For some men, the realisation that one has prostate cancer can come slowly. As there may be no symptoms of the cancer in its early stages, the first sign many men have that something is wrong comes from a test to measure the level of prostate specific antigen (PSA) in the blood.
A high PSA reading indicates something is wrong with the prostate, although it may not necessarily be cancer. Even then it may take time before the levels move beyond the normal range and require further investigation.
For other men, it is a rapid and shocking discovery to find they not only have cancer, but it has moved through their body to the Stage 4 advanced phase.
Two years ago, when Jackie Lee (not his real name) was 61, he experienced pain in his lower back. Back ache is not uncommon in older men, but Jackie was aware enough to go to his company doctor for a thorough check-up.
When his blood test came back, his PSA level was not high, they were extreme – a reading of more than 2,000 ng/mL when the normal range is between zero and four. He was immediately sent for a biopsy at the National University Hospital where the medical team sent him to the emergency ward to conduct further tests.
The doctor then confirmed that Jackie had Stage 4 prostate cancer. It had spread from his prostate to his bones.
Naturally, Jackie was shocked and asked why this has happened to him. After struggling with the news for a while, he came to the realisation that illness was part of life and that he must have the courage to deal with the situation.
The first hurdle was to tell his family – his wife, son and daughter. As he broke the news to his family, his thoughts were for them. Jackie explained the situation and encouraged them not be sad and that it was all part of life’s journey.
His family must have been concerned at his rapid weight loss because of his treatment. Within six months he had dropped from 73 kilograms to just 63 kilograms. His doctors encouraged him to eat better and to exercise more. From then on, he slowly regained his strength and is now back to 76 kilograms.
Doctors advised him that surgery was not an option and the best way forward was either with medicine or radiotherapy. He decided on oral medicine. Jackie now takes a novel hormonal medication every morning, the cost of which is subsidised by the Medical Social Fund at the National University Hospital. This novel oral hormonal medication inhibits androgen production at three sites – the testes, the adrenal glands and the prostate tumour itself.
At the moment, his PSA readings are down to normal, and he gets to enjoy some gardening around his flat as well as the occasional trip to Malaysia.
While Jackie must face the consequences of his cancer each day, he must also provide support and comfort for his wife, Molly. Molly is also unwell and used to suffer from depression. Their children are married so they live on their own.
While it would be easy for Jackie to be angry or resentful, he is not. He is grateful. Grateful for the love of Molly and his children. Grateful for the people who have been there to support and encourage him. Grateful for the doctors, nurses and social workers at the National University Hospital for their professionalism and their compassion.
With such a strong sense of gratitude filling Jackie’s heart, it is much easier now for him to courageously deal with his illness.