James’ story - prostate cancer

James went to his local doctor for his annual medical. He was told that his PSA levels had risen significantly since his last visit. This meant his prostate gland had increased in size since his last check up. James was 60 years old and knew there was a chance he could have prostate cancer.

James went back to his doctor and had a rectal examination. The prostate gland was found to be slightly enlarged so he was sent to see a urologist for another examination. The urologist told James that he thought there was a tumour but he would need a biopsy to see if it was cancerous. James waited anxiously for the biopsy to take place in two weeks time. He found it difficult to focus on his work and family and imagined all sorts of worst case scenarios.

James visited the hospital for the test, it was a fairly simple procedure. Six needles were inserted through a tube that looked like a telescope in to the back passage to remove some of the tumour tissue. The procedure was not painful but was uncomfortable. The tissue samples were then sent off to be examined in the laboratories by the pathologist. The results would be able to tell if the tumour was cancerous and if it had spread through the wall of the prostate. The results came through two weeks later. Cancer had been found in his prostate.

James waited for the follow up consultation to find out what happened next. The doctor told James about the three options for his kind of cancer – surgery, hormone therapy or radiotherapy. For James the logical solution was to cut out the cancer once and for all. The doctor agreed with him that in this case the best option was surgery. James was busy at work and wanted to delay the operation for a few months but the surgeon and his family persuaded him that he should have it sooner rather than later.

Two weeks later James underwent surgery. His operation took five hours and during surgery it was discovered that the cancer had spread beyond the prostate. The surgeon had to remove as much tissue as possible around the prostate and bladder to get rid of all the cancer cells. The surgery was much more invasive than had first been anticipated. When James woke up he was told the surgery had been a success and that all the cancer had been removed. Hopefully he would need no further treatment.

Nine days after the operation James left hospital with a urinary catheter still in place and a plastic bag strapped to his leg. The bag was to act like a bladder for the next four months. The bag was difficult to get used to and leaked sometimes. There were a few embarrassing moments at work but James found that wearing dark trousers made any leaking problems much less noticeable.

Fortunately after these incidents James was given an appointment at the local incontinence clinic and was given further help and advice about wearing the bag. He was also visited by an incontinence nurse who supplied a number of new leg bags to make things easier. James was also given a bed bag for night time which was large enough to hold an overnight output of urine. The nurse helped to make James’ recovery a lot easier and provided vital support. She showed James various pelvic floor exercises to practise in order to strengthen the muscles around the bladder and help control bladder function.

After four months James could get rid of the bag and his bladder control was assessed. His incontinence continued to improve, although he continued to wear pads for the next few months until the slight dribbling stopped.

James had three monthly checkups with the urologist who monitored his PSA count to ensure that it had not started to rise again. Because of the severity of the surgery James was left impotent after the operation. His sensory nerves had been damaged, however the surgeon informed him that as time went on the nerves may recover and an erection may be possible. He was put in contact with the impotence clinic who helped him deal with the difficult issues surrounding impotency. They gave him practical advice and help.

James has now been free of cancer for four years, he sees his urologist every six months and has passed the critical two-year period. The next important milestone for him is passing the five year mark. James continues to play golf and is just as active as he was before the cancer.