Prostate news article, January 2008
THE SILENT KILLER It kills around 10,000 men a year yet it is hardly talked about...
Article by patient Hamish Marett-Crosby. |
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It kills around 10,000 men a year yet it is hardly talked about and in the view of one man who has suffered from it, precious little is done to protect men from it. It is called the silent killer and Hamish Marett-Crosby, who was diagnosed with prostate cancer just before Christmas 2006, looks back on a troubled year.
"This is surreal," I thought. In another context it would be the stuff of fantasy, or one of those memoirs which seem to focus on what had been wished for, rather than what actually happened. Let me explain. I was lying back, flat out, looking up at the ceiling and - as I had missed both meals that day - munching a cheese roll. Further to the south, as it were, two young women were fiddling around between my thighs. They were in fact attaching some leads to a rather strange machine which was going, and I quote,:"To sort me out."
It is too soon to be one hundred per cent sure, but I think I have been sorted out. All this was happening in the basement of the University College Hospital at the top of Tottenham Court Road and I was undergoing a relatively new procedure for dealing with an aggressive Prostate Cancer. It was new to me; I had first heard of it a few months prior to that day and, while trying to find out more on the subject, I had told my Cancer Back-Up group I was going to be given High Dose Rate Brachytherapy; they hadn't heard of it either.
Is it me or is it only since I was diagnosed with Prostate Cancer that everyone seems to be talking and writing about it? For too long it has been something mentioned in hushed tones but never discussed openly. Taking myself as a typical example, the level of ignorance about the subject is astounding, yet thousands of men are dying needlessly. Cervical cancer, breast cancer; both have come out into the open over the past decade or two. Everyone is aware of them, there is nothing to be ashamed of and everything to be gained by early diagnosis. Yet as far as prostate cancer is concerned, there is a hearty dismissal of the whole thing with the variation on the not very consoling line that you're are more likely to die with it than from it. Great! But from the other side of the fence there is the realisation that the dreaded "C" word, is now attached to you. "I have cancer," I woke up saying to myself the day after the diagnosis came through. Cancer! Like winning the lottery, it's something that happened to other people.
As for the officially inspired nonsense about dying with prostate cancer than from it, it might be true once it is found - indeed if it is found, and if a test is taken soon enough, but that's the catch all, no one offers the test.
This is the time when support is essential. Someone to help you through those dark moments, when the natural reaction to the bald fact that you have cancer breaks through your defences, and you feel low, very low. I have had, and have, that support, I am lucky. I also had the advantage of working in an environment which kept the mind active and does not give you time to get involved in too much self-analysis. To those who can cope with the chaos, there is no better cure for introspection than working in a radio news room. The television is on, the radio is on, phone conversations continue all round; there are good jokes, bad jokes, scandalous gossip and the pressure of the deadlines throughout the day leading up to the key news broadcasts. Add to that the necessity, in my case, for maintaining an on-air persona. All this is excellent therapy, you have neither the time nor the opportunity to feel sorry for yourself.
Testing
We close our eyes, bury our head and hope it will pass you by but, it is - at least Prostate Cancer is - something you can be prepared for even if, for some inexplicable reason neither the health authorities, nor enough GPs seem willing to promote a simple blood test that can give early warning of something going awry. The technology is there; the risks of Prostate cancer - thousands of deaths a year - are well documented, but still the medical establishment seems unwilling to move on this matter. Could someone - in words of one syllable - tell me why?
Apparently the test can give false results (name me a cancer test that doesn't) and it's also relatively expensive to follow up but are we worried about money as regards health? Of course we're, not, at least not officially. But on the other hand, perhaps we are. Whatever it's effectiveness, however, it's all we've got, so the question has to be asked again and again until someone gives a satisfactory answer: "Why are lives being put at risk un-necessarily?"
Not having heard of the PSA blood test, and only being vaguely aware of where the prostate was, and even less aware of what it did, the whole diagnostic and treatment regime was, quite frankly, a bit frightening. The down-to-earth approach at Cancer Back-up and above all the straightforward advice I received at the clinic did much to alleviate the fear. Of the various options for treating the disease, surgery and standard brachytherapy were out, as I was too far down the road. The cancer had spread. As a result the HDR option was decided on, but that would be after a 9 month course of hormone blocking drugs to shrink and starve the main tumour, and reduce, down to nothing, the other nodules that had spread from the prostate.
"Why are you crying"
The hormone treatment worked in reducing the cancer but also had two bizarre side effects - I would get the occasional hot flush which brought me no sympathy from any woman over a certain age and it also made me very weepy. Corny sad films would have me in floods of tears. And not only films: "What are you crying for" my grand-daughter would ask as I struggled to the end of The Selfish Giant. "Because it's sad," I would reply brokenly as the tears rolled down. I now stay well clear of children's television, especially the classic repeats, and as for films, there is no chance of sitting through such famous wheepies as Bambi, Greyfriars Bobby or Lassie Come Home without breaking down entirely.
But it's not even those obvious pitfalls. Watching a documentary about the outbreak of the second world war, the sight of the Polish cavalry, armed with lances, facing up to the German tanks had me howling. People have only got to go out of their way to be kind - and many do - and ask me how the treatment is progressing, to set me off yet again.
Don't leave it too late
But there is the other side, I was lucky. Luck had brought me to Dr. Heather Payne consultant oncologist at University College Hospital. Unassuming and un-dramatic, as well as being a dab hand at sketching, she outlined, in a few horrendously graphic stokes, what she thought was the best way to deal with my problem. And forget all this nonsense about dying with prostate cancer than from it, that is true once it is found - indeed if it is found, if a test is taken soon enough - and dealt with early enough in the process. A month or two before I went to hospital, a contemporary of mine, a politician I had interviewed many times, had died of it and, in London, the centre was sprinkled with posters of the late Bob Monkhouse warning us not to follow his example and leave it too late.
Through ignorance I had very nearly done just that. The cancer had spread, the time for operation was past but, as I said, I had found Heather Payne; she was in the vanguard of developing HDR treatment in the UK, a process which would burn out the cancer and that would be followed by a mopping-up process, radiotherapy. Given the success of the proposed HDR treatment, a shorter series of radiotherapy, (at a lower dose) than would normally have been the case, would then be needed to clear up the residue. Less chance therefore for what our friends in the US Air Force refer to as collateral damage.
"I can't guarantee a cure Hamish," Heather had said, "but it's the best chance you are going to have."
As I said, simple, straightforward and direct, the best way to encourage confidence; a feeling augmented by the way her staff obviously view her as one who walks on water. She even made signing the consent form not too daunting. Why daunting? Because these days every possible eventuality has to be spelt out; it's all an element of the don't-say-we-didn't-warn-you syndrome that comes as part of our increasingly litigious society. The list of what could go wrong and what might happen is the stuff of nightmares. Don't think about it.
Not unbearable
Now to answer the obvious question. The treatment is invasive and unpleasant but not unbearable. Two days of lying down flat on your back with your legs propped up and with a load of needles in you is uncomfortable, very uncomfortable, but nothing if one considers the alternative.
And then there is University College Hospital itself. A gleaming structure of steel and glass with the oncology ward on the 16th floor. Once I had progressed to shuffling-around-mode, I could move from side to side of the tower and pass the time looking across London and then down at the traffic on the Tottenham Court and Euston Roads; a pastime which gives one a god-like feeling of superiority and detachment. Nor does one feel cut off; there is an acceptance that people will, and do, use their mobiles phones and as a consequence much of the time was spent sending texts in answer to all the enquiries about my health. Perhaps it is the presence of the Post Office Tower only a couple of hundred yards away and the knowledge that any emissions from my mobile phone would be as nothing to what was being thrown out of that London land-mark.
"It looks good," said Heather as I was discharged. "We've burnt out that tumour of yours, it's been a text book case." "In fact it looks beautiful," said this remarkable woman who can see beauty in a prostate.
So it came about that I was one of the privileged. Privileged because, after 5 days in the oncology ward in a major London teaching hospital, I was walking away full of optimism; there were many there, I left behind, who would never been in a position to feel anything similar. All that's left is to complete the radiotherapy course; with luck it will be, at worst, inconvenient, nothing like the main procedure ...and then? Well that's the big question. Do I go back to as before, or do I re-assess what I do with the extra life I have now been offered?