Do As Well As You Can

Barry Lopez, prostate cancer

Barry Lopez died of prostate cancer on December 25, 2020. He didn’t share many details about it. I think he regarded his cancer as a private matter and felt there were more important topics to write about. His impact on environmental writing and awareness of nature is enormous.

I’ve read a couple of interviews that Barry gave after his diagnosis where he talked briefly about cancer, but the only writing I’ve found is three pages in his “Deterioration” essay that was published after his death in Embrace Fearlessly the Burning World.

I don’t know Barry’s reasons for keeping his cancer to himself, but I can guess: he felt his environmental writing was more important to others, and he wanted people to focus their attention on the wonders of nature and not on his cancer because that only affected himself and a few close friends. He regarded prostate cancer as one of the common ailments that men get when they become older, like arthritis and bone spurs, so there was nothing noteworthy about him having it. Fred Bahnson offers a third idea — Barry’s religious desire to be in service to others.

Most men don’t like to talk about their pain or illnesses, and certainly not about a cancer that takes away what society says physically makes a male person a man — hair, muscles, endurance, and a healthy libido. It often causes urinary and erectile dysfunction problems, which are also blows to one’s ego. Barry wrote that each year he would cut up several dead trees with his neighbors and use the wood to heat their homes, but he had lost the strength and agility to do this. He also could no longer hike through the forest he loved.

If you spend any time outdoors, listening and watching nature go about its daily life, you realize that death is part of life in the forest, and you come to accept that you are part of this, so when you are dying, you know it’s the natural course of things and you don’t get bent out of shape.

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The details of his cancer probably aren’t of interest to most people - he had cancer, went through treatments, survived for a time, and died. But for those of us who also have prostate cancer, the details are important because we are trying to stay alive, and we want to learn everything we can from other prostate cancer men — what worked for them, and what did not. Knowing the specifics of what Barry went through could help us, but his details are sparse. I’m particularly concerned because we were both diagnosed at the same age and had the same Gleason 9 score (out of 10) from our biopsies that indicated aggressive cancer. I ended up Stage 3b, while Barry was Stage 4 with metastasis in his pelvic bone and several lymph nodes. How close did I come to being a 4?

After he was diagnosed in 2013, Barry said he was put on hormone therapy and an antiandrogen drug, although he doesn’t identify the drugs. I’m guessing they were some combination of Casodex, Lupron, and Enzalutamide. Apalutamide, which is often used today, wasn’t approved for metastatic men until 2019. I haven’t found any indication that Barry had radiation, perhaps because his cancer had already spread and radiation wouldn’t have helped. He said his hot flashes from the hormone drug were a distraction and an occasional annoyance. My hot flashes were so severe that they kept me from sleeping for longer than a couple of hours a night for more than a year.

The medium survival for someone who had Stage 4 prostate cancer in 2013 was two to three years. With the drugs, and by managing his diet and exercising, Barry was able to last for six and a half years before his drugs stopped working. Today, because of cancer research, the medium has increased to five years, and with new targeting therapy drugs coming out, metastatic men can be maintained for longer.

A number of other questions remain. His wife Debra Gwatney shared that when his drugs stopped working his oncologist said that only clinical trials and palliative drugs remained. Did he not qualify for any clinical trial where he would have access to experimental drugs that are now routinely being used to keep men alive?

Before his diagnosis, why was his PSA being checked every six months if his previous PSA was fine? The standard is to be tested once a year, although many physicians don’t even do this because the test has so many false positive results, choosing to wait until there are symptoms. What this says to me is that Barry’s PSA was already slowly rising before it took off. It also indicates that once aggressive cancer gets its footing, it accelerates quickly. Both of our cancers took off like a toboggan on an icy hill, within six months for Barry, and within one year for me. I had no symptoms of a problem, and I am grateful that my primary doctor didn’t wait. I thanked her.

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In a 2016 interview, Barry said he was writing an essay about deterioration, but noted that he wasn’t going to include his cancer because it was too big. Yet, a section about cancer did appear in this essay when it was published in Embrace two years after he died. Did he change his mind when he realized he was dying and wouldn’t have time to write a separate essay about cancer, so he included it here?

In her touching introduction, Rebecca Solnit wrote that four essays in the book were in draft form when Barry died, and I am guessing that this is one of them.

After his diagnosis, when his strength began to fail, he thought he wouldn’t be able to tackle another big book after his monumental book Horizon was published, but he “realized that was a very bad frame of mind to have,” and he figured that if he couldn’t finish it, he wouldn’t. Until he couldn’t write anymore because of the pain in his bones, he wanted to be at work.

Barry: “Cancer, of course, is a teacher. And I am writing down the lessons. It teaches empathy and compassion. It teaches patience and forbearance with all that seems to be failing in the world. It teaches tolerance of the mess we and others make of our lives. It changes one’s ambitions profoundly. It teaches the strengths to be found in community, which are different from the strengths to be found in individual striving. It teaches one to adapt.” (from “Deterioration”)

Barry died five years ago this month, on Dec. 25 at age 75, two weeks short of turning 76, heartbroken after a fire burned the forest around his home and destroyed his archive of writings and journals of fifty years. Coincidentally, John Muir, who fought to save Yosemite and the Mariposa Grove of giant sequoias, died on Dec. 24, at age 76 of pneumonia, heartbroken after losing the battle to save Hetch Hetchy, Yosemite Valley’s sister valley, from being flooded to provide drinking water to San Francisco.

Barry said, “Do as well as you can for as long as you can.” Amen.

© 2025 Mark Liebenow, author of Mountains of Light: Seasons of Reflection in Yosemite, Univ. of Nebraska Press