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

The biannual went well

Under the weather a bit

It started with a strange feeling in my throat, like the onset of a sore throat, that I knew I was coming down with something and I thought I could ward off the effects with gargling TCP in the weekend. Now, TCP that has been on the market in various forms since 1918 would not receive a ranking in taste department as both the taste and smell is vile, but it works.

However, I did not succeed, for by Monday, I had a running nose and cough along with the concern that I might have acquired Omicron XE as all the classic symptoms of a common cold presented, the running nose, the sneezing, the apparent fatigue, and occasional aches and pains. As a fully vaccinated person with a booster and prospect of another booster next month, the symptoms were supposed to be mild, in any case.

Thankfully not COVID

Even though I went out for my walk on Monday, I was not that disposed on Tuesday and today was supposed to be my biannual check-up at the hospital, so, quite early this morning I conducted a COVID-19 Lateral Flow Test to be certain whether I could attend my appointment or not. I came out negative, and that was quite gratifying.

Having taken the day off for this, I set out this morning for my appointment calling an Uber cab to transport me over, yesterday, I was not particularly agile and this morning, I was less inclined to affect any agility, I felt tired, and a bit worn out, but quite lucid too, my voice a bit croaky but the coughing had subsided.

All systems are good

Soon, I was at the waiting area, some 15 minutes early for my appointment when I was called to have my height, weight, and blood pressure measured, before I was invited into the consulting room by the main consultant who I had not seen in probably 2 years. There were two observers in room with her, a student and a junior medical doctor with whom I exchanged greetings before we started our discussion.

All indicators looked right as I learnt more about the tests that were conducted, the indication that protein in my urine would signify issues with my kidneys, the side effects of my medication that could impact on bone density, and I was informed by the junior doctor who happens to be part of a kidney study programme I elected to join some years ago that we would contacted over the next few months.

Get to living well

Besides all that, I did not have many questions, I was happy with my medication for which I had a renewed prescription for 7 months and after other conversations about lifestyle, Vitamin D deficiency, weight control and some predispositions we need to aware of, we agreed for another appointment in October. One assurance I had was if there were any particular indicators of concern in the results of my blood tests, they would be immediately acted on.

After which, I gave a urine sample and like draw blood out of stone, one of the veins in my right arm allowed the filling of 7 vials and then a 15-minute wait at the pharmacy before I left the hospital. I would typically have walked to the ethnic shops after my appointment, but I felt a bit fragile and it was a bit chilly, so, I took a cab to the shops and then one home, had a meal, called Brian and then went to bed.

It would seem that has served me well, I feel much stronger and well, and much as I am tempted to go for a walk, I might just step out for some fresh air rather than for strenuous exercise. The slight swelling and bruising when I had blood taken from is now better, the phlebotomist was more careful that when I had more holes than a colander poked into me for blood, the last time. I am grateful for good health, life, and a sense of wellbeing. 

Thought Picnic: Levitating on the confusion some have about me

This is who I am

On the public pages of my Facebook profile, I wrestle with the urge for an outburst whilst exercising considerable restraint. To be honest, I don’t do much on Facebook, the greater traffic of material comes from Instagram.

I take pictures and write long captions to them and post on Instagram, with the option for the same posting to go to Twitter and Facebook. Before Facebook severed the automatic posting facility from Twitter, the bulk of traffic to Facebook came from Twitter.

Other activities on Facebook involves posting reactions to comments, I find I can get involved in several discussions, debates or disputes, it is all good for engagement.

I am not taking that

However, the issues on Facebook are some questions that get posted to inputs from Instagram. I was kissing my boyfriend and someone I hadn’t had any interactive contact with for over 3 decades came round with the question – What am I seeing? I didn’t bother answering the person, I deleted the question and eventually removed him as a friend.

Nothing is as annoying as people who have lived abroad for decades but have not escaped the myopic frame of reference that limited their vision of a diverse humanity since they were in Nigeria. It is no secret lest there be the surfeit of assumption, my normality is different and probably does not fit in the concept of the normality of others. I am different, not abnormal. Difference is a function of diversity, not one of abnormality.

I owe no explanation

There are realities about myself that I know, and I do not need to explain to others, just as I do not intrude in the affairs of the busybodies who cannot hold their counsel. All the conclusions you probably want to draw have been drawn, I am not conventionally married, I have no children in or out of wedlock and fundamentally, I have never been attracted to the opposite sex.

It is something not understood in some societies, yet it is fully understood in others from a scientific, medical, logical, psychological and physiological perspective that we not only have the abrogation of Victorian-era laws but the promulgation and enforcement of laws and rights for protection and acceptance of the somewhat minorities who need not fear to be themselves and in that thrive as worthy and celebrated members of their communities, little and large.

My life is not a lifestyle

Then let’s disabuse ourselves of that misconception, lifestyles are about choices you can make when there are options available to you. Sometimes, a lifestyle is an adoption of a persona, a façade, a veneer behind which you hide, hoping no one would find out who you are. A lifestyle is usually looking for a sort of conformity, a pretension to normality you do not have, and you are constantly looking for a mask when you’re not looking in the mirror.

Living your own life is a long way from living a lifestyle, it is the point where you have become true to yourself regardless of what others think. It is where your individuality is expressed, and uniqueness is what you choose to be. It is where your heart beats, your soul rests, your mind sings, and your happiness begins to glow. Life is where you are becoming the best of who you are not caring about pleasing anyone, but if anyone is pleased, it is a bonus.

Life is where you have accepted who you are and know you do not need a cure for who you are. It is also where you can travel with those who accept you and jettison those reject you. It is where you soar like an eagle and find the champion in life that you are. I would marry who I choose to love and marry, and we would together decide what we want to make of our own family. Those choices would not be made for me by anyone else other than with whom I have chosen to live my life.

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It's my prerogative

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In the same vein

Over the last few weeks, I have written a few blogs on parent-child relationships because I have had to run the gauntlet of issues that are probably not unique to just myself.

It was only eleven days ago that I blocked my father on both Facebook and Instagram because I think he crossed the line from participating in my social environment into interfering with it. Some might think that was a drastic step to take, but I did not second-guess that matter, I was incensed and riled up about it, I had no other alternative than to take that action.

Then in conversation with one of my best friends, we discussed how I should have cut him a bit of slack, it is probably excusable that he confused my life with his views of a lifestyle, conflating them in misunderstanding the differences and by that overstepped the bounds of matters that are particularly mine alone and no one else’s.

Between life and lifestyle

Life is an encompassing issue that engenders the participation of every aspect of a person, in living, in livelihood, in relationships, in the community, in society and whatever area of endeavour. In life, you live, you love, you face options, you make choices, decisions can be life-changing and it could be quite different from the norm. But one person's norm might well be the abnormal of another, which is why we find accommodations and the openmindedness to live and let live.

When a person finds love and a relationship with another regardless of gender pairing; whilst it might court controversy, that is life in action, not the passing fad of a lifestyle. There are hearts, minds, bodies, and souls engrossed in this unique journey of soulmates. You cannot for the want of conformity complicate or upend the life of another to satisfy the wishes of some construct or societal mores.

Too many people have been hurt by unsavoury, imposed, or unwelcome matchmaking in the hope that something might blossom out it. Just that you think someone is good from your perspective does not mean, that is the best match for the person you think you're helping get hitched. It works for some, it is not the solution for many, we have just one life to live than to grin and bear it with misery, trying to adjust to the requirements of others when your persuasion and inclination is completely different from what they hope for or expect.

That’s my prerogative

I would spare people the agony of living through the experience of seeing the alien expressed on my living and online persona, why bring them so much grief? The liberal use of the block with that in mind does not seem that cruel or drastic anymore.

I hope to afford my parents, my relations, my friends, my acquaintances and interested persons along with complete strangers the opportunity to participate in my social media world, however, if the said participation slips inadvertently into policing my activities; I would without hesitation put a stop to that participating without recourse for appeal or redress.

My social media space is my fiefdom, if you violate the unwritten rules of respect and circumspection, you will be excluded, no matter how close you are to me. That is completely my prerogative and it would not be yielded to another for review. Just let me live.