Prostate surgery – the aftermath

Southend University Hospital
Southend University Hospital

So, how have I been after my brachytherapy? Overall I am relatively well six months on, and definitely making good progress.

When I left hospital, I felt very bruised and swollen. My waterworks required my spending a long time in the smallest room and I felt very uncomfortable in that area most of the time; not just when paying a visit. I did have a reasonable amount of energy, and managed to get back to work (from home) in a few days. I also managed reasonably well at my Mother-in-Law’s funeral, at least physically anyway.

After about six weeks I visited the hospital for a scan which was apparently for the nuclear physicist’s audit purposes only, to see that all the radioactive iodine pellets were in the right place. I saw my consultant shortly after that and, having had a blood test, was told that my PSA had fallen to 4.1, which was good. I was feeling a lot better, though the waterworks were not great.

Another week after that and I suddenly felt terribly tired all the time, and did find it very difficult to work for more than a couple of hours in the morning. I now understand that was because the radiation had really kicked in. During that time at the beginning of June I went to an exhibition at the Excel Centre in London, but had to come away after a couple of hours as I felt very tired and faint. I confined myself to barracks for a few weeks after that. I understand that not every patient has these symptoms of fatigue, but it is very common with any sort of radiotherapy.

In mid-July my energy started to return, and at the beginning of August, virtually overnight, my waterworks came back to virtually normal, though I still have a few side-effects of the treatment. I have to say I am feeling much better.

I saw my consultant again. My PSA was only 0.6 which sounds great, and apparently is on course for a cure. However, I might expect a PSA “bounce” after one or two years which is normal and not generally anything to worry about.

At the end of August I went to an afternoon presentation run by the hospital for prostate cancer patients, which was very useful. I learned a great deal about what to expect for myself, and the difficulties that others have whose cancer was more advanced than mine, and might have spread into the bone or lymph nodes. It reinforced my feeling that I have been fortunate, and when one of the nurses spoke about “curative” patients present, I knew that included me.

I am a satisfied customer, but not complacent. I have been lucky and will make sure I attend all my check-ups. Not every chap is as fortunate to be picked up before he has a serious problem from cancer. Any guy over fifty needs to see the doctor if he has any symptoms at all in the downstairs department, and also all of us should see our doctors regularly as we get older so that we can have any tests needed and make informed decisions about our health.

 

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The hospital stays Part 2

Jetty remains S Fambridge 021
(Photo credit: Jon Stow)

The gap between my hospital stays was not the best of times. On the day after I came out from my first admission Gloria and I had to register her Mum’s death and make the funeral arrangements. It was a very sad time. There were other unpleasant incidents in that intervening period over Easter.

My second admission to hospital was two weeks after the first, and before the funeral. This was for the actual brachtherapy procedure / operation. This time I had a private room in the hospital as with the seed implants I was going to be somewhat radioactive.

Again I went in in the early evening and this time was fed. I had a reasonable night’s sleep despite knowing I was facing another enema, but at least had a private loo.

In the morning I was visited by the anaesthetist and the surgeon and a nurse told me i was second on the list. I was taken down at about nine-thirty. Again I woke up well in the recovery room, was taken back to the ward and fed. I have to say that the hospital food was generally good except that I would not recommend their fish and chips – very soggy.

I had no pain, but of course the waterworks were not working very well, and what I did produce had to be checked in case any stray radioactive seeds had leaked out. I also had to demonstrate that I could at least pee a certain amount, which the staff monitored. I must have passed this test because I was told I could go home that evening if I wanted to. I was not all that confident and felt woozy, so I went for a walk up and down the ward without feeling too faint. Having awarded myself a pass on that test, I said i would go home, and called Gloria to collect me. I think we are all happier in our own beds and we needed each other’s company.

Just before I went, I had a word with a fellow patient, Ian, who had been with me having the same thing done on both stays. He had decided not to go home, but then he had been much further down the list, was back from theatre rather later and had less recovery time.

I had not very much pain from having all those needles stuck in my underneath, but I was very swollen so left with a large supply of anti-inflammatories to reduce the swelling. I also had proton-pump inhibitor tablets to counter the adverse effect anti-inflammatories have on one’s stomach.

Throughout both my admissions the nursing staff were very courteous, attentive and caring. I cannot say I enjoyed myself but everyone made sure I was as happy as I could be.

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The hospital stays Part 1

Two weeks after I made my decision to have my treatment for prostate cancer by way of brachytherapy I went into hospital for my first stay. It was a cold damp day which I had been looking forward to with trepidation. During those two weeks my Mother-in-Law had been in declining health, and on the afternoon of my admission, she died. I felt dreadful for my wife Gloria and terribly sad for her Mum. I wanted to be with Gloria, but was “locked in” to go into the hospital, with my second session already booked for two weeks later. The hospital stays straddled Easter.

When I got to the hospital in the late afternoon having made my own way by taxi, I was very emotional. I was also frightened about the treatment, worried about the early morning enema I knew was in store, and wanting a bed close to the toilet. It sounds ridiculous now, but at the time there was too much going on. I am afraid to say I threw a tantrum with the nursing staff. Later I was quite rightly embarrassed and apologised. Oh, and I had plenty of time to get to the bathroom in the morning as it turned out.

I was allocated a bed, and the procedure (volume study) was the following morning. The one complaint I had that evening was that they did not feed me. They forgot, and I did not realise, I could have had at least a sandwich.  I ended up feeling starving hungry.

Nevertheless, despite my earlier temper, the nursing staff did make me feel reasonably comfortable.

Just after five the following morning I had my enema and then was visited by my consultant and the anaesthetist. I had to hang about until mid-morning before i was taken down to theatre. The anaesthetic seemed all OK, I woke up in the recovery room and was wheeled back to the ward. I polished off a pile of sandwiches. still being very hungry.

During the afternoon i felt much better. I had an early evening meal of a quite passable curry and it was decided that I could actually go home. No, that bit wasn’t as hard as I expected.

Of course poor Gloria collected me. In the circumstances we were happy to cling to one another, and I wish I could have been there to give her a big hug the previous evening.

 

 

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Choosing my treatment

"seeds" used for brachytherapy of pr...
“Seeds” used for brachytherapy of prostate cancer (Photo credit: Wikipedia)

It was a terrible shock to be told I had cancer. I guess it is for anybody. My wife Gloria and I went through a great deal of anguish. I only wish that I had known then what I know now, which is that in my case, things were not as bad as they seemed.

I was told that my cancer was relatively localized. Scans showed that it had not spread beyond the prostate. This meant that I had three choices as regards effective treatment.

The first choice on offer was a radical prostatectomy. This involved removing the prostate gland surgically and re-attaching the plumbing (urethra) through which the urine passes out of the system. This is apparently a favoured option for men with more advanced stages of the disease than mine. It is very effective, but has more side effects and potentially continence problems.

The second choice I had available was external radiotherapy. I was told that i would need to attend the hospital five days a week for seven weeks for a daily dose of X-rays and would have to spend an hour there each time. There are side effects such as urinary and bowel issues and tiredness. Sometimes this treatment is preceded by hormone therapy, though I was told this would not be needed in my case.

The third option offered was brachytherapy, which involves planting radioactive iodine pellets in titanium “seeds” inside the prostate gland using titanium needles. This required two in-hospital stays, the first for a “volume study” which measures you up, and the second to actually implant the seeds.  The radioactivity as the Iodine 125 decays is what kills the cancer cells. Again there are potential side effects such as difficulty in passing urine, and those associated with any radiotherapy.

I was required to see three different consultants / doctors, each of whom went through the treatment in which he specialised. This was rather daunting to face up to, but what I did draw quite quickly from my appointments was that they mentioned the word “cure”, or at least a chance of one. As I have said, if I had understood at the outset what I  learned over the next few weeks I might have worried less.

After I had seen the three, I had gathered that each of the treatments had the same excellent chance of making me all better. Therefore, since the brachytherapy seemed the least disruptive to my life (as I thought) I chose that option. If it had been seen as possibly less successful I would have made a different choice, but I opted for the one which involved the two fairly brief stays in hospital.

I will tell you next time how the hospital operations or “procedures” went.

 

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Amber lights and health issues

Sony Apr 10 09 084I guess I was as guilty as many others in taking my health for granted. I had a couple of pills to take daily for what I always thought of as minor irritations, though one had been a major irritation when my blood pressure was so high way back. Towards the end of last year we had rather a lot of personal pressure. Of course the issue was not about us (my wife Gloria and I) but about the illness of her sister; what turned out to be her last illness because we lost her before Christmas.

I was feeling pretty rough and I guess it was the stress of everything (nothing to compare with Gloria’s) but I did go to our GP. She ordered the usual blood tests. It turned our my PSA was higher than a year previously; only slightly raised but enough for my doctor to refer me to a consultant. She said that at my level there was only a one-in-three chance I had prostate cancer.

To tell the truth, there was so much going on in our lives that although I collected my GP’s letter for the consultant before Christmas I did not make the appointment to see him, a urologist, until the end of January. Of course I had a lot of work on in January too, and I was by then feeling a lot better.

When I did finally go, the consultant thought I should have an MRI scan. I went along with this of course, and even when he told me there was “inflammation” of my prostate gland I still thought I might have an infection rather than cancer.

A biopsy was suggested. When Gloria and I went for the result it was a total shock for both of us when I was told I did have cancer. We never think it will happen to us. Gloria and I didn’t take in much of the rest of the consultation. I was feeling numb.

I expect we were told that we were not looking at a complete disaster, but we missed that, being rather stunned. We did recover at the end to hear that we would be scheduled to see several different doctors to hear what options I had in terms of treatment.

There will be a lot more to tell as I bring you up to date.

I may even be lucky. I am feeling much better about myself and my health, but if you are a guy of fifty-plus I think you owe it to yourself to get yourself checked out with a blood test. Then you can make an informed decision as to whether to take further medical advice if your PSA is a bit out-of-line.

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