Photons on the Prostate: My Life After Prostate Cancer Treatment

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.

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Men's things XXXIII: Prostate Cancer Screening and UK Black Men

A sobering statistic

The statistics in the UK show that Black men are twice as likely to get prostate cancer and, consequently, twice as likely to die from the disease. In plain numbers, this means that 1 in 4 Black men will encounter the disease in their lifetime.

So, it was quite disappointing when, in November 2025, the UK National Screening Committee (NSC) advised against routine prostate cancer screening for the majority of men.

That advice included the very men most susceptible to the disease, and it was justified by concerns over the overdiagnosis and overtreatment of what might essentially be benign conditions.

Blog - Men's things XXVIII: Shame, no national prostate cancer screening

To withhold the opportunity from a cohort that is most medically affected and usually clinically ignored, especially given the tendency of such men to be culturally diffident on intimate matters, where masculinity, machismo, and sexual virility are taken to demonstrate manliness and personify manhood, was as close to unconscionable as one could get.

Renewed hope: TRANSFORM

It is therefore gratifying that, two days ago, the TRANSFORM prostate cancer screening trial received further funding. The trial, which began in autumn 2025 after being proposed in spring 2024, will now invite men at the highest risk of prostate cancer to benefit from research, early detection, and more effective treatments. [GOV.UK: Major expansion of research and treatment for prostate cancer]

All eligible Black men will be invited to participate in this initiative, which is jointly funded and supported by Prostate Cancer UK and the National Institute for Health and Care Research (NIHR). This should accelerate community engagement and deepen it, particularly amongst Black men.

In June 2026, when stage 2 of the trial commences, all eligible Black men will be invited, including Black men who:

• are aged 45 to 74
• are resident in the UK
• have not had a PSA test or prostate MRI scan in the last 5 years

My own journey

Two years after my prostate cancer diagnosis, and twenty months after completing radical radiotherapy, the prognosis is good. My PSA is at the lowest reading it has been since I was first screened in February 2024.

I urge every Black man to take up this screening opportunity, all the more so if he carries the BRCA2 gene variant and has a family history of prostate, breast, pancreatic, or ovarian cancer.

Know the warning signs

Beyond that, a man should have his prostate checked if he gets up multiple times at night to urinate, waits a while to start, strains to begin, does not feel he has fully emptied his bladder after a visit to the toilet, or has pressing urges to pass urine.

Not every prostate enlargement is indicative of cancer, but it must be investigated by medical personnel. This is good news for Black men; now step forward and take control of your health.

Blog - Men's things XXXII: For the Boys in the Room: Why Your PSA Matters

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Life After Radiotherapy

Much as I have not been giving frequent updates about life after prostate cancer radiotherapy treatment, I can say that life continues with gratitude.

The usual side effects persist; the urinary symptoms are not as concerning and remain quite manageable, there is no discernible bowel issue, and weekday nocturnal insomnia gets some respite with weekend lie-ins.

My voice still vacillates between a weak, hoarse whisper and the normal timbre I am known to have. It does need checking out. When my mother first heard the weaker end of my vocal spectrum, she started casting and binding in the name of Jesus on the phone, with no exchange of pleasantries; it literally freaked me out.

Monitoring My Progress

I have a biannual consultation at the Christie Hospital with an Oncology and Urology nurse, as part of the aftercare monitoring, which may continue for another couple of years. This means that within two weeks of that appointment, I must obtain a Prostate-Specific Antigen (PSA) test, usually from my GP.

My most recent PSA level has now fallen to the lowest reading recorded since that first test in February 2024, which began the journey to an aggressive prostate cancer diagnosis.

I have written quite a bit about what this has involved, but may I suggest that you also listen to the AI Podcast for November 2025, where each of the terms related to a prostate cancer diagnosis is explained in detail.

An AI discussion podcast
on blogs published in November 2025
Reflections on Health, Heritage, and Humanity

Sharing the Good News

Meanwhile, I am doing fine, happy with the progress and thankful for the support and encouragement I get from my partner, Brian, my friends, and my colleagues. Upon receiving the result, I posted a comment in a wider Microsoft Teams chat, where I addressed them thus, with a link for them to assess their prostate cancer risk:

For the boys in the room.

I got some good news earlier today. Having undergone prostate cancer radiotherapy treatment about 18 months ago, my PSA is now the lowest it has ever been. Obviously, there is a hospital visit to review the situation.

Please, take some time to check your risk.

Thanks

Check your risk in 30 seconds | Prostate Cancer UK

Take That First Test

I take every opportunity to advocate for checking your prostate cancer health and going for at least that very first PSA test.

Beyond that, I try to address the concerns and fears that attend having your delicate bits inspected by medical personnel, as I have been through the whole gamut of touches and feel-ups. My verdict: nothing to fear and everything to gain, catching issues early and dealing with them promptly.

I hope you all find this helpful. Until the next update on men's things.

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Men's things XXV: Prostate cancer under control

Gathering my thoughts

There are many things to be grateful for: life, health, relationships, friendships, hope, faith, and the love that conquers all.

It's now been over a year ago that I began the twenty sessions of hypofractionated external beam radiotherapy for prostate cancer, the aftermath of which includes an extended time of monitoring and care. [NHS England: Hypofractionated external beam radiotherapy in the treatment of localised prostate cancer (PDF) 25 pages.]

After meeting with the multidisciplinary team in March, in conversation, I was to be seen again in 4 months, but the letter to my doctor indicated 5 months. But I received no appointments, so I had to consult the oncology department secretary about it.

It took her just over three weeks to respond. That was after I placed a phone call to her number and left a message that got a nurse to call and plan to be seen within three weeks.

Reviewing the process

Any appointment would have required first doing a serum prostate-specific antigen (PSA) test and getting the results before the appointment, and the secretary gave me just 6 working days to my next appointment to get that done.

Thankfully, for my Monday appointment, my GP surgery invited me on Thursday to provide a blood sample, and I was able to access the result on the NHS app last night.

I was concerned because the PSA results from February 2024 and the 5 test results altogether have fluctuated in ways that if I had not taken decisive action to act on the possible presence of prostate cancer by urging my doctor to be engaged, responsive, and proactive, the malignancy would have continued untouched to a seriously life-threatening situation.

This is because, in early February 2024, the PSA was borderline high at 3.5, then 7 weeks later at the end of March 2024, it had risen to 4.0 and needing further investigation, that started with a Digital Rectal Examination (DRE), through a multiparametric MRI (mpMRI) scan in April 2024, an ultrasound-guided transperineal biopsy of the prostate gland in May 2024, and a stage-2 prostate cancer diagnosis in June 2024 with the recommendation that I undergo active treatment.

Making your decisions towards the best outcomes

In July 2024, I made the choice between a radical prostatectomy and radical radiotherapy, opting for the latter, though on seeking a helpful opinion from Prostate Cancer UK, the nurse thought it was better to opt for active surveillance or watchful waiting.

I was not going to wait to watch what a clear diagnosis of cancer was going to do in my body, and worry myself silly about what I could have done on the back end of having this knowledge. That was the last time I called Prostate Cancer UK, because having come this far, I needed encouragement and support, not dissuasion.

As I prepared for radiotherapy, we had another PSA test at the end of August 2024, and it had fallen to 2.0. That sneaky thing could have been a dangerous signal to abandon treatment, as the reading had fallen below the danger zone into the normal range. However, that did not mean the cancer had suddenly disappeared. Either way, I was going through with the radiotherapy.

This began on the 12^th of September 2024 for every weekday until the 9^th of October 2024, and I worked through it, even as the side effects of chronic fatigue and bladder issues took hold. A month after treatment, I took an extended sick leave that lasted just under 2 months, spending most of that time with Brian, caring for me in Cape Town.

After treatment monitoring and beyond

When I went for my first post-treatment checkup in early April 2025, the PSA test I took, the previous week at the end of March, read 2.6 and this was the cause of my concern and it led me to question the reliability of the PSA test as an indicator of reduced prostate agitation, especially after radiotherapy, but then I also realised that the period of recuperation could be long, as exemplified in my strength, and voice.

My reckoning was that if the PSA result did not fall at my next appointment, I would request a second mpMRI scan. I am glad to say that on my receipt of the results last night, that might not be necessary as the PSA has fallen to 1.3 micrograms per litre (µg/L).

However, for my meeting on Monday, I am on alpha blockers since that regulates prostate function, since October last year, and I might be on that for some time, and I have had two episodes of epididymitis in May and August. We might have to discuss the hows and whys of that.

Apart from the occasional insomnia, the fluctuations in my voice, irregular occurrences of fatigue, and some restlessness that besets me at various times, I am doing quite well and happy with the improvements, grateful for the support from many people who have helped me through interesting times.

When I am presented with the opportunity, I talk about men’s things, the need for us to be conscious of the health of our bladders, bowels, prostates, testicles, and sexual organs. These things matter, and catching anything going awry early is of the utmost importance.

Here’s to life and living. Thank you.

References

Blog - Photons on the Prostate - A year from starting radiotherapy

Blog - A prostate cancer diagnosis, one year on

Blog - Photons on the Prostate - XVIV - I Just Can't Wait

Blog - Men's things - XXIV - A presentation

Blog - Men's things - Prostate Cancer blogs

Men's things - XXII

The post-radiotherapy situation

Three months ago today, I rang the end-of-treatment bell in the radiotherapy department of Christie Hospital. Twenty weekdays of hypofractionated radiotherapy administered to the cancerous parts of my prostate gland had begun to take its toll.

These three side effects that took hold started with chronic fatigue quite early in the treatment, then insomnia, and uncomfortable bladder issues increasing the difficulty in passing urine along with sometimes stabbing and sharp pains in the urethra. The fatigue affecting my energy levels seriously impacted my natural voice which regularly fades into a tired sounding voice belying other issues.

As I have reported, my recuperation continues apace. Though I worked through the treatment and for a month thereafter, the side effects of radiotherapy had become such that I needed to totally take time off to rest, recover, and recuperate while availing myself of essential care, help, and support of my partner, Brian.

Some side effects persist, the main one around the bladder and urinary functions is managed with medication, I feel stronger and able, but I need to manage wisely my return to normalcy as it is becoming obvious that these things take time.

Take heed and test

At any opportunity especially with young and middle-aged black men, I talk about prostate health, the need for checkups and the essential work of removing stigma and embarrassment from talking about men’s things. Things around the male reproductive system that crudely and culturally define manhood, manliness, masculinity, or virility.

Any black man over 45 should be aware and conversant with their prostate health as statistically, 1 in 4 black men will encounter prostate cancer in their lifetime. The risk is heightened if your mother or sister has had breast cancer or if your father or brother has had prostate cancer. [Prostate Cancer UK: Black men and prostate cancer]

This matter should not be trifled with, if caught early you have many options for treatment and cure. What would be unfortunate is to find that prostate cancer has spread and metastasized and there is little that medical intervention can do.

Prostate enlargement or inflammation may not be indicative of cancer, but every occurrence of what is called benign prostate hyperplasia needs to be checked out. [NHS: Benign Prostate Enlargement]

Early action helps prompt intervention

You can easily determine if your prostate has problems by running the IPSS Calculator. The International Prostate Symptom Score (IPSS) is a somewhat subjective assessment of your bladder and urinary health since the prostate gland is a muscular switch that sits beneath the bladder, surrounding the urinary tract as it exits the bladder and controlling urinary and ejaculatory flows.

Regardless of the IPSS score, it might be useful in persuading your medical team to conduct a Prostate-specific antigen (PSA) test. In my case, adverse readings on other blood tests and the fact that I am in the above 45 cohort became the impetus for requesting a PSA test in early February 2024. [NHS: PSA test]

The PSA test result would determine if other investigations and interventions are necessary. Again, in my case, we caught it early, addressed the options, and commenced effective treatment, and I am on the way to full recovery.

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Beyond radical radiotherapy

Three months ago today, I began radical radiotherapy for adenocarcinoma of the prostate. It is just six months after I received a confirmed diagnosis, and it needed immediate active treatment after consultation with a multidisciplinary team on options for surgery or radiotherapy.

I worked through the duration of radiotherapy and for a month after the completion of the treatment. However, increasingly, I suffered more impactful side effects that started with chronic fatigue, and issues with my urinary system that limited most outdoor activity as I needed to be close to available conveniences, and one unexpected effect was the way those elements appeared to affect my voice.

My voice became weak and strained, usually determined by my energy levels that was quite sub-optimal most of the time. While against what my body was telling me, I tried to continue as normal, I really had to take a break and have added domestic support that being at home did not offer.

Time off to recuperate

The decision to travel to South Africa while somewhat frail was not taken lightly, but I knew the essential support for my recuperation was best under the watchful care of my partner. I availed myself of all the customer assistance provided by the airline for my journey, no sense of determination could have propelled me through the experience.

I can attest there has been considerable progress, the occasions of fatigue are less frequent, the urinary issues while still needing medication have eased, the sound of my voice is much better with a few relapses, and the painful discomfort that needed opioid medication has completed gone and I have now totally weaned myself off codeine with minimal adverse effects.

The weather in Cape Town might have contributed to my recuperation. I can begin to consider a return to normalcy, which might take a process of reengagement. Much as I try not to have that preoccupy me and concentrate on recovery, there is a world to return to in the New Year.

Looking ahead

I am grateful for the support and care I have received through the period from anticipation when I first had exploratory tests in February, through further investigations, diagnosis, and treatment. My long-suffering partner, close friends, extraordinary neighbours, siblings, and colleagues compassionately accommodated my vulnerability with understanding.

Each time I present an update, I appreciate how it was fortuitous that we caught a high prostate-specific antigen (PSA) reading when we did because at the advent of my treatment, the PSA reading had fallen within the normal range, but for the fact that an MRI scan leading to a biopsy had detected Stage 2, yet malignant prostate cancer.

The need for men especially Black men over 45 to pay attention to their prostate health. Do the checks and have the tests, catch things early and have the best options for recovery.

Blog - Men's things - Prostate Cancer blogs

Blog - Photons on the Prostate - XIII

Other references

Prostate Cancer UK: Black men and prostate cancer

MedScape: International Prostate Symptom Score (IPSS) Calculator

Urology Care Foundation: Benign prostatic hyperplasia (BPH)

NHS: Prostate Specific Antigen (PSA) test

Prostate Cancer UK: The PSA blood test