It came, as these things often do, like a gunshot on a quiet street: Shocking and disorienting. In early December, my urine turned brown. The following day, I felt feverish and found it hard to pee. I soon realised I had a urinary tract infection. It was unpleasant, but seemed to be no big deal. Now I know that it might have saved my life.

The doctor told me this infection was unusual in a man of my age, and hinted at an underlying condition. So I had a blood test, which revealed that my prostate-specific antigen (PSA) levels were off the scale. An MRI scan and a mortifying biopsy confirmed my suspicions. Prostate cancer: All the smart young men have it this season.

On Monday, I go into surgery. The prostate gland is buried deep in the body, so removing it is a major operation: There are six entry points and it takes four hours. The procedure will hack at the roots of my genitals. Because of the damage that will be caused to the surrounding nerves, there’s a high risk of permanent erectile dysfunction. Because the urethra needs to be cut and reattached to the bladder, I will almost certainly suffer urinary incontinence for a few months, and possibly permanently. I was offered a choice: Radical surgery or brachytherapy. This means implanting radioactive seeds in the parts of the prostrate affected by cancer. Brachytherapy has fewer side effects, and recovery is much faster. But there’s a catch. If it fails to eliminate the cancer, there’s nothing more that can be done. This treatment sticks the prostate gland to the bowel and bladder, making surgery impossible. Once you’ve had one dose of radiation, they won’t give you another. I was told that the chances of brachytherapy working in my case were between 70 and 80 per cent. The odds were worse, in other words, than playing Russian roulette (which, with one bullet in a six-chambered revolver, gives you 83 per cent). Though I have a tendency to embrace risk, this was not an attractive option.

It would be easy to curse my luck and start to ask “why me?”. I have never smoked and hardly drink; I have a ridiculously healthy diet and follow a severe fitness regime. I’m 20 or 30 years younger than most of the men I see in the waiting rooms. In other words, I would have had a lower risk of prostate cancer only if I had been female. And yet ... I am happy. In fact, I’m happier than I was before my diagnosis. How can this be?

The tragedy of our times

I realised that this bad luck, far from being a cause of woe, is a reminder of how lucky I am. I have the love of my family and friends. I have the support of those with whom I work. I have the National Health Service. The tragedy of our times is that, rather than apply the most useful of English proverbs — “cheer up, it could be worse” — we are constantly induced to imagine how much better things could be. The second principle is this: Change what you can change, accept what you can’t. This is not a formula for passivity. I’ve spent my working life trying to alter outcomes that might have seemed immovable to other people. The theme of my latest book is that political failure is, at heart, a failure of imagination. But sometimes we simply have to accept an obstacle as insuperable. Fatalism in these circumstances is protective. The third principle is this: Do not let fear rule your life. Fear hems us in, stops us from thinking clearly and prevents us from either challenging oppression or engaging calmly with the impersonal fates. When I was told that this operation has an 80 per cent chance of success, my first thought was “that’s roughly the same as one of my kayaking trips. And about twice as good as the chance of emerging from those investigations in West Papua and the Amazon”.

There are, I believe, three steps to overcoming fear: Name it, normalise it, socialise it. For too long, cancer has been locked in the drawer labelled ‘Things We Don’t Talk About’. When we call it the ‘Big C’, it becomes, as the term suggests, not smaller, but larger in our minds. ‘He Who Must Not Be Named’ is diminished by being identified, and diminished further when he becomes a topic of daily conversation.

So I have sought to discuss my prostate cancer as I would discuss any other issue. I make no apologies for subjecting you to the grisly details: The more familiar they become, the less horrifying. In doing so, I socialise my condition. Last month, I had intended urge men to get themselves tested. But since my diagnosis, we’ve discovered two things. The first is that prostate cancer has overtaken breast cancer to become the third biggest cancer killer in the United Kingdom. The second is that the standard assessment (the PSA blood test) is useless. As prostate cancer in its early stages is likely to produce no symptoms, it’s hard to see what men can do to protect themselves.

Instead, I urge you to develop a better test. Prostate cancer is discriminatory: For reasons unknown, black men are twice as likely to suffer it as white men. Finding better tests and treatments is a matter of both urgency and equity.

I will ride this out. I will own this disease, but I won’t be defined by it: I will not be prostrated by my prostate. I will be gone for a few weeks, but when I return, I do solemnly swear I will still be the argumentative old git with whom you are familiar.

— Guardian News & Media Ltd

George Monbiot is a noted columnist known for his environmental and political activism. He has written several books including the critically acclaimed The Age of Consent.