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

Men's things XXXIV: Saving the life, and saving some lifestyle

The Shadow of Mortality

The pall of mortality hovers like a dark cloud at certain times, but you cannot dwell on that feeling at all. Every time you escape the dread it portends, you are grounded by the good fortune of survival and by the uncertainty that reliving it might present.

Above all other questions, it did occur to me whether I had it in me to face another cancer diagnosis. As much as I presented as stoic two years ago, my concerns and anxieties were a rumbling thunderstorm in my mind. I reached for comfort in sermons and in the faith that things, no matter how bad, would be fine.

A Diagnosis Already Known

However, when I saw the consultant at the Christie Hospital in mid-June 2024, it was not to discover anything new. I had already known for a week that adenocarcinoma of the prostate had been diagnosed, because my medical notes from another consultation had been merged with the findings from a biopsy taken three weeks before.

The doctor who made the mistake offered to redact the notes, but how do you unsee the facts as they were presented? The damage of letting the information slip through, without the essential conversation in a controlled setting, had been done.

I was reviewing the consultant's notes yesterday, and I wondered whether there had not been a haste to act, considering the stage at which the cancer was found, given their recommendation of active treatment as opposed to active surveillance.

In the haze of the moment, you do not see everything your medical results indicate; you grasp at the headline and let the detail blur. Looking at the same notes two years on brings a new realisation, a clarity that was simply not available to me then. Yet what can one do now? The decision has been made, the treatment taken, and hindsight, however sharp, cannot rewind the clock.

Registered Without Consent

I attended the consultation with a friend, but what shocked me still more was that, once cancer was diagnosed, I was immediately added to the National Disease Registration Service (NDRS), which comprises cancer diagnosis and analysis along with congenital anomaly and rare disease registration. No one told me I could opt out.

Then, on the matter of cancer, I have always felt that all who have encountered it are treated on the basis of the body of knowledge acquired from survivors and non-survivors alike. We are rarely pioneers of this unfortunate human condition.

Brian, because of his exposure to the medical field, would have been aware of what was developing, but I wanted to tell him when we met up in Cape Town, and that was just over a week away.

Weighing the Options

Meanwhile, between the visible and painful skin cancer of 2009 and the invisible, seemingly benign prostate cancer of 2024, I was totally conflicted. I was hoping that chemotherapy, of which I already had some experience from the last time, was an option, but I soon learnt that the only options were surgery or radiotherapy.

The treatment I eventually had was hypofractionated radiotherapy, effectively External Beam Radiotherapy (EBRT), over 20 weekdays in September and October 2024.

This week, NHS England will begin to offer a more targeted radiotherapy treatment for prostate cancer called Stereotactic Ablative Radiotherapy (SABR). This was first proposed in 2021; it's only five years late.

This focused treatment is down to five doses over a fortnight and lends itself to fewer side effects. [Sky News: 'Cutting-edge' prostate cancer treatment to be rolled out by NHS from next week]

Proposed Patient Pathway
Stereotactic ablative radiotherapy (SABR)
for patients with previously irradiated, 
locally recurrent primary pelvic tumours [PDF]

Progress and Its Price

More recently, the website of Elekta, the company that supplied the radiotherapy equipment for my treatment, features equipment that could offer the same radiotherapy in two fractions. MR-guided adaptive radiotherapy even promises minimal side effects compared with other interventions.

The selling points are that it lowers acute Gastrointestinal (GI) and Genitourinary (GU) side effects while better protecting erectile function. That is the elephant in the room that rarely gets talked about, where cancer treatment saves the life yet does little to preserve the lifestyle.

Then, one must acknowledge that these advancements in technology are welcome progress in tackling these issues. One cannot live in the regret of not holding off on essential treatment to wait for better options to select from. You work with what is available, and you study the changes that come along.

The Elephant in the Room

Even as I insisted on not being co-opted into a form of chemical sex to ease the issue of sexual dysfunction, I was invited to take a prescription of sildenafil citrate, typically at half the normal strength. I feel like the boy of fifteen whose first job was in a brewery, working in the laboratory, where the first wort was said to be an aphrodisiac.

Hey! Medicine expects that, if you can get it up, you already have the sexual confidence for everything else to follow. I beg to differ, as the package gathers dust in my bedside cabinet.

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

Blog - Photons on the Prostate: Three Things I Wish I'd Known

Blog - Men's things: Prostate Cancer blogs

A Google NotebookLM AI Podcast on this blog

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

Blog - Photons on the Prostate: Three Things I Wish I'd Known

Blog - Men's things: Prostate Cancer blogs

A Google NotebookLM AI Podcast on this blog

The many tests of a patient waiting in patience

A Week to Fathom

What a weekend that was, or rather, let us consider the full week, because the thought of all that transpired is hard enough to fathom.

Fresh from the good news of my PSA having fallen to its lowest level, buoying my confidence in the radiotherapy for prostate cancer, I was having chest pains that led to my attending A&E first thing on Monday.

That was one unplanned visit to the hospital. The result was reassuring; it was nothing serious, just musculoskeletal pain that some bed rest could help.

Good News, Then Distress

Friday was the main day scheduled for my biannual monitoring at the Christie Hospital. Going there never ceases to be as impactful as it is critical to saving lives. It is a visit to a renowned cancer hospital to review my PSA result and discuss the attendant issues from radiotherapy.

That went well, so I stopped by Nando's for a meal and used the opportunity to call Brian. Halfway through my meal, after our call had ended, I had a choking episode. I won’t suggest this is a longer-term side effect of radiotherapy, as dysphagia, and I have not considered if it could have exacerbated it; I’ve had choking episodes going back decades.

Thankfully, I had enough napkins to contain the relief in bringing it all back up. Not a beautiful sight, and no one noticed I was in distress either. I cleaned up in the conveniences and returned home to lie down.

Saturday Takes a Turn

Whilst that should have resolved things, as I do usually have episodes of choking on food, this one was different. Some cereal before midnight did not go down, likely due to food impaction, an obstruction, or inflammation in my throat. I threw up in the toilet and decided to postpone my pills for a few hours.

The pills did eventually go down, and I had a lie-in for most of Saturday into the afternoon.

Getting up, I made a cup of tea. I thought I had drunk the full mug, but there was pressure in my throat and quite a bit of discomfort. I had to throw up again.

The tea came up with some mucous-like substance that fell to the bottom of the toilet bowl. That was concerning. I was about to return to A&E for another ailment.

A Night in A&E

Calling an Uber, I made it to the hospital soon enough, though as I alighted, I was sick in the bushes before being triaged. From then on, I was vomiting a thickened, mucous-like substance every thirty minutes or so into a sick bowl.

Just about two hours after arrival, I saw a doctor. She gave me a drink of water, which seemed to stay down. I have not vomited after that. I was then referred for a possible endoscopy and left in the Emergency Room for two hours.

Then another doctor called me in for review. We agreed on an experiment: I would have a sandwich and a drink, and if that stayed down, I was to be discharged for further outpatient review. If I could not keep the food down, it would mean hospital admission, nil by mouth, and a possible endoscopy on Monday to identify the obstruction.

The food stayed down, but it was left waiting for a few hours before I received an email notification; an after-visit message; it was sent 30 minutes earlier. Apparently, I had been discharged, and no one had bothered to inform me. I left the hospital over eight hours after arriving. It was almost 2:00 AM.

The Weight of Being Alone

I appreciate that these matters take time. Anyone attending A&E is busy juggling the precarity of their situation that brought them to the hospital with the need to keep others informed, especially if they are alone in that predicament, and that is just the way it is.

I have every reason to want a better situation, to be in a hospital with someone. Everyone else seemed to have someone with them, but as one person, you are a container of the reflexes of concern, anxiety, or even panic of others about you. You must wonder whether it is necessary to inform anyone during the crisis or only after it has passed.

There is an emotional toll involved in the desire for information and details. I have had calls whilst a doctor's stethoscope was feeling around my body, calls I have had to ignore.

My going to the hospital should be part of accepting that the right decision has been made and that I am in good hands. Not much can be helped beyond everyone holding their nerve, thinking good thoughts, and praying for the best outcomes.

Everything takes time, and the patient patiently waiting for answers and assurances, first for themselves before finding the form of words for dissemination to others who duly need to be informed, is probably the most impacted by it all.

A Google NotebookLM AI Podcast on this blog

Photons on the Prostate - Three Things I Wish I'd Known

Full Disclosure

Despite what you read in this blog, I believe the choice to undergo hypofractionated radiotherapy as my treatment option for malignant adenocarcinoma of the prostate gland (prostate cancer) was the right choice.

After the ordeal of a prostate cancer diagnosis, gruelling radiotherapy, and years of dealing with lingering side effects, you would think I am done with reading up on issues around prostate gland health.

Now, I am glad to say it was caught early. I believe I received as good care and support as could be given by advisory and medical teams, and I am convinced that I chose the best medical outcome for my situation.

3 Hidden Problems With Radiation Treatment for Prostate Cancer
© The Prostate Clinic

Unsolicited Advice and Misinformation

In the same vein, I am usually offered tips, hints, and advice about prostate health; mostly information shared on social media, none peer-reviewed by experts in either urology or oncology to prove their efficacy. The impressions are mostly anecdotal.

My father, for instance, has mostly been swindled or scammed by snake oil salesmen offering miracle potions to treat his prostate problems that medical science has been at pains to prove he ever had. We are left humouring him when it might be prudent to sternly upbraid him. He is educated and had a high-profile professional life; he should know better.

The Prostate Clinic Revelations

Recently, I have been following The Prostate Clinic, a YouTube channel hosted by Dr Charles Chabert, a urologist in Queensland, Australia, and it has taken a few days to properly digest what he had to say.

In July 2024, I met with consultants in surgery and radiotherapy for prostate cancer. Later, I spoke to a support worker at Prostate Cancer UK who opined I should opt for Active Surveillance or Watchful Waiting over the active treatment suggested at diagnosis. Even after reading up on extensive material and sharing my journey in a series of blogs, I had to manage my consumption of information to avoid being overwhelmed into stasis.

The Question of Sufficient Information

The question then becomes: how much more information, detail, reports, studies, and research should one access before knowing without any shadow of doubt you are making the right decision, all things being equal?

You are told so much going into treatment but not nearly enough about the aftermath, it would seem.

Three Hidden Problems

The Australian urologist addressed the aftereffects of radiotherapy on the prostate that could leave you concerned about several things, of which sexual dysfunction has been a recent blog topic. He called them “3 Hidden Problems With Radiation Treatment for Prostate Cancer”, suggesting why we should not opt for radiotherapy.

When the prostate gland is irradiated, it could damage the surrounding tissue connected to the bowel (radiation proctitis, very graphic, the pictures can cause distress) and bladder (radiation cystitis) systems. Irradiating the prostate gland shrinks, scars, and can make it fibrotic, leading to two other consequences: limited salvage options or progressively reduced sexual function.

Complications and Salvage Treatments

Complications might arise if there is a local recurrence of cancer, making salvage activity quite difficult. This portends more impactful consequences for the patient and radical alternatives for bowel movements. Salvage treatments are better managed post-surgery than post-radiotherapy, where options are severely limited.

The state of the prostate gland after irradiation means that sexual function will increasingly diminish. This touches on erectile dysfunction and reduced ejaculatory performance. These are weighty matters that make you wonder if you had known all this before you commenced treatment, whether you would have made that choice.

Managing Side Effects

Again, the issue with choosing any treatment comes down to how you perceive you can manage the side effects. For surgery, they are immediate, whilst for radiotherapy they are progressive.

The possible loss of total sexual function, because the consultant surgeon had already indicated my prostate was too enlarged to guarantee the salvage of any nerves, immediately made that option a non-starter. I was not going to wait and see what a malignancy was going to do in my body through Active Surveillance; it would never have been an option for me.

My Choice

Choosing radical radiotherapy was the most comfortable choice in my circumstances. Though having an additional prayer point before I had my prostate gland zapped might have made this discovery less of a surprise and caused less concern.

Ultimately, I believe I did the right thing and will make the best of the good fortune I have to enjoy life and write better stories, with cancer behind me. I thank God.

Check your Prostate Cancer risk in 30 seconds.

Blog - Men's things XXXI: Can Intimacy Be Reclaimed After Prostate Cancer?

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 Google NotebookLM AI Audio Overview Discussion of this blog

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

An Unexpected Conclusion

I catch up on the news through the refined medium of chat shows, so I was unaware of the day's developments when my friend called to get an opinion. It was the news that national prostate cancer screening has not been recommended for men in the UK.

Whilst I am disappointed by the development, the science and research might suggest it could cause more harm; men could be diagnosed and overtreated for something benign. Because the usual growth rates for prostate cancer are quite long-term, stretching into more than a decade, immediate intervention is not always needed.

I appreciate all those arguments, but I can only share my own experience.

Pushing for Action

Firstly, the decision to get a PSA test was primarily at my own instigation and insistence. My GP had blood test results suggesting I had an anaemic deficiency for over two months, and did nothing about it until I asked why a reading was off the scale. During that investigation, I tacked on the PSA test.

As a black man aged 58, I fell into the cohort of those who could be affected by prostate cancer. Then my father indicated that he had it too, though I could not conclusively ascertain the facts.

The urinary symptoms of incomplete emptying or urgency I had attributed to the expected rather than the unusual. I was not expecting anything untoward.

Towards a Cancer Diagnosis

In early February 2024, the PSA reading was borderline on the high side of the normal range at 3.5 ng/ml. The other issue was that I had folic acid deficiency anaemia. I got a prescription for folic acid supplements and returned for another blood test at the end of March 2024.

By then, my folic acid levels had fallen outside the normal range, but the more concerning issue was the PSA at 4.0 ng/ml over the course of seven weeks.

The doctor then took the initiative to invite me to discuss this reading and conducted a digital rectal examination (DRE). His conclusion was an enlarged prostate gland with no nodules, but we needed to determine why.

This led to a referral to a hospital urology department, which, within weeks, scheduled a multiparametric MRI (mpMRI) scan at the end of April.

Challenging the Orthodoxy

At which point, I was reading up about tests, results, and indicators in the diagnostic path for prostate cancer. I then got an appointment with the urology department to discuss the MRI scan results.

We had barely exchanged greetings when the specialist literally blurted out, "We need to do a biopsy." No assessment, review, or discussion before telling me that. I pushed back and asked what the reasons were behind the decision, as the whole thing was both shocking and a surprise. The specialist would win no prizes for bedside manner.

Along with the many questions I asked, the answer that made me acquiesce was when he told me the PIRADS score was 4.

That result meant there was something concerning that had to be checked. There was no comfort with the ultrasound-guided transperineal biopsy of the prostate; even the lidocaine injections were painful, but I braced myself.

Cancer of the Prostate Gland

I had an appointment to review the results in mid-June. But my medical data in another hospital was merged into another assessment in early June, and there I learnt of the diagnosis of adenocarcinoma of the prostate gland.

When I met the urologist at the urology department, I told him I already knew, and we should cut to the chase. It was Stage 2 cancer, a Gleason score of 7 (represented as 3+4), contained in the prostate gland, and immediate treatment was recommended. I opted for radiotherapy.

In the process, I consulted with Prostate Cancer UK. I realised I could only be put on the longer hypofractionated radiotherapy over 20 working days, as my prostate was too enlarged for surgery to consider what could be saved of any sexual function, and brachytherapy could lead to serious complications.

You Always Excise the Cancer

Prostate Cancer UK felt I should have opted for active surveillance, but I had come so far in the medical analysis to back out. Apart from the fact that, besides the recommendation to treat it, I was not going to endure the presence of cancer in my body, waiting to see what it might do in years or decades.

Whilst the side effects were close to debilitating, they were manageable with good advice from the cancer health nurse consultant that my company recommended as I began treatment.

As prostate cancer leads the cause of deaths from cancer in men in the UK, and it impacts black men twice as much, the decision not to recommend national screening is quite unfortunate.

Get Screened and Scream Too

Even those with the BRCA gene mutation that suggests greater susceptibility to cancer will not find that out unless they are screened for it, probably in a separate medical checkup.

Reviewing all my medical notes, I cannot find any indication of any BRCA1 or BRCA2 gene mutation, and yet I have had two episodes of cancer malignancy in the space of 15 years.

Obviously, it means men must have a voice in their individual medical situations and advocate for the necessary interventions towards the best outcomes.

From my perspective, every time I have a platform to speak about men's health, I will say: if you're a black man over 45, you need to get the PSA test and go the full course until you are satisfied everything is fine.

Then, if anyone in your family (and that is mother, father, sister, or brother) has had cancer, get checked too. Demand to be seen as a person before you become a statistic.

Putting your health first, above any cultural, societal, or personal embarrassment, is paramount. Prostate cancer is treatable, especially when caught early. The lack of a national screening programme does not make it less incumbent on every man to step up and be part of ensuring that prostate cancer is no longer the biggest cause of cancer deaths in men.

Thank you.

BBC News: Streeting 'examining evidence' after experts advise against prostate cancer screening for most men

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 XXVII: The inconvenience of incontinence

Blog - Men's things - Prostate Cancer blogs

Key

The PSA unit ng/ml is nanograms per millilitre.

A prostate cancer diagnosis, one year on

Time always matters.

In the passage of time lies the recognition of many things: living, living well, and the joy of living. This is true despite, and in spite of, other issues such as adversity, disappointment, unfulfilled yearnings, betrayals, and episodes of diagnoses that lay bare our vulnerability and mortality.

I count my blessings and celebrate each day as an opportunity to enjoy and behold the goodness in people, ideas, and places. Having the strength and means to do so places us among the privileged in ways we often fail to appreciate.

I rarely consider myself lucky; I am more inclined to think of myself as fortunate, not by my own doing or ability, but by mercy and grace. I can only express my gratitude that each day brings opportunity and ease, ample ability, and extraordinary capacity.

The extent of our imagination and vision defines our limitations; we can only exceed them through inspiration and revelation. The scope of our influence can be limitless, but until we believe it and are convinced of that possibility, we resemble chickens seeking the perspective of eagles.

Once you know, you know.

A year ago today, I was reading hospital notes from the consultant I had seen the day before, and in an instant, I became a victim of computerization without appropriate human oversight.

A diagnosis that I should never have learnt about before meeting the responsible consultant appeared in my records and was something the consultant I visited the day before should have reviewed before posting.

That is how I unwittingly discovered the diagnosis of adenocarcinoma of the prostate. A year is quite a long time when it comes to a cancer diagnosis, as you are left wondering what it entails, if it is treatable, how you will tolerate the treatment once you have decided on whatever course is available, and the aftereffects of that ordeal.

Giving thanks always.

I was not prepared for a second diagnosis of cancer, but when it came, I encouraged myself with words and sermons about healing and living, seeing beyond adversity, and leaving no room for discouragement, regardless of the prospects ahead.

Obviously, some eight months after completing radical radiotherapy, some lingering side effects remain; my voice is light, high, and sometimes sounds quite tired, but in myself, as Brian would typically enquire, I am doing fine. All thanks to God, my partner, my friends, my colleagues, the teams of medical personnel striving for the best outcomes, and that earnest desire to tell a better story.

This puts everything into perspective; each day is a blessing.

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

Of bigger balls of discomfort

We, the vulnerable

Each visit to the hospital presents an opportunity to observe humanity at its most vulnerable and, at times, a few at their most irascible. It also showcases the society in which we live.

Illness does not selectively affect individuals based on class, race, status, or identity. There may be susceptibilities indicated by certain groups, but these are often ill-defined.

We all visit the hospital because something beyond our control has afflicted us, and we require assistance against whatever the onslaught may be.

Do the shower inspection

In the spirit of Men’s things, while I was in the shower on Saturday, I noticed my left testicle was swollen. Signs of this, the day before, led to the feeling that my underwear was a size too small. However, I ignored that indication throughout Friday until a shower inspection raised cause for concern.

We should all be doing a shower inspection and checking ourselves, examining our intimate parts for anything unusual. Men should check their testicles for swelling, hardness, lumps, redness, or heat, just as women should examine their breasts likewise.

As breast cancer can affect both men and women, we must also be mindful of assessing those parts too.

English as standard

While I acknowledge that during my time in the Netherlands, I never became as Dutch as might have been necessary, English was generally the language of transaction in business and all matters aside from government and politics.

In Dutch hospitals, the professionals, typically multilingual, would switch effortlessly to the preferred language of the patient.

I remember a 91-year-old Englishman in my ward nearly 16 years ago who had lived in the Netherlands for 50 years, and despite his fluency in Dutch, you could still hear that polished English accent from a bygone era.

How do they cope?

However, I was taken aback by the number of ethnic minority couples who visited the Accident and Emergency Department on Tuesday morning, who could barely communicate in Pidgin or broken English. Each relies on their spouses to register and relay their issues to the nurses and, eventually, doctors.

I was left pondering how they navigated society and how isolated some might feel. Whether any would receive a proper or complete diagnosis without the ability to speak for themselves is a concern. Imagine those with a rather stifling conservative background having to speak to strangers about intimate matters affecting their partners. Are the words for those issues the same ones we can comprehend?

Much as many of these couples were parents with children who had been schooled in English, exhibiting local and foreign accents confidently and expressively. No one under the age of 16 could act as a chaperone, due to safeguarding regulations. Invariably, it is probably for the best that children are not answering for their parents regarding their sex lives and similar subjects.

Bide your time

From triage through registration, basic checks, blood tests, and consultations that led to an ultrasound scan and ultimately a diagnosis. Everything pointed to inflammation, for which I was prescribed antibiotics.

At A&E departments in UK hospitals, arriving is the easiest part, even if you were blue lighted into resuscitation. Alright, perhaps that’s an exaggeration. One can expect to be there for a conservative estimate of six hours.

Take a book, a bottle of water, a phone charger, or better still, a power bank; let your patience be tested but do not suffer for the privilege of free healthcare at the point of access, regardless of status.

Men's things - XXIV - A presentation

Sharing my prostate cancer story

Within the last fortnight, I attended a gathering of black men in Manchester and Liverpool, where I was invited to tell my story about my experience with prostate cancer.

The story on its own could be compelling, as I do have friends and acquaintances, even strangers asking for advice and direction about how to navigate these issues, that I term, "Men’s things".

However, in such a semi-formal setting under the auspices of a registered charity, I felt it should not be a typical story-telling setting, but one where whoever listened learnt something and could act on it.

What the prostate gland does

To that end, I created slides with some images, because in all previous presentations I have attended on the topic of prostate cancer, the issue of the function of the prostate gland as a muscular switch between urination and ejaculation was not clear. For instance, I learnt this long after I had commenced radiotherapy treatment for prostate cancer.

Secondly, I had only found one image that gave a close-up view of how an enlarged prostate gland can present symptoms of difficulty or discomfort with the ease of urination. That visual image alone seemed to get men thinking about having checks on their prostate health.

Courtesy of NHS Overview of Benign Prostate Enlargement

Your active participation in your health, matters

On this perspective, I wove a story around my curiosity about some unusual blood test results outside normal ranges, through insistence to my GP for tests, the referral for further investigation, leading to a cancer diagnosis, then the treatment of prostate cancer, and the post-treatment side effects.

Beyond that is the need for black men to participate in surveys, especially when invited for bowel cancer screening, why men’s things should be more widely and openly discussed, and how early detection saves lives.

What I hoped men would take away from my presentation was that, “All prostate issues are not indicative of cancer, but every prostate enlargement should be investigated for cause and possible treatment.”

My presentation slides

Blog - Men's things - Prostate Cancer blogs

Blog - Photons on the Prostate - XIII

References

MedScape: International Prostate Symptom Score (IPSS) Calculator

Prostate Cancer UK: Risk Checker

Photons on the Prostate - XVII

All touched in different ways

I will be the first to say that there is life after cancer for those of us who have been fortunate to have some treatment and even a cure for the dreadful disease. Daily, I encounter many others like me who have put the event of cancer behind them and are getting on with their lives.

At the same time, it is becoming more obvious that a lot of people are affected directly or indirectly by cancer. It requires us to talk about it to learn about experiences, not so to give cancer prominence in our lives but for ideas to help with dealing with diagnosis, prognosis, therapeutics, and post-treatment of cancer.

The value of experience

The expertise and the experience of others have helped me a great deal. Colleagues whose parents have had or are undergoing treatment for cancer along with the issues that entail managing the disease all matter for understanding how it affects people and what accommodations might be necessary for their return to normalcy.

In my case, I am now five months after I commenced treatment for malignant adenocarcinoma of the prostate with hypofractionated radiotherapy. The two lingering consequences of the treatment are involved with my bladder, a known side effect for which I am taking medication and a rare and unusual side effect that pertains to the change in my voice.

A good outlook ahead

My GP has been informed by letter to initiate an investigation of the voice with the possibility of an otorhinolaryngologist (ear, nose, and throat consultant) referral.

I know nothing would happen until I make a fuss about it, as I always have to with adverse blood test results. I guess I am more preoccupied with getting back to normal, but if this persists beyond my next appointment with the oncology department in April, I will be agitating for action.

In general, I feel good, I need to adjust my sleeping patterns as I do not seem to be getting enough sleep at the right time of the day as I should. Things should improve rather than deteriorate, the prospects going forward are good.

Blog - Men's things - XXII

Blog - Photons on the Prostate - XVI

World Cancer Day 2025

Understanding a cancer diagnosis

For so long, I had viewed my story through the prism of my first encounter with cancer in 2009 and the gratitude with thankfulness for not only having survived but thrived when at the time of diagnosis research studies indicated my kind of situation rarely gave survivors another ten years.

This time last year, my request for a routine blood test began another journey to a new cancer diagnosis, over four months through tests and investigations, I learnt in June by an inadvertent medical disclosure of adenocarcinoma of the prostate.

Choosing and curating the people with whom to navigate the journey through the diagnosis and the treatment of cancer is a strange thing, people generally do not understand cancer and the way you present may not essentially indicate how seriously ill you are. Maybe, experience is the best teacher, if the observer is not self-absorbed. [World Cancer Day: What Is Cancer?]

Living a cancer reality

You take each day as it comes, the process of recovery after treatment is long and you can find yourself impatient when you realise you do not have the reserve of energy that deceptively comes in bursts and then deserts you literally abruptly.

Along the way, I have had such amazing support and understanding; the theme of World Cancer Day seeks to “create a world where we look beyond the disease and see the person before the patient.” In general, I have been seen and there are times I have wrestled with the experts to be seen, this has been encapsulated in the assertion that “It’s my body first before it’s your guinea pig.”

When I think of cancer, I think of many who have not been as fortunate, who suffered in ways impossible to articulate, then of those of us who have come out at the other end with our unique stories, and the united effort of medicine aggregating the body of knowledge acquired from all experiences to battle cancer to victory for our humanity.

More importantly, I focus on faith and hope, a future better than today where cancer is caught early and treatable. The best situation would be to avoid cancer completely. My advocacy is getting more black men to talk about Men’s things honestly, freely, confidently, and proactively for our lives and those we love. Here’s to World Cancer Day 2025.

Blog - Men's things - XXII