For those of you who are regular readers and have read the previous posts on Cancer, you can skip this first paragraph.This is the latest installment in my occasional series about how I'm adjusting to living with a big C in my life. For those of you who aren't, here's a quick summary. I'm 51 years old and in October 2011 I had a prostate biopsy following two "slightly high" PSA tests - 2.8 & 4.1. The biopsy took ten tissue samples and one of these showed a "low grade cancer" which gives me a 3+3 on the Gleason scale. I'm now on a program of active monitoring. In early February, I got the results of the a PSA test - down to 3.5 and an MRI scan which found absolutely nothing, two more tests in 2012 were at 3.5 and 3.9, in 2013 my test was 4.0, Jan 2014 was 3.8. My latest PSA test in August 2014 it was back up to 4.0 was a slight improvement, in other words the downward trend has slightly reverseed. I've no symptoms and sadly for a few people, if I'm gonna die soon, it won't be from Prostate cancer. Got the picture?
07.00 - I'm writing this in two installments. Hopefully this will give the reader some insight into the thought process I am going through today, as the day develops. As I said, I believe that talking about these things helps us cope. Knowing that other people feel the same can help, certainly has helped me at times. Read on.....
Today is the day I've been dreading. Today is the day I have my consultation with the cancer specialist. I've decided to write this in two installments, one before and one after the consult, so that anyone who is interested can understand my thought processes. It was lucky that I was playing five a side football last night as my inclination would have been to get blind drunk. I am always very fatalistic about these bi-annual consults, it is in my nature, however this time I feel I may have more reason to feel nervous than usual. My recent PSA test saw a rise from 4.0 in August to 5.5 in February. I had an MRI scan in January, so as you can see that is a fair old whack of a rise.
How do I feel? I am in a state of mild panic. Since my diagnosis in November 2012, the PSA has been very stable and now???? To make matters worse, The Royal Free, who run the hospital trust, sent me a letter cancelling my appointment of Wednesday and changing it to a telephone consultation. I personally do not think that a telephone consultation is ever appropriate for a cancer patient. I am sure it saves loads of money, but I want to see the whites of his eyes. Now Mrs T tells me that this probably means that I am being paranoid and they consider the PSA rise insignificant, but I am in no way in agreement. I am haunted by the prospect of the three deadly I's - Incontinence, Impotence and Infertility. These are common side effects of a radical prostatectimy. None of these really appeal to me.
To make matters worse, being superstitious, the consult was shifted from Weds 11th to Friday the 13th. What worse day could you possibly have for a cancer consultation with a rising PSA? I will alledgedly be getting the call around 11am. Now the sane and rational Mrs T tells me that I've still got no symptoms, all manner of things can affect the PSA level and even if it has got slightly worse, that may mean nothing. The issue for me is that the whole thing scares me. I am not scared of death, but I am very nervous of the journey that takes you to that place. Of course I am not on deaths door, I am not ill, I have no symptoms and I can still run around and play five a side football. But what if the consultant tells me that the time for "active surveillance" and the time for action is nigh? I don't really feel I am ready for the three I's. I am not ready to be diminished as a man and a human being. Then again I am even less ready to take the other route, that would be selfish and stupid. I have a famaily and much as we may have our ups and downs I suspect they'd rather have a sightly diminshed me around. I fear that a slightly diminshed me may be a little less appealing to Mrs T, although she tells me this fear is stupid. We all have fears that when reality collides with aspirations, bad things happen.
So here I am at 7am, drinking my green tea with pomegranite juice, eating my bowl of fruit. Of course (as Mrs T suggests) this is just a bad case of hypochondria, advanced man flu syndrome and paranoia mixed together, and it is all unlikely to be anything more than a blip. I've spoken to many other sufferers and they tell me that in many ways this time is the worst. The waiting between the tests. What will the MRI show? What does the PSA test mean? Where is this journey taking me? This really isn't a good day so far. The ballroom of reality can be a dimly lit place, with many doors, full of surprises, some of which are not great.