The realities of metastatic prostate cancer survival

Here’s the thing you want to know about this book: Author Paul Steinberg — a District sports psychiatrist and sometimes writer — says he has had metastatic prostate cancer longer than any man in history.

That may not be provable. He got his diagnosis three decades ago at age 35. To treat the disease, he faced castration at 40. Today he describes himself as “dying on the installment plan.”

Steinberg’s short, lively, memoir (“A Salamander’s Tale: My Story — How I Survived and Thrived for Thirty Years With Prostate Cancer”) starts with medical details accompanied with tough-guy talk: Because he and his wife wanted to have more children, his first response to the diagnosis was to ask the doctor, “How about if I spend tonight and whatever time I have before surgery masturbating so that we can collect and save my sperm?” The pragmatic response takes him somewhat aback, though: “You are facing a lethal disease. . . . This is not the time to think about having another child.”

There’s a lot of frank discussion about the sexual and other physical effects of prostate cancer and of its treatment. But the tone moves on to that of a man contemplating life, death, biology, psychology, responsibility, the universe.

“Prostate cancer has created a new reality, it has taken me away from my previously unacknowledged delusions and denials, it has forced me to transform my inner life,” he writes.

Chapter 1 is titled “The wonders of irony and paradox and ambiguity.” He quotes the Old Testament, G. K. Chesterton, Aldous Huxley, Benjamin Disraeli. He gets into monotheism and quantum theory.

Then closes out the book with a bawdy “Ode to Androgens.” (Those would be the male hormones.)

The salamander of the title, by the way, comes from his model for surviving after serious injury or disease: “Salamanders have a capacity to regenerate their tails, legs, retinas, even their spinal cords and parts of internal organs like the heart.”

Like the salamander, Steinberg has had to come back from serious damage. And he’s still here.