It's been an interesting eight days. Last Friday I had a CT Urogram at Stepping Hill Hospital, a CT scan of my urinary tract. The appointment letter said I should drink water one hour before the appointment. I did this but emptied my bladder just before I cycled to the hospital. Once there I was asked to change into one of those split-back gowns and presented with about a litre of water to drink. Before the scan I was injected with stuff to highlight the area of interest and some other stuff to make my kidneys work faster. After the scan, I'd barely got dressed when my bladder demanded to be emptied. A few minutes later and the same demand. I cycled home with my bladder demanding to be emptied again. This continued with, thankfully, longer periods between the demands for the next couple of hours.
Last Tuesday I had the first of my hormone injections (prostap) at the local health centre. Next one due 16th June and I'll get my PSA checked at the same time.
This morning was the appointment for the Flexible Cystoscopy at Stepping Hill Hospital Urology clinic. I'm getting blasé about strangers fiddling about with my private parts now. The procedure was painless but not without some discomfort. It is quite fascinating to see the inside of ones plumbing. The camera was not attached all of the time though because the doctor could see better and manipulate the gubbings better without it. There was nothing obviously wrong with my bladder. Good oh! The CT Urogram did not show up anything either. At least, not concerning the bladder. It did show that the prostate cancer has spread to some abdominal lymph nodes as well as my bones. I don't think this is a big deal because there will be no change in treatment and the treatment will be just as effective against the cancer in the lymph nodes as in the bones and prostate itself. My next check up will be in four months and my urine will be checked out again then.
Following the procedure I was advised to drink plenty of water to help prevent any chance of an infection and to expect some blood in my urine for a couple of days. If I suspect I have an infection (temperature, feverishness) I'm to see my GP. The first few times I emptied my bladder there was some discomfort and plenty of blood. By late afternoon the discomfort has gone but there are still some traces of blood.
This afternoon it was over to the Christie Hospital for my regular check up regarding the testicular cancer which is [in remission] cured. Usual procedure: provide some blood for tests, physical examination and chest X-ray. I took the opportunity to tell the doctor about the prostate cancer. Next check up in four months.
So, hopefully, there will be nothing to report on the cancer front until I get my next PSA results at the end of June.
27 March, 2009
14 March, 2009
Taking stock
As can be expected I have needed to have a bit a rethink about what is important. Feedback on the forums on the Prostate Cancer Charity suggest that it is important too. First off I wanted to be informed. I want to know what I can expect from prostate cancer and the treatment of it. The Prostate Cancer Charity website has been invaluable. It has what it calls The Toolkit which contains fact sheets covering Diagnosis, Treatment and Lifestyle. A couple of these were given to me in the information pack provided by the hospital and I've printed off several more and have started to read through them.
The other important aspect of the Prostate Cancer Charity web site is the Message Board. There are many long term members of this forum who have been living with protate cancer for years. What stands out about them is their cheerfulness, optimism, determination not to give in to their condition and their encouragement to new members most of whom will be newly diagnosed. These fellows have taken control of their lives. I don't know whether there is any scientific evidence to back this up, but it seems to me that being positive and taking control makes a big difference to ones prognosis, even when the initial clinical signs are not at all encouraging. This has given me a big fillip.
I'm a born optimist and am generally cheerful so what I am working on is taking control. Firstly with regards to diet. The general concensus seems to be that a dairy free diet that avoids red meats and is low in fat and sugar is the way to go. The dairy free part is going to be the hardest aspect for me. I love cheese and butter but I'm sure I can adapt. Replacing meat with fish will be no hardship.
Exercise is also important especially keeping the bones strong because the hormone therapy can lead to osteoporosis. I will be walking in the fresh air as often as possible. This will load the skeleton and be good for vitamin D. On sunny and bright days anyway. I'll also get some resistance exercises in the gym and do a bit of cycling.
From a practical point of view I am sorting things out so that, some distant time in the future, my wife will be able to get on with things with the least hassel possible. This will be an ongoing project.
The cytology tests of the second urine sample I gave proved suspicious so I will be having an internal examination of my urinary tract later this month. I will also be having a CT scan of the urinary tract. The CT scan is OK but I can't say I'm looking forward to the other.
The other important aspect of the Prostate Cancer Charity web site is the Message Board. There are many long term members of this forum who have been living with protate cancer for years. What stands out about them is their cheerfulness, optimism, determination not to give in to their condition and their encouragement to new members most of whom will be newly diagnosed. These fellows have taken control of their lives. I don't know whether there is any scientific evidence to back this up, but it seems to me that being positive and taking control makes a big difference to ones prognosis, even when the initial clinical signs are not at all encouraging. This has given me a big fillip.
I'm a born optimist and am generally cheerful so what I am working on is taking control. Firstly with regards to diet. The general concensus seems to be that a dairy free diet that avoids red meats and is low in fat and sugar is the way to go. The dairy free part is going to be the hardest aspect for me. I love cheese and butter but I'm sure I can adapt. Replacing meat with fish will be no hardship.
Exercise is also important especially keeping the bones strong because the hormone therapy can lead to osteoporosis. I will be walking in the fresh air as often as possible. This will load the skeleton and be good for vitamin D. On sunny and bright days anyway. I'll also get some resistance exercises in the gym and do a bit of cycling.
From a practical point of view I am sorting things out so that, some distant time in the future, my wife will be able to get on with things with the least hassel possible. This will be an ongoing project.
The cytology tests of the second urine sample I gave proved suspicious so I will be having an internal examination of my urinary tract later this month. I will also be having a CT scan of the urinary tract. The CT scan is OK but I can't say I'm looking forward to the other.
09 March, 2009
Test results
Just back from the urology clinic at the hospital and the news is not good. Prostate cancer is confirmed and what is more it has started to spread to my bones. This means that it can't be cured just controlled for a period. For those that like numbers, the PSA test from my first hospital visit was 79.9 (up from the 57) and the Gleesen number 9, with 80% of the prostate affected both sides.
My treatment starts today with hormone therapy by pills. This will last 28 days. A week or two into this treatment I will start the long term hormone treatment delivered by injections each 12 weeks. The purpose of the treatment is to knock back the testosterone produced by my body which feeds the cancer. The treatment should be effective for one or two years until the cancer adapts to lack of testosterone and starts growing and spreading again. The doctor said that there are further treatments available once this happens but didn't say what they were.
There are likely to be side effects from the hormone treatment. My libido will be reduced; I'll probably put on weight around my belly; I may get hot flushes; I may develop breasts; I'll likely easily tire.
To add to that lot there were traces of blood in the urine sample I provided at the first hospital visit. This was unexpected and may indicate problems with my bladder or kidneys but there was no evidence of this in the MRI scan. So I provided another sample today as a double check. If there is evidence of blood in my urine again I'll need to undergo an internal examination of my urinary tract including bladder and kidneys.
So what happens next? I'll peruse the various booklets provided by the nurse and see if there are any changes to my diet and life style that will help to control the cancer. I'll have a good clear out. My wife has been urging me to do that for years and it will be one less worry for her. I'll complete my "what to do when I'm dead (or very ill)" file so that my sons can support her when I'm gone. Not that I have any intention of going any time soon. I'll see if I can persuade her to learn how to use a computer - it will be of great benefit for her. Apart from these things I'll just get on with life.
My treatment starts today with hormone therapy by pills. This will last 28 days. A week or two into this treatment I will start the long term hormone treatment delivered by injections each 12 weeks. The purpose of the treatment is to knock back the testosterone produced by my body which feeds the cancer. The treatment should be effective for one or two years until the cancer adapts to lack of testosterone and starts growing and spreading again. The doctor said that there are further treatments available once this happens but didn't say what they were.
There are likely to be side effects from the hormone treatment. My libido will be reduced; I'll probably put on weight around my belly; I may get hot flushes; I may develop breasts; I'll likely easily tire.
To add to that lot there were traces of blood in the urine sample I provided at the first hospital visit. This was unexpected and may indicate problems with my bladder or kidneys but there was no evidence of this in the MRI scan. So I provided another sample today as a double check. If there is evidence of blood in my urine again I'll need to undergo an internal examination of my urinary tract including bladder and kidneys.
So what happens next? I'll peruse the various booklets provided by the nurse and see if there are any changes to my diet and life style that will help to control the cancer. I'll have a good clear out. My wife has been urging me to do that for years and it will be one less worry for her. I'll complete my "what to do when I'm dead (or very ill)" file so that my sons can support her when I'm gone. Not that I have any intention of going any time soon. I'll see if I can persuade her to learn how to use a computer - it will be of great benefit for her. Apart from these things I'll just get on with life.
02 March, 2009
MRI Scan
I had a bit of a panic this morning. The letter advising me of my MRI scan appointment asked me to confirm the appointment as soon as possible and I'd forgotten to do so. Thus, ten minutes before I had planned to leave for the appointment I was hanging on the 'phone listening to a message thanking me for calling and telling me I'd be put through to someone as soon as they were available. I was getting twitchier by the minute. At last I did get through and the appointment was confirmed. Whew! So off I set on my bike.
When I got to the scanning department, a BUPA facility set up in the hospital that provides services to the NHS as well as private patients, I was asked to fill in a questionnaire designed to check whether I have any metal in my body or had any recent medical procedures that need to be taken into account. I was able to reply "No" to all of them.
When they were ready for me I had to strip to underwear and socks and put on a disposable gown, again to ensure no stray metal. The radiologist went through the questionnaire with me again and then we were off. I'd been told these scanners are noisy but I was not quite expecting the intensity of the noise. This despite wearing headphones playing a local radio station. The radio was in audible whilst the scanner was active. Probably a bit like being in a thick walled metal box with demented smiths hammering on the outside with the sound of miss-tuned radios added for good measure. Fortunately the procedure only lasted about 25 minutes with the longest spell being about 15 minutes.
I'm looking forward to seeing the consultant again to get the results of the various tests. I'll be disappointed if it is later than next week.
When I got to the scanning department, a BUPA facility set up in the hospital that provides services to the NHS as well as private patients, I was asked to fill in a questionnaire designed to check whether I have any metal in my body or had any recent medical procedures that need to be taken into account. I was able to reply "No" to all of them.
When they were ready for me I had to strip to underwear and socks and put on a disposable gown, again to ensure no stray metal. The radiologist went through the questionnaire with me again and then we were off. I'd been told these scanners are noisy but I was not quite expecting the intensity of the noise. This despite wearing headphones playing a local radio station. The radio was in audible whilst the scanner was active. Probably a bit like being in a thick walled metal box with demented smiths hammering on the outside with the sound of miss-tuned radios added for good measure. Fortunately the procedure only lasted about 25 minutes with the longest spell being about 15 minutes.
I'm looking forward to seeing the consultant again to get the results of the various tests. I'll be disappointed if it is later than next week.
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