. “It is smart—it helps drive the plot ahead—however most early-stage prostate most cancers has no signs in any respect.” That’s why some individuals name the illness—which is able to have an effect on greater than 313,000 males within the U.S. in 2025—a silent killer. It’s virtually at all times detected by way of a routine prostate-specific antigen (PSA) check, a screening blood check that almost all males bear each couple of years or so beginning round age 50 for these with common threat. (Precise screening frequency depends upon an individual’s age and threat components.)

When a person’s PSA stage is excessive, medical doctors usually do a biopsy and, probably, assessments like a CT scan or bone scan to substantiate the prognosis. “Typically males say, ‘Oh my gosh, I really feel nice,’” Willingham says. “‘There’s no approach I can have prostate most cancers. I’ve no signs.’ After which they do.”

A extra possible path to prognosis

Earlier than the PSA check was accredited as a diagnostic instrument in 1994, males had been extra possible to determine one thing was mistaken as a result of they had been experiencing urinary retention, reasonably than Harry’s incontinence. That may imply problem beginning to pee, a weak stream, bother totally emptying the bladder, or generally, an incapacity to pee in any respect. “The prostate is in a really busy neighborhood,” says Dr. Mark Pomerantz, medical director of the Lank Middle for Genitourinary Oncology at Dana-Farber Most cancers Institute. “It sits proper below the bladder and the urethra—and if there’s a big prostate tumor, in principle it may press in opposition to that tube and trigger urinary retention.”

Different instances, males had been recognized as a result of their prostate most cancers unfold, resulting in signs that affected different elements of the physique. “Prostate most cancers likes to go to bone,” Pomerantz says. “It was not unusual, previous to PSA testing, for individuals to point out up within the emergency room with horrible again ache.” There, they’d get an X-ray that finally led to a prognosis of metastatic prostate most cancers that had unfold to the bones of their again. “We do not see that almost as a lot anymore now that we’ve a check that may catch the most cancers early,” Pomerantz says. “When it does trigger signs, usually the illness is fairly far alongside.”

Which means, if Harry had been a real-life affected person, there’d be purpose to consider his illness was superior. “It may nonetheless be native”—which implies it hasn’t but unfold past the prostate—“however it will take a tumor that is fairly far alongside to get to the purpose the place it will trigger these signs.”

Learn Extra: The Race to Clarify Why Extra Younger Adults Are Getting Most cancers

Total, Harry’s path to prognosis is “doable, however definitely not typical,” Pomerantz says. That stated, he understands why the present’s creators most likely selected to spotlight urinary incontinence and erectile dysfunction. “These negative effects are famously widespread penalties of prostate most cancers remedy, however are hardly ever the signs that result in prognosis.”

Typically, medical doctors suggest energetic surveillance, or watchful ready. But when a person’s most cancers is aggressive, medical doctors usually take the prostate out, and that is when negative effects enter the image. “The best way the surgical procedure works is the entire prostate has to come back out, and once you take away the prostate, you need to take away the a part of the urethra that runs proper by way of the center of the prostate,” Pomerantz says. “The surgeon takes the remaining urethra that is nonetheless within the physique and drags it up and sews it into the underside of the bladder to make a brand new connection. That connection could be a little fragile.” Urine may need a neater time getting by way of, for instance, which may result in leakage. Plus, there are crucial nerves that run alongside the prostate and are accountable for the sphincter muscle, which closes the bladder and retains urine contained. “If these nerves get broken in surgical procedure, then you possibly can have the negative effects that had been depicted within the present,” he says.

A pure response

All through the episode, Charlotte—who promised Harry she wouldn’t inform their children about his prognosis—struggles to comprise her feelings. Throughout a pre-planned glamping journey, she repeatedly snaps at her children in regards to the significance of savoring each second collectively, and seems on the verge of an emotional breakdown. That’s a pure response, specialists say.

“Everybody at all times talks in regards to the C phrase,” Koo says. “I believe your thoughts robotically jumps to the worst situation, and the impression it’ll have in your life expectancy.” Many males fear about how they’re going to proceed working—and the impression their illness can have on their household’s funds. “Somebody like Harry, who has younger children, may surprise: ‘How am I going to help them?’’’ he says. “It’s devastating,” irrespective of how optimistic the prognosis.

A welcome highlight

Specialists hope Harry’s prognosis encourages extra males to get screened. “Males shouldn’t be afraid of prostate most cancers screening,” says Dr. Jamin Brahmbhatt, a urologist at Orlando Well being. “It’s a easy blood check, similar to you’re getting your ldl cholesterol checked.”