Radiotherapy Week 1

Finally, the wait is over – I have started my radiotherapy signalling the start of what should be the last chapter of my prostate cancer. On the day for my first round of 20 radiotherapy treatments. I didn’t feel particularly nervous or anxious. I needed a 5.20 alarm call as my appointment was just after 8.00 by which time, I needed a full bladder and empty bowel which I achieved!

The moment arrived and I went into the room where a machine nicknamed Brunel was waiting for me. The nurses positioned me very precisely on the bed and then retreated as Brunel literally sprang in to action.

Brunel cost £2.3million and is a Varian TrueBeam machine which treats up to 40 patients a day across a variety of tumour types, including breast, lung, head, neck, prostate, gastrointestinal and gynaecological cancers.

It can deliver all forms of advanced external-beam radiation to kill cancer including image-guided radiotherapy (IGRT), intensity-modulated radiotherapy (IMRT), stereotactic body radiotherapy (SBRT) and volumetric modulated arc therapy (VMAT).

I know this all sounds a bit technical, but I think it’s helpful to know. My particular treatment is IMRT. The imaging enables the radiographer to target tumours with sub-millimetre precision. This is why the alignment with my tattoos and gold seeds is so important as it cuts down the side effects on the surrounding organs.

The three Truebeam machines at The Royal Marsden. My machine is Brunel and it will derail my cancer!

The result of cutbacks! (not really)

When I awoke after three doses that week, I felt very slow but after an hour of activity felt much more with it. I rolled up to The Royal Marsden and my final treatment for the week was done and dusted inside 30 minutes. Then back to Paddington to catch the train home, or so I thought. My train was cancelled, and I had an evening commitment. For the first time in the week I felt frazzled. Three and a half hours later I was where I needed to be and felt much better.

Saturday morning arrived and I felt perfectly normal. A two-mile dog walk and a set of tennis did not tire me. It is early days, however, with a fifth of my treatment is complete.

Howzat!

This is an extract from an article in The Times written by Mike Atherton about the England World Cup semi-final which made me think…

‘Today’s semi-final against Australia represents a once in a lifetime opportunity. It will be a full cycle, 20 years or thereabouts, before the World Cup returns here, by which time every England player will have retired. The Times will have a new cricket correspondent and some readers of this newspaper, sad to say will no longer be around ‘

I was enough to go to the final and witness this incredible game, extraordinary finish and England’s victory. It left me with an outer glow to match my inner radiotherapy glow. Believe me, I have every intention of being there in 20 years’ time!

And in other news

The Friday before my treatment Lynda and I had a fabulous time with some dear friends on their boat cruising down the Dorset coast. A perfect day.

Next time

Week 2 of my treatment and I’ll describe what it’s like to have radiotherapy. 

Pre-radiotherapy golden opportunity at The Royal Marsden

This blog is one of my exciting as it details the innovative gold seed implant process that the amazing team at The Royal Marsden administered ahead of my radiotherapy starting next week…..

The Gold Standard

As I mentioned in my previous blog, I’m resistant to the usual antibiotics used to fight infection during the implantation of gold seeds around the prostate. Not to worry, this type of resistance is quite common, and the alternative is an antibiotic called metronidazole administered via a catheter. Metronidazole is an interesting drug because it’s also prescribed to alcoholics and makes them feel very ill if they drink. I was told not to have any alcohol for 48 hours which was a little unfortunate as I was attending a charity drinks reception the following evening, but I digress…

After a short wait I was ready for the procedure to implant the three gold seeds around the prostate to help target the radiotherapy beam. Suffice to say it was pretty unpleasant and without local anaesthetic as that would only create an unnecessary infection site. It was a question of ‘grin and bear it’, except I didn’t grin, I grimaced. 

However, the pain was temporary, and I played 2.5 hours of tennis the next day with no sign of infection.

This is the instrument that delivers the gold seeds. Ouch!

My ‘first’ scan

My poor old prostate needed a week to recover and settle before the CT scan could be carried out. This scan is critical as it is used to accurately target the radiotherapy beam. Some preparation is needed beforehand. The first is to have a full bladder – easily enough done.  The second is to have an empty bowel helped by an enema. Sadly, this didn’t work but we got there in the end.  If you get my drift. 

 A CT Scanner. Yes, it may look boring, but this technology has made such a difference to life expectancy. 

Second scan and success!

Four days later and everything fell into place. Literally! The scan took around 10 minutes to complete and then it was tattoo time. Three scratches and that was that. Job done. 

I’m ready for my radiotherapy to start on tomorrow ! It will last for four weeks but I’ll get the weekends off to recover. The prostate will change shape as it shrinks after each treatment and so I’ll need a CT scan before each treatment just to make sure the remainder of the prostate is targeted accurately.

My first fitness class at David Lloyd Fulham

It was time to attend my first Les Mills class at my new home gym, David Lloyd Fulham. The class was called ‘GRIT’ which was as tough as it sounds… It’s a 30-minute high-intensity interval training (HIIT) workout, designed to improve strength, cardiovascular fitness and build muscle. 

It uses barbells, weight plates and bodyweight exercises to hit all major muscle groups. It was an absolute BLAST and I’m looking forward to my next GRIT class.

And in other news

A nice surprise came courtesy of my son, Chris. He had spare tickets for the Beach Boys Concert at the Royal Albert Hall on Tuesday for my daughter and me: we had a fabulous time and helped take my mind far away from the week’s treatment. Thanks Chris!

Next time

The start of radiotherapy. Four weeks to end my cancer!

I’m a Guinea Pig going for Gold

Back from a glorious break in the Dordogne, this blog is about being a guinea pig and feeling the gold star treatment thanks to the innovative team at The Royal Marsden Hospital..

Going for gold

Post radiotherapy preparation involves two main components.

First is the insertion of a gold marker around the prostate to enable the radiographer to target the prostate accurately with Intensity Modulated Radiotherapy.  (IMRT). I’ll also be really trendy by having a couple of tattoos in my pelvic area – again to help with accurate targeting. Gold implants and tattoos – not bad for a 64 year old!

Second is having a CT scan to map the exact position and size of the prostate.

That all sounds very straightforward, however…the weekend before the gold seed procedure I was hit by a tummy bug which meant that the treatment was cancelled. The biggest risk of the procedure is an infection (sepsis or blood poisoning) as it is carried out through the wall of the rectum which, to my non-medical mind, is probably the most bug-ridden part of the body. As a precaution, antibiotics are administered prior to the procedure. However, a blood test confirmed that I am resistant to the most common antibiotics used to treat E. coli. Unfortunately, that is a sign of the times as the general population grows more resistant to these drugs. This in turn, means I will have to have different antibiotics delivered through a catheter. I’ll let you know how that goes!

About being a radiotherapy trial guinea pig…

A trial of 1,952 men (that number must be statistically significant, but I have no idea why!) who suffer from prostate cancer is currently underway and I’ve been selected to take part.

My cancer is a high risk localised prostate cancer and 20-30% of those in my category are likely to have a recurrence following radiotherapy.

The trial I am on is called ‘Pivotal Boost’ and it aims to determine whether treating the pelvic lymph nodes with Intensity Modulated Radiotherapy as well as the prostate improves survival rates, compared to just targeting the prostate.

The trial is randomised, and I have been selected to have my pelvic lymph nodes treated as well as the prostate. Like any trial it will include a control group and three variations to the IMRT treatment. All of the patients will be followed up for disease outcome and quality of life.

I think it’s great that I am part of this research and my hope is that it will play an important part by increasing survival rates.

More information about the trial can be found here https://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/a-trial-looking-at-different-ways-of-giving-radiotherapy-for-cancer-of-the-prostate-pivotalboost#undefined

PSA update – more progress!

You may recall from previous blogs that my PSA level at the time I was diagnosed with prostate cancer was 5.4. After my prostate reduction operation, it was measured at .029 and now it’s down to .007. Sure and steady progress!

And in other news

Lynda and I have just returned from a wonderful, if all too brief, visit to the Dordogne. My first time there, but Lynda is a serial returner.

And look who’s doing all the hard work!

Next time

My next appointment at the Royal Marsden Hospital is for the gold seed treatment. It seems the older I get the more valuable I become…

My Post Op Appointment at The Royal Marsden

It’s been six weeks since my prostate reduction (TURP) surgery which removed 10 grams of tissue and I feel really good!

On Tuesday I travelled up to The Royal Marsden for my follow up appointment. On arrival I had to do a couple of things.

The first was to fill out a score sheet about how my peeing had improved. The questionnaire asked such things as how many times I had to get up in the night to pee, day time frequency, urgency and so on. Overall there was a 50% improvement compared to my condition pre op. A good result that will continue to improve.

The second task was to do a flow test which measures the flow strength, followed by an ultrasound scan to see how much urine is left in my bladder. Again, another positive result. Flow is twice as strong as pre op with only a miniscule amount left in my bladder. Previously there was a significant amount.

I do, however, need to keep up the pelvic floor exercise and found  a new learning source, David Hughes Pelvic Floor Exercise – The Prostate Clinic – is coming in handy here. Check out the YouTube video here: https://www.youtube.com/watch?v=QHwVglPQR_w

Minor concerns

I had two concerns which I discussed with my urology consultant Mr Cahill (otherwise known to his colleagues as DC or The BOSS) and his colleague Ray Nicholson. Increased urgency and some slight traces of blood in my pee. Mr Cahill reassured me that the urgency (I would describe it as a burning sensation) would be much better after a couple of months. The blood? Well that’s very probably caused by ibuprofen tablets that I am taking to combat my tennis elbow. That should be cured by a hydrocortisone injection that I am having next week. If not, it might need minor surgery.

However, the great news was that my PSA level had dropped from 5.4 to 0.29. PSA in essence measures the food supply to the tumour and starving the enemy is always a winning tactic. All in all, a stunning result. My immense thanks to all at The Royal Marsden!

David Lloyd Fulham

I happily walked a mile or so down Fulham Broadway to introduce myself to the David Lloyd Fitness Club which will be my home gym during my radiotherapy. Atif, the Assistant Manager at the Club, took me through the membership paperwork before showing me the club facilities. It’s not an exaggeration to say that it is one of the largest and most impressive gyms I have ever seen.

My absolute favourite and all-important Les Mills classes are taught by an instructor but are also available as virtual sessions via a large screen in some gyms, including David Lloyd Fulham for the maximum flexibility. I think I’m going to like it here!

My excellent results combined with the warm welcome at David Lloyd Leisure made this a very good day’s work and I returned home happy.

And in other news

If you remember, I am going to visit an art gallery each day during radiotherapy. And it’s very relevant that Lynda, my significant other, is an artist. In fact, she has an open art studio this week and its proving to be a huge success. 

My son works for a company that sponsors cricket and I was very proud to see him on TV presenting the man of the match award for an England Pakistan game. Not in my wildest dreams did I ever think that would happen!

Next Time

I am back at The Royal Marsden seeing my oncologist, Dr Suh, and I hope planning my course of radiotherapy. I will report back.

Thanks for reading

 

Keeping fit cuts cancer risk by 75%

That’s quite a headline from The Times newspaper on May 6th.

The piece covered research by the John Hopkins University School of Medicine which surveyed 49,000 people and concluded that the fittest people have the best survival rate from bowel and lung cancer. The article can be found here.

Despite being treated for prostate cancer, I am otherwise fit and well. Very fit for my age in fact. I can’t tell you how grateful I am for this level of fitness which I know is helping me cope with my cancer treatment. It’s only recently I’ve achieved this level of fitness: I used to simply dabble in ‘token’ exercise. Mine is a familiar tale but here’s how I moved things up a gear to get to the point I am now: feeling fit, healthy and ready for radiotherapy.

Working long hours is not an excuse for not exercising. In 1998, I was working long hours and travelling a lot. The company I enjoyed working for was in deep trouble. Exercise was the last thing on my mind. What down time I had, I spent with my family. I would, however, get a couple of mountain bike rides in at the weekend and if I was travelling, spend 30 minutes in the hotel gym before breakfast. My fitness was no more than ticking over.

We lived in the commuter belt for New York and I was aware that people were attending spin classes at 5am but I was simply too tired. Well, that was the excuse I made.

We returned to the UK in 2001 and I was determined to start a fitness regime. I would go to the gym two days a week before work and made up my own, pretty amateurish, routine. I was in my forties and I trying to combat a bit of a bulging tummy and give tone to what muscle I had. It was just adequate, and I combined it with mountain biking and an occasional round of golf. However, most of that was sacrificed when I set up my own company in 2009.

Discovering fitness classes I’ve tried yoga, pilates and box fit type classes on holiday and enjoyed them but never really thought about attending regularly at home as the times didn’t work. I was lucky enough to be able to retire at 63 (18 months ago) and set about getting really fit. At that point, I had two other objectives: improving my coordination and balance. I joined a local gym and thought I would try some classes. I quite liked the sound of the Les Mills BODYCOMBAT class as I thought it would be similar to box fit. In fact, its nothing like it, but instead a high-energy, martial arts-inspired non-contact workout that has you punching, kicking and striking your way to fitness. It has improved my balance and coordination no end. I was fortunate to find a terrific and inspirational instructor in Lisa who has also become a highly supportive friend. I’ve made two other great friends at the class, Evie and Tara. I soon learnt that Evie was so good and followed the move directions really well, so I positioned myself so I could copy what she was doing. Tara on the other hand, likes me being in the same class as she says I make her look good!

When I first started BODYCOMBAT, I was very self-conscious as I was the only man in a class of around 15. It would have been too easy to give up from embarrassment but my determination to stick with the class has paid off spectacularly. I’m by no means perfect, but I am much more coordinated and much fitter.

The other Les Mills class Lisa teaches is BODYPUMP and with her encouragement I started attending that too. This is a full-body weights workout aimed at getting you lean, toned and fit. Like BODYCOMBAT, it’s set to great music tracks which really help carry you through the workout: particularly the tougher sections! My strength and muscle tone have improved considerably through doing this class. As I have mentioned in a previous blog, the drugs I am taking and the radiotherapy (yet to come) weaken the bones and lead to a loss of energy, strength and muscle mass, so both these classes are ideal. My consultant at the Royal Marsden has expressly recommended I continue with my classes to help offset the physical impact of my treatment: not to mention the great social benefit of exercising with others which also lifts my spirits.

Les Mills Bodypump class

Next week I am away but the great thing about Les Mills classes is they are available throughout the UK (and throughout the world) and through its website I have already identified the time and location of classes close to where I will be staying. My fitness routine is as important to me as brushing my teeth. And as natural!

Les Mills Bodypump class

At this point, I really do need to thank Les Mills for their wonderful support, not least of which included putting me in touch with the David Lloyd Leisure Club in Fulham who have generously offered me free temporary membership so I can continue my BODYCOMBAT and BODYPUMP sessions while undergoing my radiotherapy at the Royal Marsden nearby in Chelsea.

Such gestures mean so much. I’m going into radiotherapy with a plan Mr Cahill, my consultant at the Royal Marsden, has set me some objectives once radiotherapy commences (probably in June) which I have built on.

Les Mills Bodypump class

Here’s the plan!

  • Treat cancer with respect but deal with it like any other illness.
  • Visit an art gallery each day. I will do this with help from my gym buddy Tara and my significant other, Lynda.
  • (I will also attend some cricket matches at Lords!)
  • Keep up my Les Mills BODYCOMBAT and BODYPUMP classes in London
  • Carry on with at least two weekly tennis sessions
  • Continue to play golf twice monthly
  • I have also set myself a goal that in March 2020, I will run the Bath Half Marathon to mark the end of my prostate cancer.

Les Mills Bodypump class

In other news, the wedding venue chosen by Chris and Sophie was stunning, it will be a very special day. I also went on my first mountain bike ride after my op and everything was still intact when I returned! Last week Lynda and I attended a brilliant concert by the Bournemouth Symphony Orchestra. I heard a piece not known to me by Suk, ‘Scherzo Fantastique’, which was very uplifting as was the entire concert. Music is another one of life’s great healers! Next Time In my next blog I am going to deal with the mental anguish caused by being diagnosed with cancer and coming to terms with the fact that one day life will end.

You have cancer

My first encounter with cancer was when I was just eight. A girl and friend of the same age who lived nearby had cancer and I remember visiting her a few days before she died. Perhaps we all have sad and lasting memories like that. Through the years, friends (some in their thirties) and family members have died of the disease, but nothing prepares you to be told, “you have cancer”.

Mind games

I don’t think I’m unduly pessimistic, but the diagnosis of a problem prostate played on my mind. It was either benign or cancerous. There was no middle ground. I looked to the internet for reassurance but ended up scaring myself. The question that returned time and time again was ‘would I be alive to see my son’s wedding in May 2020?’

It was also a very difficult time for those around me, as I became extremely withdrawn. I had no other mental capacity, other than to think about my fate. I struggled to be cheerful even though it was Christmas time. I know it was tough on Lynda, my significant other, as well as my children.

That January day came when the Macmillan nurse confirmed cancer. That was a very lonely moment despite the support I knew I could rely on. I just had to get on with it. The next worry was whether it had spread to the lymph nodes or my bones, known as metastatic cancer. If it had gone into the bone it couldn’t be cured, ‘just managed’, whatever that meant. What I needed was a bone scan.

How do you tell your children you have cancer?

My immediate concern was how to tell my children. Like any parent, I want to protect them, but I agonised over whether to tell them or not, at least until I knew the degree of cancer I had. I concluded the sooner they knew the better. I rang them both and there was a mixture of shock and upset. In many ways those phone calls are the most difficult thing I have ever done.

The scans – fears and doubts

I needed a bone scan to confirm whether the cancer had spread. I first needed to be injected with a radioactive dye and then had to wait two hours for it to circulate. I used that time for some retail therapy, which helped!

The scan took 40 minutes or so and it was imperative that I didn’t move. When it was all over, I asked the radiotherapist if the scans were ok. What I meant was were the images clear. However, she thought I was asking whether the cancer had spread, and she replied flatly that she couldn’t say. In my mind I asked myself whether she knew that the cancer had spread. I tried to read her body language and my mind raced with thoughts. Those thoughts continued to haunt me through the next few days. The Macmillan nurse rang me to say there was a suspicious shadow on my pelvic bone, but she needed to refer it back to the consultant. I feared the worst.

A week later Lynda and I were in Padstow on holiday. My phone rang and it was the nurse to say my cancer had not spread. We cried with joy.

It wasn’t all rosy though.  Soon afterwards I had the first consultation with Mr Cahill my urology consultant. He looked at the MRI and Bone scans and concluded that the cancer was not straightforward. He thought it had spread into the neck of the bladder and wanted me to have a PET scan.  My imagination took over once again. Once more, that question, would I be alive for my son’s wedding? A PET scan is very similar to a bone scan but with different definition. Radioactive liquid is injected into the veins, there’s a wait for it to circulate and then one lies still for 40 minutes while the machine goes into action. One compensation was that I could play music to partially drown out the large mechanical noise of the scanning magnets. Thank you, Spotify!

More days passed; my mind continued to race. Then relative relief came when Mr Cahill confirmed my cancer was advanced but localised. It had not spread beyond the prostate.

Acceptance and Purpose

Life is so much easier when you realise there are things that you can change and things that are just beyond your control. That’s acceptance and I don’t pretend it’s easy.

What if my cancer had spread? I looked in the mirror and realised that whatever the outcome, I was going to die one day. All of us know that, but having to stare it in the face is an entirely different matter. This year, next year, in a decade… that day will certainly arrive.

A book called ‘Man’s Search for Meaning’ by Viktor Frankl has helped. The author survived a number of Nazi Concentration Camps including Auschwitz. He tells of companions who just gave up but also of how survivors built purpose and meaning into their suffering. I cannot hope to do the book justice in this blog, but it was written in 1946 and is still in print. I found it both sobering and helpful. It puts things in context.

Talking of context, I feel lucky to have had this scrape with cancer because it could have been so much worse. To some extent I’ve created my own luck by keeping fit, by insisting that something was wrong to my GP and by dealing with my condition with thoroughness. I am humbled because not everyone has the knowledge or capacity to do what I have done, but there are no guarantees for the future.

Live life

Despite all my efforts and the wonderful health professionals taking care of me, I know that my cancer can return even if I’m cured.  

I know of a very wealthy investment manager who wanted for nothing. He and his wife had huge plans for ‘one day’. But that day never came as she died suddenly. I’m not saying live every day as your last, but I am saying get on with making those plans a reality while you can, because the fateful day is an inevitability.

I have lots of plans this year including my first ever 3-day pop festival (part of Lynda’s birthday celebrations) but more of that to come in future blogs.

In other news

I took my daughter Catherine and her fiancé, David, for a meal in London on Wednesday. We went to a Peruvian restaurant. Why Peruvian? It has great memories for all of us and it was where Lynda and I went last year on what was the most memorable and exciting adventure. Its not often my kids have been somewhere I haven’t, but that list is beginning to grow. As I said earlier its time to make some plans and go!

Next time

I have an appointment with Mr Cahill, and I can happily report to him that I am peeing like a teenager and the pain has gone. I am looking forward to seeing him and the other fantastic staff at the Royal Marsden. I will report back what they say…

How I discovered my prostate cancer

You may wonder how I found my prostate cancer in the first place. The main indicator for me was that I hadn’t been peeing with a strong flow. Easily dismissed as one of those ‘age things’ and it had also been a gradual process. But what really sparked me into action was an increasing pain that occurred immediately before I peed. I went to see my GP a couple of times and on the second appointment I persisted that something was not right and asked to be referred to a urologist. I just knew, you know?

Going digital

I saw the urologist in early November 2018 and had something called a digital examination, but it was far from high tech. The consultant asked me to lie on my side on an examination table, with my knees brought up towards my chest. He slid a finger gently into my back passage. Uncomfortable and embarrassing yes, but absolutely vital. Please don’t let this put you off having an examination: those two minutes very probably saved my life.

He said my prostate was a ‘little firm’ but nothing to worry about and arranged an MRI scan, which is by far the best way to confirm whether the prostate is benign or as in my case cancerous. I also has something called a PSA blood test. The PSA test is a blood test to help detect prostate cancer. But it’s not perfect and won’t find all prostate cancers which is why the MRI scan needs to be carried out in tandem.

The test, which can be done at a GP surgery, measures the level of prostate-specific antigen (PSA) in the blood.

PSA is a protein made only by the prostate gland. Some of it gets into the blood, but how much depends on age and the health of the prostate. My PSA level is 5.4, the norm for men of my age is around 4. Some patients have PSA levels that exceed 100!

I was also sent for a biopsy which had similarities to the digital examination but with the addition of cutting bits of the prostate for examination with the consultant being guided by an ultrasound scanner.

2019 arrived and two days in, I was told that I had a 3.5mm tumour. Not the best way to start the year. Even worse was to come as the results of a bone scan showed a suspicious shadow that suggested it had spread to the pelvic bone. This was the most difficult time mentally and it didn’t end there. The mental challenge is tough and I will write a blog about how I managed this difficult time in the next few weeks.

Two important phone calls

I am blessed to have some very good and remarkable friends. Omkar is exactly twelve years older than me and was diagnosed with prostate cancer five years ago. He also had a prostate reduction (TURP) although his cancer did not occur until some years afterwards.

He, along with his consultant, had to weigh up the options of either a proctectomy or radiotherapy with the latter being the chosen treatment.

He came through his treatment very well and I hope that in some small way I supported him as he has me. When I called him, he reassured me but suggested that I called another friend, Alan.

Alan had a prostate scare some years ago. Alan is very thorough and researched who the best urology consultants were. He suggested that I should see Mr. Cahill at the Royal Marsden, which I did privately. Another digital examination and his verdict was that the prostate was a lot more than “a little firm”.

I asked him how long it had been there, and he said for years, maybe as long as 10 years. It was very fortunately, a slow growing cancer.

Mr. Cahill studied the MRI and bone scan and was worried that the cancer had spread to the bladder. Another scan, this time a PET scan which is similar to a bone scan where radioactive liquid is injected into the body, which then highlights whether the cancer has spread beyond the prostate. Another agonising wait.

Four days later I was told that the cancer was still localised. What a relief. Now I knew exactly what I was facing.

Mr. Cahill arranged for me to see an oncologist who was incredibly helpful and explained in simple terms my treatment options. It was very much a fine balance whether I opted for the proctectomy (prostate removal surgery) or the radiotherapy.

The radiotherapy was just favoured, all things considered.  It has yet to be determined whether this is for five days a week for four or seven weeks. That will be decided at the end of May, once the scarring to the prostate caused by the prostate reduction has settled.

Hormones, yes hormones!

Hormone therapy shrinks the tumour by starving it of its food supply, testosterone. In fact, it’s a treatment not just restricted to prostate cancer.

Once I’d seen Mr Cahill, he prescribed Bicalutamide which is a type of hormone drug called an anti-androgen. It stops testosterone from reaching the cancer cells.

I was also injected with a drug called Prostap. It was administered just under the skin in my tummy with the longest needle I’ve ever seen, but it was painless. I will need one of these injections every three months for the next two years.

The idea of the hormone treatment is to reduce the tumour size ahead of the radiotherapy and thereafter inhibit and stop any regrowth of the cancer.

It does have side effects and the one I was most concerned about was mood swings, but I’m pleased to say this has been minimal. As I wrote in my last blog, exercise has played an important role in reducing this and other side effects.

Next time

I will be focussing on my fitness regime next and how as a forty-year-old, I came to the realisation that working long hours was no excuse for not exercising

And in other news….

This weekend I am visiting  my fantastic son Chris and his equally fantastic fiancé Sophie to visit the venue they have chosen for their wedding reception. His Mum, and future in-laws will also be there: it will be a very special time. Their wedding will be in our village church next May and it’s another wonderful thing to look forward to.

Thanks for reading

Let it flow


The operation aftermath

In this blog I’m going to describe the aftermath of the TURP operation (transurethral resection of the prostate or more simply urethra rebore). I wish I could say it’s a pleasant story, but I will tell it the way it is. It is however a good story.

The TURP procedure chips away at the prostate and those chips are then passed in the urine. It hurt to pee and it seemed to me the main pain was coming from the catheter site. It was a sharp stinging sensation and became more painful as the bits of prostate were passed. Yes, it was very disconcerting to see these small blood clot-like particles in my pee but it is a normal progression after the operation. Tiredness also came upon me and I needed a thirty-minute lunchtime nap for the next couple of days.

The fountain of youth

My flow, if Mr Cahill is to be believed (in my experience he IS!) is strong enough to go over a wall, I promise to try this in due course but not just yet. I am going on a cruise in September and the cabin has a balcony, which gives me untold options.  Sorry, I digress….

The sensation of your bladder emptying fast is odd and it leaves a burning sensation. This eased after about seven days coincidently with the end of the bloody pee. 

But it wasn’t quite over: ten days later, the wound scabs dropped off the prostate and so I was passing blood again for another three days. That has now stopped but the burning pain is still there. I’m advised this should ease in the next few days.

The last exercise men think they will ever need

I’m going to focus a lot on exercise. In later blogs I’ll cover how beneficial exercise is going into the treatments I’m having (the TURP, radiotherapy and drugs) and also how it aids recovery. But firstly, let me speak frankly about a muscle that many women are more familiar with – and aware of – than men.  The pelvic floor. My first familiarisation with the pelvic floor was after Catherine, my daughter was born and the difficult labour my then wife had. (As an aside, the agony she went through made my TURP seem like a walk in the park.) As part of her recovery she was given pelvic floor exercises and I found it difficult to imagine where it was and what it must feel like.

‘Engaging your pelvic floor’ is very much a phrase you hear directed at ladies in women’s exercise classes.  For good reason for many.  But we men also need to know about this muscle: here’s why.

Before my op I signed up to a NHS app, ‘NHS Squeezy for Men” . It’s very helpful and describes the knack of pelvic floor exercise and how to squeeze as well as giving a reminder three times a day for six lots of exercises per session. (£2.99, well spent). So why is this so important? Whether you go for radiotherapy or a prostatectomy the chances are your pelvic floor will be weakened. 

So – to the knack. I can only describe my pelvic floor as a kind of vague feeling ’downstairs’. Imagine that you are about to sneeze: your body reacts by tightening the valve in your bladder and back passage. That’s the pelvic floor saving your blushes! 

Facing cancer with fitness

I hold the view that if you face a battle of any sort, preparation is vital. I know it’s a cliché but ‘fail to plan and plan to fail’. My preparation for going into battle with cancer meant being at my best physically and mentally; I will deal with the mental and emotional side in a later blog because it’s tough knowing you have cancer and also tough for those close to you.

In terms of physical fitness, anyone who knows me, knows I’m a bit of a fitness nut and prior to my diagnosis was particularly partial to a range of group exercise programmes from the fitness masters Les Mills.  I do their BODYCOMBAT (martial arts-inspired workout: great feel-good session that also busts any stress you may be feeling); BODYPUMP (a resistance class using weights to challenge all muscles in your body – including ones you didn’t know existed and, yes, the pelvic floor is ‘engaged’ throughout!) and BODYBALANCE (an extraordinary stretch class that isn’t quite as relaxing as it sounds but is remarkable for flexibility).

Suffice to say, I was fit going into the op and my Mr Cahill was delighted with me for that!  He told me “Surviving cancer and tolerating treatment appear to be helped by strength and fitness. It is also a great help to surgeons if someone has low body fat as it enables us to operate more easily and safer. Better: especially if a tumour is found in the lower body, such as prostate cancer, when we may need to access it through the abdomen.”  Mr Cahill also firmly believes that having a good level of fitness dramatically improves the recovery process.  “Cancer treatment results in the loss of energy, strength and muscle mass. This is associated with negative feelings. Exercise can help redress these problems and men who commit to exercise in tandem with their treatment do much better.”

This week I have been to two BODYCOMBAT cardio classes, one BODYPUMP resistance class, another BODYBALANCE class, played an hour and a half of tennis and nine holes of golf as well as enjoying a good few longish dog walks.

And so it turns out: eight days after my op, I went to my Les Mills BODYBALANCE stretch class that combines, Tai Chi, Pilates and Yoga and coped with that fairly well. After nine days I played two sets of tennis…

There will be an entire blog on my fitness regime and the help and fitness coaching I am having in a couple of blogs time. But, for now, I can honestly say my high level of fitness going into this prostate cancer process has been my saving grace.

My next blog will go back to the start of my story of how my episode of prostate cancer began.

And finally…

I mentioned in my last blog the wonderful care I had during my stay in Wilson Ward. In particular I’d like to thank nurses Amy and Michelle and Dr Eva Bolton for taking such good care of me.

Let me leave you on a happy note if I may.  On Easter Sunday my soon-to-be son-in-law David asked my wonderful daughter Catherine to marry him. And she said yes!

As ever thanks for reading.

Pete’s Prostate Problem

The journey of one in eight men

I’m Pete and I have a prostate problem. I’d like to say I HAD a prosate problem but it’s still a work in progress.

Last week I had a procedure known as a TURP, which put simply is a rebore of the uretha. My surgery went well and my radiotherapy awaits. Things are looking positive. I’m feeling positive. And I want to share my experience in the hope that other men and women reading this might learn a little, be encouraged a lot and share with me in speaking out about this common, slow burning, ‘silent’ cancer that can lie in your body for a long while before you notice. I first noticed because I couldn’t pee properly, which I guess many men put down to age…. I’m a fit 64-year-old – a recent body ‘MOT test’ at Nuffield Health put me as more healthy than most 20-somethings. Nice to know. But the reality I soon discovered was, like many 60-something men I had an enlarged prostate. Not only that, mine wasn’t benign – as many are. Mine was cancerous (for the medically minded among you, my Gleason score of 3 + 4.) In this blog I will describe the episodes that my prostate journey has taken: it may not be beautifully written and isn’t in chronological order. But here we go…

The Royal Marsden awaits

I stayed with my daughter in London so I could make an early start and get to the Royal Marsden Hospital, Chelsea for 7.30 am. I was pleased to be second on the list and delighted to be moved up to number one. Oh, but hang on a minute, the first of the week?! Isn’t that a bit risky – first one back after the weekend…

Not risky at all – this is the Royal Marsden and Mr Declan Cahill is my consultant . A few visits from the medical staff to confirm my details and then it was over to the anaesthetist. Very up to date. No need to count to ten…..B R E X i t …you get the idea….zzzz

Moves like Jagger 

I regained consciousness in the recovery room at around 10.45 and felt quite normal. Except that my most private part was tethered via a three-way catheter to drips and pee bag (technically a urostomy bag). A brief visit from Mr Cahill who promised that I could now pee over a wall, although it’s been decades since I last tried.

I was then moved onto Wilson Ward and decided to restore a degree of normality by listening to the Ken Bruce programme on Radio 2 (and of course Pop Master) via the BBC Sounds catch-up. Bluetooth headphones on I started to listen. Two minutes into the show, a nurse kindly pointed out that I was, in fact, broadcasting to the ward as Bluetooth had failed to connect! The song playing was Moves like Jagger; fat chance of that !

Visitors

Just after a really good lunch (yes the Royal Marsden’s food is fantastic) I had my first visitor. My lovely significant other, Lynda, laden with a skinny flat white and other treats from Pret. She’s a very talented artist and this will become very relevant in blogs to come. Lynda has been incredibly supportive since my diagnosis. I felt myself outwardly and inwardly smiling. We spent three wonderful hours together, just being.

Afterwards I started to read but in no time at all my kids, Catherine and Chris, arrived also with some treats They both work in the City and it was so good to see them; the joy and pride they bring lifted my spirits further. David, Catherine’s boyfriend, was a wonderful surprise visitor later. He works incredibly long hours and still found time to see me.

A long night’s day into morning 

It turned out to be a long night with barely any sleep. The kind of night when you will dawn to come. The catheter made it difficult to move around and get comfortable, the normal hospital noise and what felt like an adrenaline boost were all factors. Before breakfast the doc did her rounds. She was very happy with the colour of my pee , it was the shade of a good rosé from Provence. Although I couldn’t vouch for the nose or palate, it was definitely not corked. I felt good despite my lack of sleep and thought that there was a chance that I could be discharged that day.

My morning was filled with reading and getting to know other patients That was very humbling; a man in his thirties with an inoperable tumour who needed his blood balanced, older patients with various cancers but all with hope and all being cared for and loved in the most extraordinary way.

Just before lunch and after some mild encouragement from me, the catheter was removed. As you can imagine this was not without pain, but it was worth it. Now I had to pee for myself and if I could pee into the urine bottle and empty my bladder twice, I would be discharged (in more ways than one!). I did and I was.

A big thank you to all the staff who looked after me so well on Wilson Ward.

Going home 

I arranged to meet Catherine at Canon Street Station and started my journey via the Pret opposite South Kensington Tube. The lovely girl who served me saw my hospital ID bracelet and said my flat white was on the house. Little acts like that mean so much.

Catherine and I travelled back to her house and after dinner David, his brother and I all watched the Man City, Spurs Champions League match.  Everything felt nice and normal.

I slept well that night even though it was punctuated with a few visits to the loo.  I didn’t mind being disturbed by these little victories: Pete peeing was a very good sign!

Thanks for reading my first blog: do check back soon for my next weeks instalment which will cover the early days after surgery and quickly getting back to normality