It really is amazing what you can be grateful for, when you have the right perspective.  I was diagnosed with prostate cancer four weeks ago today.  But the disease has not spread beyond the gland itself.  That’s the wonderful news I got this morning, after four long, anguished weeks of waiting.  And gloriously grateful am I to receive it!

With a PSA level of 9.5 and a high Gleason score of 9, I had pretty much convinced myself that my cancer was bound to have spread throughout my body, with the attendant impact on my chances of recovery.

The nurses had given me an unofficial heads up that the MRI and bone scan results looked good.  But the results had yet to be reviewed by the medical team and there was always the risk that they would spot something untoward.

This morning my mind was put at ease in the Rapid Access Prostate Clinic.  If I won the Lottery it couldn’t top the feeling I have now and my prospect for a full recovery is now far better than I dared hope when I was diagnosed four weeks ago.

Of course, once you are diagnosed with cancer, you are never completely out of the woods and there is always a chance that it could rear its ugly head elsewhere in my body, at any time in the future.  But I could also be hit by a bus before that happens.  So life goes on regardless and the spring in my step that eluded me on D-Day has finally materialised.  In a peculiar way, being diagnosed with cancer has given me a new lease of life.

I also, finally, have a date for the surgery to remove my cancerous prostate gland (and a few other bits and pieces) – I go under the knife on Thursday 27^th October.  The tumour in my prostate measures 1cm x 1.9cm.  Given that a prostate gland is about the size of a walnut, that seems quite large, not that it will bother me after the 27^th.  While the surgeon is in there, he’s going to remove lymph nodes in the pelvic area, as there is a chance that cancer can spread to these.  So the surgeon’s instructions on the day will be “if in doubt, whip it out”!

Apparently, the consequences of losing my prostate gland may not be as severe or as long lasting as I had feared.  I will certainly have to cope with some urinary incontinence and erectile dysfunction following surgery.  But the extent of these side effects varies greatly from one patient to another.  I could be back to my old self within weeks or it could take a year or more.  There is no way of knowing at this point.

Urinary incontinence may not be quite as bad as I’d feared.  I had thought I would have no control whatsoever, pissing myself all the time – not cool!  However it is, apparently, likely to be only when there is pressure on the bladder, such as when standing up from a seated position or bending over, stuff like that.  The silver lining is that it gets me out of many of the household chores I hate.

Urinary control is based on two sphincter muscles: one behind the prostate and one in front.  I will lose the rear one in the surgery but it’s the front sphincter that matters most.  I can prepare for this over the next couple of weeks by stopping a slash in mid-stream.  It’s not the most edifying of exercises but hardly the most arduous either.  So I can live with it (“live” being the operative word).

I’ll be wearing a catheter for two or three weeks after surgery and it is when this is removed that I’ll know what I have to deal with.  I’ll be wearing ‘pads’ (an awful word) to soak up the (hopefully) odd dribble for a while.  I have only discussed this with one other prostate cancer patient so far and he was still having problems since his surgery in January.  I’ll be talking to many more before my date with the scalpel.  So hopefully I’ll learn of others who have had a better experience.  Either way, it’s inconvenient but not the end of the world, all things considered.

Of course, the second major side effect of radical prostatectomy is erectile dysfunction (ED).  Similarly, this may not be as long lasting as I’d first feared.  There is no real pattern in the experiences of previous patients.  So, again, it’s a case of ‘wait and see’ (the traditional ‘suck it and see’ seems hardly appropriate, under the circumstances).  The Lovely Colette (TLC) can be assured of undisturbed nights sleep for quite some time following the surgery.  It can take weeks, months or years before normal service is resumed, if at all.  There is hope though.

One option is to take a quarter of a Viagra tablet six out of seven days.  This does not mean I’ll be walking around with a stiffy all the time (sorry ladies!).  To achieve the desired state, a full tablet at the weekend should do the trick.

Funnily enough, it is important to achieve erections in the first year following surgery, if only chemically induced.  If this doesn’t happen, the tissues involved effectively form a kind of scar tissue that reduces the probability of being able to get it up naturally.

There is also the option of using an injection into the base of the penis, which would definitely perk Horace up (‘Horace’ is how TLC and I affectionately address my cock).  The thought of sticking a needle into Horace seems kind of cruel.  But if tough love is what he needs that’s what he’ll get – and he’ll bloody well like it!

Overall, today has been one of the best days of my life.  The cliché that “today is the first day of the rest of your life” takes on renewed meaning after you’ve been diagnosed with cancer.  So many clichés like “life’s too short” and “don’t sweat the small stuff” assume new meaning that you had previously taken for grated.

When you are faced with the cold, up close and personal prospect of imminent death you undergo a life-changing transformation that is utterly irreversible.  Having being diagnosed with a life-threatening condition is not necessarily the end.

Blessed as I am with the beautiful family, friends and colleagues I have, I now realise what a lucky lucky bastard I am!

I was never one to get overly excited about birthdays.  Since turning 40, in particular, each passing year was not something I relished celebrating.  That was before D-Day.  My 44^th birthday yesterday was quite different to all the ones that preceded it.

Someone asked me what I wanted for my birthday.  I replied, joking (but not really), that all I wanted for my birthday is another birthday.  It seems strange to me now that I used to regard birthdays with mild annoyance.  It was as though their sole purpose was to reiterate how far removed I was from the full flush of youth, when health and optimism were in abundance.

It’s funny how it takes something like a diagnosis of cancer to shake you out of the drudgery of mundane, everyday routines and to understand your place in the universe.  I now value birthdays for what they really are – a celebration of another year of life – not a countdown to old age and death.  Indeed, it now seems to me that when we moan about getting old, we completely miss the point.  Old age is a gift, not to be taken for granted.  I used to joke that what I wanted to be ‘when I grow up’ is a dirty old man.  That is still my goal but it’s not so much a joke as it used to be.

In an effort to establish whether my cancer has spread and to what extent if it has, I had my bone scan today.  This is of paramount importance to me.  The initial diagnosis of prostate cancer is one thing but this and the MRI will quantify it, giving me a better indication of my chances of survival.  The scan itself was quite straightforward.  My appointment was for 08:30 and I was back out on Eccles Street at 08:42, so no problem with long waiting times there.  I was given an injection of radioactive material and this needed two hours to be absorbed by my bones.

There were no side-effects and I was free to leave the hospital for the couple of hours.  Breakfast called so I had a thoroughly unhealthy full Irish (cholesterol is the least of my concerns these days), followed by a visit to the Irish Cancer Society kiosk in the foyer of the hospital.  I picked up a few more booklets about radiotherapy, the emotional effects of cancer and talking to children about cancer.  The ICS nurse was very helpful and told me about a Prostate Cancer Conference in Croke Park on 5^th November.  I will be attending that if I am not in hospital for surgery at the time.

Karma demands that if I get through this I must give something back.  So my plan for the conference is to learn as much as I can about the available supports for prostate cancer patients and their families, draw what I can for my own case and to find out how I can make my contribution later.  It is a pity that it takes a diagnosis of my own to get me off my arse and doing something proactive.  I have a new found respect and admiration for people who freely give of themselves for the benefit of others, in whatever cause.

Now that my bones were nice and radioactive, it was time to return to the Nuclear Medicine Department for the scan.  I have to say that I found it very efficiently run and I did not have to wait long before finding myself lying in the scanner.  It was not as intimidating as the MRI machine, being smaller, less confined and relatively silent.  The scan would take about twenty minutes, as the machine moved slowly from my head to my feet, seeking out concentrations of radioactivity in my bones, where it would indicate a presence of cancer cells.

Out of the corner of my eye, I could see my skeleton being progressively revealed on a computer monitor.  With my layman’s untrained eye, I strained to discern anything that looked like a hot spot.  Head, shoulders, rib cage – so far so good.  The abdominal area looked brighter than I would have expected and I could clearly see my kidneys.  As this was a bone scan, I was concerned about seeing my kidneys lit up like Christmas trees and I have recently been feeling some mild discomfort in the area.  I imagine that the kidneys could be ‘riddled’ and the thought of a potential regime of dialysis or waiting for a transplant is unsettling.  There isn’t anyone in the room with me at the time so it will be the first thing I ask about when the scan completes.

The staff who appeared were all very pleasant and my question about the prominence of my kidneys is answered.  It’s perfectly normal and nothing to worry about. The kidneys are supposed to show up like this and it is why I will have to drink as much fluid as I can over the next 24 hours, to flush out the radioactive material.  The nuke med staff were at pains to stress that they are not doctors nor trained to interpret the scan result – that is Prof. FitzPatrick’s job.  However, they see hundreds of these scans and as far as they could see, my bones look normal.

Oh Happy Day!  Medical professionals can be infuriatingly non-committal so it was encouraging to hear this opinion, albeit with a disclaimer.  There is a risk that the medical team who will officially analyse the scan may take a different view.  But after waiting this long for more details, I will grasp with both hands any lifeline that’s thrown my way.

I have been feeling ‘odd’ in my abdominal area recently and actually very worried indeed about what the scans may reveal.  There is a danger when you have a serious illness that you attribute undue significance to every little ache and pain.  With middle age now upon me, I have to remind myself to be circumspect and not jump to conclusions.  I am still awaiting with bated breath an appointment to meet Prof. FitzPatrick and discuss my treatment in greater detail.

In the meantime and for the rest of the day, I am to avoid pregnant women and young children because I will be emitting radiation to a radius of about two metres.  I have never been radioactive before and wonder if I will acquire superhero powers or whether my piss will glow in the dark.  Probably not.  I consider myself to have already received my share of good fortune today!

It’s now been two weeks since D-Day and there are still no outward signs of any symptoms of prostate cancer.  As welcome as this is in itself, it is a mixed blessing in a way.  Feeling physically normal makes it harder to truly accept that you have cancer.  Maybe there has been some mistake?  No. I was never one for clutching at straws and it is highly unlikely that both the PSA test and biopsy got it wrong.  If life has taught me anything, it is that knowing a thing and feeling it are two very different affairs.  So, I must accept the diagnosis and keep preparing for the worst, like hearing a tsunami warning and bracing yourself for the tribulations to come.

Having finally completed reading the Understanding Prostate Cancer booklet, I now have some figures to quantify the likelihood of post-surgery issues.  There is a 70% probability of urinary incontinence during the year following surgery, dropping to 10% thereafter.  The likelihood of erectile dysfunction (ED) is also 70%, dropping to a less encouraging 30% a year after surgery.

Urinary incontinence is pretty much something to be coped with but there are some well known drugs for treating ED, like Cialis and Viagra.  Another drug I hadn’t heard of before is Caverjet.  According to booklet, Caverjet is “injected into the penis using a small needle to cause an erection”.   I’ll have to take their word for that because I cannot conceive of any cause/effect relationship between ‘needle’ and ‘erection’!  On the other hand, the most memorable sentence in the whole booklet, also about Caverjet, is: “a prolonged erection longer than 3 hours needs urgent medical attention”.  Intriguing!  I dare say, if I had a stiffy like that, it’s the lovely Colette who would be in need of medical attention. Ha Ha!

At a yoga class for men with prostate cancer on Monday I met John, who had his radical prostatectomy in January.  He still has problems with his waterworks now and you can tell from his demeanour that he’s fed up with it.  But John is happy to have survived and talk among the men is mostly about check-ups and comparing notes about doctors and treatments.  I was by far the youngest there and felt a bit like an interloper, with my week-old diagnosis and yet to commence treatment.  But it is an exclusive club and I will be fully inducted soon enough.  There is a common misconception that prostate cancer only affects men over 50.  So I wondered if my presence made my senior fellow patients feel a little bit better, by reducing the average age profile.

Yoga is something I had not tried before and I did find it relaxing.  Being the new boy in the class meant I kept glancing around me to see what everybody else was doing.  Connie’s verbal instructions were clear enough but I’m a visual kind of person and tend to understand what I see better than what I hear.  I will keep going to the weekly class, not least for the sense of camaraderie and mutual support that only fellow cancer patients can provide.

The strain of the impending treatment and uncertainty about the outcome is starting to show in Colette.  My wife is being exceptionally nice to me and, as every married man knows, this is cause for concern!  Colette has not read as much as I have about prostate cancer, its treatment and their consequences, both inevitable and potential.  She needs more time to get her head around it all and she feels a need to await the MRI and bone scan results, to know exactly what we’re faced with.  I have tried to convince her to avail of supports from the Irish Cancer Society and the ARC cancer support centre in Eccles Street.  But everybody is different so I don’t push it, trusting that Colette will find the inner strength to deal with this in her own time and her own way.

Colette has told Grace that I will be spending some time in hospital soon, without going into detail.  At just six years of age, I don’t expect that this will mean very much to Grace.  She has not mentioned anything to me about it so I wonder how much she will understand.  At some stage, we are going to have to explain to Grace why I am ‘not myself’ and not going out to work.  But before we can do that, Colette and I need to understand more about that lies ahead ourselves.

The highlight of this week was having my MRI scan yesterday.  This and the bone scan are the great swords of Domacles hanging over my family.  Everything is on hold pending the results of these tests, which will establish whether and to what extent the cancer has spread.  At risk of being melodramatic, I see these tests as indicators of whether I am going die of this cancer or survive it.  Concerns about incontinence or ED pale into insignificance in comparison with a literal matter of life or death.

I had not had an MRI scan before and it was more or less what I expected.  On exchanging my clothes for a most unflattering gown, Frances went through the obligatory checklist to make sure I didn’t have any metal in or on my person and whether I suffered from claustrophobia.  The scan would take twenty minutes and there would be a lot of noise so I’d have headphones on with the radio station of my choice.  It was tuned to Lyric FM but, as much as I like classical music, the choice seemed a bit clichéd for the task at hand.  So I opted for Newstalk, which I would normally be listening to in the car on the way home from work about now.

All prepped and ready, Frances left me alone in the room and the sounds from the headphones changed from classical music to Newstalk.  At this point, it occurred to me that I was about to be scanned for signs of the spread of cancer throughout my body.  I would be unable to move for twenty minutes inside a giant magnet and I’d have George Hook in my ears.  Oh well, in for a penny in for a pound, there’s going to be far worse than this to contend with later.

The first thing that struck me on entering the MRI scanner was how much more confined was the space than I expected, the top of the chamber no more than a couple of inches from my face.  I imagined how much like being in a coffin it must be, without the cheap wood and frills.  Not the most comforting of thoughts when you’re being scanned for a spread of cancer through your body.  It also confirmed my wish to be cremated when the time comes. But, being something of a science fiction nerd, I also found it a curiously interesting experience, wondering how magnetism ‘sees’ inside the body and making a mental note to Google it later.  When the scan started, it was indeed very noisy and I was glad of the company of George Hook for twenty minutes.

When it was all over, Frances returned and had checked up to find out whether there was any progress on my bone scan.  I had mentioned earlier that I was still waiting for an appointment for one.  To my surprise, there is an appointment in the system, for next Thursday, and Frances surmised there is probably a letter in the post for me.  She gave me a number to ring on Monday to confirm it.  My appointment is with, of all things, the “Nuclear Medicine” department, much to the titillation of my inner nerd.  I mean, “nuclear” medicine – how cool is that!

It has been a week of baby steps and milestones for me since D (for ‘diagnosis’) Day.  I have made no further progress into the Understanding Prostate Cancer booklet I was presented with, having swiftly come to appreciate that holiday reading it ain’t.  The sterile descriptions, while important to know, need to be tempered with good news stories of successful recoveries and reassembled lives.  If you try to digest the raw clinical data undiluted, you risk sliding into a world of corrosive self pity you can ill afford.

Good news anecdotes about prostate cancer are certainly plentiful and encouraging.  But details about the pertinent PSA and Gleason scores, which right now are of most concern to me, are usually missing.  I take after my apostolic namesake and tend to believe what I can see with my own eyes or understand through the application of logic and reason.  So I have to make a decision to take comfort from the anecdotes and to believe, despite misgivings, that the future looks bright.  This is not an easy thing for a doubting Thomas to do.  But when you have cancer you learn a lot of new stuff about yourself that you didn’t know before D-Day.

A recurring theme of the past week is telling people with expertise or experience of cancer about my respective PSA and Gleason scores of 9.5 and 9.  The reaction is always the same – either awkward silence or gentle agreement that it is “not good”.  I can almost hear Corporal Jones of Dad’s Army inside their heads: “Don’t Panic! Don’t Panic!” he screams, as they maintain a straight face.  So I don’t put them in the uncomfortable position of pursuing what they really think about it or whether they know anyone who has recovered from such apparently unfavourable odds.

To be fair, one friend did know someone who made a full recovery from prostate cancer with very similar PSA/Gleason scores.  As well as that, Eileen on the Irish Cancer Society helpline speculated that my scores could indicate that the cancer is “locally advanced” but confined to the prostate.  It may be a long shot but there is really no point trying to second guess the bone and MRI scans, of which I have still heard nothing official.

Catherine, the prostate nurse in the Mater, told me that hopefully I’ll have the scans in the next two or three weeks.  Bruising from the biopsy, three weeks ago, would show up on scans and would be difficult to distinguish from the cancer itself.  It didn’t occur to me at the time to ask how this affects a bone scan.  But I waited long enough to get the biopsy and then, again, its result.  As much as I dislike waiting, patience is a skill I am learning and I reckon it will take me another couple of weeks to clear the decks mentally for the approaching fight.

Picking up the phone to the cancer helpline was a hard call to make, being my first practical, external acknowledgement of my condition.  I could have been put straight through to a man who has been through what I have just started.  But I was not ready for that yet, telling myself I should read up more first.  Another early milestone was reaching out to the ARC Cancer Support Centre, in Eccles Street.

Both Catherine and Eileen had advised me to contact ARC as they offer good support services to cancer patients and their families.  On checking their website, I found that ARC is an excellent facility, providing practical and emotional supports like counselling, relaxation therapies and a drop-in centre, all conveniently located on the same street as the Mater Hospital.  So, following an initial phone call, I visited ARC to check it out, introduce myself in person and cross the threshold into the cancer support community.

Waiting for the door to be answered, I found myself feeling the role of cancer patient beginning to fit, acceptance settling.  Mary opened the door and invited me in to the interior of comfortable seating and shelves of books about living with cancer.  Of equal value were newspapers and other reading material, because cancer subject matter gets tiresome after a while.  The centre immediately struck me as an ideal place of respite for Colette during the difficult days approaching when I will be in the Mater across the street.

Chrissie joined us as I briefly outlined my case, including my PSA/Gleason scores, which drew the by-now predictable response.  I described how I felt I was braced for my cancer by seeing my parents dying of it and my concerns for Colette, as she had not experienced the disease this closely before.  I knew what she was about to be faced with and that she would need more support than I could provide.  But Mary and Chrissie said she is welcome to drop into the centre any time, if only to get a break from the hospital ward to have a cup of tea and to read a paper in the conservatory, or to talk to somebody in an informal environment.  There may be things she needs to get off her chest that she cannot talk to me about and these are the invaluable supports that ARC is there to offer.

Catherine, the prostate nurse, had recommended an ARC yoga class for men with prostate cancer, to help prepare physically for surgery and mentally for the time leading up to and following it.  I have always wanted to try yoga but I never did anything about it.  Classes in the community are almost entirely made up of women.  I like the company of women but being a token male in a room full of leotards and leg warmers would make me feel like a bit of a girl’s blouse.  Now that I belong to an exclusive club I might as well avail of whatever silver lining it makes available and I start yoga classes today.

The yoga class will also be my first time to meet other prostate cancer victims – another milestone.  I can’t help thinking of Meat Loaf in the movie Fight Club, where he attended a support group for men with testicular cancer.  Yoga won’t be as spectacular as a group of alienated, stripped-to-the-wait men beating the shite out of each other in a basement.  But the tenuous association with one of my favourite films of all time is still pretty cool!

Bowel cancer, given the Podge & Rodge treatment, on behalf of the Irish Cancer Society. Pure Class!

This next video is one of my all-time personal favourite YouTube videos!

Given the choice of waking up with a hangover or not, I’d choose the former at the moment.  The comforting, Bushmills-induced fog of a hangover means you get to coast through the day not thinking about cancer too deeply.  The whole scenario seems surreal and hard to believe, effectively parking it for the day.  Alas, reality bites eventually and you still have to face the mornings where your first waking thought is “shit, I have cancer!”.

For me, getting my diagnosis on a Friday gave me the buffer of the weekend to absorb the initial impact.  I say “initial” impact because there is an aftershock every time a penny drops about all the individual consequences of having cancer and how it is treated.  When I said on Day 1 that I would “cheerfully” pay the price of urinary incontinence and/or erectile dysfunction to stay alive, maybe I was overstating it just a tad!

The pamphlets that sat studiously ignored on the coffee table for two days got picked up yesterday.  While Grace watched Little House on the Prairie, I started reading up on what lies ahead.  Most of it was what Prof. FitzPatrick had already told me.  But now my wits had gathered sufficiently for the import of it all to start sinking in.  It was not encouraging reading.  My PSA level is 9.5 and my Gleason Score (a measure of the aggressiveness of a cancer) is 9 out of ten.  Not good.

I am not a betting man but I am a project manager, so risk management is one of the things I do.  Risk is the product of impact and probability, usually expressed as high, medium or low.  Well, the impact is high – that’s a given.  Taking PSA level and Gleeson Score into account, if I was a betting man, I’d be putting my money on the cancer having spread by now.

Already I can hear the medical professionals, family, friends and well-wishers chastising me for indulging pessimism.  There is always hope, of course.  But it is science and a shit-hot medical team that’s going to get me out of this mess.  I prefer to prepare for the worst while hoping for the best.  If the worst doesn’t transpire it’s a bonus.

If the cancer has spread to my bones and/or organs it may be in isolated hot spots that are treatable with radiotherapy.  I’m going to have to wait for the results of the bone and MRI scans for that.

‘Wait’ has taken pride of place at the top of my list of most hated words!

Apart from the aggressiveness of the cancer itself, the pamphlets went into the gory details of what it means to have your prostate removed.  For starters, the official name for the operation is “radical prostatectomy”.  Not just ‘prostatectomy’, mind you.  Oh no – nothing so mundane for moi!  My prostatectomy is going to be fucking RADICAL, baby!

I didn’t finish reading the pamphlet, having to put it down after reading about urinary incontinence and before starting the section on erectile dysfunction.  There’s only so much hilarity you can take in one sitting!

In the meantime, I simply have to just get on with life.  Sunday was a good day, taking Grace and her friend to the Sealife aquarium in Bray.  Sitting before the large tank full of sharks and exotic marine life swimming to and fro is therapeutic for anyone but even more so for someone with a tremendous weight on their shoulders.  I recommend it.

Returning to work is the first step to resuming some kind of normality.  Not many know about my diagnosis, which is not by design.  It’s just the way the cookie crumbled and I need to focus on closing out my existing project before I have to start taking time off for treatment.  I work with a great bunch of people and there are much needed laughs to be had.  Des returned from getting a coffee to say there was a media scrum outside the FitzWilliam Hotel.  He asked one of the hacks what was going on and was told that the Hunky Dory girls were about. Imagine his disappointment when who emerged but Dana Rosemary Scallon!

The final event before I head for home today is something you could not make up.  Three days after being diagnosed with cancer, I will be attending a focus group that I was invited to a month ago (I’m on their mailing list as a regular donor).  It’s hosted by the Irish Hospice Foundation and the subject is a forthcoming initiative called ‘Think Ahead’ – a means for people to register their wishes around treatment in the event they cannot speak for themselves, including resuscitation and funeral arrangements.  Now THAT’s funny! 

My second day as a cancer patient started, as I dare say it does for many of us, with a hangover.  Having said that, the rest of the day after leaving the hospital yesterday wasn’t as bad as I would have imagined.  Sure, there were some tears but only in brief bursts.  Starting a blog was cathartic and it gives me an outlet to get stuff off my chest instead of wallowing in self pity.

With the experience of both my parents’ cancers under my belt, I was under no illusions about life being ‘fair’.  So when I was diagnosed I did not have to struggle with the feelings of outrageous injustice that might otherwise have been the case.

It was like that when my father was diagnosed and I did not deal with it well at the time.  The poor man had quit smoking five years before.  But after 60 a day for most of his adult life, the damage had already been done.  He was given three months to live but only got half that.  It was very traumatic for all of us to see him being taken so quickly and unceremoniously.

When my mother was diagnosed with ovarian cancer it, of course, came as a terrible blow.  But she responded well to the treatment and got a year of remission.  However, despite appearing to be in good health, the cancer returned and took her away from us last year.

So by the time it came to my turn for a diagnosis, I was as prepared for it as I could be.  Prof. FitzPatrick was at pains yesterday to stress that the plan is to cure my cancer.  So that is the plan and life has to go on in the meantime.  There is also my six-year-old daughter, Grace, to consider.

Naturally, we’re not telling her there is anything wrong.  When the time comes, we’ll have to explain Daddy being in hospital for a week, when I go in for the surgery.  But we’ll cross that bridge when we come to it.

In truth, the absolute worst thing about having cancer is the thought of your young child at your funeral and your not being around to see her grow up afterwards.  I’m a long way from that scenario being borne out and hopefully Grace will be a grown woman by the time my time comes, hopefully at a ripe old age.

I have never been one to fear death in itself.  I like to think I have a healthy, philosophical attitude to the great inevitability that every one of us faces sooner or later.  I’ve never really understood the social taboo about discussing death except in a religious context (which I don’t subscribe to) or in the most superficial, clichéd terms.  Life is only a ‘temporary little arrangement’ (to paraphrase Albert Reynolds’ famous description of a past coalition government) so there is no reason why anyone should feel cheated by or morbid about dying.  We are all going to die.  It’s just a question of when and how and, not least, how we live our lives in the meantime.

I don’t know what the statistics are for recovery from prostate cancer but I’m hearing a lot of anecdotes about men who have survived it.  By all accounts, if you’re going to get cancer, prostate is the one you want!  Suffice to say, I will be looking into this further so I hope my research bears it out.

It would be a mistake to take from the above that I’m fatalistic about my cancer.  I’m actually feeling generally positive about it all.  I’ve always liked the saying ‘that which does not kill me makes me stronger’.  What will be will be and if I survive this I’ll be a better person for it.

What worries me now is what the bone and MRI scans will reveal.  I’m actually looking forward to the surgery to have this troublesome gland whipped out and good riddance to it!  But if the scans show that the cancer has spread from my prostate I’ll be in trouble.

I really, really hope the scans will tell me what I want to hear.  I had hoped the biopsy would do that but it didn’t.

So it’s a waiting game. Tick tock, tick tock……

Well, it’s official as of this morning:  I have prostate cancer.

It’s a diagnosis I was acutely aware would be possible, though I did hope I’d be given the all clear this morning, two weeks after the biopsy and less than three weeks before my 44^th birthday.

My father, Peter, died of lung cancer on 19^th October 1997 and my mother, Rita, of ovarian cancer last year, on 7^th March.  With a cousin in remission from breast cancer and an uncle (her father) currently undergoing chemotherapy, there was no doubt of a family history of cancer.

Still, with my age and the fact that I have no symptoms of prostate cancer (apart from an elevated PSA that only came to light by accident), I dared to hope that I would continue on to work from my appointment in the Rapid Access Prostate Clinic in the Mater Hospital this morning, with good news under my belt and a new spring in my step.

It was not to be.

Having watched both parents living with and ultimately dying from cancer, I can’t say it’s come as a complete surprise, shocking though the diagnosis still is.  When you see both your parents die from cancer, the first thing you lose is the complacent believe that cancer is the kind of thing that only happens to ‘other’ families.  It doesn’t.  Cancer happens to my family.

It all started on the June bank holiday weekend.  I’d been experiencing a constant but mild headache for about six weeks.  It was more a minor irritation than anything else.  At the time I put it down to stress or eye-strain.  I’m an IT project manager, so stress is an occupational hazard, and I spend most of my days in front of a laptop.  So I wasn’t unduly concerned about it, thinking it would just pass like these things usually do.

But at 4am on Sunday 5^th June I awoke with a headache that was anything but mild.  My wife, Colette, phoned the doctor on call and I went to Our Lady’s Hospital in Navan.  There, it transpired that my blood pressure was extremely high and I was informed I was at risk of stroke.  Hypertension is a very treatable condition, though, and with the right medication I could live a perfectly normal and long life.

Happy days!  I’d got a warning shot across the bows and would, from now on, take more active care of my health.  No more would I sweat the small stuff and I’d stop to smell the roses from now on.  You know, the usual stuff that lasts about as long as a New Years resolution.

Anyway, there was a routine blood test to be done so that went off to the lab and I’d follow up with my GP in Ashbourne.  There were a few things out of the ordinary like high cholesterol and very high iron levels.  Nothing that couldn’t be managed.  But there was also the matter of an elevated PSA level that stood out.  PSA is a protein produced by the prostate gland.  There are a number of reasons for it to be elevated, cancer being one of them.  However, PSA alone is not a reliable indicator of anything and further tests are called for.  So my GP referred me to the Rapid Access Prostate Clinic in The Mater Hospital, Dublin.

After two weeks waiting for the dreaded and euphemistically named “digital” examination, I was in The Mater.  I had expected that I’d have the aforementioned examination first and if the doctor didn’t like what he felt (less than I did, that is!), he’d send me for a biopsy.  Imagine my surprise when he told me that my PSA level was so high, I’d be getting the biopsy anyway.  I didn’t like the sound of that and had still to suffer the indignity and discomfort of the “digital” exam.  But it was a “quick in/out” as they say and the doctor was a perfect gentleman about it!

The biopsy was another matter.  It was much more invasive, uncomfortable and prolonged.  The staff were brilliant though and made me feel as comfortable as possible under the circumstances.  They tried to reassure me that PSA is not a reliable indicator of cancer and chances are I’d be fine.  It would probably be nothing more than an inflamed prostate but I’d have to wait for the results.

Two weeks later (today) and I’m on my way into the Mater to meet Prof. John FitzPatrick for the verdict.  I have been apprehensive but hopeful of the outcome and had planned to go into work in St. Stephen’s Green after getting the good news.  Colette came with me but we took separate cars, so confident were we that the rest of the day would be business as usual.

Sitting in traffic on the Finglas Road, an ad comes on the radio for the Irish Cancer Society.  “Have you recently been diagnosed with cancer?” it asked, offering a phone number to ring for help and support as a new cancer patient.  I’m not a superstitious person but I didn’t like the sound of that on the way to get my biopsy results.  Don’t be silly I told myself.  That ad has probably been playing for weeks but I didn’t notice it until now.

So I’m in the waiting room at the hospital, waiting for Colette to arrive after finding parking.  I’m reading the news on thejournal.ie on my smartphone when an article jumps out at me.  It’s a woman’s description of being told she had an 85% chance of breast cancer.  That’s two omens now.  I don’t like the way this morning is shaping up.

I don’t get to finish the article because Colette arrives.  While we’re talking, an older man emerges from the rear of the clinic, smiling.  He’s greeting his friend who is waiting for him and talking cheerfully on the phone.  It’s good news.  He’s in the clear and joking that he could have had a heart attack from the anxiety of waiting for the result.  Well, fair play to you, I congratulate him in my mind.  The first of many to leave this place with good news this morning, I hope.

Two minutes later, my name is called from the back of the room.  Colette and I brace ourselves, get up and go in to see Prof. FitzPatrick.  It’s the same room I met him in two weeks ago but this time there is also another doctor and a nurse present.  I don’t like the look of this.  I introduce Colette and Prof. FitzPatrick says he’s glad we’re both there.

Without making eye contact, Colette and I think the same thing: “oh fuck!”.   This is the bit I’ve been really dreading.  But protocol demands a certain amount of preamble.  Prof. FitzPatrick starts by summarising where we were at two weeks ago.  I had a very high PSA level and a strong family history, yada, yada, yada.  “So we were expecting to find something” he said.  “And you did”, I finished his sentence for him, anxious to get to the point.  “Yes, we did” he confirmed.

So, there it was.  I am now officially a cancer patient.  Not the news I was hoping for.  Not at all!  Suddenly I feel closer to my late parents, in a way I did not want and I know that they would not want for me.  So this is what it’s like to be told you have cancer.  This must be what it was like for that lady whose article I had only half read in the waiting room.  Heavy!

These thoughts went through my mind in an instant and now Colette and I were holding hands as Prof. FitzPatrick continues.  He and his team have a plan for me.  I will need a bone scan and an MRI to ascertain whether the cancer has spread.

Actually the words he used were “your cancer” – the three most chilling syllables I have ever heard in my life.  “My cancer”.  Boy, that sure makes it real, doesn’t it!

Anyway, after the scans are done, he’s going to remove my prostate gland and keep the option of radiotherapy in reserve.  He called radio a trump card and as such you don’t play it first.  Hopefully, ‘my’ cancer is confined to the prostate and surgery will have the desired effect.  If not, then radiotherapy will kick in.

The dates for the bone scan, MRI and surgery have yet to be confirmed so it’s a waiting game for now.  I have to wait a few weeks for my prostate to fully recover from the biopsy (which took 12 samples – I’m surprised there’s any of it left!).  It will still be bruised and swollen from the biopsy so scans would be inconclusive and surgery counter-productive at this stage.

There was a lot of other stuff about the effects of having my prostate removed.  Lovely stuff about catheters and the possibility of urinary incontinence and/or erectile dysfunction.  All of this I actually wasn’t too bothered about.  I only want to live.  If the price to be paid for that is a wonky willie I’ll cheerfully pay it and leave a tip!

Talking about ‘your’ cancer gives you an instant and radical change of perspective and priorities.  It’s almost liberating in a way.  I hope I still feel that way about it six months from now or whenever I’m going to have to deal with it.

So, with all that news and a subsequent chat with the prostate nurse, Colette and I left the hospital armed with new pamphlets and phone numbers.  We emerged on to the North Circular Road and it was pissing rain.  Great!