A friend asked me if I would have a chat with a guy that was recently diagnosed with prostate cancer.
I was only too happy to give him the talk that I never had and wished that I got. However, it would end up be me coming back, scratching and shaking my head.
I have said in the past that I am happy to do so but ONLY at the initial high PSA stage and tell them about the tests they have coming up or when they have already decided that they are going to have the radical surgery. I will have no part in helping them make a decision on which treatment they decide they are going to have.
The hospital had given him only one week to decide on what treatment he wanted to undergo and he still had yet to tell his partner.
I met mark an active sixty-six-year-old and his partner one fine evening in a food court. They were not going to eat but I convinced them to have something as bad news is never good on an empty stomach.
Mark had a reoccurring urinary infection. On this occasion it got so bad he had to make his way to A&E because his chest was swollen and he was not passing urine at all. He was seeing a urologist as his PSA was a bit higher than it should have been and they already had him on medication. The two tablets that he has been taking are Tamsulosin and Finasteride.
Tamsulosin is a drug that relaxes the muscles in the prostate and bladder neck, making it easier to urinate. Finasteride is used for shrinking an enlarged prostate by decreasing the amount of a natural body hormone that causes the growth of the prostate. It is also used to treat male pattern baldness. This drug also has the effect of lowering a man’s PSA levels by 50%, so during the time it is taken your PSA level has to be doubled to get an accurate figure.
Mark stopped taking the Finasteride tablets but he told the doctors that he was still taking them. His next PSA reading was 5.3 which they then wrongly doubled to make it 10.6, which was deemed extremely high, and they sent him for a MRI scan. They contacted him that same day to say they had seen something on his prostate and he needed a biopsy.
The results of the biopsy showed that he had a 9mm tumor on one side of his prostate and of the eighteen core samples taken only three were cancerous and of these three, only part of the core was cancerous. For comparison, I had twenty-four core samples taken and nineteen were cancerous along the entire core.
I’m no doctor but it didn’t seem like a lot and all of this was based on a lie in the first place. I asked him if he had had a second opinion and he said he didn’t.
Then it got a little confusing.
He said that because it was so low the hospital said they were not rushing him for an answer. I was perplexed as he had told me in one of our prior phone calls that he was going back in three days time to tell them what he had decided. He then said the doctors gave him two weeks to make a decision but he said he only needed one week. He was of the opinion that he wanted this dealt with as soon as possible and he felt the longer that he lived with this the worse it would become.
I told him of my results in comparison and he agreed that his results were not a lot in comparison. He then said a nurse at another hospital that he was referred to after the findings said that he could opt to go on active surveillance instead. He was also told that his cancer grade was between grade one and grade two. Grade four is where it has spread outside of the prostate. They had also suggested that he could opt to freeze the area of the tumor but it could come back.
I then asked him what did he want to do. He said at the first hospital they suggested that he should have the prostate removed and the second hospital they also agreed that he should have his prostate removed.
Yeah. Hmmm. You are thinking exactly what I was thinking.
I said to him that you have had two separate opinions from two hospitals. You have had a second opinion, even though you said that you didn’t. He agreed with me saying that he didn’t know what I meant initially. I asked him again what did he want to do, regarding the operation, and he now said he really didn’t know.
His partner said that it was scary and he agreed. I said that what I didn’t want to do was influence his decision – or the decision that he said and I thought he had already made. All I could do was tell him what I went through and describe that process – something that I didn’t receive.
I was feeling a little uncomfortable. As I was saying things he was saying yes to everything but I wasn’t sure that either of them got it. He said he had all his paperwork with him so I asked if I could have a look. His Gleeson was the same as mine 3+4 and I explained what it meant. I then took him through the radical surgery and, in detail, its side effects.
We spoke about the nerve bundle and he said that the doctors had already told him that one of the nerve bundles is very near to the cancer. I said it sounds like they are already preparing you for the fact that you might lose one bundle. He agreed that the doctor had already given him that hint already but I strongly suspect that he didn’t fully understand this before I told him.
He said that he was told he could have the operation in any hospital that he decided. I told them about Guys and Dr C. They took the details and said they would try and get the operation there.
We spoke generally about my Awareness talks, talking to black men, diet etc. I spoke about my recent talk to the African health students and how the men had been spreading the idea that if they have sex all the time they will not get prostate cancer. His partner laughed and said that he had stayed away from sex for a long time. He explained that it was because of his unary infections. She corrected him and said no it was before that.
Slightly awkward then.
I said to him he should wear it out. He will have a struggle ahead of him and he should make the most of it now. I told him to break it if he could. She cackled loud and hard and he didn’t get it at first and then silently rationalised.
If he hadn’t lied, he would never have got the additional tests and ultimately the biopsy.
I am just having difficulty shaking the feeling that the surgery could be unnecessary at this stage and also that he has not been told all he needs to know and what is ahead of him.
You know when you have that feeling that someone just does not get it?
Even super cool Samuel Jackson is not this cool or unmoved.
I’m not a doctor or Samuel Jackson, so what do I know?