Prostate cancer is treatable if you can catch it early

I DIDN’T know whether to feel worried or proud when my GP told me my PSA count was the highest he had ever seen.

 

William Hartston reveals his experience after being diagnosed with prostate cancer

 

The bad news was PSA stands for prostate specific antigen, a protein produced by the prostate gland (the walnut-shaped gland which sits below the bladder and around the urethra) and is seen as an early sign of cancer.

The good news was that the test quite often produces false results, with false positives worrying patients who don’t have cancer and, more alarmingly, false negatives giving an incorrect all-clear.

I had raised the question of prostate problems with my GP about a year earlier as I was going to the toilet often during the night but without other symptoms.

It sounded like benign prostate enlargement where the prostate becomes squashed against the bladder so it can’t empty completely.

He examined me, confirmed my prostate was enlarged, not particularly abnormal in a man of my age, 68, so booked me a hospital appointment for further tests.

When I arrived at Addenbrooke’s hospital in Cambridge a fortnight later, the consultant confirmed it was probable I was suffering from prostate cancer and sent me for an MRI (magnetic resonance imaging) scan and a CT (computerised tomography) scan to see what was going on.

Both involved lying still in a sort of space capsule while my body was scanned with magnetic and radio waves, in the case of MRI, and X-rays after I’d been given a radioactive injection for the CT scan.

Between them they built up a comprehensive picture of my insides which confirmed any cancer I might have in my prostate had not spread.

 

3D illustration of how prostate cancer looks like

 

A nurse had already told me my PSA score of 31 was well above a normal reading of 0-4 but my young GP must have been relatively inexperienced if it was the highest he had seen as she had seen patients registering a PSA in the thousands.

I was too intrigued by all this to be worried and may also have been helped by the fact both my parents were doctors who spent most of their working lives in the NHS.

The consultants I saw at Addenbrooke’s also seemed very competent and relaxed. There were even a few moments of great amusement. The first came when I was given a pamphlet about the biopsy where tissue samples are taken and sent away to a lab for analysis.

“Before the procedure starts, you will be changed into a gown,” it said. “Please make sure you turn me back into a human being after,” I said to the nurse.

Then after the biopsies were done the consultant asked if I had any questions. “One question occurred to me while you were filming and snipping,” I said. “Do you enjoy your work?” He laughed and confirmed he did enjoy the time he spent looking up people’s rear ends, then the nurse told me I could change back into my own clothes.

“We’ll draw a screen while you change,” she said. This time I was the one who laughed. All three people with me, the consultant, the nurse and a trainee nurse, had spent the last 15 minutes staring up my bottom.

It seemed a funny time to be worried about my modesty. When the biopsy results came through, they confirmed the cancer and I was immediately prescribed hormone tablets and, later, a slow-release implant to suppress testosterone production.

 

William underwent a MRI scan

 

Apparently testosterone is the favourite food of prostate cancer cells. By restricting its production the cells are starved for three months, leaving them vulnerable to the next stage of the procedure, bombarding them with radiation.

In the last three months I have found out more about prostate cancer. I have learned that around one in seven men will be affected by it at some stage of their lives and it is a major killer of young men.

Unlike some other cancers it generally develops slowly and when it affects older men, as is most commonly the case, they will, more likely than not, have died of some other cause before it proved fatal.

In my case I think we caught this just in time. I was lucky, my advice to anyone with similar symptoms is to get them checked out quickly.

Prostate cancer is treatable as long as you don’t leave it too long.

I have read some scaremongering reports on the internet about the hormone treatment I’ve been on being a form of “chemical castration” and being associated with a higher risk of Alzheimer’s disease.

I suspect such worries are related to higher doses than I am receiving. I have had no surprising side effects at all, apart from a recent interest in crochet. My radiation treatment will start in the new year, when I can expect daily sessions of around 10 minutes each for eight weeks.

It can result in tiredness in the second month. Is it all worthwhile?

Well, one consultant drew a little graph for me of survival rates of patients given similar treatment compared with those who do not have it.

For the first four years there is little difference but after that, the survival rates for treated patients grow higher and higher compared with the untreated. So bring on the radiation. I’ll let you know how it goes.