Radiotherapy of prostate cancer.
So in Part 2, I left you just after my treatment had ended. We had finally finished the daily trip. I have to say the hospital team was fantastic, so yes it was a long trip – each day there and back, but they helped a lot to ease the feeling on this. The treatment itself (the radiotherapy) did not cause me any pain or reaction which was just as well as I was driving. I was warned by the consultant that at the latter end of the treatment there might be issues with my skin around the area being treated, but I was fortunate enough not to have this happen to me. Apparently, the skin can become very irritated, and you deal with this by massaging appropriate cream into it. We bought the cream in anticipation but did not need it. Anyone for a free tube of cream??
How did my wife feel about all this?
I think you remember that she herself had been through breast cancer from which she came out of the other side okay. She had also gone through several operations since we had moved to our current country. I think the biggest issue which my darling wife had was the fact that my half brother had died from cancer a year before I was diagnosed. We know that prostate cancer is not hereditary and of course, he was my half brother and not my biological full brother, but this lead to a lot of uncertainty for my wife. I guess one of the crucial points of the whole process was that the initial diagnosis was followed by a very rapid look at the remaining parts of my body to see whether cancer had spread to any of these. The fact that this was rapid and of course was negative was a very comforting factor. There was still the doubt as to whether the prostate cancer could still be contained within my prostate. We could only both take the approach at that time it was a case of only time will tell. In essence, I think Sheila was just so relieved that I had finally taken notice and gone for a check-up, as you can imagine. How fortuitous was this!
Sheila came with me to some of the treatment sessions which were helpful because the drive was the same old after about 25 sessions, with still 19 to go. So really at this stage we both could only wait and see what was happening, we learned a lot about prostate cancer from various areas including the web with the caveat that you don’t believe everything you read. One of the things that always happen, of course, is that once you have a form of cancer, then you get tales from other people – some are helpful, and some are distinctly not helpful. One of our friends, when he found out, had absolutely no feeling for us at all and just went on about the fact that he had a PSA test which was fine, this did not make me feel particularly happy. You never go looking for sympathy because there are people who are way worse off than me, as we noted when we were waiting for my sessions to start at the hospital. There were folks coming in who looked, and I am sure felt very very poorly.
So how did I feel at this stage then?
I think the main issue was a feeling of having very little energy, and when I spoke with the consultants about this, they said that it was unlikely I would ever get back to my full energy level, and for some time I would expect to feel very tired at some periods during the day. This is exactly right – I would have days where it seemed okay, but then at some time in the day my energy level would drop considerably, and I would feel very lethargic. Of course, you learn to get around this, and you learn to do jobs in stages rather than trying to get them all done in one go. It takes time and a change of attitude, but it works.
The hot flushes continued, and even up to today, but again this is something that you just get used to; it is there, and while you don’t want it there is no choice. I think the other thing which I found probably most challenging to deal with (but again do you have a choice) was the fact that during the night I would have to get up and go to the toilet two and mainly three times per night to pee. We tried all ways to get around this like reducing my fluid intake in the evening, but it’s just a bodily function. I talked to the consultants again, and they said yes, unfortunately, this is an issue, but we can manage it using tablets. However, it will never go away. In a sense, this is quite debilitating because you may not be able to go back to sleep and end up having broken sleep patterns. I think even now I have only had one night since the end of the treatment where I have slept right through.
Six months on.
Six months down the road after the treatment had been completed all of the symptoms were still with me. We learned to live with them, which is fine, but nothing really had changed. I talked to the consultant again, and he reassured me that this is quite normal and I could expect no real change until possibly one year after the treatment had ended. He pointed out that radiotherapy is a serious treatment of the body which takes quite a knock when this is applied over several such sessions. Okay, fine by me as long as I know.
In terms of follow up after the treatment ended the process is a hormone injection into my subcutaneous (skin layer to you and me) in my stomach which is every three months. At the same time, I go for a PSA test. The PSA results were interesting. Initially, as you already know, they went down very low (0.077), but then they started to creep back up very slowly. They have not yet reached 1 to give you an idea, but they are certainly going the wrong way. The consultants are not bothered, but if after my next PSA the trend is continuing they may give me a Pet Scan to see if anything is happening. The interesting point they made is that my PSA tests are now different in the sense they are post-treatment so you could expect different results.
Nearly 12 months on.
It’s now almost 12 months since the radiotherapy treatment finished and we are now seeing some progress. The issue with regards to the energy levels seems to be going away. There are days in the past three weeks where I know I’m not back to full energy levels, but I feel good in myself, and it seems to last most of the day and does not degenerate as it did earlier. The other excellent news is that we started the management of the visits to the toilet at night with one pill per day in the morning and after one month it has been successful in the sense that on average now I only go once during the night which is really great.
One of the things which I didn’t realize is that with the pills and the hormone injections one of the side-effects is that you start to put on weight. This is not something I welcomed because I have always tried to keep my weight to some reasonable level. Now I have one of those things called a paunch starting to arrive, and I have to get rid of it! In reality, it’s about 4-5 kg of weight I have put on – too much. So we are now starting a fitness regime for seniors, gradually, in addition to my 15,000 to 20,000 steps per day with my dogs (and my wife in the afternoons). We will see what progress I make!!
I also had a scan of my prostate today, and a full urine test, both of which were fine.
So we continue with the injections and urine management pills for another year with a PSA test each quarter.
How is the world looking at Prostate Cancer and are you?
Throughout my diagnosis and treatment we have of course become acutely aware of the interest (or not) in Prostate Cancer and the efforts to make men and their womenfolk more aware of this being a big issue. Yesterday we watched on television the New Full Monty which we fully understand has a somewhat amusing and risqué approach which some people may well find offensive. The reason we watched it is because it is a UK Nation Wide (or even Global) attempt to spread the message, which is a small way we are promoting here. In that show were interviews with men who had either Prostate Or Testicular Cancer and it was heartbreaking to see men of as young as 24 years falling to this disease. Some at age 30 who may never have the joy of their own children. Several seeing their fathers suffering to the end the pain of this cancer.
So please help us to spread the message which at the end of the show was simple:
Guys – keep talking – keep testing.
We would add:
Gals make sure your Guy is talking and testing (for Prostate Cancer)!!
Thanks for reading and I will let you know how it goes from here.