The British comedian, Peter Kay, has a famous sketch where he describes the Hobnob biscuit as the hardman of the biscuit world. Whereas other biscuits like Rich Tea cry, wither and then quickly disintegrate in a hot cup of tea the hard nut Hobnob is the commando of the biscuit world. It will stay intact and dare the tea drinker to ‘bring it on’. I try not to swear if I can. I used to swear like a trooper when I was younger so it can still be a challenge at times. I am going to swear in this blog a lot so ‘biscuit’ will be the new swear word of choice.

I was meant to get a call from the consultant on the 30th January 2024 for my three monthly follow up. This is the three monthly follow up from the last one where my PSA had not fallen but had stayed stable at 0.22. Come the 30th that phone was glued to me like a cake at a Weightwatchers meeting. They give you a time but it has always been the case that that time is actually a best estimate.
So, I waited and I waited. I even became one of those guys that takes their phone into the toilet.

The call never came.

Biscuit.

Now from experience, trying to call the hospital was pointless. The nurses on reception don’t have a clue, are not particularly interested and are not very useful when trying to get to talk to consultants at the best of times. Also, the consultants are only physically available on certain days. So I decided I would leave it for a few days and then perhaps even venture down there and see if I could get an appointment. The the next day I got a text message, confirming my PET scan appointment in a couple of weeks. When this arrived, I was in the middle of something else so I didn’t pay much attention to it. I would come back to it later and actually look up what the scan was:

“Positron emission tomography (PET) scans are used to produce detailed three-dimensional images of the inside of the body. The images can clearly show the part of the body being investigated, including any abnormal areas, and can highlight how well certain functions of the body are working. They’re particularly helpful for investigating confirmed cases of cancer, to determine how far the cancer has spread and how well it’s responding to treatment”

I should have had my telephone appointment on Tuesday and then on the Wednesday got the appointment for the PET scan. I was walking home to the tube station on the Friday and I got a call from a nurse or doctor from Guys hospital. She was ringing to book a MRI scan for the following Friday. I said to her this is the second appointment that someone had made for me but no-one has told me what is happening. I had gone to get my PSA the week before and I didn’t even know the result of that. She apologised and said she was only there to book the appointment and didn’t know anything else but promised that she would send the consultant an email to ask if he would contact me.

I walked home in a daze.

Biscuit. Biscuit. Biscuit.

I was angry, confused and just a little bit concerned. I spent the best part of the weekend making up a hundred different scenario’s and going through each one of them in minute detail. Some meaningful bright spark – along the lines of those idiots who throw around pictures of the soursop plant as a magical cure for everything even went so far as to say that this could just be them doing final scans before the trumpeter declares a cancer free diagnosis and long life.

Biscuit and I’m slinging one for your stupid soursop fruit.

Eventually the sting did drop out of it and I got back to convincing myself that it was pointless worrying about what I didn’t know. I knew, with previous experience, that cold calling the hospital and hoping to either get a message to the consultant or talk to him directly would be a waste of time. I decided that I would wait.

Biscuit.

Surprisingly, I didn’t have to wait long.

I got a call from the consultant on the Monday. He said that he had tried to call me on the Tuesday but didn’t get through. He explained that the PSA had gone up again to 0.27 – which makes no sense. Therefore, they want another MRI scan and a PET scan. The PET scan can only be done when the PSA is above 0.20. Well, that was the mystery appointments solved.

That would be a double biscuit.

The MRI scan came and went, no problem at all. I had never had a PET scan before and the procedure was slightly different to the MRI. The first part was having a cannula fitted and then being injected with a radioactive tracer which needs an hour to circulate around the body. I was then led to a individually curtained off waiting area, which had a single pensioner style high backed chair in it. I looked at the chair and wondered how they expected anyone to get comfortable in one of those stupid things for an hour. Mid moaning, I looked down the right hand side of the chair and saw a remote type handset attached to it.

It was a comedic ten seconds before it dawned on me what I had just seen.

Remote, he dribbled.

I heard that eureka sound in my head. The high-backed pensioner chair was actually a electronic full recliner. I cackled loud enough for anyone around to hear and I didn’t care before I took possession of the prized remote.

It felt like 5 mins but I was out solid for the hour. Can’t take me anywhere!

It was time for the scan. I was given the normal warnings and then in I popped. Unlike the fully enclosed MRI scan, this is it’s cheaper cousin and my head popped out the top of it (so no decent kip going on). About 20 minutes later I was getting dressed and on my way.

It was then about 2 weeks until I saw the consultant again.

I received radiotherapy in my prostate bed, which is standard practice. What has happened is the PET scan revealed three small areas in my pelvic lymph nodes that were too small to be detected by the MRI scan and are above the prostate bed. The solution is a two year course of hormone therapy and another 5 week course of radiotherapy in six months time. Where the cancer is makes it higher risk and the aim is to kill it with the radiotherapy. The hormone therapy will shrink it in the meantime and should ensure if there is anything else that has not been detected it is mopped up as well. Having said all of that what they have found in these cases is that for 7 out of 10 men it will work.

7 out of 10. Trying to not think about the other 3.

Biscuit, biscuit, biscuit.

Initially, I will be taking hormones orally until I get an appointment for an injection. The bad boy medication is called bicalutamide if you really want to know. The injection will be an implant that I will need to take every 3 months. My PSA this time around had risen from 0.27 to 0.34. The consultant, aiming the final slap, said the tablets are harsher than the injection apparently and the list of possible side effects associated with them are impressive to say the least:

More common: Bloating or swelling of the face, arms, hands, lower legs, or feet, blood in the urine, blurred vision, body aches or pain, chills, congestion, cough, cough producing mucus, difficult or laboured breathing, dizziness, dryness or soreness of the throat, fever, headache, hoarseness, lower back or side pain, nervousness, painful or difficult urination, pounding in the ears, rapid weight gain, runny nose, slow or fast heartbeat, sweating, tender, swollen glands in the neck, tightness in the chest, tingling of the hands or feet, trouble with swallowing, unusual weight gain or loss, voice change.

Less common: Abnormal growth filled with fluid or semisolid material, ankle, knee, or great toe joint pain, arm, back, or jaw pain, bleeding from the rectum or bloody stools, blindness, bloody nose, burning feeling while urinating, burning, tingling, numbness, or pain in the hands, arms, feet, or legs, change in bowel habits, chest pain, discomfort, tightness or heaviness, confusion, decrease in frequency of urination, decrease in urine volume, decreased vision, difficulty in passing urine (dribbling), difficulty with swallowing or eating, dilated neck veins, dry mouth, fainting, irregular breathing or heartbeat, joint stiffness or swelling, light-headedness, loss of appetite, lump or swelling in the abdomen or stomach, nausea, no blood pressure or pulse, noisy breathing, pain or discomfort in the arms, jaw, back, or neck, painful blisters on the trunk of the body, persistent, non-healing sore, rapid, shallow breathing, reddish patch or irritated area, sensation of pins and needles, shiny bump, stabbing pain, stomach discomfort, stopping of the heart, sunken eyes, thirst, tumour, unconsciousness, unexplained weight loss, unusual tiredness or weakness, vomiting, weight gain, white, yellow, or waxy scar-like area, wrinkled skin, yellow skin or eyes.

Then I was on my merry way to the pharmacy to collect my box of misery.

Please accept the remaining pack of biscuits sir (or miss).