Filling the forms before brachytherapy

One thing you get very used to when you begin discussing anything to do with prostate cancer is the level of intimacy that you have to reveal. Nurses and doctors will listen, expressionless, as you discuss the workings of your erections, flow of urine, how well and often you defecate, the importance and extent of your sex life and any manner of other things.

I guess though, when you've had someone shove their finger up your bum or been probed about with MRI or with an ultrasound scanner, there's not much left to reveal about your physical self, other than what you actually do with your body when you're not sprawled on the examination table.

First consultation with the clinical oncologist

With all the results in, I was swiftly given an appointment to attend the oncology clinic at the local hospital. It all starts to feel very real at this point as they confirm with you your treatment decisions and make the necessary arrangements.

Once again, Gloria came with me (she's a brick) and still didn't bring her laptop. You know it's serious when she's paying attention like that! The waiting room was light and airy and there was a low buzz of activity as people wandered in and out, some carrying folders, others looking important. We waited with a few other folk - a lot of old men, unsurprisingly - and pondered the fact that cancer patients can get free parking. One wonders why particularly that group is singled out for that privilege.

Testing urine flow and prepping your prostate

The thing about your prostate is that it wraps itself around the urethra down which your wee comes from the bladder, before exiting to the outside world via the penis. When all's well, then all is indeed well. However, as you get older, the prostate grows and, as it grows, it can compress the urethra, making you urination more difficult.

For this reason, you'll find that you dribble rather than gush, you may sometimes find it hard to finish a wee and you can also experience "urgency" where you actually find it hard to restrain a wee from coming (usually when you are in sight of a toilet, is my experience!).

Five things to know about Prostate Cancer

In a blog like this, while I wait for something to happen (first consultant appointment next week), you the reader need something to keep you going so here are five top things that I've learned about the prostate and its associated cancer.

1. What is the prostate?

It's a little gland, typically about the size of a walnut, that sits around the urethra (the tube down which your wee comes from the bladder), above and behind your testicles. This means that if it swells, your flow of urine is restricted. So, one of the symptoms of prostate cancer for example is difficulty passing water - although it might just be that your prostate has grown, because the little blighter will do that all through your life (just like your ears). What's it for, I hear you cry. It makes the fluid in which your sperm are transmitted, through the urethra, when you come. If you have the prostate removed, you'll have a dry orgasm whenever you have sex. In other words, you still get the good bit, but without the mess.

When the waiting ends ... and you're told the results of your biopsy

I'd been told that the results from the biopsy would take a while and so I was quite surprised to receive an appointment to see the consultant a week later. Gloria and I both put a positive spin on it which went something like this:

"They probably just want to go through the result and tell us that it needs monitoring;"
"It's going to be an all-clear - I can't have prostate cancer because I feel so great;"
"If it is prostate cancer, then it's been caught early and if treatment is needed, they'll get on with it quickly."

What's next? Trans-rectal, ultrasound-guided biopsy

Fate sometimes, conspires, doesn't it? I was away on business for the next few days so didn't receive the urgent first-class posted letter that had dropped through my door, only a couple of days after the MRI scan. Not having received it, I was a bit gob-smacked to get a phone call from a lady wanting to confirm my appointment for a biopsy.

"Er, what biopsy?"
"You've not had the letter?"
"Nope, I'm in Birmingham at a conference."
"Your MRI results are showing a shadow on the prostate and Mr Smith (name changed) has decided you need to have a biopsy."
"I see."

MRI scan of the prostate

It's all so easy. Once you are in the highly efficient mincing machine that is the NHS, (sorry if you're reading this in the USA, folks - you've missed a trick) then you get dealt with, if you are "fast-tracked" as a priority. Within a couple of days of the consultant's reluctant signing me on for a scan, I was walking through the doors of the MRI suite at my local hospital.

Normally, for an MRI, you zoom in head-first, headphones on to deaden the din that is clanking and thunking around you. However, for a scan of the prostate, you're whizzed in feet first. Oh, let's not forget the prep ...

Visiting the urology department specialist

The invitation to visit the Urology department at my local hospital was fast-tracked. When the NHS fast-track it usually means that someone phones and tells you to get your arse over there double-quick. This was no different, although it was a letter, actually. And the appointment was a couple of days later. Yeah, no need to fret. Prostate cancer is not a fast-growing one, but nonetheless, they still had their skates on.

I went and found the Urology department, taking along my trusty minder (who shall be named Gloria, to protect the innocent). The waiting room was jam-packed with blokes of a certain age - most, to be fair, older than me. Or they looked it. Gloria and I looked at each other and she said, "Get used to this, mate."

Prostate cancer begins like this ...

You know that feeling of impending doom that comes when the sun is shining the most brightly? Well I didn't have that at all. Not a jot. My whole thing was a doctor visit to check out some irregular heartbeat which vanished straight after he put me on a 24-hour ECG and told me I would live for ever.

If it had stopped there then I'd be none the wiser and none of this would be happening ... yet. But, no. What occurred was that he said, bright and perky like, "I think we'll just take some blood tests, though. Just as a precaution." Yup - no problem. I have visions of perhaps there being thyroid issues, blood sugar levels, who knows what ... "Oh, and I'll tick the PSA one while we're at it - man of your age ... etc, etc."