Living with prostate cancer
In July 1996, when he was 50, Bryan Metcalf was diagnosed with prostate cancer. This is his story, describing the different treatments he has had and how they have affected his life.
I had been feeling unwell for some time. I’d had some pain in my testicles and soreness when I passed urine. I saw a number of urologists who thought I had prostatitis and prescribed antibiotics. But things didn’t really get better and my wife Maureen encouraged me to go back and see the doctor again. He examined me and did a blood test. I then had a scan and a biopsy.
I wasn’t particularly worried and went back to get the test results on my own. That is when I was told that I had prostate cancer. My wife has always regretted not being with me then but at the time, I just felt relieved to know what was wrong at last. I then had other tests including a bone scan to check that the cancer had not spread anywhere else in my body.
There are different ways of treating prostate cancer and I had to decide which would be best for me. I talked with different doctors about the possibility of having a special type of radiotherapy, where radioactive pellets are put into the prostate gland. In the end, I opted to have surgery to remove my prostate gland.
After the operation, I had to come to terms with the side effects of my treatment. I had real problems with incontinence. The weekend when they first took the catheter out was difficult. I had little control of my bladder, which was upsetting until I was fixed up with an external catheter. Things improved over the next six months and my muscle control returned. The small level of stress incontinence remaining means that I now only have to wear a small sticky backed pad in my underpants.
The surgery had damaged some of the nerves in my pelvis, so I also had erectile dysfunction. This means not being able to get or keep an erection - it certainly took some getting used to.
I needed regular blood tests to monitor my PSA (prostate specific antigen) levels. This helps doctors to check how well the treatment is working. Initially, my PSA levels were OK, but after only 4 months, the levels started to rise. I was hugely disappointed and thought it would mean having more treatment. But because the level didn’t go up a lot, my doctors decided just to keep an eye on things for a while. We carried on like this for about 4 years. Then my PSA level suddenly went up a lot.
I started taking Casodex, a type of hormone therapy, and the PSA came down. But 18 months later, it began to rise again, and I joined a clinical trial for a new type of vaccine treatment that was taking place at St Georges’ hospital in London. I had to travel to London from my home in Yorkshire every 4 weeks to see the doctors and have some injections into my groin and armpit. We made the most of it by visiting some of the capital’s tourist attractions.
The doctors talked to me about trying a type of chemotherapy that they were researching. Before you can take part in a trial, you have a number of extra tests. One of the blood tests I had suggested that my kidneys weren’t working properly. Scans showed that the tumour had grown again and was blocking the tube that drains the urine out of my right kidney. I had an operation to put in an artificial tube that allowed the urine to drain from my kidney into my bladder properly.
I stopped taking Casodex tablets and started having Zoledex implants under the skin on a monthly basis. I also had a month of radiotherapy. I have been having regular Zoladex injections for about three and a half years and this treatment was keeping things under control, but, just recently, my PSA level has started to go up again and my doctors are likely to change my treatment in the near future.
I have had lots of treatment over the years with many highs and lows. Looking back, I think the worst time was probably at the beginning of it all when I was trying to decide which treatment to have. All the different treatments for prostate cancer have side effects. As I’ve said, I’ve had long term problems with incontinence and impotence. Impotence is a big deal for a man and his partner - some treatments after my operation helped, but once I started hormone therapy, my libido reduced a great deal. Hence our life as a couple is much different from the earlier days of our thirty nine year marriage. We still love each other but the testosterone driven spontaneity is lost. Prostate cancer is a disease that not only affects the patients, but affects partners and families too.
When deciding on treatment for prostate cancer, quality of life is very important. Many men, like me, have a lot of years ahead of them to live with the side effects. If I were talking to someone else going through this, I’d say take your time to decide. Talk things over in the family and with specialists and the cancer helplines. Think about which ‘pros’ you most want and which ‘cons’ you can live with.
When something like this happens to you, it certainly makes you try and live life to the full. There have been some great highlights along the way - particularly the arrival of my grandchildren. As a family we have plenty to look forward to together. We have been all over the world in the last ten years and I have a very busy life working as a Parish Clerk, training and helping other Parish Clerks and voluntarily running an online support group for people affected by prostate cancer.
To join the online support group I mentioned, please send a blank e-mail to ProstateCancerSupportfirstname.lastname@example.org
- About 32,000 men are diagnosed with prostate cancer each year in the UK
- It is now the most common cancer in men (excluding non melanoma skin cancer)
- Surgery, radiotherapy and hormone therapy are all used to treat prostate cancer
- The risk of prostate cancer increases with age. It is quite rare in men under 50. Nearly 2 out of 3 cases are in men aged 70 and over
There is a lot more information about prostate cancer on CancerHelp UK.
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