Legendary Singer & Prostate Cancer Survivor Elton John Reflects On Gratitude & Mortality at 78— The Power of Early Detection

RELATED: Prostate Cancer: Overview

In a celebratory birthday post, shared on his Instagram page, Elton John wrote alongside a photo of himself, “Thank you all for the beautiful birthday wishes. I spent the day surrounded by friends and family, feeling incredibly loved and grateful.

“Your messages mean the world to me – thank you for everything, always.”

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As for his emotions and thoughts regarding his mortality, something many patients faced with cancer may experience, Elton John spoke on the Smartless podcast this week, admitting that while recording the song “When This Old World Is Done With Me,” which he collaborated with singer-songwriter Brandi Carlile, 43, he thought about how he won’t live forever.

Elton John, who battled prostate cancer after his 2017 diagnosis and more recently suffered vision loss in his right eye after an eye infection, reflected on his life when discussing his emotional song lyrics, according to The London Evening Standard.

He said on the podcast, “I wrote a song at the end of the album and I just get the lyrics, Bernie Taupin’s lyrics called When This Old World Is Done With Me. And so I’m writing the verse, like, ‘Oh, this is really pretty.’

“And then I get to the chorus and of course it’s about my death. And when you get to my age, which is near 100, you think, ‘How much time have I got left?’”

Elton John continued, “And you’ve got children, you’ve got a wonderful husband, you just think about mortality. And so when I got to the chorus, I just broke down for 45 minutes and it’s all on film.”

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Looking back on the hard work that went into creating his soon-to-be released album, Elton John wrote on Instagram, “This record was one of the toughest i’ve ever made, but it was also one of the greatest musical experiences of my life. It has given me a place where I know I can move forward. ‘Who Believes In Angels?’ feels like going into another era and I’m pushing the door open to come into the future.

“I decided I wanted to make an album with @brandicarlile because our friendship was so close, and I just knew the instinct that we could produce something really, really amazing.”

He concluded, “Along with my long-term collaborator @bernietaupinofficial and friend and ally @ThisIsWatt, we decided to go into the studio and try and make a truly collaborative album inspired from our musical heroes and our journey together. We started from scratch, with a blank notepad and a world-class band of legendary session musicians.

“It was one of the most difficult creative processes I’ve ever been through, but I couldn’t be prouder of the outcome. I wanted to make this record with Brandi because I knew what she’s capable of, and I wanted to sing and play with her because I knew it would be special.”

His new album is set to be released on April 4th, 2025.

We’re delighted to see Elton John continuing to challenge and immerse himself into his love of music, and especially so, about eight years after his prostate cancer journey began.

Although Elton John is concerned about his mortality as he admits it’s scary he doesn’t know how much time he has left in this life, we want to point out that “The 5-year relative survival rate for a specific stage of prostate cancer is 90%,” according to the American Cancer Society (ACS).

As per the ACS, this survival rate means “that men who have that cancer are, on average, about 90% as likely as men who don’t have that cancer to live for at least 5 years after being diagnosed.”

Thankfully Elton John’s prostate cancer was discovered at an early stage and he was able to beat the disease after surgery.

It’s important to understand that early detection of prostate is necessary as it can help reduce the risk of cancer spreading to other organs. Screening for prostate cancer generally involves a PSA (prostate-specific antigen) test and a digital rectal exam to feel the prostate gland. The prostate-specific antigen is a protein secreted by the prostate gland, large amounts of which can indicate prostate cancer.

Elton John’s Prostate Cancer Journey

Elton John was diagnosed with prostate cancer in 2017 and had surgery to treat his disease, something which he impressively didn’t let slow him down.

Following surgery, he revealed that he even wore a diaper onstage during one of his concerts in Las Vegas following his surgery—since he hadn’t yet regained control of his bladder.

RELATED: Singer Sir Elton John Reveals He Went on Stage in a Diaper after His Prostate Cancer Surgery

In “Elton John: Uncensored,” an earlier interview with the singer on BBC One, Elton John recounted to Graham Norton that he wore a diaper under his outfit during a Las Vegas show in 2017.

“If only they knew at that moment I was pissing myself,” he said.

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Elton John also wrote about his cancer diagnosis in his book “Me,” saying, “I wasn’t as shocked at hearing the word ‘cancer’ as I might have been. It was prostate cancer: no joke, but incredibly common.

“They’d caught it early, and besides, I’m blessed with a constitution that just makes me bounce back from illnesses.”

Thankfully, the surgery he underwent to remove the cancer was a success. However, 10 days later, the singer contracted a fever and a major infection.

“It turned out that I had a rare complication from the operation,” he wrote in the book, and he spent 11 days in a London hospital “wondering if I was going to die.”

The complication ultimately inspired him him to take some time off of touring to spend time with his husband David Furnish, and their sons, Zachary and Elijah.

On his decision to have the surgery, John wrote, “A lot of men won’t have it, because it’s a major operation, you can’t have sex for at least a year afterwards and you can’t control your bladder for a while.

“But effectively my kids made the decision for me. I didn’t like the idea of cancer hanging over me us for years to come: I just wanted rid of it.”

Understanding Prostate Cancer

If you or a loved one has been diagnosed with prostate cancer, it’s important to remember that most types of prostate cancers are treatable. According to the National Cancer Institute, the five-year survival rate of prostate cancer in the U.S. is 97.1%. There is, however, a small number of men whose type of prostate cancer may become unresponsive to treatment, for example, when cancer cells develop a resistance hormone therapy, the treatment may no longer work.

RELATED: Prostate Cancer: Overview 

Prostate cancer begins in the prostate the walnut-shaped gland located between the rectum and bladder that produces the fluid that nourishes sperm. Outside of skin cancers, prostate cancer is the most common cancer in American men with about one in eight men being diagnosed with this disease during his lifetime.

It’s important to remember a prostate cancer diagnosis is not always preceded by symptoms. And even when symptoms do occur, they can be inconsistent and hard to pinpoint.

“Prostate cancer is a very odd disease in that it doesn’t have a particular symptom,” Dr. Edwin Posadas, director of translational oncology and the medical director of the Urologic Oncology Program at Cedars-Sinai, told SurvivorNet.

Still, it’s important to note changes in urinary function, like urinating more or less often or waking up at night to go more than usual, could be a sign of prostate cancer. So, even if you think there’s nothing to worry about, always talk to your doctor about changes to your health when they occur.

There are many different treatment options for both early and later-stage prostate cancer including active surveillance, watchful waiting, surgery, radiation, cryotherapy, hormone therapy, chemotherapy, immunotherapy and targeted therapy. The disease is one where doctors may have differing opinions on the best treatment path to take, so don’t hesitate to ask lots of questions and seek out multiple opinions.

Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation

“I think it behooves the patient to have multiple discussions or second opinions, not only by the urologist who did the biopsy and diagnosed that man, but also with other surgeons and other radiation oncologist just to get a very circumspect view of what the treatment options are,” Dr. Jim Hu, a urologic oncologist at Weill Cornell Medicine, told SurvivorNet. “Oftentimes, I think patients need to understand that our health system is based a lot on fee-for-service medicine.”

“And so therefore, a lot of physicians, I think, who are very well intentioned, will believe that their treatment is best for that particular man,” Dr. Hu added.

Treatment Decisions After a Prostate Cancer Diagnosis

Although there are numerous treatments available for prostate cancer, what your doctor recommends will depend on what category of risk your disease falls under. Sometimes that may mean doing nothing at all.

Prostate cancer is a slow-growing disease, so unless it’s been a majorly delayed diagnosis and in a more advanced stage, medical experts will sometimes suggest actively monitoring the growth, and the patient will go in for check-ups every six months or whatever timeframe the doctor deems best.

Dr. David Wise, NYU Langone medical oncologist, explains how Gleason score affects treatment and prognosis

The National Comprehensive Cancer Network (NCCN) guidelines divides prostate cancer into one of six risk categories based on how aggressive the cancer looks under the microscope and the chance of it coming back after treatment. These risk categories help guide treatment for the different subtypes of prostate cancers.

The main risk categories for prostate cancer are:

• Very-Low-Risk (VLR) and Low-Risk (LR)
• Favorable- (FIR) and Unfavorable-Intermediate-Risk (UFIR)
• High-Risk (HR) and Very-High-Risk (VHR)

Prostate cancers classified as VLR or LR represent the least aggressive forms of cancer. This categorization will be diagnosed depending on number of factors, including:

• Your doctor can’t feel the cancer on a physical exam, or it occupies one-half or less of one side of the prostate
• Your PSA is less than 10
• Your total Gleason (which is how the prostate cancer is graded) score is 6
• If your cancer is categorized as VLR or LR, your doctor may recommend active surveillance, which is sometimes called “watch and wait.”

Dr. Nicholas Nickols, a radiation oncologist at the UCLA Department of Radiation Oncology, summarizes active surveillance as follows, ‘We carefully monitor the prostate cancer for evidence of progression or not, and then initiate treatment later, if at all.”

During active surveillance, you won’t receive any treatment but your doctor will key an eye on your cancer with a series of tests including:

• PSA Levels
• MRIs
• Repeat biopsies

It’s possible that your cancer may never progress to more aggressive forms of prostate cancer. Active surveillance should help your doctor catch any changes or progression.

RELATED: What is Active Surveillance?

Patients on active surveillance can be spared the side effects of pursuing the traditional ways of treating prostate cancer. If and when the disease becomes more aggressive, as indicated by a rising PSA, development of aggressive-looking disease on MRI, or increasing Gleason score, it can then be treated with surgery, radiation, hormone therapy, chemotherapy, or a combination of these therapies.

Dr. Edwin Posadas tells you what clues might signal that you have prostate cancer

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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