So is 'it' still there?
To be clear, we are talking cancer here...
This felt like a good time to revisit why I am writing these posts. Why bother spending the time sitting down and sharing my experiences with you? Why share some of my lowest points of my life with complete strangers? Why, why, why? Well these are simple questions to answer…so that more people become aware about prostate cancer and can catch the bugger whilst they can still treat it.
Male, female, non-binary, sloth, alien,
, whoever you are please think about sharing this page. The more we share and talk about this openly, the more people will know the signs and get checked out earlier. Simples! Now don’t be shy…share the love!We get to the part of my journey about the follow up appointments to find out if they managed to get ‘it’ all. Settle in, there is a medical fact to get your head around first…
PSA is a protein produced by normal cells in the prostate (there are other cells that can also produce PSA at very low levels, check in with your medical expert if you have any questions) and also by prostate cancer cells. They get this reading by taking a blood sample from the victim (sorry, patient…I bloody hate needles and anyone coming near me with one has a sadistic trait about them!) and sending it off to the lab for analysis. In my local area it takes about 2/3 days for the results to come back.
There is a great page on the NHS site about PSA: PSA Test
Now my PSA was registering at 18.1 prior to surgery, this is classed as high for my age and was very probably produced due to the cancer. About 8 weeks after they had completed the radical prostatectomy, they did another PSA test to see what the reading was. Now, in my case, they were wanting the reading to be lower than 0.1 as I no longer have a prostate and it was long enough for my system to clear out any PSA proteins left after surgery.
Thank fuck, it was!
Dr Akhtar: “Well this is looking good. The biopsy of the surrounding prostate area that I removed during surgery also came back clear and your PSA is negligible”
My Brain: “Party! Would it be wrong to hug him and ask for him to go for a pint with me? Yes, that would be wrong…don’t do that!”
Me: ‘That is brilliant news, thank you”
Dr Akhtar: “Let’s keep an eye”
This is when I went into the three monthly round of blood tests. Off to the GP surgery every three months to see the vampire (sorry, nurse) and give them my blood for PSA testing. Now all was going well for a while and then one result came back that was slightly raised, it had registered PSA.
Dr Akhtar: “This is still a really low reading and I would not worry to much about it at this stage”
My Brain: “Do not fucking worry about it, shit ‘it’ is back isn’t it? Where the hell has it gone…I am prostate-less!”
Me: “Ok, what is the plan here”
Dr Akhtar: '“Lets drop you over into oncology, they will be in touch”
My Brain: “Oncology? What the hell is that and why are all these departments ending with an ‘ology’. Why can’t I just stay with you Dr Akhtar, your my new bessie”
Me: “Ok, thank you”
It was shortly afterwards I had an appointment with Katie, an oncologist consultant. She is nice, very upfront about things and wanted to get things underway. It amazes me that this massive machine that we call ‘The NHS’ can operate at such a personal level.
Katie: “Nice to meet you Mark. After looking at your notes, I would recommend radiotherapy to the prostate bed and hormone therapy”
My Brain: “Woah…there for a minute Doc! Radiotherapy, nobody ever mentioned radiotherapy and what the hell is hormone therapy?”
Me: “Ok, let me go and think about that first”
So off I went to do my research (in reality, Louise is far more patient than me in researching this stuff) before agreeing to anything. Here is what we, the royal we, found out:
Radiotherapy: “Some men may also be offered radiotherapy to the prostate bed (the area where your prostate used to be) very soon after having surgery to remove prostate (radical prostatectomy). This usually happens if there’s a chance that their cancer may come back or wasn’t completely removed during the operation. This is called adjuvant radiotherapy. It is generally given within the first few months of surgery, but your doctor may suggest waiting until any urinary problems have improved.”
Hormone Therapy: “Hormone therapy works by either stopping your body from making testosterone, or by stopping testosterone from reaching the cancer cells.
Prostate cancer cells usually need testosterone to grow. Testosterone is a hormone that controls how the prostate grows and develops. It also controls other male characteristics, such as muscle strength, erections, and the size and function of the penis and testicles.
Testosterone doesn’t usually cause problems but, if you have prostate cancer, it can make the cancer cells grow faster. If testosterone is taken away, the cancer will usually shrink, even if it has spread to other parts of your body.
Hormone therapy on its own won’t cure your prostate cancer. If you have hormone therapy on its own, the treatment will aim to control your cancer and delay or manage any symptoms. Hormone therapy can also be used with other treatments, such as radiotherapy, to make the treatment more effective.
Katie: “Thoughts?”
My Brain: “Fuck I am tired, I don’t want either to be honest. I just want to go back to my normal self. Why did I not get checked out earlier (this is something that I often reflect on even to this day), life would have been simpler”
Me: “If we are going to do it, lets chuck everything at it”
Katie: “Great, I will get you booked in”
My Brain: “Booked in!…sounds like a Spa treatment. I don’t think that this is going to be very relaxing”
And so it started again. The appointment letters started to drop on the doormat and I was having to have ‘those’ conversations with my nearest and dearest…it took everything in my power to keep positive. The conversation that actually broke me was with my parents. I might be in the tale end of my forties, but my mum and dad will always be my look out. When I sat down with them and explained radiotherapy and hormone treatment was now on the cards, I could see the pain in their eyes. They had absolutely no control over the health outcome of their son and this was one of the hardest conversations that I had ever had to have with them. On getting ready to leave their house after telling them, my dad approached me, held me (my dad is not a hugger) and said “you are going to be OK son”…fuck me, that literally crippled me!
So, here we go for another set of treatment. At this point I must share that I truly recognise that I have had it relatively easy in comparison to others that have been diagnosed with other ailments (cancer included), and for that I am grateful and have the greatest respect for those experiencing their own health challenges. Strength to you guys!
Want to hear about me getting ready for radiotherapy and my first hormone therapy treatment. Head on over to my next post “Scans, full bladders and tattoos...”.
If you need more support then there are some great charities ready to help:
United Kingdom: https://prostatecanceruk.org
United States: https://www.pcf.org