Monday, 21 December 2009

Dealing with some old chestnuts

Well, I think I can face that Bob Monkhouse advert for the Prostate Cancer Charity with a slightly less troubled mind now. Certainly before 19 October 2009 I found it a creepy experience to be faced every time I went into the supermarket by Bob's staring eyes and those warning words: "Prostate cancer cost me my life. Don't let it cost you yours."

And I feel able to post this item and get back to blogging only because I’ve just received what they tell me is a (so far) 'all-clear’ based on the histology report and blood test following surgery on my own prostate.

I won’t be blogging quite so frequently for the time being, and I’m not sure that I’d have been cheery enough to do any at all had I received bad news from the hospital about margins etc. Though of course many brave people do, and Bob Monkhouse is even joking about such things from beyond the grave.

But then, cancer does give you a sense of tumour. (Sorry about that one, Bob). http://www.giveafewbob.org/

In spite of having lost that annoying and mysterious little gland I can’t say I feel greatly changed after my op, though I could have prepared myself better for some of the bewildering side-effects. But every body is different, and time will hopefully heal the damage. It’s been an educational experience in some ways: I’d always thought that pelvic floor exercises were yoga stuff that women had to do on the floor.

It certainly feels better to be out of those white surgical stockings, bags and tubes – though I’d have been able to strike a real horror note at the Halloween party I missed.

Thanks again to people who sent their best wishes. Men’s prostates seem to be getting their rightfully higher profile nowadays, what with a whole special supplement about prostate cancer being published in The Times in the week that I went into hospital, and the news that Andrew Lloyd Webber was being treated for it at the same time as me http://www.telegraph.co.uk/news/newstopics/celebritynews/6435987/Andrew-Lloyd-Webber-vows-to-beat-prostate-cancer.html

Of course you could say that there is too much information out there on the web, and after a bit your head starts spinning, especially when you read about the different ways of treating the disease. Devon even has its own Chestnut Appeal website at http://www.chestnutappeal.org.uk/ – the organ is often likened to a chestnut because of its size and shape – to provide support for patients and their families and to raise funds for treatment. And just after my op I read in the newspaper a full page article about a new ‘therapy’ for the disease which was clearly a re-hash of a piece similar to that which had appeared a year ago in December 2008 – ‘Nanotechnology delivers lethal dose of drug to prostate cancer cells’ http://www.foresight.org/nanodot/?p=2903
Initially you think, “Damn, why didn’t I wait for this new wonder drug instead of letting them cut me up?” But of course the wonder drug is not going to be available tomorrow, even privately: as one online commentator on that article noted “it takes anywhere from 3 to 13+ years for a drug to trudge through the pipeline.” And meanwhile, as the Bob Monkhouse ad says, prostate cancer is a disease "killing one man every hour in the UK."

After an initial positive diagnosis in 2004 I opted for active surveillance and regular PSA blood tests as a treatment rather than immediate surgery or radiotherapy. After all, in apparently 50% of cases the cancer doesn’t progress and you’re likely to die of something else. But earlier this year it was worryingly clear that the PSA was taking a rather too steep upwards turn, and I’m grateful to my consultant at the Royal Devon & Exeter Hospital for telling me that more dynamic action was now needed.

Exeter would have been more convenient, but the NHS currently offers only open surgery for radical prostatectomy at the RD&E, and I was pretty sure that I wanted the more modern laparoscopic procedure that is offered at Musgrove Park Hospital in Taunton http://www.tsft.nhs.uk/, just 45 minutes away on the motorway: less blood loss, a lesser risk of wound infection, faster recovery time etc.

And now, after a hospital stay of only two nights, I feel that I’ve just been given the best chance of a cure, if there is such a thing. In a moment of post-op enthusiastic admiration for the neat surgery I did look at some film of laparoscopic prostatectomy at http://www.youtube.com/watch?v=ncKSWLAnFgo when I got back home. Fascinating to watch and a tribute to the skill of the surgeon, but I fairly quickly decided that putting my feet up and admiring the beautiful autumn colours of the garden was easier on the eye. And soon, I hope, the whole thing will be a distant memory, including those upsetting side-effects about which I won’t go into detail.

But before I forget it totally, and especially for my American readers, I would like to say that, whatever they were told on Fox TV by UK Conservative MEP Daniel Hannan about our National Health Service being a 60-year-old “mistake” which has “made people iller” http://www.youtube.com/watch?v=FiSPRkq28iU
I was grateful and full of admiration for the doctors and nurses I met on Ward 3 at Musgrove Park Hospital. They could not be faulted for their careful and considerate approach. It was surely beyond the call of duty for my surgeon to call in three times during my two-day hospital stay to check up on what seems to have been a routine operation; and the anaesthetist called twice to see how I was recovering.

The NHS as a system is not perfect. My own case was marked by some minor but unnecessary clerical errors, and I did have to wait for two months for an op because of what I was told were “problems with capacity.” But prostate tumours are generally slow-growing, and the delay did mean that I got those gardening jobs done.

Any system can be improved. To reject it as a failed 1940s social experiment in “a nice togetherness”, as Mr Hannan did in his interview, sounds to me like a rejection of the whole philosophy of caring for others.

What’s so wrong with “togetherness”? It can help put lots of things into perspective. By some chance I was put in a side-room on my own in Musgrove Park after my op. Only as I was about to leave the hospital did I meet other patients in the main men’s ward as I began to experiment with walking again. There was the brave amputee Ray, about to be fitted with an artificial leg, who told me how his experience had made him want to volunteer to meet other amputees to show how he had coped. Just a few beds away was the surprisingly well-looking fellow-prostate cancer sufferer whose disease had spread to his bones. And then there were the really sick-looking people who made me wish I’d been clever enough to follow a medical career to do something for them.

I realised that I may have got off fairly lightly, for the moment anyway. Part of me was happy to go home to convalesce after my short stay. But I also felt like staying to try and cheer them up.

Mr Hannan’s cruel and dismissive judgement on our health service is as much an old chestnut as was my dodgy prostate.



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