Adrian Simons is 67 and lives in West Suffolk. He was diagnosed with prostate cancer in August 2020 but he knew something was wrong many months before he was officially given the news. This is his story, starting from when he realised something wasn't quite right. Adrian has kindly given us pemission to publish his thoughts as he goes through his treatment.
MY JOURNEY WITH PROSTATE CANCER
January 2020 - WHERE IT ALL STARTED
I went to my doctor for a regular well person’s check-up. I had one two years ago when I turned sixty-five but I didn’t have my prostate checked then. This time round I had the usual tests done but again he didn’t check my prostate. I had already decided to ask him to check it before I went and, as he didn’t suggest it, I asked him to. He questioned why I wanted it done which I found surprising, but I explained I had never had it checked and thought it was important in men my age. Anyway he checked it the usual way, a little discomfort but nothing more and it only took a moment. He said that it was enlarged and he would send me for a blood test. He printed out the form and said he would be in touch with me with the result after I had been.
I went and had my blood test. I have no problem with needles as I used to have regular hay fever injections when I was younger. My doctor rang me a few days later to say that the PSA level was high and I would need to have an MRI scan. I didn’t know what this PSA level was or how it was significant. My doctor explained that the PSA is an enzyme in the blood produced by the prostate gland. A high reading denotes a sign of prostate cancer. In the majority of men, a reading of 2.6 to 4.0 is normal but some have even lower readings. Mine came back as 6.88 which rang alarm bells with my doctor and I knew then that there was a problem. So even before anything else had happened, as far as my MRI or resulting biopsy were concerned, I knew I had cancer and was then prepared for anything that might come along.
MARCH 2020 - THE INVESTIGATIONS BEGIN
I received a letter from the Urology Department at the West Suffolk Hospital in Bury St. Edmunds saying I had an appointment on 9th March. I went for my consultation and had to drink as much water as possible beforehand. I then had to go into a room and, (behind a curtain) had to pee into a vessel which fed into a container which measured how much and how long it took me to empty my bladder. I must admit it has become more and more difficult to empty my bladder over the last couple of years .. where I could once pee six feet up a wall I was now struggling to get it any higher than my ankles! I just assumed that it was part and parcel of getting older, but little did I know that it was another sign there was something wrong. Your prostate is next to your bladder and with a cancerous tumour in your prostate pushing against your bladder it reduces the flow of urine. All news to me. I felt quite guilty because with the internet readily available I should have checked it out long ago for myself. I was prescribed with a drug called Tamsulosin which is designed to help you pee better.
I received a letter giving me a date of 27th March for my MRI scan. As the coronavirus pandemic is getting worse it looks more and more like my scan won’t happen. I've been taking the Tamsulosin drug for a few days now and it has definitely helped my flow.
On the 23rd March we all go into lockdown. I eventually got a letter saying my MRI scan had been cancelled. I wasn’t surprised .. who knows when I will have it now?
APRIL 2020 - GETTING MY THOUGHTS TOGETHER
Still in lockdown. I continued taking my tablets which helped my flow but definitely didn’t return it to anything like its original state. I hadn’t been officially diagnosed with cancer but I sort of knew the worst. When you get to a certain age you start to think about how long you have left. I often think how much of my girlfriend’s grandson I will get to see. He’s ten now and I used to imagine would I see him make eighteen or twenty one. Would I see him get married and have kids? My mother died eighteen months ago at the grand old age of ninety-eight .. would I make it to her age or would I only make it to my Dad’s age of sixty-eight? It all sounds very morbid but as you get older, and there are more years behind you than in front, these things do cross your mind. What also crossed my mind was that my Dad and my eldest sister both died at sixty-eight. I would be that age next year.. is that an omen?
I decided to have a radical clear out of all my stuff. I wouldn’t want the thought of someone having to go through all this. I had basically retired from my painting and decorating business so thought I would begin with shredding all my bank statements and anything relevant to the business. I had stuff going back at least six years so I filled quite a few bin bags!
I bought a plastic box and then set about putting anything important, such as private pension paperwork, car and van insurance details and such like into separate envelopes and marking them clearly. I remember when my father died back in 1990 and as much as he was a successful businessman, his idea of keeping his private stuff together left a lot to be desired! It took myself, my mother and my two sisters quite a while to find all the details of my father’s dealings which was quite distressing for us all. I decided then I would never leave my things in such a mess. So by doing this I was happy that if anything happened to me, anyone going through my things would instantly be able to find everything. It’s not being morbid it’s just sorting out your life. My girlfriend and I both made our wills and paid for our funerals last year .. another thing your loved ones don’t have to worry about. It was all quite therapeutic having a massive clear-out. I used to keep such a load of stuff.
JULY 2020 - SOMETHING'S NOT RIGHT
We eventually come out of lockdown and I received notification that I would be getting a phone call from the Urology Department on Friday July 10th. The phone call consisted of being informed about my MRI scan. The doctor explained that I would be in the MRI scanner for about forty five minutes and that the outcome of it could be an abnormal area detected. He also told me that if anything showed up from the scan it would lead to a biopsy of the prostate gland.
I had the MRI scan and it was totally painless. They even gave me headphones and asked what I would like to listen to! Another blood test followed to check my PSA level followed by a phone call from the Urology Department saying they had the results of my scan .. a tumour had been found and an appointment would be made for a biopsy. I was told my blood test had a PSA level of 6.74 which was down on my initial 6.88 back in January. It wasn’t a lot, but it was better than nothing.
AUGUST 2020 – THE HAMMER BLOW
I received a letter giving me a date of my biopsy for Friday August 7th which told me that it would be best to arrange a lift home as I wouldn’t be able to drive. I went for my biopsy at the West Suffolk Hospital where my consultant took twenty four wafer thin slithers of my tumour. It was a little uncomfortable but obviously important to have. I was very tired afterwards and slept for the rest of the afternoon .. I slept a lot during the day after this.
Shortly afterwards I received a phone call from my consultant saying I had an appointment to see him regarding my biopsy. If I wasn’t convinced before that I had prostate cancer, I was now!
I saw my consultant and he confirmed I had prostate cancer. He was quite blunt about it all when he told me and I feel maybe someone who was more disturbed by this revelation would have struggled with accepting the news in such a thoughtless way.
He explained I had a Gleason score of 3 + 4 = 7. The Gleason scores range from 6 to 10 .. six being the mildest and ten being the most aggressive. The score 3 + 4 (which is also classed as Grade 2) is better than 4 + 3 (which is Grade 3). He said as I was not overweight, fit and in good shape I had all the options available to me. I was then taken into a separate room and a very nice specialist Urology nurse explained it all in detail to me, telling me what forms of treatment were open to me and not to be too upset as my cancer was classed as mild. She explained that I could have what they call active surveillance, which is having regular blood tests to keep a check on the PSA level. Then there was radiotherapy or finally surgery.
I immediately thought that surgery was my best option as I just wanted to get this thing out of me! The nurse told me to think about it over the next few days, and the weekend, and let her know my decision the following week.
When I got home my girlfriend and her eldest daughter were there. When I told them I had prostate cancer they both began crying and we had a group hug. My girlfriend’s other daughter rang me a little later and was crying on the phone when I told her. It seems my family have taken it much worse than I have.
I feel very lucky though. My outlook on life has always been a very positive one and I feel this has really helped me to accept this. Everyone I talk to expects me to be depressed and down by my diagnosis and needing someone to talk to about it, but I don’t feel that way.
Both my girlfriend and her daughters tell me I should have the surgery.
I searched on the internet about how to get your PSA level down and found out that taking Vitamin D, Omega 3, drinking green tea and eating tomatoes would help. I have started doing all of these. I have bought small packs of cherry tomatoes and will eat them on my way round the golf course when I play.
I rang the Urology Clinic and spoke with a nurse I saw last week. I told her that I had decided to have the surgery and she said she would get a consultant from Cambridge to give me a call to talk to me about it.
SEPTEMBER 2020 – SURGERY IT IS THEN
I found out that one of my golf partners, who is in his seventies, had a blood test to check his PSA level. It came back as 0.65 which made me realise how high mine actually was!
I received a letter to tell me that I would get a call from a Urology and Robotic Consultant in Cambridge on 15th September. My consultant rang me to discuss my case and he asked me why I had decided to go with surgery regarding my cancer. I told him I just thought it was the best option. He said there were side-effects to having surgery and I would need to stay in hospital for between one and seven days. I also might get erection problems afterwards and I would need a catheter for a while afterwards while the area heals. I may have bruising and swelling in and around the penis and testicle area, even having radiotherapy had its own side-effects. I would also need treatment five days a week for about four weeks - this can cause bowel, urinary and erection problems as well as tiredness and fatigue and it may be some time before I find out if the treatment has worked. He explained that my cancer was a very mild one and that the chances were that in ten years it wouldn’t be any worse. He also said that by the time I was eighty there was more chance of me dying of something other than prostate cancer. He advised me to go down the active surveillance route which would involve having regular blood tests and monitoring the PSA results. If there was any increase then we could discuss possibly having surgery. Talking to him I realised I was being a little hasty wanting to go for surgery and it persuaded me to change my mind and I decided to go along with the monitoring option. I felt quite upbeat after the call.
I told all the family and they were more than happy with my decision. It reassured them that it wasn’t as bad as they had first thought and it put their minds at rest.
OCTOBER 2020 – THINGS DON’T GO TO PLAN
I ran out of Tamsulosin tablets so got a repeat prescription. I got them from a different pharmacy and after taking just two found they made me incontinent. I came back from golf and wet myself before I could reach the toilet.
I rang the Urology Clinic to discuss the problem. They couldn’t understand why it had happened and advised me to try them again but I decided not to as I just couldn’t risk it. I'll have to live with a reduced flow, well at least for the time being.
More on Adrian's story to follow ..