St John the Baptist
Serving God and the Community of Leytonstone for 180 years
Through Life in Faith - Facing up to Prostate Cancer - Page 1
On 30th December 2013 I was diagnosed with Prostate Cancer. I had been referred by my GP practice that November and following an outpatient’s appointment, had further tests before Christmas. The prompt for all of this was a PSA test, which I had been having every year since my early fifties. I wasn’t, however, referred because of a sudden increase in the PSA level. It was more a nurse’s intuition. My PSA level was not much higher than what would be regarded as normal for someone approaching 60 and after I was diagnosed it actually fell. The PSA test is far from foolproof as there are other factors that can cause an increase in the level, which is why it is important that the results of the test are taken in the context of other measures that may have affected it.
I wasn’t surprised when I was told I had cancer. Not because I had other signs, far from it, there was nothing to indicate I had Prostate Cancer. No, the reason I wasn’t surprised is because it seems to run in the family. My father was diagnosed with it at a younger age than me, and both his brothers died as a result of it. Doctors will tell you that you can’t die from Prostate Cancer, but you can die as a result of it. If you are unlucky enough for your cancer to progress into Advanced (metastatic) Prostate Cancer it will spread to other parts of the body. It is when it reaches this stage that it causes death. There is no cure for Advanced Prostate Cancer, although there are treatments, which may keep it under control for a few months or may be longer. It was this type of Prostate Cancer that killed my uncles. Family history had also uncovered that one of my great grandfathers on my mother’s side of the family had also died as a result of Prostate Cancer.
The first time I came into contact with Prostate Cancer was when my father was diagnosed with it in 1978. As I said, at 57 he was younger than I was when he was diagnosed. He was also at a more advanced stage than me. There was no screening available and so it was the tell-tale sign of blood in the urine, which set alarm bells ringing in his and my mother’s heads. He was referred to Guy’s hospital where the diagnosis was made. He went into hospital for an operation and had a partial prostatectomy, which removed the cancerous area. However, the cancer returned and he had to have a further operation, a radical prostatectomy, to remove the entire prostate gland. This was followed up with weeks of radiotherapy. The whole family supported him, but particularly my mother, who travelled with my father to Guy’s hospital every day whilst he was having the radiotherapy. And I know that it was their faith that kept my mother and father going through this difficult time.
Through Life in Faith - Facing up to Prostate Cancer - Page 2
My eldest sister had married in 1976, a couple of years before the cancer was diagnosed, and the next decade and a half was to see three more marriages and eleven births. But my father made sure he took a full and active part in everything. I think it helped him to focus on something positive to deal with the side effects of his cancer, and he needed it. The external beam radiotherapy of those times was not like it is to day. The ability to focus tightly on a small area like the prostate gland, as you can today, was not possible. It was inevitable that healthy tissue in the areas around the prostate would be affected and this scarred him for the rest of his life, in more ways than one.
The side effects of the surgery and the radiotherapy were to cause him a number of issues. Most of these would improve with time, but their memory was harder to fade. Cancer is a worrying disease and as the years went by you always knew when his annual check-up was coming, as he would get increasingly anxious, even though each year he was given a clean bill of health.
Whilst faith helps it is only human to be a little anxious, especially over cancer. It had returned once already. The effect of cancer in someone can cover the whole spectrum of faith, from losing it through to making it more steadfast than ever. I think for my father and mother it certainly was towards the latter end of the spectrum. In 1983 my father took early retirement. The cancer had already changed his retirement plans, but the one thing it could never shake was his faith.
I had done some research into Prostate Cancer before I was diagnosed. I knew it is normally a slow growing cancer and many men will have it and possibly die without ever knowing they had it and for others, the first they would know they had it might be when it had reached an advanced stage. It was this knowledge and the background of Prostate Cancer in the family that informed me that the likelihood of me getting it was high. And the best thing I could do was to face up to it.
Through Life in Faith - Facing up to Prostate Cancer - Page 3
The PSA test was invented in 1986. Then, as now, it was only available on request, and certainly in the early days its availability was not well publicised. Also it was only available to men over the age of 50. It is a myth that only men over 50 can get Prostate Cancer, although rare, younger men can get it. There was an article in a newspaper not long ago about a man who had died as a result of Prostate Cancer at the age of 47. The PSA test is not reliable, but still, after nearly 30 years, it is the only screening test available for Prostate Cancer.
So it was, that when I reached 50 I asked for my first PSA test and had been having them regularly up to when I was diagnosed (and since). A score of 4.5 would not normally have led people to suspect I had cancer and this even fell to 3.9 three months after I was diagnosed. It was the family history that swung the decision to give me an MRI and rectal biopsy, which ultimately led to the diagnosis.
It may seem odd to say it, but when I was diagnosed with cancer I felt more pleased than sorry for myself. As I said, I knew there was a good chance of me getting it because of the family history. Now I knew I had it I could deal with it and face it head on. That is where my faith helped.
I was diagnosed with a Gleason score of 3+3, the lowest score you can get, which meant it was localised and low risk. I had regular PSA tests and attended the clinic throughout 2014 and in late November, nearly a year after being diagnosed, I was asked if I would agree to another biopsy, this time a transperineal template biopsy. Of course I agreed, but did ask if it could be delayed until the new year. A transperineal template biopsy requires general anaesthetic and is normally carried out under day surgery. The surgery allows them to take more cores for testing and from the whole of the prostate.
Through Life in Faith - Facing up to Prostate Cancer - Page 4
I had the biopsy on 27th February. I don’t take to general anaesthetics very well, but this was the least of my problems. They put a catheter in me during the operation and when they took it out they told me that if I didn’t pass a certain amount of urine I would have to have it put back in and stay overnight. I drank several jugs of water and prayed very hard to urinate. It took time, but I did succeed and was allowed home. If you don’t know what having a catheter removed feels like for a man, the closest I can compare it to is fingernails scrapping across a chalkboard! What it would have felt like having one put in, not under general anaesthetic, I dread to think.
The results of my latest biopsy increased my Gleason score to 3+4. I will never know if this was a progression in the cancer or because they were able to take more samples from a wider area. Regardless it had increased. Even with a score of 3+4 this would not necessarily indicate a change in treatment for some people, but for someone like me, with a history of Prostate Cancer in the family the recommendation was that action should be taken. Now my faith and resilience would be tested. Both options, surgery and radiotherapy, have similar, life changing, side effects and now I had to make a decision, surgery, radiotherapy, or stay on active surveillance.
I went to Bart’s to meet with the consultants in surgery and radiotherapy and discuss the options. I then took a week to read about the options in more detail, and pray about it. At the end of that week I made my decision and opted to have surgery.
The surgery I am having is robotic assisted laparoscopic radical prostatectomy and I was lucky enough to meet the man who invented the robot when I attended a pre-operative consultation at University College Hospital, London. Because I wanted to delay my operation until after my holiday there was also time for me to take part in two clinical research programmes. These weren’t specifically for Prostate Cancer patients. Both were looking at assisting and improving recovery after surgery. I felt privileged to be asked to take part and hope that the findings from both research programmes will help others in the future.
Through Life in Faith - Facing up to Prostate Cancer - Page 5
In a manner of speaking I have lived with Prostate Cancer for over thirty-five years, first with my father, then with the knowledge I would probably get it, and in the last couple of years with having it myself. I know I will live with it (or rather the side effects of having it) for the rest of my life, but I also know that I have had my faith and the faith of those around me to support me in the past and it will do so in the future.
By the time you read this I would have had the operation and will be on the road to recovery. How long that process takes and what it will be like I cannot say. May be that will be another story.