John: I told my GP I respected him. But if I'd followed his advice I'd probably be dead.

John Walker was 46 and in good health when he was diagnosed with prostate cancer. This is his story.

I'll never forget the day I was diagnosed with prostate cancer. I sat open-mouthed, looking at the specialist who had delivered the bowel-twitching news, seeing his mouth opening and closing but not hearing anything he was saying.

I'm a life-long Manchester City supporter. What that means is blind optimism born of years of under achievement so to discover that some nasty, horrible and potentially life threatening disease has taken up residence without permission is a blow of spectacular proportions.

How? I was 46 and in perfect health. Prostate cancer affects only old people and I'd not experienced any symptoms. Wrong! I was suffering from symptom-less prostate cancer. As every man knows, cancer is one of numerous illnesses or diseases that affect other people. Women may have smear tests and check their breasts as a matter of routine from adulthood, but men? No. Stressful jobs, drinks with the boys, burning the candle at both ends — all in the average day for super-bloke!

I have been fortunate in several ways. Although sometimes it doesn't feel like it.

I'm lucky I have a pushy wife. Being well versed in female self assessment and preventative action (ie. she gets check ups and looks after herself), she persuaded me at the age of 45 to have a PSA (Prostate Specific Antigen) test to determine the health of my prostate. She'd read an article in a magazine about mens' health. I received the information with fairly bad grace but a couple of weeks later I'd had the blood test so everything in my garden was rosy. The test would come back negative and life would continue along its normal course.

Problem: the results of the test were not desperately conclusive.

No, the reading wasn't negligible, as is the case for healthy prostates, but it wasn't spectacularly worrying either. A reading like mine of 3.3, as I later discovered, is not enough in some parts of the country to warrant further investigation. This is where my second stroke of good fortune occurred. The Mid-Cheshire Hospital Trust covers the area I live in. It is by no means the most proactive Trust in the country for many reasons, but in the area of urology it tries very hard. I was referred to a specialist. No reason to worry, I reasoned. A reading of 3.3 is very low. Nearly negligible.

The third stroke of good luck was the specialist himself. As it turned out, he is a top man in the field of prostate cancer. How anyone can get their kicks through rectal examinations and prostate biopsies is beyond me, but in quick succession I received both from him. The former is painless. The later is relatively so due to a pain killing injection.

The idea of having a rectal examination is unpleasant. Try to put your dislike into some form of muted acceptance of the inevitable, like visiting the dentist.. After all, if the examination discovers your prostate is slightly enlarged, then that could be the first step to diagnosis and cure.

For the biopsy, my prostate was stabbed twelve times (it looks like a colander, said the specialist later) and core samples sent for analysis. Being stabbed twelve times is still six more than most people receive. Still, I reasoned, I've gone through the usual hoops so at least there's no chance of a wrong diagnosis.

Stroke of luck number four was that the cancer discovered, was in its very early stages and was confined to the prostate capsule ; number five was that with relatively swift action the cancer and my prostate could be irretrievably removed, according to the specialist ; and number six was being referred to the local hospital prostate cancer support group.

With hindsight I think that the help provided by the support group pre-operation was most important. To speak to people who had been through what I was now experiencing and successfully come out the other side was a great lift to my spirits. I've joined the support group myself, so if I can help in the way I was helped, then I'll be more than happy.

I'll not bore anyone with details of the operation. If you want to know then ask — I'll happily oblige. I had my prostate removed. There are alternatives including hormone therapy and brachytherapy — discuss them with your specialist. Knowledge is power. There are also a number of alternative remedies available. Read as widely as you can! Having prostate cancer is not the end of the world. However, it means a radical change to your way of life.

Don't believe that because of their jobs male doctors necessarily adopt a different attitude to you and I about health.

When I went for my PSA test, I was initially refused by my GP as he believed I was too young to get prostate cancer. Knowing my wife would not take no for an answer, I insisted and look what happened! I tackled him about it later. He said that the balance of probability was that I didn't need the test because of my age, general health, lack of symptoms etc. He was a generalist, not a specialist, and he had to consider all sorts of things before coming to a decision. I said I respected his decision, but that if I'd followed his advice I'd probably be dead now or in extreme discomfort. It didn't seem to phase him all that much so my advice is whatever the problem don't simply accept what you are told by by a GP, especially if you don't agree. Ask for a specialist.

The role of the NHS appears to be restricted to getting rid of the problem. After care and long term recuperation are at best patchy and at worst non-existent. In the case of prostate cancer, the removal or treatment of the prostate may well affect your penis and how it functions. It is eighteen months since my prostate was removed and obtaining erections is still a problem. Drugs like Viagra and Cialis help but their availability through the NHS is restricted.

In the USA, trials have been conducted where men who have had their cancerous prostates removed, have been given viagra or similar within weeks of the operation, in an attempt to establish if they help return the men to what I will term as 'normal sexual performance'. The support group I'm involved with raises a lot of money for research and training purposes and is considering funding a similar trial. There will be no shortage of volunteers!

So you've survived the diagnosis, had the operation and come through to laugh in the face of reality once again. OK — perhaps the sex life could be better and the specialist does say things will improve. Very soon the horrors and despair you felt not so long ago will be no more than a relatively unpleasant memory, tinged with a bizarre sense of the ridiculous. Don't forget that the incidence of cancer in all of its ghastly forms continues to increase.

By 2010 up to one in every two people will have cancer of one form or another. At the start of the twentieth century, only one in ten would succumb, so something in the modern way of life appears to encourage the disease. Virtually all men will have prostate problems during their lives and while not all of them will be cancerous, an increasing number will be. As for age, evidence suggests more and more younger men will be diagnosed. Research is therefore more important then ever

This article stemmed from my reading a short piece in the Independent on Sunday which suggested prostate cancer is an older mans' disease.

Surprisingly enough, I disagreed and many of the reasons why are outlined above. The word ' cancer ' does not necessarily mean ' death ', although it is entirely understandable that initial reaction to such a diagnosis seems like it. Sadly, as with most things nowadays, treatment of cancer by both conventional and alternative means is a growth industry in itself ( no pun intended ). Obviously, as much research as possible is needed to attempt to eradicate all cancers, but when I find out that there are as many people involved in promoting spurious, unproven remedies as there are suffering with the disease in all its forms, I begin to wonder.

I'd like to thank everyone who helped me. From the overworked and under researched GP who did his level best to dissuade my wife and I from getting a PSA test in the first place, to the well-trained specialist and support staff who saved my life. Special thanks must also be given to your wife who suffers as much, if not more than you. She acts as your personal nurse, but has a more personal interest. She worries about the future and she feels your frustrations as much as you do.

Finally, stroke of luck number seven is being alive when Manchester City last won the League Championship in 1968. I intend to remain so when they next lift the Premiership Trophy. (Dream on, John — Ed)

John Walker

Page created on November 3rd, 2003

This article reflects the experience of the individual. It is not health information from the MHF under the terms of the NHS England Information Standard. It was last updated in 2010 since when John has indeed been lucky enough to see Manchester City win the league title.

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