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My
Prostate and I
19
November 2024
Those of you
who have visited my site for a while might remember that back in 2014, I had
to have a heart by-pass and that I documented my progress in “My
Cabbage and I”. I thought I would do the same in relation to my
current medical adventure, namely Prostate Cancer.
Some years
ago, I asked for a Prostate-Specific Antigen (PSA) test because my
father had prostate cancer, although he died with it, not of it, at 993/4!
My GP at the time essentially told me it was a waste of time as it gave
false results in both directions and I had no symptoms. He gave me the
‘finger test’ and said everything felt normal. I left it at that.
On 7 October
2024 I went for my annual blood test (this follows heart surgery
indefinitely I think and ensures the regular medication is not wrecking my
body!) and decided to push for a PSA test at the same time:
a) because I
was giving blood anyway so what’s one more phial;
b) because
there has been much more publicity about it over recent years (such as the
case of Bill Turnbull from BBC Breakfast);
c) My age
(76);
d) because
it was in the family.
I had had no
symptoms of anything awry at all. I had to have a telephone consultation
with the GP (is there any other kind?) to persuade her but she agreed to let
me have the test.
Two days
later, whilst I was on a windy corner in Otley, with the rain lashing down,
she rang to say the results were in and I was in the “dance-off” (for
Strictly fans!). At my age, the PSA reading should have been around 6.5
nanograms of PSA but it was 11.7. She had therefore arranged for me to get a
MRI scan at Airedale on 10 October 2024. Let no one say the NHS cannot move
fast when it wants to! Guess what, the photo showed a grinning tumour,
huddled against the side of the prostate, preparing its escape.
On 17
October 2024, I attended Airedale Hospital for a urine flow test – passed
– quite literally! I also had an ultrasound and another finger (she was
very gentle!). All this was a prelude to a biopsy which happened, again at
Airedale, on 22 October 2024.
For the
uninitiated, this involved having an enema before being strapped into a
chair with stirrups. It did occur to me that some people might pay good
money for this!
I asked her
to warn me if it was twins!
The nurse
(hopefully a well qualified one) sprayed a freezing solution on my perineum,
followed by a local anaesthetic. Gel and an ultrasonic transmitter were
inserted into my rectum. She then stuck a long (ish) needle/probe into the
aforementioned perineum and using an ultrasound image to help steer (I
trusted her to be a good driver!), she pushed the end of the probe into the
tumour to collect samples. The probe made a clicking noise, presumably every
time it ‘snipped’ a sample. A nurse was deployed to keep me distracted
and we talked holidays, jobs, grandchildren, you name it. She should have
been a hairdresser!
To be fair,
the procedure was not quite as bad as it sounds or as I expected, though I
wouldn’t recommend it as a party game.
After the
procedure, I was given padded paper knickers to wear to catch any remaining
‘ooze’!
When the
judges scores were in, my cancer was scored as a Gleason 7 (4+3) and a
tumour stage of early stage T3A.
The Gleeson
score grades prostate cells from 1 to 5. 1 and 2 are normal cells whereas 5
is horribly abnormal. The judges give 2 scores, the first one for the worst and the second for the rest. In my case the score of 7 overall is
4+3 which is slightly worse that 3+4. Just my luck!
There are
other complications to the scoring system all of which you can look up on
the Cancer Research UK website if it is a slow day!
The experts
involved have a Multidisciplinary Team (MDT) meeting to discuss the way
forward as a result of which I saw the oncologist on 14 November 2024 to
discuss treatment.
To put all
this into perspective and credit to the NHS, my prostate issue has
progressed through blood test - results – MRI – ultrasound – biopsy
(with more ultrasound) – results – MDT - oncologist all within 51/2
weeks which I think is pretty damn good.
Northern
Trains did their best to throw a spanner into the schedule but that’s
another story!
The eventual
treatment will be Intensity Modulated Radiotherapy or IMRT – the NHS runs
on acronyms/abbreviations!
A radiation
‘death ray’ (for the tumour!) is accurately shaped/focused to the
size/site of the tumour and minimising damage to surrounding tissues. It is
now regarded as the current NHS standard, offered by most NHS trusts.
There are
risks of side effects but if we worried unduly about potential side effects
(does anyone actually read the annoying little leaflets in tablet packs?),
one would not even take an aspirin. Why does the leaflet always obstruct
access to the tablets whichever way you open it?
My research
suggests percentage outcomes/side effects are favourable, both short and
long term, which the oncologist confirms.
As a prelude
tomorrow I start taking Bicalutamide for six months to put my tumour on a
starvation diet, by denying it testosterone. This should shrink it, making
the ‘death ray’ more effective. This will be about mid March 2025. More
details about that later on. The reduction of testosterone may have some
weird effects on me but we shall see.
I will keep
updated but the message I want to get across to all men over (say) 50/60 to
get a PSA test, especially if you are having a blood test for something
else. I had no symptoms of anything at all and almost on a whim, I had the
PSA test. I nearly didn’t bother. As a result, a potential death sentence
has hopefully been nipped in the bud. I have seen someone die of prostate
cancer and it is not a way I want to go! In fact, I am making a stand. I'm
not going!
I get the feeling from media that routine PSA screening maybe
round the corner but who knows when this will happen or for what age groups.
GET TESTED!
You never know.
1
February 2025
Now
received my first appointment at St. James Hospital Leeds in the
radiotherapy department, towards the end of the month. My understanding is
that this basically involves a scan and aiming exercise to pinpoint where
the focal point of the radiation beam will be. some sort of marking is done
(possibly tattooed or permanent marks) so that the aim is consistent for the
treatment itself. The actual treatment follow shortly afterwards and
will involve attending the hospital 5 days per week for 4 weeks.
Still
taking the Bicalutamide which is having no noticeable effects.
Hopefully behind the scenes it is starving the cancer of 'androgen receptors'
so it does not grow.
26
February 2025
For the
next stage of my treatment, I visited the Bexley Wing of St. James Hospital
on Monday. Things were pretty chaotic as the computer system had gone down
and everything - but everything - is run by it. This visit was for a
planning scan. After checking in, I was interviewed by a radiographer
essentially to check all their information about me was correct,
answer any questions and sign the obligatory form of consent to proceed. I
was then given a little bag of 'goodies' amounting to a couple of boxed of
DIY enema kits, a schedule of immediate happenings, a couple of leaflets and
an illegible carbon copy of what I had just signed.
Stage 1 -
DIY enema, wait up to three quarters of an hour for it to work.
Then 'perform'.
Stage 2
-
Drink three cups of water to ensure I had a full bladder and again wait -
this time without 'performing'.
I believe
the purpose of the enema is to ensure it is as small as possible, so keeping
it out of the way of the 'death ray'. Why the opposite is true of the
bladder I am not sure as yet. These steps will be repeated each time I go
for treatment.
Stage 3 -
Off to the radiotherapy department where I had a scan and 4 small tattoo
marks were strategically placed. These are only small crosses/dots so that I
can be precisely lined up by lasers each time I go, not anchors, hearts or
anything exciting! I just hope they remain visible for log enough, as a
couple of showers later they are very faint. Wouldn't like the ray gun to
miss!
I was
lucky, because of the computer system, a few people got sent home. I was
given the choice of returning another day or waiting but once there, there
did not seem much point in wasting the trip. I was able to get lunch in the
cafe there - rather revolting cheese sandwiches as it turns out on sliced white
bread! I have not consumed white bread for years and I had forgotten how
horrible it is (other than toasted).
On the
subject of food, one of the leaflets indicated whilst undergoing treatment I
should not eat cabbage, baked beans, onions or garlic - so that is about 30%
of by diet up the spout! Worse, I should not consume alcohol! need to make
more enquiries about this!!
22 March
2025
On Monday
17 March 2025, I started my radiotherapy treatment. I have to visit St.
James (Bexley Wing) every day for 4 weeks so I am now one week into it. The
process is much the same as the planning scan mentioned above. The enema is
straightforward enough. The consumption of the water is also straightforward
in itself. The problem comes when there are delays. On one day, one of the Intensity Modulated Radiotherapy or IMRT
machines was out of action and there was a lot of switching of patients from
one machine to another. Having consumed the obligatory water, I waited
patiently and waited but when it got to about an hour and a half delay, with
a straining bladder, I had no option but to "go"! This meant
consuming more water and waiting again. More delay meant I had to go through
the process again so I spent a considerable number of hours in the waiting
area!
Naturally I
have taken a book to read each day but sitting waiting becomes very
soporific and I have found it hard to stay awake some days. At least Wi-Fi
is available.
As regards
diet, there are a number of possible side effects such as a burning
pain when passing urine and diarrhoea, Reducing to a basically bland diet
reduces the risk of diarrhoea. It is also essential not to become dehydrated
in any way. This helps with the risk of urinary problems but also I
discovered that if you become dehydrated, when you drink water, the first
thing your body does is re-hydrate and so the cups of water you drink do not
all serve to fill the bladder, which is essential as it will
then push your bowel and part of the bladder out of the treatment area. This may help to reduce some side effects
from the radiotherapy. This is also the reason to avoid alcohol and
caffeine. As it happens, I quite like the relatively new Guiness Zero so
that is my port of call when socialising. It is not Taylor's Landlord but I
can live with it!. As far as tea and coffee are concerned, I have tried
decaffeinated coffee and it is fairly poor. However Taylors do a decaff. tea
which is not at all bad and tastes pretty much like the real thing (which is
what I usually drink).
So far, I
am not experiencing any side effects but of course this is only one week in.
Suffering
walking withdrawal symptoms!
16 April
2025
Last Friday
I completed my radiotherapy course at St. James Hospital in Leeds. The
procedure is very quick in itself but the time is taken in waiting for the
enema to do its stuff (45 minutes). You are then allocated to a machine
waiting room where you have to drink 3 cups of water over 15 minutes (the
size you get at water machines) then wait another half hour before going for
the treatment. No far, I have had no side effects other than having to get
up more during the night for a wee, due to being permanently very hydrated.
Allowing for parking etc, you can write off a minimum of two hours every day
just in the hospital, plus traveling. In that context I was lucky living
only about an hour's drive away. Some were traveling a lot further. At least
for radiotherapy patients the parking is free. Most of my treatments were in
the afternoons so I missed the morning rush hour and had no difficulty
meeting the appointment times.
It is very
much a production line process with each machine having two changing rooms
and as one patient has been treated, the next is getting changed and ready.
There are a lot of machines (I think 14) and it was very busy with both
prostate sufferers and those with other forms of cancer. Getting ready
simply a matter of stripping from the waist down (except socks!) and donning
the familiar back to front 'f'rock'. Once on the platform, it is arms out of
the sleeves and the 'frock' is rolled down but only as far as essential so
preserving one's dignity. Shirt pulled up.
The next
step is to get a PSA blood test in 4/5 weeks prior to seeing the oncologist.
Hopefully the reading will be low and be a baseline for further readings. I
will then be subject to a blood test every 6 months for 5 years then
annually thereafter every year for life. I have annual blood tests every
year anyway after by heart adventure See My
Cabbage and I above.
A positive
effect of the treatment is that I have not drunk any alcohol for a over
month so have lost weight. Every cloud...!
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site is given in good faith and no liability is accepted in respect of any
damage, loss or injury which might result from acting on it.
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