Men's things - Prostate Cancer blogs

A journey of discovery

Over the last 7 months, I have written a series of blogs about my journey to the discovery of malignant prostate cancer and the consequent treatment with radiotherapy along with the attendant side effects that I hope I am managing well.

I have compiled a range of blogs and annotated each to highlight how I navigated the issues that arose through each diagnostic and treatment stage.

The Men’s things blogs cover issues we need to be talking about and in this case, it is the prostate gland, the Photons on the Prostate blogs are of my experience having chosen radical radiotherapy for the treatment of prostate cancer.

Take the test

The need to have an eye on your prostate health is critical and you can start with the International Prostate Symptom Score (IPSS) Calculator. I did not know I had an enlarged prostate; I have always strained to pee and when it started, it was a weak stream with a feeling my bladder was not emptying completely.

It took a PSA test to determine my prostate was enlarged, that is always the first step, but your risk is heightened if you are a black man over 45, have had a brother or father with prostate cancer, or have had a sister or mother with breast cancer.

The technical terms are explained, linked, or illustrated in the blogs and I hope you find the information useful.

Men's things – Results of my PSA test have led to a Digital Rectal Examination; my doctor is concerned, and I received a referral.

Men's things - II – Taking a multiparametric MRI scan of my prostate gland.

Men's things - III – Why must I have a prostate biopsy? You have a PI-RADS score of 4.

Men's things - IV – Bear the pain under local anaesthetic as your reaction is informative.

Men's things - V – Some pain in the perineum, blood in the urine, and a few notes to self.

Men's things - VI – The wait can be a weight on your mind.

Men's things - VII – ‘Bring a friend’, suggests you might get some interesting news.

Men's things - VIII – Understanding your test results is crucial to having a voice in your health outcomes.

Men's things - IX – You have been diagnosed with adenocarcinoma of the prostate, I knew that already

Men's things - X – Finding yourself on a national cancer register after a cancer diagnosis.

Men's things - XI – Understanding the risk factors with prostate cancer in black men.

Men's things - XII – The daunting prospect of radical prostatectomy, not pleasant.

Men's things - XIII – Discussing the options for radical radiotherapy of the prostate.

Men's things - XIV – Holistic Needs Assessment managed by the Macmillan Cancer Support charity.

Men's things - XV – It is always your body first before it is their guinea pig, my journey of discovery.

Men's things - XVI – Centring the patient in the medical conversation, the Predict Prostate website and the ProtecT study.

Men's things - XVII – Radiotherapy planning session, a CT scan and my first tattoos.

Men's things - XVIII – Creating the right mindset for a diagnosis of malignant prostate cancer; faith.

Men's things - XIX – Image Guided Radiotherapy (IGRT) and the first experience.

Photons on the Prostate - I – Taking the first session of radiotherapy for prostate cancer.

Photons on the Prostate - II – Understanding the protocols and arrangements around treatment.

Photons on the Prostate - III – Independence, vulnerability, and seeking help during illness.

Photons on the Prostate - IV – Radiotherapy; how the linear accelerator works – YouTube video.

Photons on the Prostate - V – Dealing with the side effects of radiotherapy; tolerating fatigue.

Men's things - XX – Getting a sick note and the need to be conversant of your medical situation.

Photons on the Prostate - VI – At the halfway point, hypofractionated radiotherapy is explained.

Photons on the Prostate - VII – Reflecting on independent arrangements for out-patient attendance.

Photons on the Prostate - VIII – Dealing with the side effects of radiotherapy; fatigue.

Men's things - XXI – The International Prostate Symptom Score (IPSS) Calculator.

Photons on the Prostate - IX – Ringing the bell at the end of twenty radiotherapy sessions.

Photons on the Prostate - X – Dealing with the side effects of radiotherapy; the waterworks.

Photons on the Prostate - IX

Time shows up again

It never really occurred to me until a few minutes ago that fifteen years ago today, I was discharged from the hospital after an eighteen-night stay for a myriad of health complications manifesting in skin cancer, that ride back home to the security of my castle was the beginning of seeing life beyond cancer.

This afternoon, I completed 20 sessions of hypofractionated radiotherapy for malignant prostate cancer, I left the suite to ring the bell thrice to signal once again, life beyond a second and different episode of cancer.

“It was a bell of hope and expectation to us, the sound of enduring survival of the human spirit, and the herald of the beginning of the rest of the ringers' lives, free of cancer and thriving after cancer.” [Photons on the Prostate - IV]

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Appreciation and consideration

For this last day, I had planned to thank the receptionists and the multidisciplinary team separately with cards and gifts, I felt they were professional, friendly, considerate, caring, engaging, prompt to act, and exhibited good bedside manner understanding the kinds of human infirmity and vulnerability we all face. A little gesture of appreciation goes a long way.

Having discussed the issues with my prostate behaving like a kettle on the boil, they arranged for palliative medication to address this discomfort. The pharmacy had a 30-minute wait time for service requests; after my radiotherapy, I had forgotten to pick up my prescription, I was already halfway home when I remembered and returned to the hospital to retrieve my goods.

The last radiotherapy session was uneventful; however, I was given advice on how to manage symptoms, calling the hotline, which is open 24/7, and the possible follow-up appointment post-treatment in about six weeks.

In the aftermath of all this

I wished everyone good luck as I left the radiotherapy suites, 20 weekdays that began 4 weeks ago, quite daunting a prospect and how the passage of time helps pale into insignificance. I have not acquired a taste for still water, I am so looking forward to feeling that fizz on my tongue.

I still have dishwater (decaffeinated) Earl Grey tea and Nescafe instant coffee that I might drink in remembrance of this episode in my life, God forfend this becomes a habit. Then, I stripped off the transparent Tegaderm film dressings that protected the three tattoos I acquired for positioning me on the gurney of the linear accelerator. You might get marked by cancer; you do not have to be defined by it.

Photons on the Prostate blogs

Blog - Photons on the Prostate - VIII

Blog - Photons on the Prostate - VII

Blog - Photons on the Prostate - VI

Blog - Photons on the Prostate - V

Blog - Photons on the Prostate - IV

Blog - Photons on the Prostate - III

Blog - Photons on the Prostate - II

Blog - Photons on the Prostate - I

Blog - Men's things

Photons on the Prostate: My Life After Prostate Cancer Treatment

A Diagnosis at Fifty-Eight

I was just over fifty-eight when I was diagnosed. As a black man in the UK, where one in four of us will encounter prostate cancer compared with one in eight of the broader male population, the PSA test ought to have been offered long before I had to ask for it, especially as other indicators in my blood work already needed addressing.

An AI-generated infographic on the blog content. (Click to enlarge.)

I asked for it in early February 2024, and by the end of March my PSA had risen from 3.5 to 4.0. What followed I have set out in full in my earlier series, "Men's things" and "Photons on the prostate": the examinations, the imaging, and the biopsy that confirmed adenocarcinoma in mid-June 2024. I will not retread it here. [Prostate Cancer UK: The PSA blood test] [Check4Cancer-Private]

Twenty Sessions Begin

Two years ago, I began twenty sessions of hypofractionated radiotherapy for prostate cancer. It was scheduled for weekdays alone, so I thought I could fit both work and the treatment in comfortably.

The treatment began on a Thursday, which gave me two sessions before the weekend. Little did I know how impactful radiotherapy would be. The chronic fatigue set in far earlier than expected, and the weekend literally wore me out.

A Toll on the Body

By the fourth session, I returned from the hospital and had to go straight to bed; I simply had no energy for anything. I obtained a sick note, though with the proviso that I would not be completely signed off work.

Then came a range of side effects. After the fatigue, my voice became a husky whisper, betraying such tiredness and exhaustion that, after one meeting, a participant asked my manager why I was still working. I had the capacity and the facility to continue, yet the toll could not be ignored.

Alongside this came urethral pain, bladder incontinence, and a greater urgency, all exacerbated by a prostate gland reacting to the radiotherapy. Coupled with nocturnal insomnia, I began to wonder whether I could be productive at anything at all.

Planning Around the Pain

Towards the end, I had to plan my outings carefully, as I could not go twenty minutes without needing to visit a toilet. I was prescribed paracetamol and codeine to ease the pain, along with Tamsulosin to manage the prostate issues, which I am still taking. I also obtained a RADAR key to access disabled toilets, and a "Just Can't Wait" card to show premises owners whenever I had an urgent need.

Four weeks later, I was ringing the bell, ending the treatment and ushering in a new life: the beginning of the story after prostate cancer. However, I needed to recuperate by taking long-term sick leave and having someone care for me, because home in Manchester was no longer convenient.

A Journey to Recover

Against the wishes of many, I jetted off to Cape Town to be with Brian, my partner. The trip was comfortable enough, because I used airport assistance for every leg of the journey. Even though I arrived in Cape Town literally a shell of myself, the weather proved almost as good an elixir as the companionship.

Much as I had every urge to return home, I took as much time as possible to recover sufficiently for general activity. My sick leave eventually ran to seven weeks, and I returned to work in January 2025.

In truth, I should have taken a phased return, but the burden at work was light, so I decided against it and settled in well enough. In time, working alongside an occupational therapist, we found ways to manage both the work and the pressure.

Two Years On

Two years on, some side effects linger. The loss of my voice remains unexplained, even after review by an otolaryngologist and her team, and I put it down to one of the rarer side effects. Bowel incontinence can be occasional, bladder incontinence is quite frequent, and sexual dysfunction is not helped by the mental stress of it. The nocturnal insomnia, meanwhile, should have me beavering away late into the night.

Now, better and more targeted treatments are available in the UK, including ultra-short five-visit radiotherapy, tissue-sparing focal therapy, and new at-home medicines, all a far cry from the twenty to thirty-nine sessions of hypofractionated radiotherapy. [ICR: Thousands of men with prostate cancer will now be offered high-powered radiotherapy on the NHS]

Even so, I do not think I would have wanted to wait for these developments, given my determination, once advised to pursue active treatment at diagnosis, to rid myself of the cancer as soon as possible. I would not have been persuaded of watchful waiting or active surveillance in the circumstances.

A Word to Men

Three check-ups at the Christie Hospital, every six months, have had my Prostate-Specific Antigen (PSA) test results read at the lowest level ever. I can only advise that men keep their prostate health in view, have it checked, and follow through on any adverse results.

A visit to the Prostate Cancer UK website for the risk checker, followed by an at-home review of your own symptoms using the International Prostate Symptom Score (IPSS), is a sensible place to begin. Not every prostate enlargement is indicative of cancer, but every such situation must be checked and kept under monitoring. Thank you.

Related Blogs

Blog - Men's things XXXV: A Man's Search for Dignity

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

Blog - Photons on the Prostate - A year from starting radiotherapy

Blog - A prostate cancer diagnosis, one year on

Blog - Men's things - Prostate Cancer blogs

A Gemini Notebook AI Podcast on this blog

Men's things 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.

Men's things XXV: Prostate cancer under control

Gathering my thoughts

There are many things to be grateful for: life, health, relationships, friendships, hope, faith, and the love that conquers all.

It's now been over a year ago that I began the twenty sessions of hypofractionated external beam radiotherapy for prostate cancer, the aftermath of which includes an extended time of monitoring and care. [NHS England: Hypofractionated external beam radiotherapy in the treatment of localised prostate cancer (PDF) 25 pages.]

After meeting with the multidisciplinary team in March, in conversation, I was to be seen again in 4 months, but the letter to my doctor indicated 5 months. But I received no appointments, so I had to consult the oncology department secretary about it.

It took her just over three weeks to respond. That was after I placed a phone call to her number and left a message that got a nurse to call and plan to be seen within three weeks.

Reviewing the process

Any appointment would have required first doing a serum prostate-specific antigen (PSA) test and getting the results before the appointment, and the secretary gave me just 6 working days to my next appointment to get that done.

Thankfully, for my Monday appointment, my GP surgery invited me on Thursday to provide a blood sample, and I was able to access the result on the NHS app last night.

I was concerned because the PSA results from February 2024 and the 5 test results altogether have fluctuated in ways that if I had not taken decisive action to act on the possible presence of prostate cancer by urging my doctor to be engaged, responsive, and proactive, the malignancy would have continued untouched to a seriously life-threatening situation.

This is because, in early February 2024, the PSA was borderline high at 3.5, then 7 weeks later at the end of March 2024, it had risen to 4.0 and needing further investigation, that started with a Digital Rectal Examination (DRE), through a multiparametric MRI (mpMRI) scan in April 2024, an ultrasound-guided transperineal biopsy of the prostate gland in May 2024, and a stage-2 prostate cancer diagnosis in June 2024 with the recommendation that I undergo active treatment.

Making your decisions towards the best outcomes

In July 2024, I made the choice between a radical prostatectomy and radical radiotherapy, opting for the latter, though on seeking a helpful opinion from Prostate Cancer UK, the nurse thought it was better to opt for active surveillance or watchful waiting.

I was not going to wait to watch what a clear diagnosis of cancer was going to do in my body, and worry myself silly about what I could have done on the back end of having this knowledge. That was the last time I called Prostate Cancer UK, because having come this far, I needed encouragement and support, not dissuasion.

As I prepared for radiotherapy, we had another PSA test at the end of August 2024, and it had fallen to 2.0. That sneaky thing could have been a dangerous signal to abandon treatment, as the reading had fallen below the danger zone into the normal range. However, that did not mean the cancer had suddenly disappeared. Either way, I was going through with the radiotherapy.

This began on the 12^th of September 2024 for every weekday until the 9^th of October 2024, and I worked through it, even as the side effects of chronic fatigue and bladder issues took hold. A month after treatment, I took an extended sick leave that lasted just under 2 months, spending most of that time with Brian, caring for me in Cape Town.

After treatment monitoring and beyond

When I went for my first post-treatment checkup in early April 2025, the PSA test I took, the previous week at the end of March, read 2.6 and this was the cause of my concern and it led me to question the reliability of the PSA test as an indicator of reduced prostate agitation, especially after radiotherapy, but then I also realised that the period of recuperation could be long, as exemplified in my strength, and voice.

My reckoning was that if the PSA result did not fall at my next appointment, I would request a second mpMRI scan. I am glad to say that on my receipt of the results last night, that might not be necessary as the PSA has fallen to 1.3 micrograms per litre (µg/L).

However, for my meeting on Monday, I am on alpha blockers since that regulates prostate function, since October last year, and I might be on that for some time, and I have had two episodes of epididymitis in May and August. We might have to discuss the hows and whys of that.

Apart from the occasional insomnia, the fluctuations in my voice, irregular occurrences of fatigue, and some restlessness that besets me at various times, I am doing quite well and happy with the improvements, grateful for the support from many people who have helped me through interesting times.

When I am presented with the opportunity, I talk about men’s things, the need for us to be conscious of the health of our bladders, bowels, prostates, testicles, and sexual organs. These things matter, and catching anything going awry early is of the utmost importance.

Here’s to life and living. Thank you.

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 - XXIV - A presentation

Blog - Men's things - Prostate Cancer blogs

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

Full Disclosure

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

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

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

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

Unsolicited Advice and Misinformation

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

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

The Prostate Clinic Revelations

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

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

The Question of Sufficient Information

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

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

Three Hidden Problems

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

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

Complications and Salvage Treatments

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

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

Managing Side Effects

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

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

My Choice

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

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

Check your Prostate Cancer risk in 30 seconds.

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

Blog – Photons on the Prostate - A year from starting radiotherapy

Blog - A prostate cancer diagnosis, one year on

Blog - Men's things - Prostate Cancer blogs

A Google NotebookLM AI Audio Overview Discussion of this blog

Men's things 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

Photons on the Prostate - XII

Do not defy the prostate

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

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

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

Keep an eye on your prostate health

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

The male reproductive system - Macmillan Cancer Support

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

Dealing with a prostate cancer diagnosis

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

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

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

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

Finding time to recuperate

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

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

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

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

Blog - Men's things - Prostate Cancer blogs

Blog - Photons on the Prostate - XI