42. Second chances might only come around once – Part 1

Walnut

I have known of Dennis for years. We have never worked together but he is a bit of a chip off the old block. He is actually quite funny but I’m funnier. He is the Brad Pitt to my Denzel, only he is richer but I am prettier. He is 6 foot tall and some change – and I’m going to wisely leave it there.

He is not going to tell a penguin that thinks it’s a cat that it’s a cat. What he might do instead is say “OK then let’s see you climb that wall then” and pull up a chair, with some popcorn, and sit back and watch. I never knew he had prostrate cancer until he approached me after the PC talk I did at work. I thought he might not be ready to share his story when I tentatively asked him if he was interested. He replied when do you need it by. Over to you Dennis….

My Dad died when I was thirty and he was seventy-one.  At the time it all seemed pretty sudden : he was diagnosed, he got worse, then worse still.  And then he was gone.  In reality it was probably more like eighteen months, but looking back across more than twenty years it now seems a bit of a blur.  At the end, he was riddled with cancer, his body emaciated and his brain so affected that he looked at us but didn’t know who we were.  But the death certificate suggested that it had probably started with prostate cancer.

Born in 1926, he’d smoked for much of his life, and I guess at the time I’d put his cancer down to that.  He’d lost his sister a few years earlier to breast cancer, and some years later, his younger brother succumbed to prostate cancer as well.  But they’d all smoked.  Me?  I’ve never smoked in my life, and I’m teetotal.  So I was fine.

Right?

I’m not saying I’m a saint.  I’m more than a little partial to a bit of chocolate, and in my twenties and thirties, I probably put away enough fizzy drinks to sink a battleship, so I’ve been carrying a bit of extra weight for years.  Large T-shirts gave way to XL, then XXL to the point where 3XL was my go-to choice.  Probably should have rung alarm bells, but I’m 6′ 1″, so there’s plenty of space to spread seventeen stone about.

And then in August 2017 I suddenly found myself needing to pee quite a lot.  It had come on practically overnight.  I’d go to the loo, but by the time I’d washed my hands, I felt like I needed to go again.  Just a urinary tract infection, right?.  I bought a crate of cranberry juice and figured ‘that’ll fix it’.

A few weeks later and while things were better, they still weren’t right , so gave in to my wife’s incessant… encouragement… and booked a doctor’s appointment.  I walked in, sat down and explained the symptoms.  It only took her a few seconds and a drop of blood.

“You’ve got type 2 diabetes.”

Hmm.  It wasn’t what I wanted to hear, but when you’ve had a diet that consisted largely of sugar for decades, you can’t really be surprised.  In some ways it was a relief, I said to her.  I explained about the family history of cancer, and that it had always in the back of my mind.

She looked at me, overweight and just turned fifty.  “Have you ever had your prostate checked?” she asked.

“No.” I said.

“Hop up on the bed…”

A snap of rubber glove, a squirt of lube, a quick rummage and she declared herself not concerned, but “We’ll do a few blood tests to just check you over.  Get them done and come back in a couple of weeks for the results.”

I had the blood tests done on the Friday.  At 7pm the following Monday, the phone rang at home.

It was the surgery.  “You have got type 2 diabetes,” they said.  “And we want to put you on statins as you have high cholesterol too.  But we’re concerned about your PSA.  It should be about 3.  Yours is nearly 8.  And with your family history, you qualify to see a consultant within two weeks.  Would you like to do that?”

Sitting on the stairs on a Monday evening, with my dinner going cold, this was not a question I was expecting.

“Um, yes.  Please.”

“Right.  We’ll get on with it.  If you have any questions, ring the surgery tomorrow, and look out for a letter.”

I put the phone down and told my wife what they’d said.  High PSA count.  A bit concerned.  Should see a consultant.  I didn’t sleep easy that night.

The next day, I considered things afresh.  Chances are it’s nothing.  A false alarm.  To be honest I was more worried about the diabetes.  Once you’ve got diabetes, you’ve got diabetes.  But prostate cancer?  That’s fixable right?  Fact is, I didn’t really know.

The next two weeks passed slowly.  I had a letter that gave me a 9.00am appointment but said ‘Keep the day free, just in case’.  I’d spoken to my boss and explained why I was taking a day off, but played it down.  “Just being sure.” I said.

On the dot of 9.00am I was called into the consultant’s room, and he asked me to run through what had brought me to the doctor’s in the first place.  I related my tale and for the second time I hopped up on the bed, hugged my knees and thought of England.

If my GP had been trying to get to my prostate, the consultant was trying to reach my tonsils!  “Well,” he declared.  “something doesn’t feel quite right.  I’d like an MRI scan.”

My experience of the NHS to date was that it works at glacial pace.  I mentally planned for another day off.

“They’ll expect you downstairs at 10.00am.  Follow the signs and come back here at midday.”

An MRI scanner is a big machine with a narrow tube running though it.  My shoulders were squeezed and the top of the tube was about two inches from my face.  I was feeling mildly claustrophobic, but fortunately they had to push me so far through the tube to scan my nether regions that my head just poked out the other end.  The technician put a cannula in my hand, explained that they’d take some images, then inject me with some fluid and take some more.  He then said the machine was really loud, put some ear defenders on me and walked off to start the procedure.

The booming was indeed loud, and after about 10 minutes I had the odd sensation of my arm going cold as the fluid ran in.

Ten minutes later and the platform I was lying on slid me out, like Scott Tracy being loaded into Thunderbird 1.  It wasn’t worth me going home, so I went back upstairs to sit and wait for midday.

Eventually I got called back in, and the consultant was conferring with someone else.  They swivelled the screen round and I looked at what I presumed was my prostate.  I didn’t fully grasp what they were saying,  but it didn’t sound great.

“…so we’d like to do a biopsy.  Are you free at four o’clock this afternoon?”

I couldn’t think of anything else more important, so yes, I said, I could be free…

Normally you associate going into an operating theatre with masked figures, bleeping machines and a sterile, sci-fi like environment with patients in those gowns that don’t quite close properly at the back.  I walked in with my rucksack over my shoulder and was told I could leave it in the corner.  I sat down, and the chap who’d been talking to the consultant explained what he was about to do.  You can’t actually get to the prostate from the outside without opening you up.  However, what you can do is to stick a needle into your rectum, go through the rectal wall and get to the prostate that way.  Now the rectum isn’t the most hygienic of areas, so passing a needle through that carries a certain risk of infection.  “So we’ll give you a large dose of antibiotic,” he said, giving me the largest tablet I’ve ever seen.  “And sign here.  If you suffer any untoward symptoms in the next week or so, go straight to hospital.  Do not go to the GP.  Do not wait and see if you improve.  Hospital.  You may have a blood infection.”

“How bad might it be?” I asked.

“Potentially fatal.”  He said.  He indicated the consent form again.  “But you’ll be fine.  Sign here.”

Looking back on the whole period of my treatment, the next half an hour was undoubtedly the worst part.  And quite frankly if that’s as bad as it got, then I’ve got much to be thankful for.  Lying on my side, shorts and boxer shorts round my ankles and hugging my knees, they started by giving me an anaesthetic.  And I don’t mean in my arm.  Or my rump.  I mean ‘in there’.  And then, after five minutes for it to work, they take what I can only describe as feeling like a bicycle pump, and poke it where the sun doesn’t shine.  But this is a bicycle pump with a sharp pair of snips on the end, and I feel tiny pieces of… me, being snipped off, deep inside.

Several times since that day, I’ve tried to explain what that felt like.  Normally when someone sticks something sharp into you, it’s your arm, or your leg, or your mouth if you’re at the dentist.  And you  can point to the site of the jab.  But this, this was strange.  It was just… inside.

Sixteen times they went in, and came back out with a little bit more of my prostate.  I know, because they were counting them off.  And then that was it.  Done.  When you’re ready, hop up and get dressed.

As I was signing the form earlier, the consultant had explained that the procedure would mean that I’d see blood in my urine for a few hours, in my stool for a day or so, and in my semen for about a month.  But other than that – fatal blood infections aside – there shouldn’t be any side effects.

Then it was just a case of waiting for the results.  It was about ten days.  Felt like a lifetime.

During that time I did pee blood, but only for the rest of the day.  And there was a bit of blood in the pan when I went to the loo.  I was still sore so didn’t really feel like investigating to see whether there were traces of blood in my semen, but eventually curiosity won out, and strictly in the name of experimentation…

Let’s just say that it was a disturbing sight and move swiftly on.

To get my results I went into see a consultant oncologist who, bizarrely, had the same name as my first girlfriend.  She’d been a plastic surgeon, but I hadn’t seen her for 20 years.  I wondered if she’d changed specialities.  Turns out there’s more than one G. Smith in the NHS.

This Miss Smith didn’t beat about the bush.  As I sat down, she introduced herself and then said “Well, thirteen of the sixteen samples that we took are cancerous.  We’d recommend treatment.”

She ran though the options.  They could go ahead with what they call ‘watchful waiting’ which is basically ‘Do nothing, but test you on a regular basis to see if the situation’s getting worse.’  Then there were a few experimental treatments, but essentially it came down to radiotherapy or surgery.  Bombard the cells with radiation, or open me up and cut it out.  However, should the radiotherapy not work, it would be likely to have caused a lot of internal scarring which would make subsequent surgery far more difficult.  In addition, it turns out that being zapped with radiation makes it increasingly likely that you’d develop some other cancer twenty years down the line.  If you’re 75, then there’s a good chance that by 95 you’d either be past caring, or wouldn’t be around to care.  At 50 though, I was rather hoping to be fit and healthy at 70.  Surgery sounded like the sensible solution, not having been persuaded by the ‘Wait and see.’ option.  However, I did say I’d like to speak to someone about the radiotherapy, just to be sure.  An appointment was made.  As was another appointment for a bone scan, to make sure it hadn’t spread.

Speaking to the radiotherapy specialist, he basically repeated what I’d been told, and recommended the surgery.

That then, was that.

Meanwhile, because this had all started with what I’d thought was a urinary tract infection, someone decided that just to be on the safe side they wanted to have a look inside my bladder.  So a few days later and I’m back in a treatment room.  By and large, if a doctor wants to look at your insides from the inside, then short of cutting you open, then there are only three ways in.  The biopsy had ticked off one.  Looking at my bladder ticked off the second.  (And as it happens, thanks to an issue with my oesophagus recently, where I had to have a camera down my throat, I’ve now completed the set.)

By now I’d got used to dropping my trousers in front of a room full of strangers.  Some local anaesthetic cream was applied, and everything ‘down there’ went numb.  I focused on the TV screen over the bed which suddenly went from showing a picture of the operating theatre, to a picture of my insides.  We passed the troublesome prostate “Really quite small,” commented the consultant / cameraman, and we carried on to my bladder.  “All looks fine,” he declared, “but I’ll write and confirm it.”  What he neglected to mention was “By the way.  When this anaesthetic wears off and you go to pee it’ll feel like a stream of razor blades for the next 24 hours.”

No – he left me to find that out for myself.

Not long after that I went for the bone scan.  This was to determine whether the cancer in my prostate had spread anywhere else.  The process involves injecting you with a radioactive substance, letting it percolate around your body for two hours, and then you lying very still on a table while a machine takes the necessary images.

The lady who gave me the injection unscrewed a lead canister and took out the phial.  She then looked at me as someone who has injected many overgrown teenagers with a radioactive marker and said, with a twinkle in her eye…

“You’re not going to get any superpowers you know!”

Darn!

Fast forward a couple of weeks. The bladder check had come back clear, and the radiation test had a) revealed nothing else untoward and b) had not given me the ability to climb sheer walls, fly or turn invisible.

I reflected on what had happened recently.  I hadn’t even got to the surgery part yet, but by my rough estimate, every penny I’d ever paid in National Insurance during 30-odd years of employment, I’d had back in terms of tests, scans, biopsies and consultants’ time.  I will never begrudge the NHS a penny for as long as I live.

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