My brother (left), his grandson, and me last Christmas.
MAY 18, 2019: The inconsistency of PSA testing has hit close to home – my brother has just been diagnosed with advanced and aggressive prostate cancer, but his PSA showed little signs of change.
Prostate cancer was confirmed a couple of weeks ago, but he’s obviously had it for years. It’s out of the capsule and he has secondary lesions on his spine, pelvis and upper arm.
So far, no symptoms are showing with any of his internal organs (other than his prostate, obviously). He is peeing fine and there’s no bleeding anywhere.
However, the spinal tumour was large and extremely painful, the trouble first showing up last June (2018). His GP found nothing with digital examinations, so gave him painkillers and suggested he see a physiotherapist.
Physio gave temporary relief only, so he went to a chiropracter. No help. Back to the GP, who referred him to New Plymouth’s main hospital to be screened for a speciulaist appointment.
After a delay of several months – because the hospital is chronically shortstaffed and suffering from NZ-wide strikes by young doctors – the doctor who finally saw him in late March suspected bone cancer and had him admitted urgently for tests.
When I told one of the hospital specialists I’m a prostate cancer survivor (more than a decade now) and our father also had it diagnosed in his 80s, the place scrambled and my brother was soon told he had terminal bone or prostate cancer.
He was immediately transported by plane to Palmerston North (a three-hour road trip away) whose hospital has the major radiation treatment centre for the lower half of the North Island. After treatment with radiation and steroids, the tumour shrank and his doses of morphine for the pain were greatly reduced.
Back in New Plymouth a week later, he was given a digital examination by a hospital doctor, who found signs of cancer; that was confirmed by a biopsy. His Gleasons was reported as a low 3/4, but the secondary tumours are considered aggressive.
He is now on initial treatment with a combination of hormonal therapy plus docetaxel-based chemotherapy, just as my old friend Mike Scott predicted when I asked his advice last month. Mike runs that fabulous website The ‘New’ Prostate Cancer Infolink, in my view the best source of prostate cancer news and information in the world.
My brother went through the usual stages of shock, despair and denial, but moved quickly to the positive stages. Despite a stiffened arm, he has returned to work as one of New Zealand’s top freelance photographers, works the dog 4km each day and is generally positive about getting on with his life.
I would say his prognosis for years of useful life are good, despite the spread of the cancer. He can be sure of support from me (we have worked together for years anyway).
The screening of prostate cancer continues to be a worry. After I was first diagnosed in 2008, my brother has had regular digital and PSA tests every year since. My PSA never changed and my cancer was discovered by a GP with long fingers. Goes to show, doesn’t it.
BELOW: A couple of my brother’s photos that are about to be published in his 35th book. They show Mt Taranaki.
The surgeon who removed my prostate back in early 2009 reckoned I could count myself probably clear if I went a decade without any signs the cancer had spread.
So far as I know, it hasn’t. I have an annual PSA test and it’s always next to nothing, but since it never budged before I was diagnosed in late 2008 I don’t quite trust it as a sure sign. There are no other indications, however, so it all seems good.
I did get a heart scare over summer, but an exploration of my main arteries showed no sign of trouble. Turned out it was the result of a nasty virus. All good now.
My peeing is a bit slower sometimes, but I can still go eight hours of sleeping at night without having to get up for a visit to the loo. Unless I’ve had a few beers (but I’ve switched to low alcohol beer and don’t drink wine any more, so no problems there).
In terms of “performance”, everything works just fine (and a lot less messily, if you get my drift). I finally got used to the loss of a few centimetres.
At 71, I feel fit and well, and don’t ever think much about the lucky escape from prostate cancer. I hope plenty of readers of this blog have the same outcome.
My newspaper column this week (Taranaki Daily News, Saturday March 18, 2017) urges men recently diagnosed with prostate cancer to make more use of support groups.
In New Zealand, most provinces have them. They’re run in conjunction with the Prostate Cancer Foundation of NZ, the NZ Cancer Society and local area health boards.
I went to the New Plymouth one in Taranaki province recently for the first time and was surprised at the low attendance.
I also got a shock to hear one guy talk about discovering he’d had recurrence after 12 years. Twelve years!
I’d always hung on to advice that once you passed a decade of no further signs of cancer you were in the clear. Cured, in effect – although that’s not a word the medical profession ever uses.
I’m into my ninth year of showing no signs of anything untoward, so I thought I was getting close to the magic decade. Not so, it seems.
Anyway, the main message is make use of the support groups, or the dear old government might stop supporting them.
The contact for the New Plymouth one is: Peter Hickey (021-162-1334); firstname.lastname@example.org. Or go to the Prostate Cancer Foundation website to find out how to reach the group in your region: https://prostate.org.nz/support-groups/
It was an unwelcome reminder of mortality and all that, especially since there was a time back in 2009 as I faced surgery to combat prostate cancer when it seemed he might outlast me.
Macavity’s kidneys let him down in the end and he went off to the big vet-aided sleep aged 16. I don’t feel bad about outliving him, of course, but I’ll miss the little bugger.
For some reason I re-read My Cancer Story on this blog last night, and there he was in a photo, tucked under my chin while I snoozed after one of my first days back at work following the operation (as the photo above shows, he also liked to sleep on Lin’s shoulder).
Digging a hole in the garden for him and planting a commemorative rhododendron – the kind of sentimental stuff us humans do when we lose a beloved pet – set me thinking again about how lucky I am to be alive.
I haven’t done that for a long time, as the memory of my brush with prostate cancer faded and I gradually resumed “life as usual”.
I even missed my annual PSA test recently. The doc forgot to add it to the usual cholesterol and god-knows-what-else indicators he orders for my yearly trip to the lab.
But, oh well, next year will do. It’s been seven years and so far nothing shows. I know, I know…this ignores all the frantic advice I was wont to give in the earlier days of the blog. It taks a decade to be clear, and all that.
Why am I being so blase? I don’t know. Maybe it’s simply a matter of moving on. I turned 69 last week, so perhaps there is some unacknowledged instinct that says I’m on the final run, so why worry?
Reading the blog again after several years of putting it aside was a revelation in some ways. Talk about intense. Did I really mean to reveal so much private stuff? It seemed to go down pretty well with you all, if the comments are any guide, but I wonder now.
All that introspection in the later chapters about hitting the road like a gypsy and living a stress-free life seems misplaced. Especially now that Lin and I have abandoned caravan dwelling and are putting ourselves through the immense stress of buying and renovating a house in our old hometown, New Plymouth.
I’m supposed to be retired. I quit the job in Wellington running the journalism school in 2013. But life is busier than ever – writing books and articles, and getting into a fascinating project to produce a phone app for people wanting to visit the battle sites of the 19th century land wars that began here in Taranaki.
As for my health, it’s never been better. The joints and the back act up after a day on my knees laying paving stones, but no more than you’d expect in your 70th year. The blood pressure pills have been halved and the cholesterol seems to be staying down (when I stay off the pies – all that physical labour makes for an enormous appetite).
The 18-year-old pee stream (was that some kind of obsession or what) has diminished, but it’s still a good flow. Orgasms have never been so intense (those nerves really did get joined up again).
So that’s about it. I’m good, thanks. Best of luck to those of you still on the journey.
Just had another routine PSA test and the result is negative again.
That means I have how been clear of prostate cancer for six years. Life is good.
I am now meant to be retired, but approaching the age of 68 I find my work as a freelance writer, editor, photographer and journalist is as busy as ever.
I published my latest book – on how my home province of Taranaki in NZ has cleaned up its many rivers – in October last year. The next book, about a pioneering Taranaki family, is nearly ready to go to the publisher.
In my spare time, I write the occasional indepth article for a local magazine called Live.