Sunday, February 17, 2013

How To Live, With Prostate Cancer

I am not a doctor, so I can't and shouldn't give medical advice. But I am a survivor, so I can tell the story of my journey.

I want to be really frank, transparent even with this short read, but don't let brevity distract from the potency of the message. For some who read this, it could well be life saving.

Every man aged 40 & over should read this account and pass it on to their families, friends and peers. For that matter every woman with a 40 plus man in her life or family should read this, and share it widely.

Prostate cancer is one of those sneaky afflictions that sneaks up on men unannounced, and without much, or any warning. But once it has us in its clutches, it is often too late to do anything about it.

At around age 50 my doctor, or GP, started doing blood tests to measure PSA levels. Results were, hmm, OK; in low single digits; don't worry too much about it was the prognosis.

And over the next few years results bounced up & down a bit, but generally trended upwards. The key here is, of course, that regular testing over a period of time is critical, and not simply a one off test as it is the trend that is important.

Oh yes, I shouldn't forget the DRE... I had all those fairly uncool digital rectal inspections. When you see, and hear, your GP pulling on those latex gloves, you kind of think this is definitely not cool. Does this make you feel great? No, not really.

My prostate was enlarged, not hugely, but noticeably. This, I was told, was not necessarily anything to worry about, as it could occur without anything cancerous going on; and in any case, if not cancerous this could be treated successfully.

I was also experiencing some bladder issues; again, nothing that could be deemed conclusive regarding cancer, but just another thing going on that required watching.

Actually, I was finding it harder to 'go' at times. And whilst it might have been harder to actually 'go', the need was certainly more frequent: I was having to get up during the night 2-3 times regularly.

The most embarrassing thing was going to the public urinals and standing alongside lots of other men, doing what you do; or trying to. It's frustrating and embarrassing standing there waiting; and waiting; for the flow to start.

When my PSA reached around 7, my GP recommended I see a specialist. I was a bit ho-hum about this, but like all good patients did as I was told. After all, he was my doctor, and should know what he is doing.

I'd already had an ultrasound, which was also inconclusive and didn't reveal anything suspicious so my specialist, having looked over these results, told me a biopsy was the next best step, where they go in and cut out some small core samples for analysis.

So, a few days later I was admitted, anesthetized, and the next thing I knew I was laying there trying to wake up. Job done. Another nice experience? Not really.

The wait for the results was a bit of a challenge but pretty soon, there they were. Positive! I had 5 positive results for Prostate Cancer out of the group of 12 samples.

Straight away I was dispatched for a series of very thorough scans & x-rays from head to foot; the results from these too were nothing too concerning, and it looked like the cancer had not began to spread, or metastasize.

My Gleeson score of 6 was getting up there; on the threshold of medium risk, but not yet drastic.

The specialist gave me a list of options including leave it for a few months, to radiotherapy, to radical surgery.

I thought about this for a while... about 5 seconds, and said let's go in and get that sucker.

So, quite quickly I was introduced to a really, really good surgeon who reviewed all the information and we decided to get on with it as soon as possible. We did further scans to get a better picture of what was going on, and be more sure that it hadn't spread.

There was a delay of about six weeks to make sure I had no residual issues from the biopsy, and promptly after that I was admitted to hospital for robotic surgery.

I decided to go for robotic rather than conventional surgery as the potential recovery time was much quicker, and there seemed to be fewer post operative issues.

The operation went really smoothly, and after about six hours I had my eyes open again; the robotic nerve sparing surgery was very successful; and next day I was up on my feet. A bit tender, but getting around.

Amazingly, I had virtually no pain; and no bleeding. Nursing staff were really surprised at my recovery post operation and my surgeon told me that I make him look good; but I think, too, that my friend God had His fingerprints on this procedure as well.

I was discharged 48 hours after the operation and part of the deal was having to have a catheter and a leg bag for a week; not one of my favorite activities, but all part of the process I was told.

A week later I went in and had the catheter and bag removed. At last!

They made me drink liters and liters of water for a few hours, carefully measuring what came out; and checked just how I was holding it all in.

I had been prepped to expect that I would be incontinent for some time; probably for a few months; and possibly for many months. This would mean wearing pads to soak up those 'unfortunate leaks'.

But, much, much to the surprise of the nursing staff I had no incontinence; at all, so didn't have to wear pads and all of that stuff. Cool.

The next thing was my pathology results. The affected parts were sent away for analysis to see just how developed the cancer was. Results soon came back and confirmed that in fact it was more developed than we had thought, so getting in quick was vindicated.

Now, I'm maintaining a watching brief for several years to see that no further complications arise.

Oh, and by the way, all the plumbing problems went away.

Moral to this story:

Each year in my home country of Australia 20,000 new cases of prostate cancer are diagnosed; and each year almost 3300 men die from prostate cancer.

Prostate cancer often has no symptoms, and is not necessarily confined to older men; it is often easy to treat if diagnosed early.

If you are a male aged 40 or over, go see your doctor and get a checkup. If he says no need to worry yet, insist, or go see another doctor.

The greatest risk for men is complacency, and the fear of having it checked out. Men, generally, are late presenters; they don't go to their doctor unless they really have to. This reason alone means many men have prostate cancer develop unawares, and by the time symptoms are experienced, it is too late.

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