Interview 41

Age at interview: 59

Age at diagnosis: 59

Brief Outline:

Diagnosed with prostate cancer 2000, brachytherapy 2000 and short hormone treatment.

Discusses the likelihood of imbalance of diet and stress in those with cancer.

I believe that most serious illnesses are caused by diet and stress and I think an imbalance of diet and stress can cause most things and I think that most cancers are brought on by stress. Nearly everybody I've known who's had cancer has had some form of stress.
 

Describes how he went to the doctor feeling unwell but nothing leading him to believe there were prostate problems.

Right, perhaps I could start by asking you how you first thought there was a problem, what first made you seek treatment?

Well that's rather unusual because I didn't have a problem. I felt unwell, nothing led me to believe it would be prostate. I went to the doctor who did a blood test and initially it showed that, he then sent it back for a different blood test, trying every avenue and my PSA was only 3.9 which was borderline. 

When you say you felt 'unwell' just general malaise or any specific symptoms?

I'd felt very weak, felt very you know very lethargic, which is not like me. The PSA was only 3.9 but he said he'd do another one in 6 months. I went back in 6 months and it had leapt to 5.4. So he then asked me if I would go and see a doctor at the local hospital.
 

Explains that he finds it difficult to talk about cancer as it is seen as a taboo subject.

I don't know if being diagnosed with cancer anywhere in the body is something that people regularly talk about because cancer is a horror word and once you enter into that particular world people seem to clam up. You mention cancer and people don't react very well to it they just clam up and don't talk about it. I think prostate cancer is probably even more sensitive because it's that area which is personal, private and it's the area that you don't generally talk about. So having diagnosed with prostate cancer I found it very difficult initially to talk about it. 

But it is still one of those subjects that people find is taboo, you don't speak about it and I would hope that in the future with so much work going into cancers of various forms, so many societies, and so many places are now, you know, are bringing it to the fore, that it will generally be spoken about and then it will be far easier to approach curing it. 
 

Suggests that others should consider all types of treatment carefully.

The only thing that I would say is that anybody having prostate cancer should consider every aspect of treatment. I wouldn't go for the first thing that was offered, in other words if your oncologist advises you to have one [treatment] I would certainly try and speak to somebody else, not change your mind or his mind just to settle your own mind that what you're doing is giving you [the best chance of a cure].

Yes I don't think, I don't think you should take the first option because this is something which is going to affect the rest of your life so you need to have, you need to have fairly quick treatment because obviously in certain cases it progresses at a rate which is uncomfortable so you need to have quick treatment. But delaying the treatment to get the right treatment is probably more important than going in and having the first treatment that's offered to you. I believe you should make sure that you know what's being done to your body. If you're going to be more comfortable with a certain treatment then go for it, take all the advise you can, you do have to apply yourself to learn as much about it as soon as possible but to give yourself the best chance of recovery you should ensure that the treatment you have is something you're comfortable with. 

Describes his treatment and wishes that he had been told more about the side-effects.

Brachytherapy - brachy comes from the Greek word new and therapy for treatment so it's a new treatment, so there's nothing sinister about the wording. And what is entailed is an injection which leaves seeds of radiotherapy or iodine treated seeds in the prostate which will destroy it over a period of time, probably 3 months. The injection is made very precisely, there are a couple of fittings you have on an ultrasound machine and you're then marked in indelible ink with tattoos, very small tattoos which don't come off when you wash, and the injection is made in the perineum, I think it's called, which is in between the anus and the scrotum. And there are a number of holes made and the seeds are then left at equidistance according to exactly where your prostate is and within the prostate. In the meantime there is an ultrasound machine which is entered into the rectum which ensures that the seeds are only left in the prostate so the chance of incontinence or any damage to the sexual nerve is not necessarily completely eradicated but is unlikely. 

The percentages are very low whereas with radiotherapy on the arc treatment of radiotherapy the beam will obviously cover some 5% of the external organ which can result in more serious damage because of the sensitivity of the patient. In my case I seem to fairly sensitive because since I had the treatment which was 6 weeks ago I've had problems urinating, however this is improving the whole time and the doctor is fairly confident this is not a long term problem. Whereas I believe that being of a sensitive nature in that area I probably would've had problems if I'd have had radiotherapy which would've been longer term.

The tattoos, the tattoos are small indelible marks which they judge from the ultrasound so that the treatment for radiotherapy or the Brachytherapy can be very precise. And you are put into an ultrasound machine, a tunnel and these, you have a small injection of an indelible ink which in my case was in my left and right side and across the top of my prostate below my belly button for the more precise. These then allow them when you go for any treatment to align you exactly. And I've been for ultrasound since to see exactly where the seeds were and it takes several minutes for them to align you on the platform inside the tunnel so that you're absolutely centre and they can actually do the ultrasound on exactly that position.

And this is what you do, you go in the Sunday, you're prepared for the operation, only in as much as your diet, you can't eat and then on the Monday morning in my case I had the operation and I came home Tuesday lunch time. And I think the only thing is that I think the doctors should warn you of the discomfort. I'm not saying they're wrong in not warning you of it because you'd still have this, you'd still have it done but it is quite uncomfortable in some cases. However in some cases there's no reaction at all, this is probably like other treatments, some people react badly to radiotherapy but one must remember you're having a gland burnt daily and constantly and it must rather be like having sunburn and you then go and lay in the sun again and obviously that aggravates it even further. So the symptoms that you get from it are fairly obviously and you know if you think it through you know you only get, you only get practical advice from the doctors and you can discuss the problems with them and there's always help lines and they do encourage you to use them and I think that's you know it's very good. And I've used the help line a couple of occasions, not when I've been panicking but when I've been extremely uncomfortable.

You have a general anaesthetic because you have, you have an ultrasound, a rectal ultrasound and you have the injections which are made into the perineum.  Now I had quite a lot of discomfort afterwards er it was uncomfortable to stand up and it was uncomfortable to sit down but funnily enough I never was aware of any skin abrasion or puncture, I wasn't aware of that at all and when I went back to the doctor he said "Oh it's healed up very nicely," and I hadn't even been aware from the time, if I'd have thought about it I must've known there was mini be puncture holes but I hadn't even thought about those and that was probably because of the discomfort I had in sitting down where it felt as if I you know was very swollen underneath.  But that has now passed and it is 6 weeks and it took a good 4, 5 weeks for that to pass.  The first two weeks were extremely painful but gradually went off.  As with any operation it obviously takes a while for the area to heal and while you're still being burnt with radiotherapy then obviously the treatment is being repeated and as the dosage weakens so your healing powers will obviously improve.  And I think it's at its strongest for 6 weeks to 2 months but they do advise you to have little contact with small children and pregnant women for 3 months or as little as possible, as little close contact.  So obviously it's working quite actively for 3 months and it doesn't set off any alarms if you go through the airport apparently I'm told so (laughs).

After the operation, is there anything else you want to say about that?

 Yes one of the things was that if you pass urine you're allowed home, if you're unable to pass urine er the doctor said that you may well be on a catheter for up to 10 days, he said after which time you'd normally be allowed home and things would proceed normally.  So I was quite pleased that I didn't have to have a catheter because you have that during the operation then it's removed after the operation but I expected urinating to go back to normal a lot quicker because I hadn't had to have a catheter.

Explains how his confidence is returning after initial urinary problems following Brachytherapy.

After the Brachytherapy, although at no time did I suffer any embarrassment I felt that the opportunity to be embarrassed was there. So this, you know I phoned the doctor up because extremely uncomfortable and very painful and I've since seen the doctor and this is one of the side effects that certain people experience. I experienced this pain in the bladder and trouble passing water and passing water far too often to get involved in doing anything else and this obviously leads to a lack of confidence and you don't feel like leaving home. But this has improved dramatically over the last week and it's nearly, I wouldn't say it's nearly back to normal that's probably right but it's on it's way and this is one of the symptoms that you may get. And the doctors aren't worried so far be it for me to be worried because I don't have their experience and I'm sure they're right. And my confidence is gradually returning and I can go out of the house and travel about now and it's getting back to normal.
 

Describes his temporary problems with passing water after Brachytherapy.

After the Brachytherapy, although at no time did I suffer any embarrassment I felt that the opportunity to be embarrassed was there. So this, you know I phoned the doctor up because it was extremely uncomfortable and very painful and I've since seen the doctor and this is one of the side-effects that certain people experience. I experienced this pain in the bladder and trouble passing water and passing water far too often to get involved in doing anything else and this obviously leads to a lack of confidence and you don't feel like leaving home. But this has improved dramatically over the last week and it's nearly, I wouldn't say it's nearly back to normal that's probably right but it's on it's way and this is one of the symptoms that you may get. And the doctors aren't worried so far be it for me to be worried because I don't have their experience and I'm sure they're right. And my confidence is gradually returning and I can go out of the house.