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.

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