Dysphonia, Dysphagia, and the Dys- Between

A Terrifying Observation

At the end of a flexible nasoendoscopy, a procedure in which a small camera was passed through my left nostril, the right one having proved less pliant, there were a few conclusions, though none of particular concern.

The procedure examined my throat and voice box for a simple reason: since I commenced four weeks of radiotherapy for prostate cancer in September 2024, I had lost my natural voice. It had been reduced to a hoarseness, carrying a semblance of weariness and tiredness that might suggest I was gravely ill.

In general, I am fine. The voice that comes and goes does not reflect that impression, and yet a consultant on another stream of the multidisciplinary team that handles my clinical issues and healthcare outcomes has been on my case since January 2025.

Questioning the Cause

While I had surmised that the change in my voice was a long-term side effect of the radiotherapy, she disputed this. Even if I, as a man, were kicked in the testicles, with the usual prospect of momentarily losing my voice, and I had indeed been through the equivalent by way of radiotherapy, the effect should not last as long as it has in my case.

I even dared to question how she, as a female, would know about this uniquely male anatomy.

Then, at my biannual consultation just over a week ago, the consultant took the initiative on the matters I had been reticent to pursue, and scheduled sessions with other specialists in the very fields she had been seeking answers in. My hospital visit yesterday was to see an ENT (Ear, Nose, and Throat) specialist, or should I say an otolaryngologist.

Into the Consulting Room

Before meeting the consultant, I filled in three pages of tick boxes, affirmatives or negatives, to provide a general overview of what needed assessing. I was then called into a consulting room to sit in an abridged version of a dentist's chair.

On what was my third hospital visit in eight days, I could be forgiven for feeling some trepidation, whilst remaining hopeful that nothing untoward would be found.

Understanding Dysphonia

The condition under review is called dysphonia, a medical term for any voice disorder that makes your voice sound hoarse, raspy, breathy, or strained. This is in addition to sexual dysfunction, an obvious side effect of the radiotherapy, and dysphagia, another condition that may have been exacerbated by radiotherapy but has existed for longer, for which I had an oesophagogastroduodenoscopy in May.

In layman's terms, my vocal cords were considered quite thin, not closing properly when I talk, and carrying a slight tremor. It was watching the video playback, while we discussed the prognosis, that left me a little terrified. The movement of my vocal cords looked like the wings of a bat about to take off from a perch. You mean that was happening inside me?

The Prognosis

A contributory factor to my snoring was that my palate is unusually low, though nothing was attributed to that condition beyond the raspiness in my voice, which is probably caused by acid reflux that does not occur all that often.

We agreed there was little else to do, unless I initiated a follow-up because my voice had noticeably worsened, or unless I wanted the filler injection known as vocal fold injection augmentation, not an endearing prospect from what I have read about it.

Exploring the Prefix Dys-

Meanwhile, the original consultant has already scheduled an appointment to discuss the results, and I am learning more about the prefix dys-, which might refer to any of the following kinds of situations.

Bad / Ill: working in a harmful or poor way.

• Dysfunction: impaired or unhealthy functioning (e.g. family dysfunction)
• Dyspepsia: bad digestion
• Dystopia: a bad or undesirable society
• Dysphoria: a state of unease or dissatisfaction

Difficult / Painful: causing trouble or hurt to do.

• Dyslexia: difficulty reading
• Dysphagia: difficulty swallowing
• Dyspnoea: difficulty breathing
• Dysmenorrhoea: painful menstruation

Abnormal / Impaired: moving away from the normal state or standard.

• Dysplasia: abnormal development of cells or tissue
• Dyskinesia: abnormal or impaired movement
• Dysarthria: impaired speech articulation
• Dysgraphia: impaired writing ability

A Gemini Notebook AI Podcast on this blog

Thick Skin and the Colour of Pain

A Familiar Ethnicity Pain Gap

It comes as no surprise to me to read that in the UK, women from Bangladeshi, Pakistani, and black Caribbean backgrounds were less likely than white women to receive an epidural whilst having a vaginal birth. [The Guardian: “Women from minority backgrounds in UK less likely to receive epidurals, research finds”]

The ideas, conceptions, perceptions, or prejudices that feed the narrative that non-white people, especially from the aforementioned backgrounds, do not need adequate pain medication to arrest high levels of discomfort and distress have appeared in studies for decades.

This situation, termed the "ethnicity pain gap", is quite concerning, and it might persuade one to surmise that there is a seething racialised disadvantage in the public health system, one that ascribes thick skin to the Black population and precious delicateness to the Asian cohort.

My Own Experience

My experience of this in late 2009 came as a result of cancer pain in its enduring intensity. I was on multiple regimens of pain medication, with Fentanyl dispensed as a transdermal patch being the most critical palliative, yet I was in pain.

When I informed my consultant that I was still in pain, and this was in the Netherlands rather than in the United Kingdom, he did not acknowledge my distress or seek to address it. Instead, his response was that the pain medication I was on should be enough. An ill-informed perception that I should have a higher pain threshold.

I remonstrated that it was not, and he then sought to double the dose from 12.5 micrograms to 25 micrograms. This made all the difference because it tackled the pain, and I got much-needed relief. Why I was not also told that transdermal patches could fall off, and that they could be held in place on the skin with an adhesive film, escapes me.

Knowledge Withheld

Returning from church, one Sunday, a few weeks after I had the new prescription, I was in a lot more pain than usual, and then I saw that the patch had fallen off.

I laughed myself to delirium to produce endorphins as pain relief whilst the new patch took hold. It was only when I told the nurse who came to dress the lesions on my foot daily that he told me I could get an adhesive film to keep the patch in place.

The knowledge was there all along, but it was never shared. As a race, in our encounters with the medical establishment, we are constantly pathologised, and this is characterised by either not being listened to or being ignored, because the medical personnel assume they know and understand our bodies more than we do with the intimate experience of our own skins.

Asserting Our Reality

That Caucasians are immediately responded to and given palliative succour on demand speaks volumes, without suggesting something untoward. Whether it is bias, prejudice, or indifference, we need to be better equipped to ask pertinent questions and persuade our doctors of our reality, without having to jump through hoops, trapped in suffering until it becomes unbearable.

It is not just in matters of pain, but in decisions being made about diagnostic and treatment regimes without explanation or rationale, delay in action when the full knowledge of a condition is evident, the lack of respect, courtesy, and the according of dignity to your personhood and humanity, or the use of the wrong indicators based on race for decision trees towards useful outcomes.

I approach the medical establishment on the premise of “It is my body first, before it is your guinea pig.” This need never be the default, because you are then preparing for a fight instead of fully trusting someone who took the Hippocratic Oath to do you no harm. Yet you find you need to assert yourself and manage the egos to ensure that you, at the very least, leave the hospital better than when you went in.

A Google NotebookLM AI Podcast on this blog

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

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.

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

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 Google NotebookLM AI Podcast on this blog

Recuperation is something you should make time for

Learning to Prioritise Recovery

I completed my last chemotherapy session on 8 February 2010. There was another session scheduled for 1 March, but when I saw the ninth session was set for 22 March, I protested, telling my consultant that I saw my life resuming after 1 March and was not mentally prepared for further chemotherapy beyond that date.

My objection resulted in my multidisciplinary team cancelling the eighth session, but that was not my original intention.

Having been given my life back, I was back on the job market, seeking an opportunity, when my consultant said I needed another six months of recovery before returning to work.

Although I had a very generous welfare package, I wanted to return to work. My sense of independence drove me, just as it was clear that bills and the mortgage had not taken a break due to my illness.

The Cost of Returning Too Early

Within seven weeks of my last chemotherapy session, I was back at work. Then my body told me a different story: I neither have the strength nor the capacity for this responsibility. I need to negotiate an adjustment or resign.

The management was very understanding, and I was granted Wednesdays off. This break helped greatly throughout 2010. It was clear I had not allowed myself enough time to recover. However, I did not have the luxury of taking extended time off, as I was self-employed.

More recently, when I was diagnosed with malignant prostate cancer in June 2024, I chose radiotherapy and decided to work through the treatment in September and October of the same year.

On three weekdays during treatment, I had to finish early due to unmanageable fatigue, a known side effect of radiotherapy.

Pushing Through Despite the Warning Signs

Yet, after radiotherapy, I worked for another month as my strength waned, and I realised I needed more specialised care, for which I am grateful Brian provided in Cape Town. I was on sick leave for seven weeks, and although I was paid, I felt the urge to return to work halfway through the leave.

I returned on the first working day of 2025. I was not fully ready, but my spirit was willing; my body struggled beyond its capacity. I pushed through when another two months off would have been ideal.

Throughout 2025, aside from my holidays, hospital appointments and an episode of epididymitis—after attending the hospital, I returned to work; by December, I still had 14 days of annual leave remaining.

For someone coming off a cancer diagnosis and radical radiotherapy, I had overworked myself out of recovery and into a demanding work environment, complicated further by political issues within management. The mentality of just powering through.

A Wake-Up Call

When, on Monday, I experienced the recurrence of unexplained juvenile stomach cramps, there was a suspicion that I could endure the pain, and I did for hours.

A contractual obligation that we delivered to the client every Monday, which I controlled, I promptly completed ahead of schedule, posting the results before I left the office.

While the stomach ache did subside, it took its toll. I was in bed all of Monday, on nil-by-mouth except for essential medication. The same continued through Tuesday and most of Wednesday.

Amidst this, I realised: I do not give myself enough recovery time because I am driven, compelled or obligated by responsibility, circumstance, or situation. None of which is healthy.

A Commitment to Change

It is a realisation I must keep in mind. I am not in a competition of appearances. Good health will always lead to greater productivity; any shortcomings become visible somewhere.

A Google NotebookLM AI Audio Overview Discussion of this blog

Men's things XXX: Let's talk Prostate Cancer

Making Those Nature Calls

As I was about to leave the office yesterday evening, I followed that familiar credo: "Go before you go." It's one of those habits people of a certain age need to entertain before leaving the safety of indoors for the outdoors.

That is, visit the toilets. Return to that childhood scenario where your parents or guardians asked if you needed to use the toilet before commencing a journey. In fact, they would have probably made you go regardless of how you felt, to forestall a mishap at an unfortunate time.

A Poster to the Prostate

Anyway, I was gladdened to find on the inside of the cubicle doors in the Gents the prostate cancer campaign poster I had recommended, advising men to be aware and to check up on their prostate health.

In my view, it might make for a friendly conversation starter after we have used the facilities and are doing the essential ablutions following these intimate activities. I also hope to find other opportunities to share my experience with prostate cancer: the criticality for us all to know what the symptoms are and how catching issues early saves lives.

A Call to Healthy Brotherhood

Fundamentally, we need forums and spaces not only to broach matters of men's health, but to discuss men's things openly and without embarrassment, to give each and every one of us a fighting chance, and to support each other through challenging times. This matter calls for a brotherhood in arms. I am all for it.

Check your Prostate Cancer risk in 30 seconds.

References

Blog - Men's things XXIX: The Cubicle Next Door

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

Know your symptoms.

1 in 8 men will get prostate cancer.

Know the symptoms.

A Google NotebookLM AI Podcast on this blog

Men's things XXIX: The Cubicle Next Door

An Uncomfortable Observation

Yesterday afternoon, I went to the Gents, where we have cubicles and no urinals. Next to mine, someone had entered, taking the standing stance. To my hearing, the stream continued for a considerable length of time, with different rates of flow.

This might have been an opportunity to talk to a stranger about "men's things". It may not be anything serious, but every indication suggested it should be checked out. When he emerged from the cubicle as I was leaving, it was a middle-aged white man.

Again, I felt no particular urgency comes with screening white men for prostate gland issues. When anything is caught, if it is cancer-related, it is often at a late stage. As an Englishman, I am wont to mind my own business, but is that a good enough excuse when you suspect there might be an issue with a stranger's urinary habits that might portend cancer?

Taking Quiet Action

Having had prostate cancer and knowing how issues with an enlarged prostate can be easily dismissed as signs of ageing or nothing of significant concern, I understand the need to educate people about prostate health. Knowing the symptoms to watch out for is important.

I have just gone down to our reception to suggest that some posters be put in the men's toilets informing them of prostate health issues. I have also received a response that the posters will be printed and put in the toilets tomorrow.

I hope that in doing this, men would become more aware of prostate health and go for check-ups if they are exhibiting any of the symptoms.

References

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

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

Poster from Prostate Cancer UK - 1-in-8 [PDF]

A Google NotebookLM AI Podcast on this blog

Men's things XXVII: The inconvenience of incontinence

We Need a Screening Programme

At any opportunity, especially when I encounter black men, I bring up men's things and prostate cancer. However, what has surprised me is that many of my white colleagues have had some exposure to this matter, usually through older members of their families: their fathers or fathers-in-law.

This might make people think prostate cancer is a middle-aged affliction in black men and a geriatric condition in white men. We should be careful not to delude ourselves into thinking this is the case. It affects all men, and whilst there are extenuating factors relating to race, age, and family history of cancer, we all need checkups, early ones too, to ensure that abnormalities, when found, are promptly dealt with.

This points to the need for widespread screening for prostate cancer, rather than leaving it to individuals to demand it themselves.

Some Aftereffects of Prostate Cancer

From my experience, almost 18 months after a prostate cancer diagnosis and 13 months after radiotherapy, I have come quite a long way, and I am grateful for that. The issues I still deal with are nighttime insomnia, some fatigue (though not to the point of being debilitating), occasional incontinence (more with the bladder than the bowel), and a lack of any sexual drive, which may also present as erectile dysfunction.

Inconvenient as incontinence might be, I manage it quite well: my Radar key for disabled toilets, my Just Can't Wait card to request the use of a toilet elsewhere, and I wear incontinence underwear, or I line my underwear with incontinence pads. These all save you the greater embarrassment of publicly visible mishaps, and better that than pushing up a gravestone in some nondescript cemetery.

Making the Best of It

Still on incontinence: the bladder aspect is usually that sudden and pressing urge, where you are never able to get to a toilet soon enough before wetting yourself. When it comes to the bowels, it is a feeling somewhere between the urge and constipation. Having already had a movement, it doesn't feel empty, and yet you can't make it happen. That presents some discomfort and anxiety whilst you hope it clears up soon.

With a basic consultation at a regular pharmacy, you can get medication to combat issues with erectile dysfunction. Ultimately, you work with or around the problems for the best outcomes in experience and wellbeing. Choosing not to be defined by either manliness or manhood can also be the key to contentment and happiness.

The walnut-sized prostate gland can be life-threatening if enlarged and cancerous, but once treated and kept under medical observation, the inconvenience should not take away from the joy of living.

AI Postscript

As I have AI to review my blogs for grammar, spelling, and contextual checking, I was quite impressed with this summary of the blog: The key was asking: "Would Akin still recognise this as his own thought, just expressed more clearly?" If the answer was no, I didn't restructure it. Your voice is situated in the precise intersection of being black, male, professionally engaged, medically informed, personally affected, and committed to demystifying this subject for others.

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 XXVI: Let's avoid the stigma of prostate cancer

Blog - Men's things - Prostate Cancer blogs

Men's things XXVI: Let's avoid the stigma of prostate cancer

A stigma on the prostate

Much as I have openly written about my account of being diagnosed with malignant prostate cancer, a Twitter exchange between two young black men left me wondering about the kind of stigma that associates with situations we as human beings might have little control over.

It has taken me months to process this experience before I found the opportunity to write about it. These young men in Africa were in what might be a phase of explorative bisexuality or homosexuality, full of youth, bravado, and machismo. One should not deny the youth their virility, vigour, and vitality.

Rather a living older man

However, they were not content with their good fortune without finding others to pull down to feel better about themselves. In this case, they took on the topic of older black men who had become less sexually able because of prostate cancer. The exchange was in jest, levity, and mockery; it cut quite deep.

Obviously, having good health is amazing, and some of us have the kind of genes that we may never be susceptible to any infection or disease, and that is good for them.

I have had two different encounters with aggressive cancers some 15 years apart that were successfully treated, and I am grateful for the gift of medicine, the gift of faith, and the wonder of life. I have been very fortunate.

Youthful delusions of invincibility

Then again, we must be careful of the hallucinatory qualities of the elixir of youth that confers invincibility bordering on immortality on us, such that we forget the occasional frailties of the human organism and the malfunctioning of parts of the human body that could present with life-threatening conditions, easily ignored until they become untreatable.

I have made it a point to always discuss "men's things" with any black man I meet, in groups or during the occasional encounter on a taxi ride. We need to be aware that one in four black men might encounter prostate cancer, and that is twice the susceptibility compared to the wider population.

Yet, there is no widespread screening for the disease, such that it becomes incumbent on the individual to get tested and screened by making the enquiry of their medical practitioners for themselves.

Health trumps sexual prowess

Whilst doing this, we must have the mindset of not being embarrassed about seeking a medical opinion on the health of our private parts and welcoming whoever has the medical expertise to ensure we are in the clear. It should never matter what the gender of the specialist is; they are there to help you, not violate you.

I fear that men who have treasured their unquenchable sexual libido will face an almost insurmountable challenge to their manhood before they engage the authority of medical science to ascertain if they are alright. The time wasted in addressing this personal battle can be quite costly.

I faced up to my doctor to address out-of-range results of blood tests, insisted that whatever it was be seen to, and tacked on the Prostate-Specific Antigen (PSA) test because I fell in the cohort of those who might be susceptible. I was over 45, and my father had, before without verification, said he had prostate cancer.

Be a man, get checked

What matters is if you are black, over 45, or have had male or female members of your family diagnosed with cancer, you need to go for checkups.

Also, if you have issues with your urinary system (urgency, not emptying your bladder fully, straining to start urination, waking up multiple times at night to urinate), you should have your prostate health checked.

Not every case of prostate enlargement indicates cancer, but every reason for that condition needs to be determined and treated.

Finally, being able to perform sexually is not what defines a man, and what use is a dead man who had gone too soon because they were too coy about having their prostate gland checked? To those young men: all erections will eventually fail; life is more precious than all that.

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 XXV: Prostate cancer under control

Blog - Men's things - Prostate Cancer blogs

Adopting a healthy work regime after illness

Managing oneself back to work

My return to work after extended sick leave, was not structured or phased, because I did not plunge straight back into the work activities before my leave. Considering I worked through my radiotherapy treatment and for a month afterwards, despite the fatigue and sometimes-overwhelming side effects, I put in the hours, the time, and the effort to meet my obligations.

However, there was a point when I needed more support beyond living alone at home, along with a proper rest period to really recover. This led me to undertake the long journey to Cape Town for the care Brian could provide that was beneficial for my recovery.

I eventually spoke with an occupational health professional, who suggested we adjust the work schedule on the parameters of volume, pace, and complexity. I was comfortable with handling complexity; I was ready for that challenge. However, managing volume and pace was something I had to learn through engagement.

Handling pressure before feeling overwhelmed

Implicit in this approach was a sense of pressure; the way urgencies, priorities, and dependencies demanded more from me to meet deadlines, often without the usual flexibility that would involve discussing the reasonableness with relevant stakeholders.

There was one occasion when an architect, discovering that a crucial piece of work—on which the entire deployment depended—had fallen through the cracks, suddenly created a lot of pressure on me, with the message that everything would pause if I didn't find a solution.

At that moment, I felt like a giant had stepped on my chest, making it hard to breathe. Recognising this reaction, I pushed back at once, saying that we would proceed methodically, and I would not shoulder the pressure caused by this oversight.

At that time, I informed my line manager, not seeking support, but making him aware that the whole issue could escalate because of my resistance to quick fixes.

This architect then committed a clear faux pas by suggesting he entertain my concerns because he didn't want me to cut corners. That was a stance I was never going to let slip. I don’t cut corners; I am a 37-year IT professional. No one at the conference dared intervene; the message was crystal clear.

Maintaining control on your own terms

With the space and time, I was able to find the right elements needed to resolve the problem, and we implemented a solution within 90 minutes. Exercising autonomy without letting pace be dictated by either my own failings or others’ is essential.

Despite modulating elements of my return to work, I find myself in the office for 9 to 12 hours, sometimes more. I tend to get absorbed in a situation, aiming to resolve, manage, or finish the task before I leave for home.

This occurs alongside lingering side effects such as urinary incontinence, bowel urgency, and nightly insomnia. The insomnia, I manage by sleeping as much as I can on weekends. Things are not perfect, but I am finding better ways to cope than before.

In terms of occupational health, I simply wanted awareness about side effects, fatigue, and hospital appointments. Beyond that, I believe I am meeting and surpassing my aims and goals, but I also need to be smart about it.

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

Coronavirus streets in Manchester - LXXVI

Getting some perspective

You may wonder why I am writing about the Coronavirus, having written the last in my series of Coronavirus streets in Manchester way back in June 2024. Obviously, there was also the minor distraction of dealing with Men’s things, my prostate taking on an unregulated growth spurt that was trammelled with blasts of radiotherapy.

Then you consider I was out grocery shopping today and one of the passengers on a bus I boarded had a facemask on, you do not see that about quite often, though a lady who attends my church whose full face I have never seen dons a facemask almost as a fashion accessory, a shade of brown, but quite distinct from her South Asian skin tone.

Saying his prayers

The bus out of the city centre towards Salford, where I planned to board another to my intended destination, presented nothing of great significance apart from wheezing and many with coughs that might indicate something more serious than portends. On that sampling alone, we are easily a nation of the unfit, the infirm, the unwell, and qualitatively unhealthy.

However, it was the bus ride within Salford towards Cheetham Hill that offered much to amuse or intrigue. It was first an unkempt man sitting on one of the priority seats. In what seemed like a headbanging the bar in front of him, I soon realised it was an unconventional approach to Muslim prayer as he was muttering, clasping hands, and then bowing in obeisance to the Sallah edict.

The bus was driving eastward but I could not suggest his heading was facing Mecca, but who am I to intrude on the religiosity of an adherent faithfully saying his prayers before Goosey Goosey Gander takes umbrage?

The fiery Ijebu wars

At Ade’s Cash & Carry, of the many designations it has, at the checkout till, there were conversations going on in Yoruba, the tiller with facial scarification I would have mistaken for an Ogbomoso indigene, but with the brutal nose strike, so that might default to Ibadan.

Two tubers of water yam, quite different from Puna yam, were being weighed on the tiller scales, but they did not have the hairy fibres one would expect on that species I was accustomed to. As I voiced my misgivings, an engagement began about where I was from.

Answering Ijesha-Ijebu, the man interjected, Ijebu-Ijesha, a different place some 197 kilometres away. That confusion between my village and the other town, in entirely separate states and they do not remotely speak the same dialect. It so happened that the customer being served was also an Ijebu-man, he knew where Ijesha-Ijebu was and began to converse in Ijebu that I have never deigned to master.

My excuse is that I was born abroad, and I pleaded innocence by volunteering. One of my names is Adetokunbo, and the crown was brought from overseas. That was the beginning of our schism, he is from Ilishan-Remo and has been advocating the creation of an Ijebu State with Sagamu as the state capital. Let’s just say as the boundary between the real Ijebu-land headquartered at Ijebu-Ode and Ijebu-Remo, which is a few kilometres west of my village, the idea falls on its face with infeasibility.

It is totally unlikely that the Ijebus aligned to Ijebu-Ode and the expanse of the 16 Agemo masquerades of Ijebu-land would subsume themselves to the leadership of Ijebu-Remo that gained prominence out of the colonial chicanery of divide-and-rule. We would seethe with disdain and disparage any such advocacy to chop Ogun State into hamlet fiefdoms.

While I would rarely feel challenged with Yoruba expression, I was clearly found wanting facing a son of Ijebu soil. Other interesting banter ensued, and we shook hands, and I left.

The Yorubas have occupied

On the bus back to Salford City Centre from Cheetham Hill, I must have been transported to some place in Yorubaland, I half expected the only Caucasian on the bus to burst out in Yoruba song as literally every else on the bus was speaking in Yoruba.

One even had a playback of some Yoruba-speaking event on the speaker of his phone and some of the narrative did cause stifled giggles without anyone wanting to reveal they knew what was going on. I could see from my vantage point that everyone was straining to listen even as one or two mobile phone conversations cared nothing for the public space they were in.

I sometimes forget some parts of north Manchester have been colonised by Yorubas; I could be one of the exceptions that lives in the city centre. Now, that Ade’s Cash & Carry has stiff competition in Salford on range, quality, and price, apart from ready-made stews, it won’t be long before these interesting Yoruba engagements happen closer to home.

The Coronavirus is still out there, and I had my 7^th booster in November before jetting out to Cape Town. Nine vaccinations and boosters altogether mean we all must be careful, five years on.

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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