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.

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

A Gemini Notebook AI Podcast on this blog

Photons on the Prostate - XII

Do not defy the prostate

Just over three weeks after radiotherapy treatment, if I am not already aware of what my prostate is, where it is, and what effects noticing it can have on you, I will have been in a parallel universe, but I am here in the full knowledge of this interesting piece of anatomy the size of a walnut.

Do not be deceived, its size is hardly indicative of what it portends; it was its growth in size and volume that suggested something untoward was at play.

Evidently, malignant prostate cancer after two PSA tests, a digital rectal examination, a multiparametric MRI scan with contrast that presented a PI-RAD score of 4, needing an ultrasound guided transperineal biopsy of the prostate.

Keep an eye on your prostate health

There are a whole range of issues that could be indicative of an enlarged prostate gland, usually referred to as benign prostatic hyperplasia (BPH) that would normally be non-cancerous but it is necessary to determine that is really the case, no assumptions should be made without a medical assessment.

The male reproductive system - Macmillan Cancer Support

A good check on your prostate health can be started with using the International Prostate Symptom Score (IPSS) Calculator as the site of the prostate gland below the bladder and surrounding the urinary tract as it exits the bladder can present issues with the ease of urination, a high IPSS score should alert you to proceed for the PSA test.

Dealing with a prostate cancer diagnosis

After the biopsy, the prostate was determined to have some cancerous cells and diagnosed as Stage 2 with a Gleason Score of 3 + 4 = 7, intermediate cancer and very amenable to treatment.

The urology department then referred me to a cancer specialist hospital for active treatment of cancer. While there were options for active surveillance, a radical prostatectomy, or radical radiotherapy.

After consultations, I elected for radical radiotherapy taking 20 courses of hypofractionated radiotherapy of the prostate for a total of 60 Gy on weekdays.

The side effects, various and different for each patient are for me concentrated on the waterworks, difficulty in urinating and burning sensation with the same, while presenting with urgency and frequency along with nocturia. Also, there is the fatigue that tends to show up with my voice sounding thin and weary.

Finding time to recuperate

One area my elective radiotherapy option might differ from others is I commenced treatment without neo adjuvant therapy which is hormone therapy to reduce testosterone, I later found out that my testosterone levels were quite low, which might well have been a blessing of sorts.

I was active throughout my radiotherapy treatment including for 75% of the appointments getting myself to and from the hospital as an outpatient. There were two or so days when after radiotherapy in the morning, I had to take the rest of the day off. In the main, I tolerated the treatment well and exercising will and mind over body at certain times.

However, radiotherapy while painless exerts quite a toll on the body, it was malignant cancer, and one needs to find the time to properly rest and recover to give the body the range and scope to return to full health and vigour. Despite the advancements in the science and engineering of radiotherapy, radiotherapy will touch healthy tissue as part of treating the cancer, which needs to heal too.

The outlook is incredibly good, now, get your checks done.

Blog - Men's things - Prostate Cancer blogs

Blog - Photons on the Prostate - XI

Men's things - XIII

Things we have to do

This morning, my second visit to The Christie, the largest single-site cancer centre in Europe and the first UK centre to be accredited as a comprehensive cancer centre. I know where I am going, Department 22, where many men with their partners and some women alone or with their own partners sit in one of four waiting rooms to be assessed, reviewed, or treated.

There have been offers to chaperone me to the hospital, from my neighbour, my friend, or a fellow steward from my church, but I have decided I am best able to cope with the conversations to be had alone. Obviously, if the opportunity were presented, Brian is definite and my best friend Kola, I would have welcomed to be with me through all this.

Taking the piss test

Having checked in, I was presented with a form, the International Prostate Symptom Score (I-PSS) which is a patient’s subjective rating of how they view their urinary health on a scale of 0 (Not at all) to 5 (Almost Always) on the various indicators of Incomplete Emptying, Frequency, Intermittency, Urgency, Weak Stream, Straining, and Nocturia.

Your total I-PSS score will suggest from your perception and feeling how the prostate gland is constricting the urine flow from your bladder to your urethra. My score fell within the range of mildly symptomatic though a bit higher than the score from two weeks ago.

I had already had a consultation on the option for a prostatectomy just over a fortnight ago, I was not enamoured about the aftereffects of surgery, it was all too unpleasant to countenance. Then getting to grips with the idea that something was manifesting inside you has left me somewhere between denial based on its invisibility and bafflement in terms of how to address it.

Just because you’re pissing poor

The consultant for the radiotherapy treatment option came in and introduced herself before asking how I came to know about the prostate cancer diagnosis. Walking her through each stage of testing and results leading to more investigations, she got a good idea of my understanding of the medical situation under discussion.

The I-PSS score then became the issue, and when I thought I might be able to avail myself of the breakthrough brachytherapy treatment for prostate cancer, I soon found out that I would not be eligible because of the treatment possibly complicating my urinary health. [Cancer Research UK: Brachytherapy for prostate cancer]

While I could appreciate no medical personnel would like to leave a patient worse off than they were before treatment, I felt that basing that decision on the subjective equivalent of a hunch when it would have been ideal to undergo urinary health analysis and tests was quite irregular.

Imagine being able to game the system because you had prior knowledge of adjusting the I-PSS score to suit the treatment you want even if the outcomes can be at best dubious and consequently debilitating.

Surely, there is a better way

I had multiple conversations with the consultant and support nurse when I was offered the external radiotherapy treatment that might stretch on for 20 low-to-medium dose sessions. Understandable to protect the functionality of my urinary system, which is under stress from an enlarged prostate, but that comes with other side effects. [Cancer Research UK: External beam radiotherapy for prostate cancer]

In all cases, however, the cancer will be removed totally. My inclination would be to opt for radiotherapy, but I will make no decision until I have had a conversation with my Holistic Needs Assessment team. The consultant twice said she knew I was going to read up on everything we had discussed, I can only wonder what could have given her that idea.

I am doing fine, I feel well, and I am quite hopeful and positive. Things would turn out right, I just need to get a handle on how I should pray. On my way out, I saw directions to the chaplaincy and prayer rooms, I found the chapel and sat in there for a while. As I was about to leave, the chaplains were coming out of their office for midday prayer, I was invited to join them, which I did and we had a moment of devotion, prayer, and reflection before I returned home.

Blog - Men's things

Blog - Men's things - II

Blog - Men's things - III

Blog - Men's things - IV

Blog - Men's things - V

Blog - Men's things - VI

Blog - Men's things - VII

Blog - Men's things - VIII

Blog - Men's things - IX

Blog - Men's things - X

Blog - Men's things - XI

Blog - Men's things - XII

Men's things - XII

Gathering my thoughts

There is much to write about, the last couple of weeks, the continuation of my experience with Men’s things, the change of government in the UK, and the glorious two weeks I got to spend with Brian in the city we both love, Cape Town.

This blog however will be dedicated to the issue of Men’s things as my appreciation of the situation has both been given a sense of triumphalism borne of faith as much as putting into a hermetically sealed containment the foreboding and fear that greets cancer invading your body.

What I was not meant to see

Poring over and through the NHS app, there was a cache of documents that contained what I would think were exchanges about discovery and diagnosis between medical personnel that the uncurious would probably never have accessed.

I open each of the recently uploaded documents. While the indiscretion of the medical establishment meant I learnt of a diagnosis of adenocarcinoma of the prostate before I was officially informed, when I eventually met the urology consultant who also conducted the biopsy of my prostate gland, I was left with the impression that things need to be done. Still, I had time to consider the options and probabilities.

Blog - The note that crept in

Yet, appointments and engagements were coming in thick and fast despite my having intimated I was going away on holiday for just over two weeks. Within two days I had a phone call to set up an appointment at The Christie Hospital and by the time I got home in the evening, there was a letter confirming the appointment in my mailbox.

The word they never spoke

There was an inordinate urgency to the activities that concerned me. The cache of documents contained one word no one spoke to me, and I think out of some bedside manner of reducing the sense of alarm at relating their discovery to me. I was left reeling halfway through my holiday when I saw the word malignant, and there is nothing benign about it.

Today, I attended my first appointment at The Christie Hospital to discuss one of the treatment options with a consultant who would perform a Robot-Assisted Laparoscopic Prostatectomy (RALP), if I should choose that pathway after a further meeting about the radiotherapy option which I currently have quite limited information about.

The consultant was in no doubt about malignancy in the intermediate range with good outcomes even as the possible complications after a robotic procedure do not present a pleasant consideration in the immediate to near term.

The core consideration with trenchant immunosuppression is this needs to be dealt with sooner rather than later. A lifesaving matter for which one might be persuaded to pay less attention to masculinity, manliness, or virility for the sake of living.

Phew! That was daunting

His patter was confident, experienced, and competent with every indication that he plans to save the vicissitudes of the plumbing and mechanisms of that environment, but only after he has had the opportunity to look in there. It was daunting as much as it was interesting. He answered my questions in detail and addressed my concerns frankly.

Obviously, I still need to review everything I was told to understand what it entails; whether I am prepared for this ordeal and what it portends. Whilst understanding the seriousness of the condition I also believe that there is every possibility I do not have to go under the knife but have a medically confirmed miracle of healing.

What is critical is for all I have learnt about prostate cancer, I do not choose anything out of fear, anxiety, or the pressure to act. I need to keep my faith and belief strong; focused on the process and outcomes desired. It is the only mindset that guarantees that whatever happens, I will look back on this with a great testimony and a better story. By His stripes, I am healed. [BibleHub: Matthew 8:17, Isaiah 53:5, 1 Peter 2:24]

Blog - Men's things

Blog - Men's things - II

Blog - Men's things - III

Blog - Men's things - IV

Blog - Men's things - V

Blog - Men's things - VI

Blog - Men's things - VII

Blog - Men's things - VIII

Blog - Men's things - IX

Blog - Men's things - X

Blog - Men's things - XI

Men's things - XI

Generational medicine involves talking

It is one of those unspoken things that even became the butt of a joke and some rather frank talk, though, I am not laughing now. Along the way, I have not acknowledged certain conditions that have appeared in the family, that medicine would consider factors indicative of a predilection to that condition.

This area of generational medical history is somewhat more developed in female medicine, like if breast cancer has been diagnosed in one member of the family with any degree of consanguinity, other females are advised to undergo tests and attend to a regular monitoring of their health to catch issues early. Some females even take radical precautionary measures if genetics suggest a susceptibility.

Reluctantly, it was during an eye test a few years ago that I volunteered the information that someone else in the family had glaucoma. I did not and do not, but that information alone meant from that time on, my eye tests were free on the NHS. When the patriarch did attribute certain chronic health issues to the prostate, I found myself dismissing the concern as that of a hypochondriac. [Refer to the first sentence of this blog, for the context.]

The cancer you can see

Prostate cancer is now an issue to deal with but differently from when I first had cancer some 15 years ago. Then with Kaposi’s sarcoma, I saw it appearing for almost a year like the slight irritation of Athlete’s foot that did not respond to any fungal treatments and then a discolouration that I ignored even as others where noticing that my health was beginning to deteriorate. I just put a brave face on things and continued as I always did.

Then, it became a painful weeping sore, at which point, it is was stupidity that took hold, I could weather this problem, I thought. Just bandage up the foot and walk, it was bearable enough until it became unbearable. When I finally went to see my doctor, if there was any alarm in her voice, she was as measured as she could be, as she said, “This is serious, I need to refer you.”

She probably had seen many presentations of late cases like mine before, her urgency coupled with care and understanding without any judgement, condescension, or condemnation was very helpful in accepting the seriousness of my condition. I could feel the cancer, I could see it too, it was utterly dreadful and thankfully something could be done about it.

Appreciating the graveness of my condition was exemplified in the statement of my consultant, just two weeks later. “We can treat this,” he said, “but it depends on how your body can take the treatment.” He continued. “If you can tolerate the treatment, you’ll be fine, if not, you probably have five weeks.” Five weeks! Life could have ended before the end of 2009.

A different prospect presents

With prostate cancer, everything is internal, the biopsies would suggest cancer has been detected very early and again something can be done about it. Apart from the results of the Prostate-Specific Antigen (PSA) test that led to the Digital Rectal Examination (DRE) suggesting an enlarged prostate and so, a multiparametric Magnetic Resonance Imaging (mpMRI) scan, and consequently an ultrasound-guided transperineal prostate biopsy, these are all internal medical indicators, I feel fine and well.

The weight of this situation is inferred in many other ways, as being added to the National Cancer Registry with a diagnosis and the initial prospect of treatment options that on the face of it have no particularly pleasant outcomes.

The invisibility of this invasion on my particularities and what might portend has me in a dalliance of disbelief and anxiety. I am steeling myself, not with substance abuse, but with the encouragement of the Word of God.

It is probably a kind of delayed shock too; I am here with my partner, and it is difficult to bring up the subject in the first instance and then begin to assess the situation. Yet, we must face up to what we intend the outcomes to be, first with myself and then together. It feels like we are hardly anywhere there.

Why I am writing about this

Any health condition is difficult to talk or write about, especially among men and even more so when it comes to men’s things. Black men are too macho for such talk.

I took the PSA test as an add-on blood test in trying to address an anaemic situation that I had tracked through two previous sets of results that were indicative of a deficiency in vitamin B12, iron, or folate (vitamin B9).

Years ago, I had folic acid deficiency anaemia and knowing that it is essential in binding other vital vitamins and minerals for good health, I wanted my doctor to address it, this has given rise to a series of Men’s things blogs.

One alarming statistic is, 1 in 4 black men will get prostate cancer in their lifetime. [Prostate Cancer UK], I don’t know if 1 in 100 or even 1 in 1,000 black men get the basic PSA test to forestall any indication of prostate activity for medical intervention. I reproduce the information from the Prostate Cancer UK website below:

You may also be more likely to get prostate cancer as a Black man if:

• you are aged 45 or over – and your risk increases as you get older
• your father or brother has had it
• your mother or sister has had breast cancer.

As for my journey, I already have a diagnosis and will avail myself of all medical expertise available strengthened by faith whatever the situation. We never quit living and living well.

Blog - Men's things

Blog - Men'sthings - II

Blog - Men's things - III

Blog - Men's things - IV

Blog - Men's things - V

Blog - Men's things - VI

Blog - Men's things - VII

Blog - Men's things - VIII

Blog - Men's things - IX

Blog - Men's things - X

Men's things - X

Registers of choice and fate

Registers are interesting repositories of information indicating where you might belong, in a class, with a group, by choice or automatically. Your curiosity about registers is to determine what is stored about you and could correct incorrect or changed information.

It starts with birth registrations that include your full name, the names and occupations of your parents, when and where you were born, and the day the entry was placed in the register.

With life, you will probably have to register a birth, a marriage, and a death, the first and last is usually done by someone else. In school, you might end up on a register with a roll call to determine who is present or absent. As an adult where any semblance of a democracy exists, we might say a voters’ register.

Another register that matters to me is predicated on religious faith; being in the Lamb’s Book of Life having accepted Jesus Christ as my lord and Saviour. “Nothing evil will be allowed to enter, nor anyone who practices shameful idolatry and dishonesty—but only those whose names are written in the Lamb’s Book of Life.” (NLT) [BibleHub: Revelation 21:27]

Not this register at any time

In my meeting last week, it was said in passing and I heard the nurse right; it was one register to which I would never have wanted my name appended, and my utmost desire is to be taken off that register with the testimony of an all-clear having had a prior proof of a diagnosis.

Yes, there is a National Cancer Registration and Analysis Service and with a cancer diagnosis, the person is automatically registered, to track how cancer is managed nationally. You can seek with apparent difficulty to have your information removed by opting out. [CRUK: What is cancer registration?]

While I would rather not answer present if my name is called out of this register, I appreciate that when it comes to cancer treatment, the book of knowledge that is brought to bear on any new diagnosis comes from the long trail of studies, treatments, observations, and the lives of those who succumbed to the disease and the many who survived too.

Registered for better outcomes

That is why when in a consulting room, I welcome students to participate in the conversation. I engage them fully and try to paint a picture of how some of the wonders of progressive developments in medicine, have helped deal with disease that once was a life sentence but is manageable for some, curable for others, or controllable for many.

Sometimes, the prospects and options for dealing with men’s things when biopsies return positive results can be daunting. My decision is not to dwell on this but to encourage myself with messages about healing, living, wellness, and strength.

What I do with the knowledge of a cancer diagnosis is everything, and what I intend to have, is a better story than what any prognosis suggests. The first step to this is checking on your men’s things, going for the requisite tests, attending all appointments to discuss any issues and giving yourself the early fighting chance of knowing you have the choice of a possible cure.

Blog - Men's things

Blog - Men's things - II

Blog - Men's things - III

Blog - Men's things - IV

Blog - Men's things - V

Blog - Men's things - VI

Blog - Men's things - VII

Blog - Men's things - VIII

Blog - Men's things - IX

Men's things - IX

It is serious stuff

My decision to share my experience of what men face with prostate cancer is one I do not treat with any levity. You will read humour and maybe laugh at my expression; it does not take away from the seriousness of what a diagnosis of adenocarcinoma of the prostate might present.

Cancer is part of the human experience, it does not have to define your outlook as the end of the road of your existence, the greatest battle you will have is in your mind rather than in the prospects, the treatment, your recovery, and much else. If you believe at the receipt of such news that you will die, you quite likely would, if you choose that you will live, you have everything to live for.

Take the fine part

I speak as someone who 15 years ago received a cancer diagnosis with the prospect in the words of my consultant who had the weight of medical expertise on his side of his prognosis. He said, “We can treat this, but it depends on how your body can take the treatment, if you can tolerate it, you’ll be fine, otherwise, you probably have 5 weeks.”

I took the fine part and left the weeks part in the dust of history, and that has become my testimony of living and living well.

All with a friend

For my appointment to get the results of the transperineal prostate biopsy that was taken a month ago, I already had a good idea of the situation, the rest was to understand what they had observed towards the conclusions they would draw which would give me a handle on what I need to address.

We boarded the Uber taxicab, my friend had come as support because I was invited to bring someone to accompany me, when he called me to confirm, I was almost with the mind to tell him not to be too bothered, but he came over and I am glad for his support.

The driver asked where we were going and I said the Peter Mount Building, and it is ironic that a building where men are checked for men’s things, where manliness, masculinity, and patriarchy meet the humbling of disease has mount in the name. Surely, someone is having a joke at our expense.

Balls, nuts, very salty

He knew where the building was at as I told him, I had been there before because someone had a staplegun to my goolies, a month before. I guess I used goolies as a collective for everything pertaining to men’s things in that area. He asked if I still had them, I do, as my friend opined about how the man rumoured to only have one brought the world to ruin in World War II.

The driver half took the hint that he needed to check his men’s things and we all agreed that we do not talk freely enough about men’s things to have the prospect of early diagnoses if anything is awry. He said he was going to spend the rest of the day thinking of Akin’s nuts, I suggested he should try them salty. We all laughed until our sides ached. I was dressed as if I was going to a party.

Cut to the chase

Arriving quite early, the waiting room was busy, I took a seat and occupied myself with studying a map of the west of Manchester, I even found an error on the map. Soon, I was called into a consulting room where I showed the consultant that I was already aware, for over a week, of the information he was about to share, and that he should cut to the chase.

Blog - The note that crept in

Without dwelling on the point, we discussed what the future might be, from a medical perspective, and I thought of a different future blessed by what my belief grants me. Even as I positively attended to the information, I felt a little tremor in my hands, partly out of shock that you will naturally expect and at the same time, you must overwhelm the circumstances with a greater sense of personal and Godly hope.

Leaflets, pamphlets, and booklets later, we departed for a hearty brunch. Please, have a brief look and feel at your men’s things, the earlier you know, the better your prospects. I will continue to write about this. It is well with my soul and yours.

Blog - Men's things

Blog - Men's things - II

Blog - Men's things - III

Blog - Men's things - IV

Blog - Men's things - V

Blog - Men's things - VI

Blog - Men's things - VII

Blog - Men's things - VIII

Men's things - VIII

Interpreting bloods and dreams

In preparation for my biannual consultation today, I printed out sheaves of information for which in the analysis I would hope to have satisfactory, convincing, and comforting medical assessments of the situation. Like the kings of old, their dreams then and our blood results today, need interpretation. They hold some keys to the future.

The bloods have been telling wild stories of rage and range that has led me into many lairs of the medical establishment for observation, through inspections, radiography, biopsies, and another set of appointments and scheduled tests. It is tough if a king cannot remember what they dreamt, just as it is difficult if you cannot review your blood and other results to ask pertinent questions.

Silence is never an option

Having a long-term health condition you have effectively managed for about 15 years gives you some experience handling how doctors relay or disseminate information. You have to read the obvious and then read between the lines. In the UK, they are not as direct and forthcoming as our Dutch neighbours, they are reserved though a certain cohort is abrupt with a patrimonial bedside manner.

The Dutch are interventionists, they do not wait and see how things develop, they go after the issue with alacrity and immediacy. I recall my Dutch doctor saying, “This looks serious, I have to refer you.” She was already on the phone making appointments and speaking with urgency, I could be in no doubt about the seriousness of the situation. When I saw the professor, a few days later, he said, “We have a bed for you upstairs.” That was the beginning of an 18-night stay in the hospital in September 2009.

That compared to how three different health institutions vacillated for almost 3 years on a co-morbidity that could be treated and then I was put on new therapeutic drugs, but this was after I had a conversation along the lines of, “I am well aware of my mortality, what are you going to do about this co-morbidity?”

We have to talk about it

Regardless of who you are seeing, it is evident you must have a good understanding and grasp of your situation and give full voice to your concerns unrelentingly until you get satisfactory answers leading to hopefully, your desired outcomes.

Next week, I will be attending a follow-up consultation to discuss the results of the transperineal prostate biopsy I had just over 3 weeks ago. What has been scheduled has left me almost falling off my seat. There is a multidisciplinary team (MDT) with the qualifications of pelvic and urology along with the elephant in the room, who have set something up for the day after with no detail and this has an expiry of a year hence. As it comes under the topic of upcoming tests and procedures, I am left wondering, is this adopting a wait-and-see approach, or there is really nothing to see, and we are just in close monitoring?

You can bet I have many questions for all my follow-up consultations, I am not a tough customer, just one who knows what everyone should know for themselves. “It is my body first before it is your Guinea pig.” Selah!

Blog - Men's things

Blog - Men's things - II

Blog - Men's things - III

Blog - Men's things - IV

Blog - Men's things - V

Blog - Men's things - VI

Blog - Men's things - VII

NB: I use bloods to mean blood tests.

Men's things - VII

Now I know the time

Only yesterday, I was writing about waiting for the next appointment to discuss the results of the adult histopathology labs ordered on my last visit after the transperineal prostate biopsy which leaves little room for comfort at the thought of it.

This morning, a new appointment arrived in my mailbox with a link to the hospital trust portal where you can review what is expected of you on your next visit.

It sheds no further detail apart from the name of the consultant I might be seeing and the option to bring a friend or relative along. The reliability of ‘friend’, the one who was to accompany me for the biopsy is questionable and no fault of his beyond the apparently recondite lack of facility.

Needing someone to lean on

I might have to inform my neighbour as she upbraided me sternly for not letting her know I was off to the hospital for a quite involved procedure.

Strangely, in preparation for the other visit, I was informed of the one-stop-shop service, I cannot recall the suggestion to bring someone along, it was loaded with possibilities without indicating any actualities, which makes it seem ominous that I might need a shoulder to lean on.

Obviously, I would be asked to produce a urine sample on demand or under duress before I see the consultant who trained in Manchester and holds several supervisory positions in clinical, educational, and training institutions. In my earlier feedback, I remonstrated about not being given the full details that informed the decision to do a biopsy until I asked questions and asked to see the MRI scans.

In my own time, at my own pace

I have resolved, whatever the outcome, I will take my time to decide on the next steps. For what it is worth, no one would want to lose the efficacy and function of the prostate gland and on one of those sessions where I heard a talk on prostate health, one of the speakers did say there is expertise to ensure it is not totally excised that you become a eunuch blessed with a protuberance.

That thought alone, I should banish from my mind. I already have my delayed biannual checkup scheduled for June and a week later, this one. Better to just think of the summer of love and the beauty of the flowers in fields and meadows. What bliss, what bliss indeed.

Blog - Men's things

Blog - Men's things - II

Blog - Men's things - III

Blog - Men's things - IV

Blog - Men's things - V

Blog - Men's things - VI

Men's things - VI

The wait, the weight

You find yourself waiting for something, the bits taken out and being processed in histology to determine if there is a case for pathology.

Meanwhile, the men’s things are healing even as you peek at the effluent now and then to note if the colouration is gone or if there are whirls of foreignness visited on the nectar that I sure do not want to explain to anyone.

Issues like this can weigh on the mind but giving it space can distract you from living and the vicissitudes of life. There are things to get along with, and those are better concentrated on.

The pinch of a prick

Even though you do not know what to expect, it has been over a fortnight, and you are hoping for the best. The longer things are you begin to think they cannot agree there is much to be concerned about though I cannot say I will be amenable to another biopsy.

This is one thing you only want to happen once and never again. As I describe the experience as mellifluously, I doubt I am proselytising the necessity to have these things checked. It is just unpleasant, not an unbearably painful and intolerable thing.

Apart from the occasional urethral irritation, there is not much else to report. Until I am invited for a further conversation, I will not be bothered about it. It would appear there is no urgency and so on my part, there is no need for any anxiety.

Blog - Men's things

Blog - Men's things - II

Blog - Men's things - III

Blog - Men's things - IV

Blog - Men's things - V

Men's things - V

The aftereffects of the aftermath

I have put it down to the shock the body has felt to the nicking of bits down there with regards to the transperineal prostate biopsy I had on Tuesday. Nary a discomfort, just sometimes one of the awareness of vulnerability more than anything else.

There has been the occasional tinge of pain in the perineum, and the bloody discolouration in the urine continues, but not as much, it is in the clean-up with tissues that I might notice the obviousness. The quantity that is passed during the night has increased slightly, however, besides that, I feel well, and I have returned to doing the things I enjoy.

Amongst men I have discussed this with, there is a knowing, that no one talks about it, but I introduce it with humour that even the ladies might interject with their experiences of childbirth. It brought to mind again my first biopsy almost 15 years ago. A deep biopsy of the fungating tumours in my left foot, that 5 injections of Lidocaine did little to contain the feelings the nerves conveyed to my brain.

Blog - The looming abyss of a deep biopsy (September 2009)

Please take note for yourself

Even during the apparent start of this experience, an advocate has been won, I want to stand before a group of men to make them aware of a few things.

1. The need to have regular checkups.
2. Having an appreciation and knowledge of the results of their bloodwork, so they can ask good questions for useful answers.
3. Understanding when any result is out of range and immediately discussing this with their medical personnel for a pathway to remediation.
4. Speaking up for yourself regardless of the preponderance of medical expertise around you.
5. Pressing for the best outcomes whilst always seeking prompt action on the situation.
6. Follow through with the advice you get along with the additional tests suggested, remembering at the back of your mind that it is your body first before you are their Guinea pig. Seek a second opinion if you need more clarification or are unconvinced of the recommended pathway.
7. Do not leave anything to chance, act immediately and get full assurances and information about everything, if there is nothing else to be done, schedule your next screening, else, consider your treatment options and stick with the plan.

Blog - Men's things

Blog - Men's things - II

Blog - Men's things - III

Blog - Men's things - IV