Men's things - XIII

Things we have to do

This morning, my second visit to The Christie, the largest single-site cancer centre in Europe and the first UK centre to be accredited as a comprehensive cancer centre. I know where I am going, Department 22, where many men with their partners and some women alone or with their own partners sit in one of four waiting rooms to be assessed, reviewed, or treated.

There have been offers to chaperone me to the hospital, from my neighbour, my friend, or a fellow steward from my church, but I have decided I am best able to cope with the conversations to be had alone. Obviously, if the opportunity were presented, Brian is definite and my best friend Kola, I would have welcomed to be with me through all this.

Taking the piss test

Having checked in, I was presented with a form, the International Prostate Symptom Score (I-PSS) which is a patient’s subjective rating of how they view their urinary health on a scale of 0 (Not at all) to 5 (Almost Always) on the various indicators of Incomplete Emptying, Frequency, Intermittency, Urgency, Weak Stream, Straining, and Nocturia.

Your total I-PSS score will suggest from your perception and feeling how the prostate gland is constricting the urine flow from your bladder to your urethra. My score fell within the range of mildly symptomatic though a bit higher than the score from two weeks ago.

I had already had a consultation on the option for a prostatectomy just over a fortnight ago, I was not enamoured about the aftereffects of surgery, it was all too unpleasant to countenance. Then getting to grips with the idea that something was manifesting inside you has left me somewhere between denial based on its invisibility and bafflement in terms of how to address it.

Just because you’re pissing poor

The consultant for the radiotherapy treatment option came in and introduced herself before asking how I came to know about the prostate cancer diagnosis. Walking her through each stage of testing and results leading to more investigations, she got a good idea of my understanding of the medical situation under discussion.

The I-PSS score then became the issue, and when I thought I might be able to avail myself of the breakthrough brachytherapy treatment for prostate cancer, I soon found out that I would not be eligible because of the treatment possibly complicating my urinary health. [Cancer Research UK: Brachytherapy for prostate cancer]

While I could appreciate no medical personnel would like to leave a patient worse off than they were before treatment, I felt that basing that decision on the subjective equivalent of a hunch when it would have been ideal to undergo urinary health analysis and tests was quite irregular.

Imagine being able to game the system because you had prior knowledge of adjusting the I-PSS score to suit the treatment you want even if the outcomes can be at best dubious and consequently debilitating.

Surely, there is a better way

I had multiple conversations with the consultant and support nurse when I was offered the external radiotherapy treatment that might stretch on for 20 low-to-medium dose sessions. Understandable to protect the functionality of my urinary system, which is under stress from an enlarged prostate, but that comes with other side effects. [Cancer Research UK: External beam radiotherapy for prostate cancer]

In all cases, however, the cancer will be removed totally. My inclination would be to opt for radiotherapy, but I will make no decision until I have had a conversation with my Holistic Needs Assessment team. The consultant twice said she knew I was going to read up on everything we had discussed, I can only wonder what could have given her that idea.

I am doing fine, I feel well, and I am quite hopeful and positive. Things would turn out right, I just need to get a handle on how I should pray. On my way out, I saw directions to the chaplaincy and prayer rooms, I found the chapel and sat in there for a while. As I was about to leave, the chaplains were coming out of their office for midday prayer, I was invited to join them, which I did and we had a moment of devotion, prayer, and reflection before I returned home.

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