My journey with Prostate Cancer - a cautionary note

It was January 2019 and I just heard that 2 friends had been diagnosed with prostate cancer. It had been a few years since my last examination, so I decided to ring my GP and book and appointment.

Whilst a digital examination can ruin your day, I took the view that 5 minutes of discomfort was worth it - just to put my mind to rest.

• I had no symptoms, so this was just a regular check-up.

I have a great GP who saw me the same day and said she thought she could feel something odd and referred me to my local Urology centre just to be sure. Within 5 days I was seen by a consultant for a second examination who assured me everything was fine.

As I was now in the system of the Urology centre, they took control of regular PSA tests throughout 2019 (every 3 months). The PSA results were always within acceptable margins and after a year (it was now January 2020) they suggested I have an MRI for no other reason than a year in their system dictated further investigation. A week later I received a call to say there was nothing abnormal with the MRI, and so I continued with PSA tests quarterly throughout 2020. All PSA results continued within acceptable margins.

• I still had no symptoms of any kind

In January 2021 my PSA was slightly elevated and the Urology centre suggested I have a biopsy on the basis that if all was OK, I could be effectively discharged and placed back on annual PSA tests with my GP. Knowing that a biopsy is pretty invasive I suggested I have another blood test to compare results. The Urology team were very relaxed and emphasised that I did not really need to have the biopsy - it was simply a way of deciding whether to keep me in the system or not. If I preferred, I could simply continue with PSA tests and be monitored.

2 weeks later and my next PSA test had dropped slightly, yet still a little elevated. As the centre put it "well, we are none the wiser", so I elected for the Biopsy in February 2021.

• I was still showing no symptoms whatsoever

I won't explain the details of the biopsy other than it is undeniably unpleasant, but on balance is a vital means to an end and offers a definitive result. After 30 minutes the procedure was over, and I was told to expect a call some 3 weeks later.

I decided not to keep this process and the biopsy a secret - sharing with colleagues and friends as it's a topic that is rarely discussed. If there was anything to worry about without any symptoms, then other men need to be mindful.

A week later I received a letter from the Urology centre on the Friday saying they needed to speak with me the following Monday - that ruined our weekend for sure!

As you can imagine, for myself and family, the wait was tough. When the call came in I was told that of 15 biopsies taken, cancer had been detected in 6 samples. The way I am wired, whatever the situation, I immediately switch into a "so what are my options, what decisions can/should I make? OK I am now in control of the situation". It's how I deal with things.

My ability to have any options and make a choice was largely because of early detection. That made life easier for me personally, but of course for my family they were simply observers, helpless worriers, not able to do anything practical. I am not sure how I would have handled that if it had been one of them with the diagnosis.

As I say, I am not someone to keep things to myself, so everyone at work, friends etc were all told what I was facing- not for any sympathy, but with a clear message from me - "If not for yourself, then your partner, father or grandfather - get tested. Waiting for symptoms can reduce the options and choices you can make."

The options were Robotic Radical Surgery, 4D Brachytherapy and External Beam Radiotherapy. I elected for surgery having weighed up the pros and cons. Within a week I was seeing a Consultant Surgeon and 2 weeks later went into Guys Cancer Centre via the London Bridge Hospital.

Due to lock-down, I had to be dropped off at the kerbside by my wife - neither of us really knowing what lay ahead in the next 24 hours.

• I still had no symptoms, but I knew I had cancer. It was a weird place to be.

That was at the end of March. Since then I have recovered well - the Consultant was happy with his efforts on the day, told me the cancer was 'moderately aggressive' and that I could have easily had the surgery a year earlier. The challenge is that MRIs are images, and it requires human interpretation - his view was that if he had seen the images he would have immediately called me in for a review in early 2020.

That was a tough message to take onboard. However, I considered that a year earlier I could have been in hospital for major surgery just as Covid was hitting hospitals badly. Maybe it was for the best.

After surgery I was left to wait for the results of my first PSA test after 10 weeks. A score of less than 0.1 and prostate cancer is undetectable, anything higher and there is a chance that some cells remain which can require further treatment such as radiotherapy.

Just prior to going into surgery and almost every day for 4 weeks after Yodel and DPD did very well as gifts, hampers, flowers, chocolates, even Gin arrived literally on a daily basis as were text messages, WhatsApp messages and the like from friends, family and colleagues all offering support. At such a worrying time gestures really mean so much, not just to me but my family also.

After a few weeks I returned to work, maybe explaining to colleagues in a little more detail than they wanted the procedure, and yes Teams and Zoom meant some people even saw my scars.

One evening we had a companywide comms call. I took the final few minutes to thank everyone for their support, not realising just how emotional that would be for me. I recall telling people that the surgery went extremely well, and the physical side of things was fine. On the mental front I explained that I struggled with being told I had cancer - and I still do to this day. On the emotional front - it changes you and emotions can swing up and down. For sure work issues get put into context and for some I may have been overtly blunt - I mean, how trivial is it that people can get upset over a presentation or font change or someone being 5 minutes late for a call - nobody has died!

A couple of weeks ago I received my first blood results post op. The PSA was undetectable which was a huge relief. Going forward, regular PSA tests will continue to monitor that nothing changes.

My fears post op have not materialised, so life is back to normal.

I am incredibly lucky, but there is a cautionary note:

• PSA blood tests are notoriously unreliable and so digital examinations are a legitimate ask of your GP.
• Last year, due to Covid 52,000 men in the UK who would have been referred by GPs were not. That is a real worry as early detection is everything.
• Since my operation, a number of friends have chosen to get tested and 2 have been referred for further testing.
• Talking openly about this does not come natural to most men. It's a fact that most men die with prostate cancer, they just don't die of it - so be open with your family and friends.
• If you suffer any symptoms, take a PSA test and don't get fobbed off by a GP who does not want to examine you - it's their job and it',s your life so put that into context when you speak with them!
• If you are facing a digital examination - its 5 minutes of discomfort
• If you are facing a biopsy - its 30 minutes of discomfort and some pain
• If you are facing surgery or radiotherapy - be positive, listen to and trust the experts
• kick cancer where it hurts by acting swiftly and taking control
• Donate if you can at www.prostatecanceruk.org

I know I am not clear of cancer, and it will take a number of years of testing to get to a point where I no longer have to look over my shoulder, but I count myself incredibly lucky.

The support of family, friends, colleagues, clients (yes, I did tell everyone) has been enormously helpful these past months. Knowing others care is incredibly humbling.

Take control of your health. Be safe.