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

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

Photons on the Prostate - XXI: Living with the Trade-Offs

Following the Rules

It is somewhere between following my own rules of "Go Before You Go", or the situation making the rule irrelevant because it simply did not apply. I left church yesterday feeling alright and planned my route home in the rain.

I stopped off at Marks & Spencer, hoping to get a Christmas cake: that thick icing covering the juicy and moist fruitcake, that bargain offer after the season, going for a song. They had everything but that.

I could have made for home directly, but I took a circuitous route, going through an arcade or two, hoping to see a cake shop, until I was approaching home from an entirely different side of town.

The Cold Walk Home

As I was walking through the breezy, cold, barely above-zero weather; a scenario that activates the bladder at a higher frequency and urgency. I quickened my steps, hoping to get home just in time. Much as I did enter the foyer intact, I did not make it into my apartment before an unfortunate recurrence of something I thought was history.

I can report that I have a sufficiently longer time between visits to the toilet, though I might wake up thrice during the night for that too. I do try to gauge what opportunities I have to get to places before I need to wield my "Just Can't Wait" card. It is, however, not an exact science.

Managing the Reality

This is something I have grown accustomed to living with. The apparent safety that incontinence underwear offers means the dangers of embarrassment are reduced. It is usually a leak, then a full wetting.

In view of this, getting rid of prostate cancer through treatment, rather than having full bladder, bowel, and sexual function whilst under the threat of cancer you cannot predict, is always the better option. I would write on the matter of sexual desire at some point.

References

Blog - Men's things XXX: Let's talk 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 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 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.

Urinary incontinence: One of those prostate things

Not holding tight enough

I found myself looking at a range of men’s underwear for a particular issue when I realised that my sturdy resolve to postpone a nature call until a time when I could access suitable conveniences was leading to embarrassment.

The pair of red trousers I wore recently turned a dark shade due to wetness, but I was literally at my front door, and the little control I seemed to have before was no longer effective; I had just wet myself.

As it stands, this is the second time I have had to deal with urinary incontinence in a week. It is cause for concern as it is understandable that the complete resolution of prostate issues will take time.

Wear to wherever

For the long-haul flights to and from South Africa, my incontinence underwear cost a fortune, and their care required special washing machine bags with a low-temperature and gentle cycle programme.

Tena seems to have a more affordable range with less stringent maintenance and care factors to keep them in use. Most of the time, I do try to be near public conveniences, and it also makes sense to use them as often as possible, to avoid being so hard-pressed and causing a mishap.

Generally, these are for leaks rather than for full flows; containing this within the underwear rather than allowing it to show around the front and down the trouser leg could be a saving grace too.

A second fainting spell, fifty years apart

Just a lift too high

He lifted my right leg by the foot towards the back, and I was out. I cannot tell how long I was out for, but I eventually came to, and considering he neither panicked nor called for help, it could not have been that long.

That was fifty years ago, around this time of the year. We had gone cycling together into the wilderness among the tin mines of Jos, near Rayfield. This was both adventurous and dangerous. We once came upon a gathering of menacing men who not only shooed us away, but they were also quite threatening, though it is unlikely that reporting them to the police would have made much difference.

On that day, we had ridden out on an uncharted route around the paddocks, too deep to approach, with standing water that spelled danger and death by drowning, with the possibility that one may not be found at all. However, that was a story of childhood.

Woozy, down and out

What brought back that memory was suddenly standing up, and I had a serious woozy feeling, very much like when I took my eighth COVID-19 booster on Monday. I had willed myself back from the pharmacy to the office and sat down; everything seemed to sort itself out in minutes.

This time, I grabbed onto something, thinking I was holding on until I heard a crashing sound. It was me hitting the floor, and I lapsed into a kind of dreamland, believing I was still holding on and about to get up.

I was out, quite totally out, and I cannot remember how long for; I just realised I was picking myself off the floor and made for the sofa to sit down and gather myself together. What just happened? I had a fainting spell.

A bit delicate, I realise

Until this afternoon, I had handled these sudden drops in blood pressure caused by standing or sitting up quite well. I think it was exacerbated by my medication, which, as an alpha-blocker, could accentuate light-headedness and, in some cases, lead to passing out.

It was not a side effect I had associated with the medication, having only learnt of this usually rare side effect from a YouTube video this morning. [The NHS: About Tamsulosin]

While I have tried not to feel too delicate in my recovery stretch, the reality suggests that I need to be more careful and considerate of the unforeseen events that could put me at great risk and peril. The knowledge is helpful, and I am doing quite well after that episode.

Postscript: The medication for the treatment of benign prostate hyperplasia (an enlarged prostate), also treats high blood pressure.

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

Whither the weather

As we reach the end of spring with the impending arrival of summer, the little sunshine that offers a sense of warmth might lead you to do silly things.

That is how I left home yesterday evening in shorts and a shirt without a vest or singlet. It felt warm enough to be daring. And since I wanted to make up my steps for the day, the exercise would serve as protection against the elements.

On the first leg of my outing, everything felt fine until dusk crept upon us unawares. The first supermarket I visited had the lamb I sought to buy, but I was not particularly enamoured with the brands of tomato puree.

Getting across town

I knew I had to get to the other side of town to a shop that carried the brand I needed. With barely 70 minutes to spare before the shop closed, I boarded a bus back into town and then another out to the shop. The bus traversing the route directly from the supermarket to the shop was not expected for another 24 minutes.

By the time I boarded the bus from the city centre to the shop, a cooler breeze was blowing, and I could feel it on my legs and through my flimsy clothes. The added discomfort meant I had to find conveniences when I alighted at my intended bus stop.

I just can’t wait

The shopping centre was closed; I walked into the nearest public establishment, a casino, and asked to use their toilets. The receptionist was about to tell me the toilets were only for customers, but I showed her my Just Can’t Wait card on my mobile phone.

The Just Can't Wait card in the Bladder & Bowel Community app.

She quickly retrieved a key from her desk drawer and directed me to the toilet. What a relief that was. As I handed back the key, I thanked her for her understanding. This is the second time I have had to brandish the card. When you are pressed, you can only press for the conveniences, to handle that pressing need.

Blog - Men's things - XXIV

Blog - Photons on the Prostate - XVIII

Photons on the Prostate - XVIII

Just Can’t Wait

At the culmination of radiotherapy for prostate cancer in early October, apart from the fatigue, I had serious bladder issues accompanied with pain and the regular inability to pass urine. Any time I stepped out of my home, I needed to know there was a convenience about, because I needed one within 30 minutes of leaving home and frequently thereafter.

While I had many conversations with the Macmillan Cancer Support nurses, it was the Cancer Support Nurse Consultant that came through my employer’s insurance services who was the most helpful, in that, she had the time for extensive conversations and the knowledge to deal with issues around cancer, treatment, the management of the side effects, and recuperation.

On her advice, I got the Just Can’t Wait card and a Radar key to facilitate urgent access to conveniences when needed. The times they have been life savers and helping the avoidance of embarrassment are precious beyond expression.

Changing side effects

On one of our conferences when I talked about the changing side effects I was experiencing, she intimated the side effects are not textbook experiences that would occur as indicated in the various medical notes referenced. Some may never occur or would occur at different times for different people depending on innumerable factors. I just had to work through them.

To deal with the pain beyond easing the constriction of my much-enlarged prostate after radiotherapy, I was on Codeine which I later learnt metabolises to morphine in the body. This informed my moderated use of it to avoid addiction.

Rather than adhere to the recommended early dosage of two tablets up to four times a day, I only took two tablets at night and immediately weaned myself of it once the pain had subsided, some six weeks later.

Until recently, I have had no bowel issues, they were slightly irregular, but I had no urgency pertaining to that. Codeine could exacerbate constipation, so, I did take a laxative just to avoid complications. It never really came to that.

Please, toilet, now

However, lately, I think I have been quite daring with my outings, I have had some uncomfortable bowel urgencies that have had me considering how I navigate my city and my outings. Pitifully wielding my Just Can’t Wait Card and rushing to access a disabled toilet with my Radar key while preserving my dignity, is a test of composure without paying much heed to embarrassment. Needs must.

Yesterday, as I attended the Pearson Vue test centre to take a Microsoft Certification examination, I had missed the direct bus to the location, the alternative was a longer walk than I anticipated, and soon I realised, having a toilet nearby would be a great relief.

We are required to register at the reception but there was no time for that, I walked in and emphatically said, “Please, can I use a toilet, now?” The receptionist helpfully directed me to the toilet dispensing with the required formalities until after my emergency.

Today, halfway back from shopping for ethnic goods, I knew I had to find a toilet before boarding my next bus as I was unsure nature would allow me to avoid any embarrassment.

One would think a shopping centre would have public toilets, but what use are they when they are closed? Even as many public toilets have been closed due to cuts and other issues, I am becoming more aware of people with bladder and bowel issues are limited in their abilities to leave their homes.

The large Tesco store behind the vaunted shopping centre came to the rescue, I would not have survived realising they had no toilets and thankfully, the disabled toilets were close by.

More toilets needed

We can wear incontinence underwear or some with even more serious abdominal issues might have colostomy, ileostomy, or urostomy bags to divert waste or urine from the body where the natural organs have been bypassed due to medical issues. [Salts Healthcare: What is a stoma?]

You do wonder if some public action is required to address access to more public facilities without the need to expose oneself to the indignities, we have little control over.

I am thankful the mishaps have been minimal, contained, or have happened so close to home that they have been bearable. Life is not just finding a toilet but knowing that you can find one when needed makes life a little more fun.

Blog - Men's things - XXII

Blog - Photons on the Prostate - XVII

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

A benign review of a malignant past

The shifting feasts of consulting

This was my third outing of the week after church on Sunday and the office on Tuesday. I had a rescheduled appointment from December that I attended yesterday. It was my usual biannual checkup, which has shifted from the April/October cycle to a January/July cycle in three years.

Once I realised, I would not be able to attend the early December appointment because I would be out of the country, I called to postpone the appointment and reschedule it to mid-January. I ensure I never miss my hospital appointments or consultations as it deprives others of time and audience with scarce medical personnel.

A miscommunication between us some 18 months ago meant I never received my expected scheduling for May, and we fell into a June/December cycle that only happened once. Besides rescheduling, I was promptly given a prescription to make up for the additional time.

Let’s keep to what we discussed

For this consultation, I had a few issues to discuss, the main one being the unfortunate mismanagement of information that I should not have received until I had met the consultant involved in that area of investigation and diagnosis. The computerisation of personal medical records meant that a certain diagnosis ended up in my clinic notes that the person I met should have redacted before forwarding to my doctor and I.

Blog - The note that crept in

The sinking feeling of reading a diagnosis of adenocarcinoma of prostate over a week before my scheduled appointment with the consultant urologist was as earth-shattering as it was a humbling reminder of one’s mortality. When I remonstrated with the doctor, he offered to redact the diagnosis, but what good was bolting the doors after the horses had bolted?

Meeting with the chief consultant of the team that had assumed my care for over a decade and she for about 8 years, she immediately understood the issue.

She said she would raise an incident with the multidisciplinary teams to ensure that they are aware of what information gets passed to the patient; that it is centred on their particular consultations; and that the more interested patients can assess seemingly hidden interdepartmental communications to read the chatter pertaining to them.

A malignant test of the benign

For me, what I learnt was the difference between the definition of malignant to the layperson and the medical establishment. When I read malignant adenocarcinoma of the prostate in interdepartmental communications, I read it as a qualifier of the type of cancer, something rampaging and very likely to cause death.

To the medical eye, malignant always means cancer regardless of stage or metastasis. The absence of cancer in the presence of a growth or tumour will be considered benign. [Medical News Today: What are the different types of tumour?]

My consultant patiently explained the terms fully to enhance my understanding. Other issues in my notes were from the perspective of the person I saw. Any similarities would suggest a lazy engagement, as situations and circumstances do change between visits.

All good and nice

We discussed the readings of my blood tests, and the need for new assays, though this time without a urine sample and at the end of my allotted time with a medical student present, I was handed on to the phlebotomist who had no problem drawing three vials of blood before I was sent on my way to collect my renewed prescription and I made my way home.

In all, the consultation was pleasant, and the typical readings were within normal range, it is likely I have lost a centimetre in height, and the physiotherapy to address issues in my spine will not commence until all the other medical issues are resolved.

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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