PROSTRATE, BUT NOT BROUGHT LOW. It’s not supposed to happen. But it does. Your doctor refers you to the hospital and you find out that you’ve got cancer. If you’re going to get it then apparently the prostate is the place. The success rate for treating prostate cancer when caught in its early stages is something to shout about. So is being diagnosed with the bloody thing. I suppose I was a sickly child. Back in the smoggy 50’s it was tonsils and adenoids that laid me low. Then, thank God, I enjoyed nearly four decades of rude health. There was the pony club finger incident when I neatly removed most of my right pointer with a sledge hammer while trying to encourage the posts for the bending race into the gymkhana show ring. That was operator error. 1999 saw the heart attack before my 50th birthday and some would say operator error repeating itself. It was perhaps a tap on the shoulder waiting to happen. It was in the genes, not helped by life style, fuelled by alcohol and encouraged by stress. The stent sorted it out and the daily pills have kept things ticking along nicely. It is quite a disappointment therefore to be told that I now have prostate cancer. Early stages she said, but then that’s a bit like being told you can’t bank the money when you’ve won the lottery roll-over. Getting up in the night to pee is a warning sign. Getting up three or four times every night becomes downright inconvenient and should send you off to see your GP. I saw mine a year ago and a blood sample showed my PSA at 4.8 was, so he said, ok. A year later and it wasn’t. It read 7.8 and the GP’s latex gloved finger told him and me that my usual walnut sized prostate had grown to apple proportions. There is no process in the UK where men of a certain age are screened for prostate problems. When I hit 60 I was sent a diy kit to see if I had bowel cancer. Happy birthday to me I thought as I deposited my sample on the paddle provided and posted it back to the unfortunate person who had to open the mail. I was sent an all clear. Discovering if you’ve got prostate cancer seems a hit and miss affair. Just because you can no longer pee up the wall with gusto doesn’t mean you’ve got cancer. “Can’t you reach over that five bar gate?” asked one of my farmer friends. “I’d be damned lucky if I could reach the toe of my Hunter wellies,” I replied. Flow is one thing they want to know about and before the further examination in hospital I had to complete a log of how much I drank and how much I then expelled over three days. My three days were not consecutive because I felt that the excesses on the Saturday, the day of the Calcutta Cup match, would present an unfair bias. The examination in hospital involves more drink. When you’re ready you have to pee into a bottle to give a sample and then a bucket like receptacle that reads the force with which you do it. I gave it my all not wanting to fail. Sadly the thin trickle was nothing you could write your name in the snow with. The biopsy itself involved lying down on my side with my knees up towards my chest with my exposed back-side towards the guy I’d only just shaken hands with. I had donned one of those unflattering hospital gowns with an open back and I could soon understand why. Prostrate for the prostate, a probe was inserted up my bottom and the experience was no more painful or humiliating than being beaten on the bare buttocks by a ferocious headmaster in front of the entire gawping school. The gland is scanned and a local anaesthetic is pumped into it. None the less a series of eight “shocks” surprise you. There’s a count down from the operator for the first and second but after that the anticipation is almost as bad as each jolting incision as they remove bits from you for analysis. You’re in and out just like the probe. I felt rather sorry for the man who had to do the job even though he does it day in and day out, so to speak. You see red for a few days with the first splash of pee and you feel a bit uncomfortable while you wait for the week to tick by. Getting the results isn’t opening an envelope. We, that is my partner and I, attended the department of urology once again. When my turn came and my name was called out over the heads of all the other drinking men gathered worriedly around the NHS water dispenser, I got up and followed the nurse in green. “Would your partner like to come too?” she said. This was the first warning shot that my results were not going to be good. Good news can be imparted with ease, face to face. Bad news needs to be shared between three or more. The words of the very proficient and perfectly charming Macmillan nurse didn’t hurt me. I wasn’t shocked. I half expected the news and when your body isn’t performing as it once did, when you’ve probably been putting off even talking about it, the c word doesn’t have quite such a sting. I knew it would be bad. PSA up, prostate enlarged, uncontrollable pee as weak as that from a gnat, the unpleasant biopsy and a feeling deep down inside that not everything was working or acting as once it did. My partner cried and the nurse sprang from her comfortable chair with a tissue. The options were gone through and it soon became clear that nothing is clear. Each case can be different. Each case will be different. You’re introduced to jargon that is going to become a part of your every day vocabulary for some time to come. You’re on a brand new and unwelcome learning curve where if expressions like ‘Gleason’ and ‘tumour involvement’ don’t put the wind up you, then ‘laparoscopic prostatectomy’ and ‘external beam radiotherapy’ actually make you want to get up and leave the room. If I was getting a buying signal from the nice nurse it was that surgery, the removal of the prostate, was probably right for me. She reassured me about the potential removals men, closed the door on ‘watchful waiting’ and ‘brachytherapy’ (firing a legion of radio active seeds into the prostate) and handed me my cancer file. The file was green which is probably more appropriate than a red one. Never the less when you leave the comfort of the private interview room and emerge back into the austerity and cold functionality of the general waiting area, all those thinking about picking up the helpful leaflets about sex after damage, stop and look. The green folder is a badge to those that know. It’s the cancer folder, a green plastic box file they give you. A gruesome present you’d rather not have to take home with you. The follow up copy letter to your GP arrives a day or so later and you can see in four paragraphs of type what the nurse told you in forty minutes. “You’ll be fine,” say all those you choose to tell because what else can they say. Actually one did get the wrong end of things and thought that the condition involved the removal of at least one testicle. There followed a moment or two of embarrassed laughter with that one. You are certainly not alone which is a source of encouragement. Everyone knows someone who has had it and by and large it’s good to talk. There are the horror stories (“I bled like a pig for weeks” OR “Zoladex turned me into a zombie”) but the friends and acquaintances I spoke to all had positive things to say. I guess that birds of a feather and all that and I’d far rather hear the first hand experience from someone I know than go on line to read things from those I don’t. It soon becomes obvious that my new condition is something that will affect not just me. It isn’t selfish and wants to share. We’re not sure what to say to our nearly 7 year old son, so we say nothing. He’s bound to catch the abrupt end of those conversations or phone calls and we do need to say something to him, I’m not sure what though. My partner is beginning to understand that her partner may no longer be able “to get it up”. She’s nearly twenty years younger than I am so the prospect of no more or restricted bedroom antics is not something she’d given much thought. Of even more concern perhaps is the idea of sharing a life with someone who is incontinent. A leaky partner would be worse than a wet weekend in Bognor. So I’m faced with a choice. From the eight different types of treatment available it seems that like some macabre quiz show my options are being paraded before me. The choice, as they say, will be mine. I will have to make a decision. It’s not whether to go private or use the good old NHS. The health service seems absolutely brilliant and, so I’m told, which ever course of treatment I select will be undertaken within 31 days. I could of course choose to do nothing. I think that would be silly. I like the common sense approach of one of my friends who has been and done it. He owns a car dealership. “If it’s an Audi A6 you’re after I’ll tell you all about it. If it’s a cure for prostate cancer then listen to the experts.” There’s a lot in that advice. It seems that everyone has their own take on what is a very common complaint. Some talk about it but there is a ‘manhood’ issue at stake and that’s something we can joke about but not really face. Just why the treatment works fine for some and not for others remains one of those great unanswered questions. I’ll soon take my turn. My number in the queue will come up and I hope after the event that other thing will continue to as well. I’ll keep you posted.
