Man up!!!

I saw a post on Facebook recently which says that 21 ejaculations a month can prevent prostate cancer (PC) in men. Predictably, only men laughed and joked at this link. Well, it’s pub humour really, isn’t it? Locker room stuff giving men the okay to ejaculate for a good cause! And yes, quite funny in the scheme of things.

But…

Not if you are just emerging from under the shadow of prostate cancer and you’ve just watched your husband come to terms with having the cancer and finding his way back to a good and meaningful life.

Tain’t easy, chaps. And we (I say we, because as you will find out if you are diagnosed, your wife or partner is an integral part of the whole process) thought we were immune!

My husband always had regular prostate checks so we weren’t at all worried about the Big C. But in 2015, Fate laughed and sent a PSA back that showed an exceptional rise from the year before. My husband’s specialist urologist decided to perform a biopsy.

The biopsy showed cancer – and we were told ‘You won’t die of this cancer. It’s small, slow-growing…’ We opted for a non-invasive process called Active Surveillance which is twice yearly PSA tests and an annual biopsy.

My husband is very fit, very active, carries no excess weight and always looks in damned good health. We grow our own food, he’s a farmer, we eat fresh wild fish and he has a red wine every evening. He has never smoked and leads a well-balanced existence. So last year, despite knowing he had PC, we had a good year – lots of work and play! He had his second PSA for the year in October and it had remained stationary. Hurrah! Life was good!

He went off for the annual biopsy (always a day procedure with a GA) and we got on with our busy existence until his appointment with the urologist for post-biopsy results. We didn’t give it a thought because of that brilliantly stationary PSA figure.

We sat in the urologist’s room and he was oddly serious. We knew something was wrong…

My husband had 30 core samples taken from the prostate. Over 75% showed an increase of up to 80% malignancy and worst on the right hand edge of the prostate. We were advised to have the prostate removed, preferably robotically (much better nerve-saving results) which meant travelling interstate.

We were blind and dumb with shock because the PSA results didn’t line up with the biopsy results. Apparently this can happen. I remember we sat in a coffee shop, just trying to process what we had heard and it wasn’t sinking in. We both felt as if we were talking about someone we knew – not my husband!

But then began the research, and the search for the BEST prostate surgeon for our purpose. All the time with fear in the back of the mind as to the future. What the side effects would be, the psychological effects, the physical recuperation – all of that. And way back in the mind, the fear of Death.

(Mr. Declan Murphy)

We found our specialist uro-oncologist – the best we could have wished for. He was somewhat of a pioneer of robotic prostate surgery in Australia, an Irishman with a delicious voice and he spared time to skype us and talked for ages, calming my husband with clear, unambiguous information and diagrams – including me in the appointment, telling me what to expect, asking me how I felt about what would happen. Because don’t forget, chaps, this operation means you have to reassess your whole view of self – especially if you measure your masculinity by your ability to ejaculate! And boy, after seeing the responses on that Facebook post, I think there are quite a few who think that’s what a man is really all about!

We flew to Melbourne and on the morning of surgery, my husband was admitted to Epworth Hospital and eventually he lay on a theatre trolley as they prepped him for surgery. They let me stay with him as they put lines in both arms, pressure stockings on his legs and so forth. He was silent and very pale. I kissed him as they wheeled him away and then walked down the stair to the hospital restaurant, talking on the phone to a dear friend who was a nursing sister in the same hospital. All of a sudden, my legs were like jelly and I leaned against the windows in the sun and just slid down and sat on the floor, still talking to my friend. I wasn’t the only one – others were leaning against the windows in the same way and no one knew how I desperately wanted to cry.

I saw him four hours later-   he was as white as a cadavre, nauseous and vague with very strong pain relief.

His prostate had been filled with cancer – at the point where delay would have resulted in leakage into lymph systems and thus bones. In the intervening 7 weeks from biopsy to operation, the prostate had gone into overdrive. The up-side was that owing to the robotics, our oncologist had removed the prostate cleanly with no leakage to the rest of the body.

The next day my husband returned to our rented apartment with a catheter and bag. This was to be our life for two weeks. He had to cope with the need to empty the bag frequently, me helping him change the bag every evening and making sure to avoid infection in the penis.

We flew back to Tasmania two days after major surgery and I honestly don’t know how I got him home. With five incisions, the bag, mental exhaustion and physical pain, we limped home and he went to his own familiar bed. But his throat had been scratched by the anaesthesiology tubing, subsequently ulcerated, and he could barely swallow – even water. He became so dehydrated, our GP almost admitted him to hospital. In addition, he had excruciating pain in the chest and shoulders which is accumulated gas from where they expand the body cavity to access the prostate. That pain lasted for 14 days which is a common but not highlighted side-effect!

It was a tough fortnight before he returned to Melbourne to have the catheter removed. After that, it was tiredness, reducing pain, regular PSA’s and finally, recovery. In addition, you men out there, bear in mind that for some time, patients must wear incontinence pads. It’s humiliating and requires exceptional adjustment of one’s view of oneself.

But the advantage of robotics is that nerve endings, although bruised, can be saved. My husband was out of what he called ‘nappies’ in 2 weeks, with the help of physio exercises and the guidance of a specialist physiotherapist. And his PSA’S began showing virtually zero residual levels.

He has worked hard on returning to physical fitness and regaining what he had lost. But tiredness from major surgery is ongoing and may last 12 months. There is also a touch of post-op PTSD which is normal with any major surgery. So never let it be said that this is an easy road. It is one however, which doesn’t have to be travelled alone in a good relationship. This is the time when partners lean on each other and I think he’s a super-hero to have been as brave as he was, to go through the indignities and come out the other side wanting men like the Facebook mob to see the importance of doing what he did!

Was it worth it?

Hell yes! My husband would have cancer through his whole body by now and be on radiation treatment with no guarantee of a cure.

Instead? Two weeks ago, his PSA results showed he is in remission. Sadly though, our 33 year old son has 40% more chance of having PC – because of his Dad. Bear in mind also that at least 8 men of our acquaintance have been diagnosed recently and that one in three men will have PC.

So come on, chaps…

Man up, bend over and have the ‘Fickle Finger of Fate’ examination and regular blood samples to test your PSA levels. It’s a lifesaver!