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."

We were called up to a second waiting room which was just as packed with the brothers, uncles and fathers of all the fellahs downstairs. Then we waited. Urology is a busy department and getting to see the consultant is a slow process, but we got there. The rather bored looking man behind the desk was not the main person. He looked at my notes, looked at me and asked all the usual questions. Here they are, with my answers in italics, for reference:

• Do you have any difficulty passing water? Nope - none at all. Veritable waterfall
• Any urgency - needing to go right now? Occasionally. Doesn't everyone?
• What about sex? I've only just met you (I didn't really say that). All working fine
• Any issue with spontaneous erections? Do I get them? Yes. Any issue. No. Deal with them in the usual way
• Blood in the urine at all? Nope

He then told me what I already knew, that my PSA (which incidentally stands for Prostate Specific Antigen - a sort of marker for Prostate Cancer) was 4.9 and did I know that that was higher than normal for a man of my age? Yes I did.

"Hmmm. I'd better shove my finger up your bum then," says he. Not quite in those words. Now, let's just step back a moment. This guy is, I believe, Greek and he's fairly hefty. You know what's coming?

Fingers like Cumberland Sausages. I chose not to look at him again until the indignity was over. He wasn't able to feel my prostate at all, either because my sphincter was clenching in protest or because his fingers were just too short and stubby. And he wanted to have me standing up, leaning over the bed. (I prefer to lie on my side, clutching my legs. And I like my doctors with slim elegant fingers that can probe without causing distress, but I digress.)

More with the Hmmm and then he said, "So, I think we'll monitor you for six months and watch your PSA. If it climbs then we'll need to look further." This is basically translated as, if you do have prostate cancer, it will get worse and then your PSA will go up. Then we'll do something.

Fortunately for me, there was a very bright Urology nurse, sitting in on the consultation. "Do you think that it might be an idea to give him an MRI, just to be sure?"

There was a pause. "Hmmm. Yes, that would probably be a good idea. So we'll look at your prostate with the MRI and then give you a call if there's anything showing up."

That all seemed very reasonable to me and off we went, Gloria and I, discussing the merits of MRI (Magnetic Resonance Imaging) against those of CAT (computerised axial tomography) scanning. I was feeling great. Gloria was beautiful (still is) and the world was readying for Christmas. What could possibly go wrong?

Let's put it this way, I had reason to thank the bright nurse in the consultation room ...