Silent Killer II

Surgery was booked for Wed 30 Sep, 2020 almost 4 months to the day since my treatment began for stage 2 prostate cancer. 

The surgeon organised an ultrasound scan a month before surgery, so he could check if the drugs had been successful in shrinking the prostate. The scan involved shoving a plastic cucumber up my ass (at least that's what it felt like) so he could image the prostate. The results were fed into a computer to measure the size, shape & orientation of the prostate, which in turn are used to programme the robot, so it knows exactly how to operate on me when the time comes. 

My prostate is small, at about 20 cc and I believe they can be as large as 80 cc. Interestingly, the drugs had no effect on shrinking my prostate, which is a shame as I was unlucky and suffered terribly with side-effects. I hope they've softened-up the cancer cells, making them weaker and more susceptible to radiation, so my suffering was worthwhile.

Surgery week involved me having to take another trip to the hospital to get tested for MRSA and COVID. If I had either, surgery would be cancelled. Fortunately, I was given the all-clear and everything was go for the big day. 

The evening before surgery I was given some laxative powder, one sachet to take before bed and the other when I woke up in the morning. The first one had zero impact and I was questioning why they bothered to give me it. However, it soon became apparent. There must be a cumulative effect because the second one wreaked absolute havoc on my guts. I was doubled up in cramps and all sorts of stuff was being evacuated from my ass at great speed. Unfortunately, this didn't stop for 6 hours! I had to carefully plan my drive to the hospital and time it to the nearest minute, so I could get there without shitting my pants. 

The pre-op chat involved taking blood pressure, signing the usual disclaimers should anything go wrong and sprinting out of the room to use the toilet every 15 minutes. Fortunately, the chaos that was going on in my bowels stopped about 30 min before surgery. I was given the option of having an epidural and being awake throughout the procedure, or having a general anaesthetic. I had zero interest in seeing and hearing what goes on, so opted to be comatose. 

Surgery went well, with the robot implanting 64 Iodine 125 seeds into my prostate. These stay in my body permanently, with the radiation gradually declining over time. Iodine 125 has a half-life of 8 weeks, which means that two months after surgery, the radiation dose is 50% of the initial amount. The radiation continues to halve every 8 weeks, so by 8 months post-surgery, I will have received more than 90% of the dose. 

They also surgically inserted a gel pack, which sits between my bladder and back passage. The prostate is only 1-2mm away from my colon and this gel pack helps prevent the radiation from burning through the colon wall, which wouldn't be good. It's a slightly uncomfortable feeling having this inside you (you can feel it), but the gel pack dissolves after about 6 months, so it's only a temporary discomfort.

They explained I'd have catheter in place after surgery. However, I didn't fully appreciate what this meant. I woke up with a plastic hosepipe sticking out of my knob. You can skip to 03:40 min in the video below to see the gory details of how it's inserted.

The catheter was connected to a bottle to collect the urine. It's a weird feeling as you literally have no control over peeing. It comes out whenever it wants to come out and you don't have to force it. Every so often, the nurse would come in with a geiger counter to check the bottle and make sure no radioactive seeds had become dislodged! 

The catheter came out the next day and as expected, it was unpleasant. Going to the toilet was uncomfortable for a couple if days, as it burned like hell when I was having a pee. 

My leaving pack contained drugs and a debrief by the nurse explaining that I was highly radioactive and I was not to have any young child sit on my lap (is it too early for Jimmy Saville jokes?) or be close to a pregnant woman for 6 months. It was also explained that I would set off radiation sensors at airports and railway stations (I didn't know there were such things). I was given a card explaining that I had radioactive material implanted in me, so the security forces could rest assured I wasn't a nuclear terrorist. 

To be honest, post-surgery was easier than expected. I wasn't in much pain and the only difficulty was sitting down for extended periods of time because the gel pack was so uncomfortable. The common side-effects of surgery are impotence and incontinence, both of which I luckily managed to avoid. Or so I thought ...

After 4-6 weeks, I noticed a change in my poo. I became constipated and the stools were rock hard and literally tore my ringer to shreds when I eventually managed to strain one out. Yes, there was lots of blood. The doctor's don't know why this happened and it lasted for about 6-8 weeks. After the 'London Brick' experience, I then had gel-like ectoplasm streaked with blood leaking out of my ass. WTF! It certainly made me think twice about ripping out a big fart, as the follow-through could be quite messy. This 'colonic mucus' is a known side-effect of the radiation, which they forgot to tell me about. 

The radiation also affected my bladder, making it extremely difficult to pee. However, drugs solved this problem and it's continuing to get easier as time passes and the radiation dies down. 

Fortunately, I'm not impotent and I get a prescription for viagra, just to make sure everything keeps working down there. Happy days! On a side note, I didn't know that as a cancer patient, you get an exemption card which entitles you to free prescriptions. Every cloud ... 

I had a follow-up blood test in Feb 2021, which was 4 months post-surgery. The radiation has destroyed half my prostate but I still have half a prostate left. Normal PSA levels are between 0-3, so the doctors predicted a value of 1.5. My results came back at 0.6, which was much better than expected (compared to 15.5 pre-surgery). Because of this good result, my oncologist allowed me to stop taking the cancer drugs 3 months early. It took several months to flush them out of my system but I'm no longer throwing up and feeling sick every day. What a relief! 

I don't want to be overly optimistic, but it looks like we've nuked the cancer. However, I can't be officially signed-off as cancer-free for 5 years. I also have to have blood tests every 6 months for the rest of my life. 

This lockdown year has certainly been a rollercoaster and it was only by complete chance that I found out I had prostate cancer. This insidious disease kills nearly 40 men every single day. If you're reading this and are a guy over 40, I implore you to complete the questionnaire and pester your doctor for a PSA test every year. Catch it early and you have loads of treatment options with a great chance of being cured. If you don't catch it, the outlook is fucking grim ...

Be safe out there.