So, you get de-prostrated and after the immediate side effects begin to subside, you are confident in the knowledge that you should no longer have a PSA reading. It’s undetectable. And for me, so it was for quite a while.

I saw this movie trailer on one of the socials for a horror film called ‘It Follows’. The premise is quite simple. A ‘curse’ is passed on when you have sex with someone. The entity then follows the last person in the sexual link. When the entity catches up with that last person they are treated to a quite horrible, limbs contorted and ripped off manner of death. The entity silently walks at normal pace, never hurry’s or runs. It has all the time in the world. It showed real promise in the trailer but it was as scary as watching prime ministers question time.

Minus the grizzly death and sex, the PSA post prostatectomy is very much like that. Other than a couple of years grace, my PSA has been on an upward trajectory. It was only a point here and there. One month maybe a point down but it marched on, slowly but surely.

PSA 0.11 February 2022

PSA 0.14 June 2022

PSA 0.15 September 2022

PSA 0.16 November 2022

It was after the November PSA that the team at Guys informed me that I was nearing that magic number of 0.20. Just like the famous TV show the ‘Price is Right’ – when you hit the correct number you get a prize. However, unlike a new washing machine, gas bbq set or TV, the prize would be the dreaded radiation therapy and possible hormone treatment and the gloriously delicious list of side- effects that you may or may not experience. It is one thing slowly drawing near to your mad, unpredictable, ex-girlfriend’s front door after years of a happy life. It’s another to be knocking on the door and being held hostage by her and her new, fresh from prison boyfriend.

For a long time, I just accepted that this was an eventuality. By saving the nerves there is always a possibility of cancer material being left behind. Had they ripped out everything – prostate and nerves then this might not be happening but at a heavy, impotent price. But I was also doing something much more dangerous, something I had criticised many a Black man for in my talks. I was trying to deny it. I was almost hoping it would go away. If I didn’t give it any attention it wasn’t there and wouldn’t bother me. Then almost as payback for all the talks I had done, I remembered someone I had shared a stage with and his, at the time fantastic statement.

A gentleman called Chris Cottrell, said he could predict what his PSA was going to be before he had even had the test.

To summarise the story, at 25 years old he was diagnosed with non-Hodgkin lymphoma. Years later he would have a PSA with a reading of 42. He had aggressive prostate cancer. He was advised against surgery because of the previous radiation therapy he had received. He was in a grim predicament. He managed to find a surgeon who would perform the prostatectomy operation and enjoyed a few years of undetectable PSA. A doctor suggested that he should join the gym. He did just that and not only lost weight, but became fitter and stronger than he had ever been.

He also noticed that his PSA began to fall.

I was desperate, so I reached out to him.

His theory was as brilliant as its simplicity. If you go to the gym and end up fatiguing the muscles (as Schwarzenegger would say ‘no pain, no gain’) the testosterone that would otherwise be feeding your cancer is now required for muscle repair. Brilliant! And he had the figures and a 3 year funded research programme at Kings plus an exercise company, The Exercise Clinic, to prove it.

I had just over two weeks to try and make a difference. With the Rocky tune ringing in my head, I went back to the gym. I hit the weights and they slapped me back 10 times harder. When I started, I could only do 2 dips. My muscles hurt and then muscles I didn’t even know I had hurt even more. At one stage I couldn’t lift my arms above my head. Today I can do 3 sets of 15 dips. Oh and there is navigating the ‘summer boys’. Summer boys is a derogatory term for the gym idiots who spasmodically come in the gym without a clue, block up the machines and weights while they text and watch tok tic. Then continually look in the mirror to see how they have grown in the last 5 minutes. I was confident I could and would make a big change.

And I did, indeed, make a big change.

The flipping thing shot up, like a pair of nun’s pants!

PSA 0.20 December 2022

Much of what the doctor said was a blur. I sat in stunned silence, the next appointment would either be the start of radiotherapy or an explanation of what was to come. I didn’t need to look up the range of side effects I could look forward to. It was like someone taking the spoon out of the casserole pot of issues I was already trying to deal with, peeing on it and putting it back in and closing the lid.

For most of the year being able to have more than 4 hours uninterrupted sleep was a rare luxury. I was looking at part time jobs to keep the household afloat, a number of other issues and now this flipping PSA. Stress had become my continuous shadow.

It’s hard juggling life’s problems. It’s harder to be strong all the time and even harder to continue to lie to yourself and pretend that everything is all right.

I went to that great universal doctor in the sky, Dr Google, and discovered I had most of the fillings for a depression sandwich. It was a long time in the making, punctured only by a determined effort on Christmas and Boxing Day, but the final deterioration came around the 27/28th December 2022. I had no-one to talk to – not that I really wanted to talk anyway. I turned off my phone and travelled aimlessly on the tube, a de-prostrated hobo, for the best part of the day. In the evening, I was reminded of a dinner appointment that I had completely forgotten about, with a group of church buddies. One friend knew some of what had been happening but the others knew nothing. That evening, with good distracting fellowship, I could finally look like I could get back on track. Albeit a train with a dodgy undercarriage.

A day or so later the fight had come back. I was going to throw everything at this, including the neighbours kitchen sink if I had to. Then it dawned on me, the one major area that I had not changed.

My diet.

Yes, I had still cut down the red meat and chocolate but otherwise it’s fair to say my body was swimming in sugar. I was still enjoying the therapeutic, nightly Häagen-Dazs, sweets, diet coke & malibu and cakes. In fact the whole cake thing had got so bad that not only was I getting a cake with lunch for dessert, I also got another cake to fuel me from the cake shop back to the office or home.

More like Olympic swimming.

I am much more successful with going cold turkey than moderation, so that’s just what I did with it all. The Häagen-Dazs, meat, cakes, diet-coke and sugar. I debated long and hard about this and after reading a new article (more about that in my next blog) about the soursop fruit (also known as custard apple, cherimoya, guanabana, and Brazilian pawpaw). I not only went and got one, I also have been drinking one cup of the tea a day. I didn’t think I would ever find a tea more vile than green tea but I have a worthy heavyweight champion in soursop, sorry sour sock tea.

I had no idea if all of this and continuing gym activities 3 times a week would have the desired effect but I was not going to go out without trying. It was a couple of weeks later that I would make that familiar trip to Guys hospital. They were packed and running late as usual. I found a seat and got comfortable with my sudoku. Eventually I was called and ventured into the office of a doctor I had never seen before. She went through the previous PSA’s and mentioned that the upward trend had now reached the threshold of 0.20 and that we will be looking at radiotherapy. I casually asked about the last PSA figure.

“Oh, you did a recent test?” she asked.

“Yes, I did one last week”

“Oh, OK then, let’s have a look”

PSA 0.17 January 2023

“Oh, so it’s gone down” I said.

She was still talking about fluctuating results and radiation while I was somewhere else letting the result sink in. I then told her about Chris and his theory and the fact that he is currently doing trials at Kings College and what I was doing. I told her of my concerns and if I had a chance to avoid radiotherapy, I would take it. I only asked for another week. She agreed to talk to the chief doctor. Just as she was leaving the room, she asked me if I had seen this booklet on radiotherapy.

Hold on Mr Undertaker, put away your tape measure.

She came back a few minutes later and the big cheese not only agreed that I could have a bit more time he was giving me 2 month’s worth of extra time. If I was getting any symptoms then I could ring and get an earlier appointment. It’s fair to say not many people leave the Oncology department smiling. I had temporarily joined that very small group of men.

3 weeks on and I’m loving the gym and seeing the results and I am not missing the foods that I have given up and am steadily losing weight. Dessert is now a couple of pieces of fruit. I have perfected the “stop blocking the machine, step aside” look for the summer boys.

Then I got a shoulder injury, have not been to the gym in the last week.

Then out of the blue yesterday, I got a new appointment from Guys hospital for the week after next. That means I have to get my PSA taken next week. So much for the 8 weeks.

Does anyone know of any swear words beginning with ‘d’ ?