A Diagnosis at Fifty-Eight
I was just over
fifty-eight when I was diagnosed. As a black man in the UK, where one in four
of us will encounter prostate cancer compared with one in eight of the broader
male population, the PSA test ought to have been offered long before I had to
ask for it, especially as other indicators in my blood work already needed
addressing.
| An AI-generated infographic on the blog content. (Click to enlarge.) |
I asked for it in
early February 2024, and by the end of March my PSA had risen from 3.5 to 4.0.
What followed I have set out in full in my earlier series, "Men's
things" and "Photons on the prostate": the examinations, the
imaging, and the biopsy that confirmed adenocarcinoma in mid-June 2024. I will
not retread it here. [Prostate
Cancer UK: The PSA blood test] [Check4Cancer-Private]
Twenty Sessions Begin
Two years ago, I
began twenty sessions of hypofractionated radiotherapy for prostate cancer. It
was scheduled for weekdays alone, so I thought I could fit both work and the
treatment in comfortably.
The treatment began
on a Thursday, which gave me two sessions before the weekend. Little did I know
how impactful radiotherapy would be. The chronic fatigue set in far earlier
than expected, and the weekend literally wore me out.
A Toll on the Body
By the fourth
session, I returned from the hospital and had to go straight to bed; I simply
had no energy for anything. I obtained a sick note, though with the proviso
that I would not be completely signed off work.
Then came a range of
side effects. After the fatigue, my voice became a husky whisper, betraying
such tiredness and exhaustion that, after one meeting, a participant asked my
manager why I was still working. I had the capacity and the facility to continue,
yet the toll could not be ignored.
Alongside this came
urethral pain, bladder incontinence, and a greater urgency, all exacerbated by
a prostate gland reacting to the radiotherapy. Coupled with nocturnal insomnia,
I began to wonder whether I could be productive at anything at all.
Planning Around the
Pain
Towards the end, I
had to plan my outings carefully, as I could not go twenty minutes without
needing to visit a toilet. I was prescribed paracetamol and codeine to ease the
pain, along with Tamsulosin to manage the prostate issues, which I am still
taking. I also obtained a RADAR
key to access disabled toilets, and a "Just Can't
Wait" card to show premises owners whenever I had an urgent need.
Four weeks later, I
was ringing the bell, ending the treatment and ushering in a new life: the
beginning of the story after prostate cancer. However, I needed to recuperate
by taking long-term sick leave and having someone care for me, because home in
Manchester was no longer convenient.
A Journey to Recover
Against the wishes of
many, I jetted off to Cape Town to be with Brian, my partner. The trip was
comfortable enough, because I used airport assistance for every leg of the
journey. Even though I arrived in Cape Town literally a shell of myself, the
weather proved almost as good an elixir as the companionship.
Much as I had every
urge to return home, I took as much time as possible to recover sufficiently
for general activity. My sick leave eventually ran to seven weeks, and I
returned to work in January 2025.
In truth, I should
have taken a phased return, but the burden at work was light, so I decided
against it and settled in well enough. In time, working alongside an
occupational therapist, we found ways to manage both the work and the pressure.
Two Years On
Two years on, some
side effects linger. The loss of my voice remains unexplained, even after
review by an otolaryngologist and her team, and I put it down to one of the
rarer side effects. Bowel incontinence can be occasional, bladder incontinence
is quite frequent, and sexual dysfunction is not helped by the mental stress of
it. The nocturnal insomnia, meanwhile, should have me beavering away late into
the night.
Now, better and more
targeted treatments are available in the UK, including ultra-short five-visit
radiotherapy, tissue-sparing focal therapy, and new at-home medicines, all a
far cry from the twenty to thirty-nine sessions of hypofractionated radiotherapy.
[ICR:
Thousands of men with prostate cancer will now be offered high-powered
radiotherapy on the NHS]
Even so, I do not
think I would have wanted to wait for these developments, given my
determination, once advised to pursue active treatment at diagnosis, to rid
myself of the cancer as soon as possible. I would not have been persuaded of
watchful waiting or active surveillance in the circumstances.
A Word to Men
Three check-ups at
the Christie Hospital, every six months, have had my Prostate-Specific Antigen
(PSA) test results read at the lowest level ever. I can only advise that men
keep their prostate health in view, have it checked, and follow through on any adverse
results.
A visit to the Prostate Cancer UK website for the risk checker, followed by
an at-home review of your own symptoms using the International
Prostate Symptom Score (IPSS), is a sensible place to begin. Not every
prostate enlargement is indicative of cancer, but every such situation must be
checked and kept under monitoring. Thank you.
Related Blogs
Blog - Men's
things XXXV: A Man's Search for Dignity
Blog - Photons
on the Prostate - Three Things I Wish I'd Known
Blog - Photons
on the Prostate - A year from starting radiotherapy
Blog - A
prostate cancer diagnosis, one year on
Blog - Men's things - Prostate Cancer blogs
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