Start spreading the news …

da-da, da-di-da … da-da, da-di-da … (to the unmistakable tune of “New York, new York”) …

Was really nice to hear from Mf from the sunny (? I didn’t get time to ask about the weather) south of France today and to know that she (as well as all those other people ot there) was keeping up with events. Thank you. Was also nice to get offers of help and support from Jd’s piano teacher, who had only just yesterday had been discussing prostate cancer. So while being ill may not be fun, it is appreciated how people rally round.

Anyway, anyway, anyway (as Dawn French would say) this time next week (10th March – Gm’s birthday – must get a card!) I shall be settling down in my own private room in hospital (a priviledge afforded to soon to be radioactive people) looking forward to another general anaesthetic wavy line moment on wednesday – followed by two weeks lounging around at home – can’t be bad – almost a price worth paying I hear you ask?!:-)

Flaked out

Its now friday evening after my prostate volume study on Wednesday. Spent most of thursday and a fair bit of today in bed. While its a little sore sitting at present things are generally fine – although my lower GI tract has been shaken up a little and has yet to settle again I think.

Hospital was, unsurprisingly, not a joyful experience but a late admission (cocked up admin) and relatively early release meant less time than expected was spent in there. The other great plus – no hospital food – okay, one little salad before discharge, but what can go wrong with a salad.

The procedure was a little bit freaky with 3 docs making like a quick fit advert in pre-op with simulataneous action on the canular, oxygen and pressure cuff fronts, followed by the wavy lines you expect for a movie flashback. Didn’t even get the counting backward from 10 …

Have found the laying about at home slightly easier than expected, but then again if you’re asleep it helps! Can’t believe how unsociable hospitals are, what with the late night noise and a 6am start. But at least it has helped resist the lure of the laptop/email/work/… I am only doing this while shutting down the home PC Mp left on!

The phoney war ends

Got treatment dates today – hurray! It was only a two week wait, but life felt a little on hold, not able to plan the next couple of months.

If everything goes according to plan, will be away from work for most of Feb, although I will be back in for the second week. Busy trying to schedule work so as not to dump too much stuff on other people.

Have just finished long list of follow-up questions for the medical team including when can I get back on my bike and will my laptop be safe from the gamma rays. Talking of which, a US patient seemed to suggest worries about long term risk of the radiation – another question for the boffins.

The road ahead

Heard back from nO yesterday about next steps in the brachy treatment route. Am due:

• an assessment day – to confirm suitability and describe process in more detail (I hope)
• a prostate volume study (PVS) – to work out how many radioactive “seeds” are required
• the implantation – when the seeds will be inserted (by needle) into the prostate

It looks like this will take place over the next four to six weeks and will require a good two and a half to three weeks off work. Now just have to wait for the letter confirming dates and times, and schedule the time off work – more joy! Have a bunch of activities and meetings scheduled for Jan and Feb, to say nothing of my routine lecturing. Everyone has generally been very accommodating but even if they weren’t I sure as blazes am not going to put work in front of health.

D-day+1 – the decision (delayed)

First day back at work (in the bed + laptop home office) after Xmas and took five muinutes out to try and contact nO to let her know about the decision to have brachytherapy (i.e. internal radiation treatment)- but there was no response from e-mail or voice mail. So we shall have to wait to hear back, and see when we can schedule treatment for.

The decision in the end was pretty clear cut as soon as dK said he thought my LUTS did not preclude the brachytherapy. The risk of impotence seems much lower (must ask nO about the preventive use of viagra) than surgery, and while there is a chance of on-going LUTS (which may be made worse by the radiation, at least initially) it seems the risk of stress incontinence (or worse) is minimal.

The brachytherapy also seems to be much more managable compared to external beam radiation. There won’t be daily trips to Southend, and the side effects seem (with brachy) should be much more localised as the radiation won’t have to travel through the surrounding flesh. Even dO (who you might expect would bat for his own specialism) thought brachy better than external radiation.

Anyway, the bedtime cup of tea has arrived (Mp having returned from choir) and its time to turn in and hope tomorrow brings some news of what to expect and when.

D-day: a new year, a new me

Spent New Year at Nf and Df having a hectic time with us five and their two (much?) younger little people. Oh the early years seem like so much hard work looking back and so distant.

Mp and I made some time, slobbing in bed as usual, to talk about where we were up to with the decision on treatment. While I don’t feel ready to be an old man and face up to failing functions in the groin department, I do need to get on and make a decision. Nf was asking whether we were edging towards a decision, but its much more like acting on a decision that has really already been made, at least subconsciously. Its a new year, and given I am a great one for putting things off, I need to act.

In acting, its like I will be making my disease concrete. By choosing a treatment option, I will be making what is currently a set of probabilities into a course of action. And what is currently a set of theoretical side-effects may become reality – like Shroedinger’s cat, opening the box and collapsing quantum probabilities into a fixed state of affairs – but without anyone/thing dying!

Unlike the side effects which may or may not happen, the treatment will for sure leave some mark and will perhaps make the reality of situation sink in. The next challenge is minimizing the mark on my life by being informed about the treatment side effects and how best to manage them.

Too many cooks …

So we are off tomorrow for our fifth post diagnosis opinion and another insight into the world of prostate cancer opinions. Nc at work said its good to get a second opinion but this is going a bit beyond that.

In terms of options, we have (in no particular order as they like to say in reality show count-downs to a kicking off …) active surveillance (AS), surgery (S), external beam radiotherapy (EB) and brachytherapy (B) and in terms of opinions we have the following opinions:

        AS       S       EB       B
1       Y        Y        Y        n
2       n        Y        Y        n
3       Y        Y        Y        Y
4       n        Y        Y        Y
5       ?        ?         ?        ?

A fair few people (e.g. Ic and Nm) have said wouldn’t it be nice if doctors just told you what was for the best, although it doesn’t appear to work that way. Ic’s theory was it was about fear of getting sued, although I am not that cynical and think its down to not knowing, or not wanting to impose – given the fine and personal balance between side effects, effectiveness and personal views. Although I do wonder how much dK was struggling last last week between patient choice, and professional judgement – maybe its just a surgeon/confidence thing!

Anyway, after tomorrow we will have completed the first round of opinions – and then we have to decide whether we want even more cooks at the feast and go for a sixth second opnion!

Telling the little people

Told the kids last week – was it really only last week – the news. Lots of people had been asking if we had and it didn’t seem right to be keeping things from them, particularly as the number of joint hospital visits was increasing and we might be moving in the direction of treatment requiring time in hospital.

Ps’s ears pricked up at the mention of the “C” word and was clearly worried. “Doesn’t cancer kill you?” was his first question. We were able to reassure him that while cancer does kill people, there are many forms of cancer and mine seems low risk and treatable with very good chance of success.

We got into a general discussion about treatment, again prompted by a question – I think from Ds. Mention of surgery led to the very senstive interjection from Jd of “chop it off” and the discussion started to go down hill from there.

To increasing chants of “chop it off” we moved on to “zapping it” with radiation therapy, the dots used to line you up and then things got really surreal with Ps bringing up James Bond strapped to the table about to be zapped by a laser, and Ds stroking an imaginary cat doing his best “I’ve been expecting you Mr Bond” Blofeld impression.

While Mp and I were clearly both thinking “But this is serious news” the kids were clearly getting to grips with the news. Turns out later that Ds already knew, having spied an email in the mailbox that is usually open on the computer – so much for keeping things from the kids.