Wednesday, 13 May 2020

Rog T's Cancer Blog - mugged while I was looking the other way....

Lets start with a few statistics (courtesy of Cancer Research UK)

There are around 165,000 cancer deaths in the UK every year, that's around 450 every day (2015-2017).
UK cancer mortality is ranked higher than two-thirds of the world.

Each year more than half (53%) of all cancer deaths in the UK are in people aged 75 and over (2015-2017). 

Mortality rates for all cancers combined in the UK are highest in people aged 90+ (2015-2017).

The most common causes of cancer death vary considerably by age group; different cancer types tend to cause death in young people compared with older people.

Cancer deaths in England are more common in people living in the most deprived areas.

You may well have two questions, why have I chosen to highlight these particular facts and why have I chosen today? Well the answer to the first question is quite simple. As a cancer sufferer, I wanted to make the point that cancer will kill far more people in the UK this year than Covid19. It will do the same next year, the year after that...… And the older you are, the more likely it is to kill you. Cancer hasn't gone away, in fact it may well come roaring in with a vengeance as resources were diverted from the other healthcare areas to deal with the covid pandemic. It also seems the poorer you are, the more likely it is to kill you.

I got to wondering about the daily covid statistics. Just suppose you've been under treatment for cancer, compromised immune system and other issues and you contract covid19. Which stat do you fall under? If you'd never had cancer, then you may well have survived. Not that covid and cancer are vain enough to argue over who killed you, but it does matter. It occurred to me that covid may well change the way we treat cancer, at least until the worst is over. There are many things which strike me as strange about our response as a nation to covid compared to cancer. The lockdown and the measures taken by the chancellor have caused the deepest recession on record. I have no argument, it was the right thing to do. But cancer treatment has never had a whisker of the global resource thrown at covid. Over ten years cancer will kill over 1.65 million UK citizens. Unlike covid, it isn't a stealthy mugger that does you in, if you are unhealthy, a couple of weeks after you get it. You can be as healthy as you like and it will cruelly dismember you often over a period of years. God alone knows the true cost to the economy of cancer?

It is not just the people who have the disease. I have recently been writing my autobiography. I came to the shocking realisation that I was suffering from PTSD as a result of my mothers cancer in 1970. I realised that I suffered a massive personality change during this period. I was lucky, despite the prognosis of the professionals, my mother recovered. But the damage was done. I don't really think I will ever trust any one fully again as a result. When you are eight years old and you realise that your mother is going to die and that your father will be in pieces and you are the least of his concerns, it is a hard lesson and one that you can't walk away from.  I am not saying this for sympathy, don't get me wrong, my life is amazing and I wouldn't swap it. But there are so many children who have lost parents, who did not have a happy ending. What is the true cost of all this misery?

When you think of the billions the nations of the world have spent on armaments, and what could have been done if they'd spent maybe 25% of that on cancer research? Would we have a universal cure? Maybe, maybe not, but we'd have countless better treatments. We'd have countless less damaged people. We'd have countless less people lying in bed in agony, draining the NHS resources.

My issue with cancer is not so much that it kills people, we all have to die. What is evil is the way it dismembers people first. The way it exposes their children to the spectacle of seeing parents destroyed. And sometimes, it is the parents who see the children destroyed.  What is the real cost of all of this? Why will we take the hit for an infectious disease, but not for a stealthy killer that goes about its business year on year?

Anyway, that is the answer to the first part of the conundrum. And the second? Well I had an MRI last week, I catalogued my trip here last week. My journey with cancer has been a strange one. I have suffered the opposite of what one might call psychic ability. Every time I have felt worried about a scan or test, it has been fine. Every time I've been complacent, I have been given a good kicking by the disease. On the 27th March, I arrogantly wrote an entry of my blog worrying about whether attending NHS clinics for tests was worthwhile in the covid era, given that my cancer was behaving itself five years after my treatment. What an idiot I was. Cancer was not to be mocked. My worries about catching covid right now feel like an extraordinary arrogance. Today I got the results of my MRI. Now lets not exaggerate. They were not something to be 'overly concerned' about. The area of my Prostate that was treated with HiFu is fine. That's great news. Then BANG, the smack in the chops. There are 'changes' in the other area, the side that was not treated. Oh, ye fool, ye arrogant fool. Panic sets in. The changes were not significant enough to warrant an instant biopsy. It would be discussed at the next team meeting. It was likely to be either a biopsy or a period of closer surveillance in the MRI machine. Due to heavy workload backlog and a bank holiday, this would most likely be a minimum of three weeks, before I get the view of the team.

It had all been going so well. There was me, worrying more about a disease that has killed few people of my age (my immune system is fine, my treatment was not one that affected it). It seems that, for me at least, 2020 just got a lot worse. As I have said before, the worst aspect of cancer is the mental torture you put yourself through. The choices you get are never pleasant. You can have this treatment and it will be highly unpleasant or you can have this, which will also be highly unpleasant. Prostate biopsies give you a nice period of peeing blood. The trans-perineal version, which I have, also has a general anaesthetic. And that is before they actually start doing anything to you.

So I realised that there I was looking down the tunnel for the oncoming train, when I should have been keeping an eye on the mugger who was about to hit me on the head and rob me.

It is ironic really, isn't it. The motto Boris has chosen to use to fight covid is "Stay Alert". But the covid virus is something no degree of staying alert will stop. However, when it comes to cancer, staying alert is actually very sensible advice. Look out for symptoms, look out for changes. Tell your doctor if you are worried, have regular check ups. Ironic really isn't it. The biggest killer does not get the message that might actually save a few lives.

Let me just finish by saying, the chances are this is nothing. My consultant specifically said that it was 'inconclusive' which is very different from 'there is a bloody great tumour and you better come in ASAP'. It is a timely reminded. Maybe God just enjoys reading this series of blogs and felt I'd got lazy, I bloody well hope so, but for the next three weeks, I will be in full on hypochondriac/doom monger mood, mostly for the least logical of reasons. I am lucky. I was diagnosed in 2011, when the NHS still gave men my age PSA tests as part of the check up. Whatever I have, the best doctors in the world have a close eye on it and it is small and not of particular concern. Be grateful for what you have, not fearful of what might be around the corner.

For those of you who are regular readers and have read the previous posts on Cancer, here's what this is all about. I write this blog because knowledge is power and if you know what you are dealing with, you have more weapons in the locker to fight it. It is a personal view, I'm not medically qualified. This is for the sole purpose of information for those who are interested.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 54years 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 gave me a 3+3 on the Gleason scale. I was put 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, August 2014 was 4.0,  February 2015 it was  up to 5.5  and my latest in August 2015 was down again at 4.6. In October 2015 I had a transperinial Prostate biopsy, that revealed higher grade cancer and my Gleason score was raised to 3+4 (Small mass + more aggressive cancer). On 22nd Jan 2016 I had HIFU (Hi Intensity Focused Ultrasound) treatment at UCHL). My post procedure PSA in May was 4.0 which was down, followed by 3.7 in August, and 3.5 in October  which means that the direction is positive . However in January the follow up MRI revealed "something unusual which requires investigation" After a follow up biopsy, it appeared this was nothing to worry about. My two most recent PSA tests were Ok (3.7 and 4.6) and an MRI scan in March was very positive. My last PSA in October was 4.6, so stable and good news.

  I've no symptoms apart from needing to wee quite regularly and sadly for a few people, if I'm gonna die soon, it won't be from Prostate cancer. Got the picture? 

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