Friday the thirteenth

13 December, 2024

Friday the 13th is not traditionally a day where great things happen. So, before I go into detail, for anybody who cares about me - which I’m hoping is most of you - I’ll start with the spoiler.….

But at the same time it wasn’t the greatest news I’ve ever received either. Let’s start at the beginning.

Today was my scheduled first meeting with my consultant, Professor Peter Hoskin, at the Mount Vernon cancer centre in Northwood. It was a slightly protracted start as nobody had sent them the results of my PET/CT scan, and I sat around for an hour or so whilst several people phoned several other people trying to find the scan report. Eventually they found somebody who had the report and got it sent over, and the good Professor read it, then came into a consulting room, perched himself on the side of a bench and explained what he now knew. He’s an assuring presence, with clearly an incredible grasp of what he’s about. He also talked fast and used a lot of long words, so I started taking notes.

I’ve got the report in front of me and it uses a lot of long words I was not totally clear on, but it’s not hard to translate it with the aid of some AI and Prof Hoskin’s excellent explaining skills. Basically, I’ve got a large tumour on my prostate, and the cancer has spread up through my lymphatic system into my abdomen. To coin a phrase, it is “metastatic”, albeit thank all available deities, no it isn’t in my bones.

Fuck, fuck, fuckety fuck. There goes any hopes I had. that this was restricted to my prostate and could be quickly and easily dealt with.

This led to the next phrase I didn’t want to hear: “chemotherapy”. I really hoped that was a pleasure I’d be dodging, but apparently not. So what happens now?…

I stay on the Biculatamide - no issue there, it’s not causing any side effects and may be slightly reducing the size of my prostate, as evidenced by reducing discomfort - which wasn’t enormous in the first place.

I still need the LHRH injection, of something called Decapeptyl. This will be telling my hypothalamus (part of the brain) to tell my testicles (where, like most men, I actually do a reasonable proportion of my thinking, so they occasionally need some instructions) to stop producing testosterone. That should happen next week at my GP’s practice.

Then the bit I didn’t expect, and really can’t say I’m looking forward to. Courtesy of the spread of the cancer, 18 weeks of chemotherapy - every three weeks, for six cycles, I’ll have some blood tests, then 2-3 days later spend an hour whilst a chemical called Docatexel is trickled into my veins. To stop that completely trashing me apparently I’ll have some anti-emetic (anti sickness) drugs before, and steroids after each time. You can tell that a drug is powerful if you need two other drugs to help your body withstand the treatment, can’t you. One more fuck for good luck. Oh yes, I’ve been given the number of a 24/7 helpline in case the effects of any of this treatment get too much, and a leaflet telling me to make sure it’s programmed into my phone. Yeah, that inspires confidence too. Also told to expect my hair might thin out (seriously, how would you tell, I’ve hardly any anyhow), sexual desire and function may drop off (bugger). But that’s there to eliminate the spread of the cancer from everywhere outside of my prostate, and clearly that absolutely has to be done.

Then, after that’s over, they’ll line up 4-5 weeks of radiotherapy to kill off whatever’s left of the cancer - presumably mostly from my prostate. (And hopefully only the cancer, and not me as well!). Side effects with that too apparently, that I’ll talk about another day. And then another pill, an anti-androgen called Daralutamide, every day for at least two years after that - that seems to basically be there to ensure the cancer never returns. I’m in this for the long haul aren’t I?; so much for any hope of a quick cure.

All of this comes with leaflets with a section that says “serious and life threatening side effects”, but to be fair, so has a decent chunk of my professional life for 30-odd years. I am, bluntly, somebody used to taking danger money, and assessing personal risk.

I perhaps should be more distressed or scared about this than I am. My emphasis, right now, is on understanding what is happening and going to happen, quantifying the risks, and making sure that at the end of the day I get the right outcome.

Is there any good news in all this? Absolutely there is. If this all goes well, and everything I can find tells me I’m in really good hands, the cancer will go. Likely within a year. Maybe an unpleasant and brutal year, but less than a year. I can handle that.

I talked to Prof Hoskin about my personal and professional lifestyles. Not only can I continue to maintain my exercise regime, but I should - so I will. I was warned that my energy and inclination may drop off a bit, but I’ll manage that, I’m confident.

CAA and EASA guidance say that I can potentially get my class 1 and class 2 medicals back as soon as 8 weeks after radiotherapy finishes - so potentially by next autumn. That is absolutely something to fixate on, and I will.

Prof Hoskin also could see no reason for me not to continue flying within my PMD, so I damned well will. Yes of-course I will keep monitoring my own health, but that is also something I will fixate on.

And one thing is providing me with some much wanted emotional therapy. The BBC is repeating one of the best ever pieces of childrens’ Christmas television. The opening sequence alone of this reminds me of all the best parts of my childhood, and the storytelling is just a piece of utter joy. If you’ve never seen it - in the UK it’s up on iPlayer, presumably you can find it in other countries. Give it a go.

What’s coming up isn’t optional, of-course, but my attitude towards it is.

Finally, I’m 54, and this cancer has probably been detected and my treatment starting just in the nick of time. Just possibly if at 50, or 51, I’d had a PSA test, despite apparently being totally fit and healthy, this might have been tackled much more easily, with far less of the coming physical distress, and less risk. So, blokes, all of you, aged 50 or over, or with the faintest suggestion of a problem in your groin area. GET. A. PSA. TEST. (And ladies, if you have husbands, brothers or fathers 50 or over - talk to them about this too, this matters.)